<?xml version="1.0" encoding="UTF-8"?><rss xmlns:content="http://purl.org/rss/1.0/modules/content/" version="2.0"><channel><title>IRIN - South Africa</title><link>http://www.irinnews.org/irin-fp.aspx</link><description>Updated everyday</description><language>en-gb</language><lastBuildDate>Tue, 15 May 2012 17:31:08 GMT</lastBuildDate><item><title>FOOD: Power to the people!</title><pubDate>Tue, 15 May 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2011/201104051041120547t.jpg" />]]>JOHANNESBURG 15 May 2012 (IRIN) - The UN Development Programme (UNDP) launched its first Africa Human Development Report today, stressing food security as a means to a better quality of life for all. </description><body><![CDATA[JOHANNESBURG 15 May 2012 (IRIN) - The UN Development Programme (UNDP) launched its first Africa Human Development Report [http://www.undp.org/content/undp/en/home/librarypage/hdr/africa-human-development-report-2012/ ] today, stressing food security as a means to a better quality of life for all.  

The argument is straightforward: Most people in Africa depend on agriculture, and better nutrition is good for human development. More food production means more food and income in people’s pockets, which has spin-offs which are beneficial for health and education. 

The report is not another exhortation to farmers to grow more food. Pedro Conceicao, chief economist with the UNDP Regional Bureau for Africa, explained that exclusively looking at linkages between small-scale farmers and agriculture or gender empowerment and agriculture were “piecemeal approaches” and not helpful. “We have to move beyond silver bullet obsessions [such as agricultural subsidies] or attention-grabbing headlines.” 

He reasoned that high economic growth rates in Africa had not necessarily resulted in a reduction in poverty and food insecurity - which points to accessibility to food and purchasing power as key factors. The report emphasizes “empowerment” and participation as important levers for change. 

It argues that countries need to implement a more strategic vision of food security. An approach to emulate would be what Ethiopia had done to beef up its agriculture sector by setting up a separate Agricultural Transformation Agency (ATA) [ http://www.ata.gov.et/about/our-mandate/ ] right next to the prime minister’s office. It is modelled on similar initiatives in Asia which helped accelerate economic growth in South Korea and Malaysia, for instance. ATA addresses bottlenecks in areas such as soil management, research and extension services. 

The report calls for new approaches covering multiple sectors - from rural infrastructure to health services, to new forms of social protection and empowering local communities. It calls for action in four critical areas: 

1. Increasing agricultural production: It acknowledges that boosting production would be integral to any approach to becoming food secure, and calls for investment in research, infrastructure and inputs and a Green Revolution in Africa; 

2. More effective nutrition: Develop coordinated interventions which boost nutrition while expanding access to health services, education, sanitation, and clean water; 

3. Building resilience: Investment in crop insurance, employment guarantee schemes, and cash transfers to shield people from risks and make them less vulnerable to shocks; 

4. Empowerment and social justice: Gender empowerment, access to land, technology and information are important to make people food secure. 

IRIN interviewed two leading experts on the issues. 

Steven Wiggins, research fellow with the UK’s Overseas Development Institute, who has been studying agriculture and rural development in Africa since 1972: 

Africa is not one unitary entity: “There are 56 countries in Africa... When Africa is considered as a single unit, there is a great danger that it is compared to other similar units, above all Asia, leading to analyses that suggest that if only Africa were more like Asia, then things would improve. Well, I’m not sure that Botswana has very much to learn from, say, Afghanistan, thank you very much. Hyperbole aside, the point is this: in Africa we have several, if not many, cases of admirable progress in food and nutrition security, but we overlook this.” 

Real progress takes time: “A longstanding issue in African policy debates is the search not only for growth, but for growth that is `transformative’. Even when an African economy grows, the pessimists say `yes, but where is the transformation?’ usually noting that in Asia growth is transformative. Well, yes, where that has apparently happened in Asia... it is the result of 30 or 40 years of sustained progress. Yet damning judgments are made about African countries after less than 10 years of sustained and high economic growth." 

Too complicated and demanding: It would have been better had it [the overview [of the report] stuck to a few fundamental propositions that are well supported by the evidence, namely: smallholder development plus primary health plus clean water will almost always reduce child malnutrition. Yes, let’s add girls in secondary school to the list: that will strengthen these links. But it’s that simple. 

Peter Gubbels, the West Africa co-coordinator for Groundswell International, a global partnership of local farming communities, has 30 years of experience in rural development, including 20 years living and working in West Africa. He is based in Ghana. He says: 

Move beyond the Green Revolution: “The report… seems to embrace the Green Revolution approach to agricultural improvement, citing... the results... in Asia, and seeking to now apply those lessons to Africa. The report suggests implicitly, that one reason Africa still has hunger is because Africa has not benefited from `science-based, input-intensive’ support. This is highly misleading. There have been many efforts to promote Green Revolution in Africa. Almost all have failed.” 

Missing bits: “There is no mention of Conservation Agriculture, or of the Brown Revolution [to promote soil fertility and conserve water].” 

Under-funding in agricultural research: “This is true but is also misleading. There has been a great amount of funding in the CGIAR [Consultative Group on International Agricultural Research] system in Africa, including IITA [International Institute of Tropical Agriculture] in Nigeria, from the 1970s onwards. One reason donors reduced funding in the 1990s was because it was not generating good production results. 

“But this report seems to assume that investing in new seeds, fertilizers, tractors, irrigation and training is what is needed... And how many very poor small-scale farmers can afford tractors?” 

Understanding resilience: “Equally disturbing is the suggestion that long-term resilience measures can enable risk averse, poor small-scale farmers to adopt riskier, but more productive, agricultural technologies. This is twisting my understanding of resilience. The aim is to reduce (or at least manage risk), using low external inputs and local ecological systems, not to increase risk by creating dependence on external expensive inputs (insurance, etc) for poor, vulnerable farm families working in marginal conditions. The way forward would be to develop crops and technologies that both increase food production and reduce risk by conservation agricultural techniques.” 

"Subsuming” nutrition into food security: “There is not just food insecurity in Africa. There is both food insecurity and nutrition insecurity. Currently in the Sahel, there is both a food crisis and a nutrition crisis. They may be linked, but the causes are quite different, and the solutions that are [rooted] in food security are almost always inadequate. 

“Just as we need to change the strong association of agriculture with food security, we also need to move nutrition out of the confines of food security. There is still a very strong tendency to believe that food aid, and increasing food production, solves most of malnutrition. It does not. It only helps prevent major spikes in the already existing emergency level of chronic and acute malnutrition.” 

Controversial issues side-stepped: “The report also almost completely sidesteps... genetically modified seeds... the role of agribusiness in land-grabbing, control of seeds, pushing pesticides and herbicides.” 

jk/oa/cb 
]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95459</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2011/201104051041120547t.jpg"/></td><td valign="top">JOHANNESBURG 15 May 2012 (IRIN) - The UN Development Programme (UNDP) launched its first Africa Human Development Report today, stressing food security as a means to a better quality of life for all. </td></tr></table>]]></content:encoded></item><item><title>SECURITY: A quick reaction force moulded by Africa&apos;s circumstances</title><pubDate>Wed, 09 May 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2011/201109090734440184t.jpg" />]]>JOHANNESBURG 09 May 2012 (IRIN) - Africa’s crises are both honing and stalling the formation of the African Standby Force (ASF) of the African Union (AU) - a quick reaction force that could eventually number about 30,000 troops to be deployed in a range of scenarios, from peacekeeping to direct military intervention.</description><body><![CDATA[JOHANNESBURG 09 May 2012 (IRIN) - Africa’s crises are both honing and stalling the formation of the African Standby Force (ASF) of the African Union (AU) - a quick reaction force that could eventually number about 30,000 troops to be deployed in a range of scenarios, from peacekeeping to direct military intervention. 

Originally intended to become operational in 2010, the deadline for the ASF has been reset for 2015; but despite the delay, the ASF is becoming increasingly woven into the operating procedures of current AU security operations. 

The ASF “is very much a work in progress”, African Union Commissioner of Peace and Security Ramtane Lamamra told IRIN, but “at the political level there is a strong support for it under the guiding principle of bringing about African solutions to African problems.” 

Once up and running, the ASF will be based on five regional blocs each supplying about 5,000 troops: the Southern African Development Community (SADC) force (SADCBRIG), the Eastern Africa Standby force (EASBRIG), the Economic Community of West African States (ECOWAS) force (ECOBRIG), the North African Regional Capability (NARC), and the Economic Community of Central African States (ECCAS) force (ECCASBRIG), also known as the Multinational Force of Central Africa (FOMAC). 

The regional forces are not a standing army like national forces. As the AU Peace and Security Council protocol of the ASF stipulates, they “shall be composed of standby multidisciplinary contingents with civilian and military components in their countries of origin and ready for rapid deployment at appropriate notice.” 

The ASF is the legacy and logic of the Constitutive Act of the AU adopted in 2000, the successor to the Organisation of African Unity (OAU). In a complete break from the OAU, which had advocated non-interference in member states, the Act gave the AU both the right to intervene in a crisis, and an obligation to do so “in respect of grave circumstances, namely: war crimes, genocide and crimes against humanity”. 

Lamamra said the ASF “Implies the immediate availability of the instruments [of intervention and prevention] to be translated into concrete deeds... when they relate to some kind of enforcing decisions of the legitimate organs of African Union, such as cases of unconstitutional changes of government… or armed rebellion, such as the terrorist situation in northern Mali.” 

The African Union Mission in Somalia (AMISOM) was held up as an example of what the ASF could be. “I believe the learning curve for the standby force is AMISOM. We have to deliver on the lessons learned in the AMISOM process - five years of effective presence on the ground under quite challenging circumstances,” Lamamra said. 

“The lesson of AMISOM is that Africans should be ready to make sacrifices, and Uganda has wonderfully shown that they are ready to make sacrifices for the common good of Africa.” Uganda has supplied most of the AU troops supporting the Somali government against jihadist rebels. 

The AU has deployed 14 staff officers to Mogadishu, the capital of Somalia, “in the first ever deployment of ASF elements,” El Gassim Wane, AU Commission director of peace and security, told IRIN. 

A field exercise - Amani II, following the Amani I mapping exercise in 2010 - is being planned for 2014 and three of the five brigades are expected to take participate. 

Article 4 (h) 

Lamamra was confident that by 2015 all of the ASF’s regional brigades - with the probable exception of NARC, owing to the disruptions of the Arab Spring - would be operational and able to fulfil all the criteria of AU’s Article 4 (h), which influenced the international development of the UN Responsibility to Protect (R2P) doctrine. 

There are six scenarios in Article 4 (h). The lowest rung is the attachment of a regional military advisor to a political mission; then an AU regional observer deployed within a UN mission; followed by a stand-alone AU regional observer mission; and deployment of a regional peacekeeping force under the auspices of a Chapter VI mandate, all within a timeframe of 30 days or less. Scenario five is a multidimensional AU peacekeeping force deployed within 90 days, and scenario six relates to “grave circumstances”, such as genocide, and deployment within 14 days. 

Lamamra said the timeline of 14 days for level-six intervention should be reassessed to about seven days. “For instance, resolution 1973 of the UN Security Council was adopted on 17 March and the actual military operation started on 19th March - 14 days would have been too much in terms of protecting civilians.” 

In a 2010 paper, The Role and Place of the African Standby Force within the African Peace and Security Architecture, [ http://www.iss.co.za/uploads/209.pdf ] Solomon Dersso, a senior researcher at the Addis Ababa office of the Institute for Security Studies, a Pretoria-based think-tank, notes that “Article 4 (h) not only creates the legal basis for intervention but also imposes an obligation on the AU to intervene to prevent or stop the perpetration of such heinous international crimes anywhere on the continent.” 

However, implementation of R2P rests with the Security Council, while the imposition of Article 4 (h) resides with the AU and does not require the Security Council’s blessing. 

Scenario six of Article 4 (h) has yet to be used by the AU and Dersso told IRIN he “sincerely doubted” the article would be invoked in the short term against member states, as “it would deprive the AU of any leverage it has over a target government,” and the AU has already “shied away” from implementing the article in Darfur. 

He expected the ASF to be close to being able to comply with Article 4 (h) level-five scenarios by 2015, but the development of regional forces was proceeding at different paces. 

The two-speed progress of the regional brigades - in which ECOWAS and SADC are recognised as the furthest along the path - is not just a consequence of the two regional blocs housing the continent’s economic power houses of Nigeria and South Africa, AU Commission director of peace and security El Gassim Wane told IRIN. 

“ECOWAS and SADC have made tremendous progress, EAS Brigade too, while NARC in the north was lagging behind, but then started speeding up, but the Libyan crisis meant progress had to stop,” he said. “Money may play a role, but money alone cannot explain that. ECOWAS and SADC focused early on conflict and security issues, so had a competitive advantage in the very beginning. Experience, length of involvement in peace and security issues, have certainly played a key role.” 

Alex de Waal, executive director of the World Peace Foundation, told IRIN the availability of a standby force could cloud judgment. 

“Intrinsically, in most of these situations what is needed is a political response, and there is a temptation that if you have a standby force to use it because you have a military capacity… And my concern over something like Mali would be that the military option runs the danger of getting the AU into a Somalia-type situation, where the use of military force five or six years ago by the US and Ethiopia very seriously rebounded. But having said that - yes, in a situation where there is a need for some sort of peacekeeping deployment in the context of a political initiative, it makes sense.” 

Alternatives to the ASF? 

Analysts have questioned whether 30,000 troops would be sufficient to deal with the continent’s crises, and 2012 has illustrated that such concerns are valid. A range of crises this year erupted within the space of a few weeks, from the uneasy relationship between South Sudan and Sudan deteriorating into skirmishing, to coup d’etats in Mali and Guinea-Bissau. 

Wane said the establishment of the ASF did not necessarily mean it would be the only security option at the AU’s disposal, and the four-country operation against Joseph Kony’s Lord’s Resistance Army, (LRA) a rebel movement that started in northern Uganda, could be considered as a useful model for the future. 

“It’s not an ASF operation per se, as ASF has its own processes, and it was not really conceived as an ASF operation - it was conceived as an ad hoc, very flexible arrangement to enhance effectiveness to deal with the LRA once and for all. It’s a very flexible and creative way of dealing with a specific security issue… Who knows? We may replicate it elsewhere, where there is a security problem,” he said. 

The force ranged against the LRA - comprising soldiers from the Central African Republic, Democratic Republic of Congo, South Sudan and Uganda - has fought against the LRA in past, but is set apart, as it operates under the aegis of the AU. 

Abou Moussa, the Special Representative and Head of the United Nations Regional Office for Central Africa (UNOCA), based in Libreville, Gabon, told IRIN: “The specific nature of this deployment [against the LRA] is termed ‘authorised’ as compared to ‘mandated’.” 

“Under authorised deployment, each country provides for the needs and requirements of their respective troops without the AU's contribution. This is extremely important, as this can be considered as their own contribution towards the determination to put an end to Kony's actions. It is very costly. However, the AU covers the needs of staff officers - some 30 of them posted to the various coordinating centres.” 

The AU task force has three operational centres, located in Dungu, DRC, at Obo in CAR, and Nzara in South Sudan, with its headquarters in Yambio, South Sudan. 

“The Regional Coordination Initiative means more subtle changes in the way the operation is run, with representatives of all four countries involved in the command structure in Yambio,” which sidesteps the politically sensitive issue of the DRC’s refusal to host Ugandan forces on its soil, Ned Dalby, a central Africa analyst for the International Crisis Group, a conflict resolution NGO, told IRIN. 

In July 2005, the International Criminal Court indicted Kony and four of his commanders, Okot Odhiambo, Dominic Ongwen, Raska Lukwiya and Vincent Otti, for a variety of crimes against humanity and war crimes. Lukwiya and Otti have subsequently been killed, but the arrest warrants for the remaining three remain outstanding. The LRA has not been active in Uganda since 2006. 

go/he 

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95426</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2011/201109090734440184t.jpg"/></td><td valign="top">JOHANNESBURG 09 May 2012 (IRIN) - Africa’s crises are both honing and stalling the formation of the African Standby Force (ASF) of the African Union (AU) - a quick reaction force that could eventually number about 30,000 troops to be deployed in a range of scenarios, from peacekeeping to direct military intervention.</td></tr></table>]]></content:encoded></item><item><title>NIGERIA: Bone marrow register an “important milestone”</title><pubDate>Fri, 27 Apr 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2009/200904201846340843t.jpg" />]]>LONDON 27 April 2012 (IRIN) - Only a fraction of the millions of people worldwide with blood and autoimmune disorders survive - especially those in poorer countries - partly due to the lack of bone marrow stem cell transplants. A recently established Nigerian bone marrow registry hopes to boost matches between donors and patients, and survival chances.</description><body><![CDATA[LONDON 27 April 2012 (IRIN) - Only a fraction of the millions of people worldwide with blood and autoimmune disorders survive - especially those in poorer countries - partly due to the lack of bone marrow stem cell transplants. A recently established Nigerian bone marrow registry hopes to boost matches between donors and patients, and survival chances. 

Some 200,000 babies are born annually in sub-Saharan Africa with sickle cell disease [ http://www.irinnews.org/Report/91483/HEALTH-Sickle-cell-disease-still-feared-and-deadly ], a blood disorder in which mutated red blood cells can clump and block blood vessels, causing pain, infection and organ damage. Nigeria has up to two million sickle cell patients, many of whom can benefit from stem cell transplants. 

Stem cells are the building blocks of blood and immune cells. [ http://stemcells.nih.gov/info/scireport/chapter5.asp ] “Establishing the mechanics of stem cell transplantation in Nigeria is a very important milestone,” said Terry Schlaphoff, deputy director of South Africa’s bone marrow registry. [ http://www.sabmr.co.za/ ] 

Bone marrow registries hold key information about stem cell donors to help match them with patients. There are currently two such registries in Africa, one in South Africa and now Nigeria. 

In countries with low per capita incomes, stem cell transplants remain relatively rare due to lack of knowledge, trained health workers and, most importantly, availability of stem cells. “African patients who need a matching donor have virtually no chance of survival, unless they are wealthy enough to travel abroad for treatment,” said Seun Adebiyi, founder of Nigeria’s bone marrow registry. 

Matching bone marrow or blood cells collected from donors to the patients who need it [ http://www.nhs.uk/Conditions/Bone-marrow-transplant/Pages/Introduction.aspx ] can offer lifesaving treatments for more than 70 diseases, including leukaemia, lymphoma (cancer) and sickle-cell anaemia. 

Limited availability 

Worldwide, there are fewer than 15 million registered donors, and patients far outstrip the number of donors, according to the Netherlands-based information centre, Bone Marrow Donors Worldwide (BMDW). [ http://www.bmdw.org/index.php?id=mission ] 

Reflecting only a fraction of overall need, 14,206 transplants from non-relatives and 4,255 transplants from umbilical cord blood were provided to patients worldwide in 2011, said Machteld Oudshoorn, chair of BMDW’s editorial board. 

For most patients in developing countries, awaiting a transplant “remains associated with significant morbidity and mortality, and represents one example of high-cost, highly specialized medicine”, according to a recent medical report. [ http://jama.ama-assn.org/content/303/16/1617.long ] 

Adebiyi, himself diagnosed with stem cell leukaemia and lymphoblastic lymphoma, is also calling for the establishment of Nigeria’s first umbilical cord bank, as the cord can provide stem cells without having to collect them from donors, thereby increasing matches and reducing waiting times. 

The more donors there are, the better the chances are of finding a match, said Schlaphoff. “It is said that the likelihood of finding a match is one in 100,000, but for some patients it may be one in a miracle. Because of …the need for very close matching [of cells], no country is self-reliant.” 

Globally, it is already difficult to get a stem cell transplant from a non-relative, with only one-third of patients able to do so, said Oudshoorn. Nearly half of all stem cell transplants [ http://www.nature.com/bmt/journal/v45/n5/full/bmt201010a.html ] occur with cells originating outside the patient’s country of residence. 

None of the some 50,000 transplants performed in 2006 were in countries with incomes below US$700 per capita, according to the most recent data compiled by BMDW. [ http://jama.ama-assn.org/content/303/16/1617.long ] and only 2 percent of bone marrow transplants [ http://jama.ama-assn.org/content/303/16/1617/F1.large.gif ] took place in the Eastern Mediterranean and African regions combined. Most transplants took place in Europe (48 percent) and the Americas ( 36 percent). 

Three countries in Africa are able to harvest and transplant bone marrow - Egypt, South Africa and Nigeria. 

“I think it is very important to establish a national registry, but there should also be transplant centres experienced in performing transplantations with allogeneic [genetically different human] donors,” said Oudshoorn. 

oja/pt/he

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95359</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2009/200904201846340843t.jpg"/></td><td valign="top">LONDON 27 April 2012 (IRIN) - Only a fraction of the millions of people worldwide with blood and autoimmune disorders survive - especially those in poorer countries - partly due to the lack of bone marrow stem cell transplants. A recently established Nigerian bone marrow registry hopes to boost matches between donors and patients, and survival chances.</td></tr></table>]]></content:encoded></item><item><title>MALAWI: Without land reform, small farmers become &quot;trespassers&quot;</title><pubDate>Thu, 26 Apr 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201204232148290834t.jpg" />]]>BANGULA 26 April 2012 (IRIN) - Dorothy Dyton, her husband and seven children used to make a living farming just over a hectare near the town of Bangula in southern Malawi’s Chikhwawa District.</description><body><![CDATA[BANGULA 26 April 2012 (IRIN) - Dorothy Dyton, her husband and seven children used to make a living farming just over a hectare near the town of Bangula in southern Malawi’s Chikhwawa District. 

Like most smallholder farmers in Malawi, they did not have a title deed for the land Dyton was born on, and in 2009 she and about 2,000 other subsistence farmers from the area were informed by their local chief that the land had been sold and they could no longer cultivate there. 

Dyton and her neighbours did not immediately accept the devastating change in their circumstances. They had already been removed once from the land during former President Hastings Banda’s regime in the 1970s and had not been allowed to return until Banda’s regime ended in 1994 and the cattle ranch established there by his political ally, John Tembo, had ceased to function. 

After receiving the go-ahead from the district commissioner, they continued to farm the land for another season. But in 2010, as they prepared to plant, they were met by a police van and the chief, Fennwick Mandala, who warned them not to come back. The next day, the farmers again set out for their fields, but this time they were met by tear gas and rubber bullets and that night six of them were arrested and charged with trespassing. 

Since that time, said Dyton, “life has been very hard on us.” With a game reserve on one side of the community and the Shire river and Mozambique border on the other, there is no other available land for them to farm and the family now ekes out a living selling firewood they gather from the nearby forest. The three oldest children have had to drop out of school to help their parents. 

“People aren’t getting enough to eat,” said Isaac Falakeza, another community member. “Some are doing piece work on other people’s gardens, others are harvesting water lilies. You can see how malnourished the children are.” 

User rights only 

In Malawi, like most other countries in the region with the exception of South Africa, Botswana and Zimbabwe, more than 60 percent of land is customary, meaning that it is mostly untitled and administered by local chiefs on behalf of the government, with local communities merely enjoying user rights. 

The system has led to many abuses, with some government officials and chiefs selling off customary lands and dispossessing smallholder farmers who are already competing for dwindling arable land as Malawi’s population increases. 

“There’s nothing [they] can do because they’re not protected in any way by the law,” said Blessings Chinsinga, a lecturer at the University of Malawi’s Chancellor College, who is researching the political economy of land grabs and land reform in the country. 

In a research report co-authored by Chinsinga, he notes that the issue of “land grabs” in Malawi dates back to Banda's transferring of large parcels of land from smallholder farmers to the estate sector, largely to the benefit of political elites, men like John Tembo who helped sustain his regime. 

Stalled land reform 

Following the ousting of Banda and the transition to democracy, the government set up a Commission of Inquiry on Land Reform the findings of which formed the basis of a new land policy in 2002. The policy attempts to address smallholder farmers’ lack of security of tenure by allowing them to register their customary land as private property, but the legislative changes needed to implement the policy have not gone through parliament and the land reform process has effectively stalled. 

“Politicians own massive tracts of land; they benefited from the previous system, so they’re reluctant to adopt a new legislative framework that would correct the land imbalances,” commented Chinsinga. 

In recent years, the government of recently deceased president Bingu wa Mutharika focused public investment on boosting the productivity of smallholder farmers through its farm input subsidy programme. The programme was credited with several years of bumper maize harvests, but as Malawi went into financial crisis last year, the sustainability of the programme was called into question and the number of beneficiaries was reduced. [ http://www.irinnews.org/Report/93954/MALAWI-Farm-subsidy-programme-shrinks ] 
Critics of the programme, like international NGO Grain, point out that “all the fertilizers and seeds in the world cannot make much difference for the great mass of farmers in Malawi, who do not even have enough land to grow the food their families need.” 

Green Belt Initiative 

A 2010 report by Grain, [ http://www.grain.org/article/entries/4075-unravelling-the-miracle-of-malawi-s-green-revolution ] noted that Malawi’s lack of land reform had resulted in increasingly inequitable distribution of land, with large tracts of farmland ending up in foreign hands. In 2009, the government allocated 50,000 hectares of farmland to the government of Djibouti, reportedly in exchange for assistance constructing an inland port in Nsanje. The details of this and other such deals are shrouded in secrecy, according to Chinsinga who has focused his research on land transfers relating to the government’s Green Belt Initiative (GBI). 

Another programme championed by Mutharika, the GBI aims to acquire 340,000 hectares of irrigable land along Lake Malawi and the banks of the Shire river with the goal of increasing agricultural production and national food security. Several foreign companies have acquired land under the auspices of the programme which, according to Chinsinga’s paper, “views customary land as an unlimited reservoir that can be targeted for conversion for privatization”. 

Rather than increasing food security, the paper suggests that, “land transfers under the GBI could have tremendous negative implications on livelihoods, food security and social justice”. 

Illovo Sugar 

Chikhwawa District is already dominated by sprawling sugar plantations owned by South African sugar giant Illovo Sugar. According to several sources, Illovo is intent on expanding its presence in the area and enjoys government support because of the much needed foreign exchange it generates. 

The 2,000 hectares of land once farmed by Dyton and her neighbours is now owned by a company called Agricane, which is leasing it to Illovo for sugar cane production. Agricane’s country director, Bouke Bijl, explained that his company bought the land from a bank which had acquired it from John Tembo after he defaulted on a loan. 

Like Chief Mandala, he described Dyton and other farmers who complain they have been dispossessed, as trouble-makers with no ancestral claims to the land. "There was a directive from the District Commissioner that they shouldn’t have been there and should make way for development but they chose not to understand that," he said, referring to the 2010 standoff between the farmers and security personnel. 

Ironically, Agricane's core business is providing technical support to clients, many of them international donors who are implementing community development projects. Bijl noted that the company's biggest challenge in carrying out such projects was the issue of land tenure. "We're seeing a lot of projects collapse because the communities have never been prepared sufficiently to deal with it," he told IRIN. 

He added that once the land outside Bangula starts generating a profit, a trust fund will be established to support community development in the area, and donors will be approached to fund irrigation schemes that would benefit local smallholder farmers. 

ks/cb

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95363</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201204232148290834t.jpg"/></td><td valign="top">BANGULA 26 April 2012 (IRIN) - Dorothy Dyton, her husband and seven children used to make a living farming just over a hectare near the town of Bangula in southern Malawi’s Chikhwawa District.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: No HIV and TB workplace policy, no mining licence</title><pubDate>Mon, 26 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2007/200703129t.jpg" />]]>CARLETONVILLE 26 March 2012 (IRIN) - Regulators are increasingly scrutinizing HIV and TB responses in South Africa’s mining sector, which could lead to the industry being hit where it hurts - the bottom line.</description><body><![CDATA[CARLETONVILLE 26 March 2012 (IRIN) - Regulators are increasingly scrutinizing HIV and TB responses in South Africa’s mining sector, which could lead to the industry being hit where it hurts - the bottom line. 

Speaking to hundreds of mine workers and community members in the mining town of Carletonville on World TB Day, Deputy President Kgalema Motlanthe urged the mining industry to improve TB services by adopting the GeneXpert rapid TB test, upgrading health centres to allow for the treatment of drug-resistant TB, and by extending health services to those from surrounding communities and mines that may have limited access to healthcare. 

At the same event, Mineral Resources Minister Susan Shabangu announced that mining companies, whose HIV, TB and workplace safety policies are being audited by her department, will have to submit their policies as a prerequisite for renewing their mining licenses. 

As part of the deputy president's call for all mine workers to be screened for TB and HIV in the next year, World TB Day celebrations were accompanied by HIV and TB screenings, during which at least 1,220 people were examined for TB and 260 people were tested for HIV. 

Going to ground 

Before addressing the crowd, Motlanthe and Shabangu joined other officials, including Minister of Health Dr Aaron Motsoaledi and South African National AIDS Council deputy chairperson Mark Heywood at a community dialogue meeting with about 200 miners, who raised concerns like housing, compensation for their families if they should die, and unfair dismissal following TB diagnoses. 

Mark Heywood, who also heads the human rights organization, Section 27, encouraged miners to report such dismissals. 

"In South Africa it is illegal for anyone with HIV or TB to be dismissed or chased away from employment," Heywood told IRIN/PlusNews. "We encourage any mineworker who has been dismissed because of TB or HIV to report it - to overcome TB we have to protect human rights." 

As in many countries in southern and East Africa, South Africa's high TB incidence is fuelled by a high HIV prevalence. Although many people carry TB, only 10 percent will ever develop the active disease, but because of their compromised immune systems, people living with HIV are up to 37 times more likely to develop active TB. 

Miners are also at a higher risk of TB due to bad living conditions, often in the poorly ventilated, overcrowded single-sex hostels that have historically characterized mining in South Africa, and have facilitated TB transmission. Miners exposed to high levels of silica dust also often acquire a serious respiratory illness called silicosis, which increases their risk of developing active TB. 

According to Shabangu, South Africa's mining sector sees three times as many cases of active TB as the general population, mostly in the gold mining sector, where studies have found that up to a quarter of all miners may have silicosis. 

The Gold Fields mining company, which hosted the event, has already taken steps to address poor housing by building single-family homes on its mines, as well as helping others purchase their own homes, CEO Nick Holland told IRIN/PlusNews. 

The company spends about R100 million on TB screening and treatment annually, and has managed to enrol around 3,500 miners in its HIV treatment programme. 

Motsoaledi will join fellow health ministers and mining representatives from the Southern African Development Community (SADC) at an April meeting in the Angolan capital, Luanda, to address the region's response to TB in the mining sector. 

The gathering is expected to produce an SADC declaration on the issue by August 2012. A regional plan of action will inform future TB interventions, which may include the introduction of regional health passports for migrant workers and the harmonization of TB treatment policies and regimens. 

llg/kn/he 

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95169</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2007/200703129t.jpg"/></td><td valign="top">CARLETONVILLE 26 March 2012 (IRIN) - Regulators are increasingly scrutinizing HIV and TB responses in South Africa’s mining sector, which could lead to the industry being hit where it hurts - the bottom line.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Children with TB below the health radar</title><pubDate>Fri, 23 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201203221423360353t.jpg" />]]>YSTERPLAAT 23 March 2012 (IRIN) - To a casual observer the two dozen children running round in the grassy schoolyard look like ordinary kids playing, but the surrounding buildings are the wards of the Brooklyn Chest Hospital (BCH), which specializes in treating severe cases of tuberculosis (TB), a disease rarely associated with children.</description><body><![CDATA[YSTERPLAAT 23 March 2012 (IRIN) - To a casual observer the two dozen children running round in the grassy schoolyard look like ordinary kids playing, but the surrounding buildings are the wards of the Brooklyn Chest Hospital (BCH), which specializes in treating severe cases of tuberculosis (TB), a disease rarely associated with children. 

TB affects nearly a million children globally every year, and up to 70,000 die from this preventable and curable disease per annum. Problems in detection, difficulties in diagnosing, and the fact that children rarely spread the disease have kept paediatric TB off the public health radar, but this is changing. 

"Before I came here I was feeling so tired - I had pains in my chest, I [couldn't] walk, and I was sleeping all the time," said Yonele Ndamane, 13, who came to BCH in November 2011 to be treated for multidrug-resistant (MDR) TB. He says he got the disease from his 24-year-old brother, with whom he shared a room, and who has also been diagnosed with MDR TB. 

"If you see an adult with TB there's going to be a child who's exposed and at high risk," said Anneke Hesseling, Director of the Paediatric TB Research Programme at the Desmond Tutu TB Centre at Stellenbosch University in Western Cape Province. 

According to the 2012-2016 National Strategic Plan for HIV, STIs (sexually transmitted infections) and TB, South Africa has the third highest level of TB in the world. New infections have increased by 400 percent over the last 15 years, approximately 1 percent of over 50 million people per year develops active TB, and more than 70 percent of TB patients are co-infected with HIV. 

In this context, the number of children thought to be infected with TB is huge. Hesseling estimates that in TB-endemic areas the disease will be active in 15-20 percent of children, but reliable figures are hard to come by. 

"Up to the early 2000s there was little money for research into childhood TB. If we wanted to do research… we had to attach it to an adult study," noted Simon Schaaf, who has been conducting research into paediatric TB with Hesseling and others at the Desmond Tutu TB Centre. 

Paediatric TB differs from adult TB in several ways. First, the available diagnostic tools make it very difficult to confirm TB in a child. The most common mode of testing - coughing up a sample of sputum to be checked under the microscope for the bacteria - often does not work because young children are usually unable to produce a sample. 

Even when a child can provide a sample, it will often come back negative because children are usually infected with far fewer organisms. And as yet there is little evidence that new molecular tests like GeneXpert will assist in paediatric diagnosis. 

Better treatment needed

The response to TB treatment is another inadequately understood issue. "For many years children were given the same milligram-per-kilogram dosage [as adults]. But the problem is that if you give 5mg/kg of Isoniazid (a standard first-line TB drug) to an adult, and 5mg/kg of Isoniazid to a child, the levels that are reached in the blood are not the same,” Schaaf told PlusNews. 

“We did several studies and found that we need slightly higher doses for children… Children are not small adults. The liver size is different compared to the rest of the body - a child's liver functions better because of less other toxicity or disease or damage. It could be that kidney function is better - adults have 60 percent body water, children have 80 percent. All of these factors can play a role," said Schaaf. 

As result of this research, the World Health Organization (WHO) changed its guidelines on first-line drug dosages for children. Hesseling and Schaaf recently began a similar five-year study funded by the US National Institutes of Health (NIH) to examine the second-line drugs used to treat MDR and extensively drug-resistant TB (XDR TB) in children. 

"We actually don't know what dosages children should really have," Schaaf noted. "We were using the doses that we use for adults [to treat MDR] in children, but because we saw that it's not sufficient in first-line drugs, we need now to look at the second-line drugs." 

HIV co-infection looms large among the other issues complicating paediatric TB. HIV-positive children and infants are especially vulnerable to the most severe and deadly forms of TB, like TB-meningitis. Known and unknown interactions between drugs also complicate the management of TB in HIV co-infected patients. "With HIV-TB co-infection... you're giving that many more drugs,” Schaaf pointed out. The NIH study will also look at how TB and HIV drugs affect one another. 

The results could yield critical information. "I take 15 pills every day,” said Yonele. “I'm taking white ones, yellow ones, and then a grey one. It's difficult - some of them are not right-smelling - and I get an injection every day, but it's okay," he said with impressive equanimity. 

Perhaps the biggest problem is that medicines are rarely available in doses suitable for children. "You have to break up tablets and crush them, and it's difficult to get the right dose for a child," Schaaf said. 

At the end of the day, if the research into better and more child-friendly methods of diagnosis and child-specific dosages is to be effective, greatly increased awareness of TB as a serious and, in some areas, all too common childhood disease is desperately needed. 

"TB can go anywhere, anyhow. It is a disease of poverty and it is a disease associated with HIV, but anyone can get TB, at any age… it's important [to know] that very young babies can get TB," Schaaf commented. 

Evelyn Dodgen, the head teacher at the Brooklyn Chest Hospital School, agreed that many parents are unaware of the dangers of TB. She worries that children are living in households with adults who are sick with TB but ignorant of the risks to children, or that when children fall sick it is often unacknowledged for far too long. 

"Parents must listen to the children when the children tell them they're sick - there are so many signs to look for: headaches, coughing, vomiting, not eating, and especially when they complain that they are so tired that they just want to sleep... If your child stays absent from school for three weeks, there is something wrong," she said. 

Paying attention to the signs can mean more effective treatment. "The other message is that by far the majority of childhood TB is curable, even MDR TB and XDR TB,” said Schaaf. “As long as you identify it early enough and treat it with the correct drugs." 

lm/kn/he 

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95132</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201203221423360353t.jpg"/></td><td valign="top">YSTERPLAAT 23 March 2012 (IRIN) - To a casual observer the two dozen children running round in the grassy schoolyard look like ordinary kids playing, but the surrounding buildings are the wards of the Brooklyn Chest Hospital (BCH), which specializes in treating severe cases of tuberculosis (TB), a disease rarely associated with children.</td></tr></table>]]></content:encoded></item><item><title>SOUTHERN AFRICA: TB preventative therapy scorecard</title><pubDate>Fri, 23 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201203221135570456t.jpg" />]]>JOHANNESBURG 23 March 2012 (IRIN) - Tuberculosis (TB) is the leading killer of HIV-positive people globally. Almost 15 years ago the World Health Organization (WHO) and UNAIDS recommended that people living with HIV be given isoniazid preventative TB therapy (IPT), to prevent active TB, but national implementation of IPT has been slow.</description><body><![CDATA[JOHANNESBURG 23 March 2012 (IRIN) - Tuberculosis (TB) is the leading killer of HIV-positive people globally. Almost 15 years ago the World Health Organization (WHO) and UNAIDS recommended that people living with HIV be given isoniazid preventative TB therapy (IPT), to prevent active TB, but national implementation of IPT has been slow. 

IPT, intensified TB case finding, and infection control are now the World Health Organization’s three strategies for reducing TB among people living with HIV, also known as the "Three I's for HIV-TB." 

IRIN/PlusNews charts the uneven adoption of TB preventative therapy in southern Africa, which has the unhappy distinction of bearing some of the world's highest HIV and TB burdens. 

Botswana 

After rolling out IPT at three pilot sites, the country began a national IPT rollout in 2001 that allows for symptomatic TB screening to rule out active TB as a prerequisite for IPT. By 2005 IPT was being offered alongside voluntary HIV testing and counselling, antiretroviral (ARV) treatment and prevention of mother-to-child HIV transmission services, although pregnant women and children under 16 are not eligible for IPT in Botswana. 

Three years later, doctors and nurses were prescribing IPT at more than 600 health facilities, according to the Botswana Ministry of Health. By 2007 the country's IPT programme had enrolled about 72,000 eligible patients. [ http://www.scribd.com/doc/85871800 ] 

In 2009, a clinical trial conducted in Botswana found that taking IPT for 36 months prevents significantly more cases of TB in people living with HIV than simply taking a short course of IPT for six months.

Like neighbouring South Africa, Zimbabwe and Namibia, all HIV/TB co-infected patients are eligible for HIV treatment, regardless of their CD4 count (a measure of the immune system's strength). 

Lesotho 

As of September 2011 the country had not yet implemented IPT, but was set to finalize draft national guidelines. 

Malawi 

The WHO estimates that the country accounts for about 2 percent of HIV-TB co-infected patients globally. Malawi has adopted IPT and uses symptomatic screening to rule out active TB, but guidelines recommend that IPT be stopped in patients who recently started taking ARVs. All HIV-positive patients are started on ARVs if they are diagnosed with TB. 

Mozambique 

The country carried about five percent of the global HIV-TB burden in 2010, according to WHO. [ http://www.scribd.com/doc/85856183 ] In recent years it embarked on an aggressive scale-up of IPT provision, and increased the number of HIV patients on IPT almost 20-fold between 2008 and 2010. TB screening of HIV-positive people shot up 60 percent in the same time. In 2011 the country disseminated updated IPT guidelines, but is not yet completely in line with WHO recommendations because it does not prescribe IPT to pregnant women. 

Namibia 

IPT has been rolled out to HIV patients and others who have been in close contact with someone recently diagnosed with active TB. To qualify for IPT, people living with HIV must meet specified requirements - for example, they must be relatively healthy, with no history of alcoholism or liver disease. HIV-positive children also qualify for IPT, provided they have never received it previously and have not had active TB in the last two years. [ 2011 natl guidelines http://www.scribd.com/doc/85863343 ] 

HIV-negative children up to five years of age who have been in close contact with someone who has active TB and is still infectious also qualify for IPT, as do adults who have been in contact with such a person and have compromised immune systems due to conditions like diabetes and leukaemia. However, as the country's 2011 national HIV strategic plan notes, IPT implementation and monitoring have been limited by the lack of a dedicated plan to track HIV-TB services. 

About 60 percent of TB patients are co-infected with HIV and so are eligible for treatment regardless of their CD4 count. All people living with HIV are eligible for ARVs if they are diagnosed with TB. [ http://www.scribd.com/doc/85859185 ] 

South Africa 

Almost 300,000 people were co-infected with HIV and TB in 2010. The country is estimated to account for about 24 percent of the world's HIV-TB burden, according to the WHO. [ http://www.scribd.com/doc/85856183 ] 

South Africa has had national guidelines for administering IPT since 2002, but coverage remains low, partly due to a lack of awareness among health care providers, according to small qualitative studies by the Aurum Institute, a South African health research organization. 

The country's recent large-scale IPT trial among gold miners failed to prove that community-wide IPT worked better than the recommended targeted provision to high risk groups, but did demonstrate IPT's protective benefits against active TB. 

The Aurum study also confirmed that IPT reduces the risk of death for people living with HIV by halving the risk of dying in HIV-positive patients on or just starting antiretrovirals (ARVs). Based on this finding, South African guidelines no longer discourage the use of IPT in ARV patients. [ http://www.plusnews.org/Report/95042/SOUTH-AFRICA-Preventative-TB-trial-disappoints ] 

Swaziland 

In a country where about 85 percent of TB patients are co-infected with HIV, health workers use symptomatic screening to rule out active TB and prescribe IPT. In 2009 about 2,000 HIV patients received IPT, according to a report by the HIV/AIDS news service, AIDSMap. [ http://www.aidsmap.com/Spurring-community-engagement-to-ensure-the-proper-implementation-of-the-Three-Is-for-TBHIV/page/1733423/#item1733431 ] By 2010 Swaziland accounted for about 1 percent of the world's HIV-TB co-infection cases. [ http://www.scribd.com/doc/85856183 ] 

Zambia 

National guidelines were drafted in 2010, allowing health workers to prescribe IPT for HIV patients without signs of active TB. While Zambia lagged behind the region in adopting IPT, its decision to recommend IPT for national use was bolstered by the use of IPT in the large-scale TB prevention ZAMSTAR clinical trial, which took place in Zambia and South Africa. About 23,000 people, or 2 percent of the global HIV-TB burden, is in Zambia. 

Zimbabwe 

An estimated 4 percent globally of the people co-infected with HIV and TB live in Zimbabwe. [ http://www.scribd.com/doc/85856183 ] Although the most recent TB control guidelines do not recommend the use of IPT, in 2011 the country was in the process of developing national IPT guidelines. 

llg/kn/he 

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95141</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201203221135570456t.jpg"/></td><td valign="top">JOHANNESBURG 23 March 2012 (IRIN) - Tuberculosis (TB) is the leading killer of HIV-positive people globally. Almost 15 years ago the World Health Organization (WHO) and UNAIDS recommended that people living with HIV be given isoniazid preventative TB therapy (IPT), to prevent active TB, but national implementation of IPT has been slow.</td></tr></table>]]></content:encoded></item><item><title>AFRICA: Reverse migration slowing urbanization rates</title><pubDate>Thu, 15 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2007/200711304t.jpg" />]]>JOHANNESBURG 15 March 2012 (IRIN) - Twenty years ago, South Africa’s cities were braced for a massive influx of rural migrants following the scrapping of apartheid-era pass laws which had restricted black people’s movements. Cities such as Johannesburg and Durban have indeed grown, but not at the phenomenal rates projected and others have hardly grown at all.</description><body><![CDATA[JOHANNESBURG 15 March 2012 (IRIN) - Twenty years ago, South Africa’s cities were braced for a massive influx of rural migrants following the scrapping of apartheid-era pass laws which had restricted black people’s movements. Cities such as Johannesburg and Durban have indeed grown, but not at the phenomenal rates projected and others have hardly grown at all.  

With little access to the formal job market, most rural people lack the resources to live in cities for long periods. They often maintain homes and families in rural areas and return there for marriages, burials and when the going gets too tough in town.  

According to Deborah Potts, a reader in human geography at King's College London, similar patterns of circular migration are playing out in many African countries, countering the effects of rural-urban migration and confounding the widely-held assumption that the continent is urbanizing rapidly. [ http://www.irinnews.org/Report/95015/AFRICA-Challenging-the-urbanization-myths ]

“There are some countries, and it seems to be a smaller and smaller proportion, that are urbanizing in the way that is widely understood,” Potts told IRIN, “but there’s a whole other group of countries, and a much larger group that, based on recent census material, is hardly urbanizing at all; and then there’s yet another group of cities where there has been evidence of de-urbanization.”

In a paper released by the Africa Research Institute in February, [ http://africaresearchinstitute.org/counterpoint-article.php?i=6PZXYPRMW7&p=1 ] Potts notes that high living costs and the lack of formal job opportunities in African cities, particularly following the structural adjustment programmes of the 1980s, have narrowed the gap between rural and urban living standards.  

“Confronted by economic insecurity and other hardships worse than where they came from, people behave as rationally in Africa as anywhere else,” she writes.

Hidden migration

The policy implications of circular or urban-rural migration are significant, but part of the problem of developing policies for a mobile population is counting them. “All of the figures we have are problematic because there’s hidden migration,” commented Prof Phil Harrison, a member of South Africa’s National Planning Commission. “Many households have multiple locations with some members in a rural area and some in informal settlements, and they move between them.”

With South Africa’s last census conducted in 2001 and the results from a 2011 census not yet available, Alan Mabin, head of the School of Architecture and Planning at the University of the Witwatersrand in Johannesburg, said that many politicians and city planners were still projecting growth based on old assumptions.

"Many people still think that controlling migration to cities is a good thing, that cities will otherwise be overwhelmed," he said.

Data from the Independent Electoral Commission, which tracks voter movements, reveals that South Africa’s population is on the move, but not just to cities. “There’s a lot of step-wise migration and movement within municipalities,” said Harrison. “People are drawn to areas of greater economic opportunity, but also where infrastructure and housing is provided.”

Social grants for the elderly, children and the disabled can support a family living in a rural area where the cost of living is relatively low and have even stimulated the growth of cash economies in some areas. The higher fertility rate in rural areas has also compensated for any out-migration. 

“In rural areas, we probably have a stable population for the next 20 to 30 years,” said Harrison.

In other parts of Africa which lack the economic safety net provided by government welfare benefits, rural households can often rely on access to land held by local traditional authorities to grow food for their families. 

Potts said that countries like Malawi have remained deeply rural, despite the fact that people often struggle to grow enough food for their families, because of the lack of jobs and high cost of living in the cities. “People certainly move to towns, but they don’t tend to stay,” she said. “People are seeking somewhere where they can find a reasonable standard of living and they’re not finding it, so they keep moving.”

Still a magnet

While news that Africans are not flooding into cities may come as a relief to local authorities, Loren Landau, director of the African Centre for Migration and Society at the University of Witswatersrand, warned against complacency. “While the rates of migration may not be as high as some feared, the growth rate when translated into absolute numbers nonetheless represents an important demographic and political challenge to local authorities and others mandated to provide for the urban poor," he told IRIN.  

Cities like Johannesburg remain a magnet for migrants from inside and outside the country and while the expected levels of growth have not happened, the city is still growing at an estimated 1.9 percent per annum, twice the national rate. 

"We've still got a backlog in terms of addressing needs like housing," said Harrison. "It might actually be a blessing if growth isn't as fast as was anticipated."

ks/cb

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95085</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2007/200711304t.jpg"/></td><td valign="top">JOHANNESBURG 15 March 2012 (IRIN) - Twenty years ago, South Africa’s cities were braced for a massive influx of rural migrants following the scrapping of apartheid-era pass laws which had restricted black people’s movements. Cities such as Johannesburg and Durban have indeed grown, but not at the phenomenal rates projected and others have hardly grown at all.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: What the world&apos;s largest preventative TB study taught us</title><pubDate>Tue, 13 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2010/201010111149540738t.jpg" />]]>JOHANNESBURG 13 March 2012 (IRIN) - Even though the world&apos;s largest study of preventative tuberculosis therapy indicated that community-wide isoniazid preventative TB therapy (IPT) failed to lower community TB levels among 27,000 South African gold miners, that was not Thibela’s only result. We review some of the others over its seven years:</description><body><![CDATA[JOHANNESBURG 13 March 2012 (IRIN) - Even though the world's largest study of preventative tuberculosis therapy indicated that community-wide isoniazid preventative TB therapy (IPT) failed to lower community TB levels among 27,000 South African gold miners, [ http://www.plusnews.org/Report/95042/SOUTH-AFRICA-Preventative-TB-trial-disappoints ] that was not Thibela’s only result. We review some of the others over its seven years:


1. You do not always need an X-ray: In southern Africa, health workers and patients in rural areas often cannot access X-rays to confirm or rule out active pulmonary TB. Without X-rays to verify that patients did not have active TB, many physicians were unwilling to start patients on IPT. Thibela found that health workers could exclude at least 90 percent of active TB cases through sputum testing and symptom screening – asking patients if they were experiencing night sweats, a persistent cough or weight loss. Based in part on these findings, South Africa's latest IPT guidelines issued in June 2010 no longer require chest X-rays and TB skin tests to start HIV-positive patients on IPT.

However, in high TB prevalence settings, researchers noted that chest X-rays increased TB case detection.

2. IPT and HIV: People living with HIV, which compromises the immune system, are up to 37 times more likely to develop active TB. Findings from Thibela were able to confirm what many had long suspected but had failed to prove: that IPT provision to people living with HIV reduced their likelihood of dying. In fact, Thibela researchers showed it halved the risk of death among HIV-positive patients on or just starting antiretrovirals (ARVs). Based on this finding, South African guidelines no longer discourage the use of IPT in ARV patients. [ http://www.irinnews.org/Report/91055/SOUTH-AFRICA-Preventative-TB-therapy-halves-risk-of-death-among-ARV-patients ]

3. Slamming side-effects: Although the World Health Organization had been recommending IPT since 1999, implementation has been slow, partly due to challenges in TB screening and doctors' fears of possible side-effects, most notably liver damage. Thibela researchers, however, found only a small number of cases of liver damage and these were among heavy drinkers. The most commonly reported side-effect of IPT was increased appetite.

4. Ignorance is not always bliss: IPT roll-out has been slow globally but in South Africa, coverage was below 1 percent in 2010 - eight years after the country introduced the preventative therapy. Zambia has only recently begun piloting IPT.

Thibela researchers found that doctors were unwilling to prescribe the drug to patients because they did not know about the drug's TB prevention benefits and did not have experience in prescribing it. Some doctors said they preferred to wait to treat TB with more familiar drug courses than to prevent it.

5. Mobilizing men: Although Thibela eventually included about 27,000 mine workers, mostly men - 80,000 indicated they would be willing to participate in the study. Thibela published research on the community mobilization and education strategies it used to get men on board in a November 2010 supplement of the medical journal, AIDS.

"The uptake we achieved was truly remarkable, especially when you consider it was almost an exclusively male population and men are notoriously poor adopters of health strategies," said Thibela's lead researcher and chief executive officer of South Africa's Aurum Institute for Health, Gavin Churchyard. "We've shown that it is possible to mobilize an entire population to adopt a health prevention strategy."

Strategies that worked well to drive up men's willingness to participate included the use of peer educators, community events and incentives tied to project phases. Less popular were the use of mobile-phone messaging due to frequent phone number changes, and treatment buddies, which sparked privacy concerns among actual trial participants.

llg/kn/mw

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95064</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2010/201010111149540738t.jpg"/></td><td valign="top">JOHANNESBURG 13 March 2012 (IRIN) - Even though the world&apos;s largest study of preventative tuberculosis therapy indicated that community-wide isoniazid preventative TB therapy (IPT) failed to lower community TB levels among 27,000 South African gold miners, that was not Thibela’s only result. We review some of the others over its seven years:</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Preventative TB trial disappoints</title><pubDate>Fri, 09 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2007/200703128t.jpg" />]]>JOHANNESBURG 09 March 2012 (IRIN) - After seven years of research, the world&apos;s largest study of preventative tuberculosis (TB) therapy has found that untargeted, community-wide distribution of TB prevention drugs did not improve TB control on South African gold mines.</description><body><![CDATA[JOHANNESBURG 09 March 2012 (IRIN) - After seven years of research, the world's largest study of preventative tuberculosis (TB) therapy has found that untargeted, community-wide distribution of TB prevention drugs did not improve TB control on South African gold mines.

Conducted among 27,000 gold-mine employees in 15 mines, the Thibela TB study tested the theory that treating an entire community with the first-line TB drug isoniazid could result in long-lasting reductions in active TB cases and TB prevalence. [ http://www.tbhiv-create.org/about/studies/thibela ]

Workers in eight mines were offered TB screening. Those with active TB were treated, while those without active TB - about 24,000 - were given a nine-month course of isoniazid preventative TB therapy (IPT). Workers in the remaining seven mines were screened and treated according to national guidelines whereby only high-risk individuals with HIV or silicosis would have been eligible for a six-month IPT course.

But according to results released on 8 March at the annual Conference on Retroviruses and Opportunistic Infections in Seattle, Washington, the community-wide IPT provision did not reduce TB incidence or prevalence within communities.

In people who do not have active TB, IPT applies one of the two drugs commonly used in combination to treat active TB as a preventative measure. While many people carry TB, only about 10 percent will ever develop it. However, those with compromised immune systems, such as people living with HIV or silicosis - a lung-destroying respiratory illness often contracted by miners exposed to silica dust - are much more likely to develop active TB.

Gavin Churchyard, the study's principal investigator and chief executive officer of South Africa's Aurum Institute for Health, said that while Thibela showed poor results at community level, it did underscore IPT's proven effectiveness in preventing active TB among individuals who were on the drug course but this protection waned quickly once patients stopped taking IPT.

He added that the long-running trial also revealed important insights on how to better conduct future large-scale, cluster randomized control studies and that these techniques were helping to shape studies evaluating the effects of newly introduced TB diagnostics such as GeneXpert. [ http://www.plusnews.org/report.aspx?reportid=92301 ]

Researchers are now recommending that governments such as South Africa’s continue targeted IPT provision aimed at high-risk groups. However, Churchyard added that focused rollouts remain difficult when people did not know they were "high-risk", ie HIV-positive or suffering from silicosis.

Poor working and living conditions, coupled with high rates of silicosis, have fuelled TB on the mines for years, aggravated by the advent of HIV. The South African Department of Health, in its TB Strategic Plan for South Africa 2007-2011, has estimated that the country's gold-mining industry has the highest TB incidence in the world. [ http://www.globalizationandhealth.com/content/5/1/11 ] 

Silicosis is estimated to affect a third of all South African gold miners and autopsies have shown that many miners remain undiagnosed and untreated, particularly black mine workers who traditionally assumed the most dangerous jobs in the mines under apartheid. [ http://www.tbonline.info/media/uploads/documents/.../ehrlich-tbmines.pdf ]

With an HIV prevalence of about 18 percent, South Africa has had national IPT guidelines in place since 2002 but eight years later the coverage was estimated to be below 1 percent. Last year, 320,000 people were put on the preventative therapy, according to Churchyard.

Next steps

Thibela is the second large-scale, community-focused TB prevention trial to report disappointing results in the past six months. In October 2011, the ZAMSTAR study conducted among almost 963,000 people in Zambia and South Africa found that enhanced, community-based TB case finding also had no effect on incidence or prevalence. Both Thibela and ZAMSTAR are part of the Bill and Melinda Gates-funded Consortium to Respond Effectively to the AIDS/TB Epidemic. [ http://www.plusnews.org/report.aspx?reportid=94117 ]

Thibela and ZAMSTAR researchers are evaluating data that Churchyard said they hoped would tell them why both studies failed to lower new and existing cases of TB at the community level. Thibela researchers will report the findings of these models at the bi-annual South African TB Conference in June 2012.

"The reasons we're exploring are, broadly, that we didn't achieve adequate IPT coverage, or there is a high rate of ongoing TB transmission in the mines, or miners' vulnerability due to HIV and high silica dust exposure undermines IPT's protective effect at the community level," Churchyard told IRIN/PlusNews. "It's likely that all three contributed to the fact that it didn't work.

"We can't stop here, we have to seek solutions to control TB in the mines."

Thibela investigators will also present their findings at an April 2012 ministerial meeting of the Southern African Development Community. The meeting in Luanda, Angola, is expected to bring together ministries of health, finance and labour and industry representatives, to discuss TB in the mining sector. The meeting is expected to produce a SADC declaration on the issue by August 2012 and a regional plan of action to inform future TB interventions. 

llg/kn/mw

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=95042</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2007/200703128t.jpg"/></td><td valign="top">JOHANNESBURG 09 March 2012 (IRIN) - After seven years of research, the world&apos;s largest study of preventative tuberculosis (TB) therapy has found that untargeted, community-wide distribution of TB prevention drugs did not improve TB control on South African gold mines.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: New reports chart progress - and costs - in HIV fight</title><pubDate>Mon, 27 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2007/200708221t.jpg" />]]>JOHANNESBURG 27 February 2012 (IRIN) - Mothers, babies and newly diagnosed HIV patients are receiving more of the services they need but progress comes at a cost, according to a new report that predicts a funding shortfall for HIV treatment in South Africa.</description><body><![CDATA[JOHANNESBURG 27 February 2012 (IRIN) - Mothers, babies and newly diagnosed HIV patients are receiving more of the services they need but progress comes at a cost, according to a new report that predicts a funding shortfall for HIV treatment in South Africa.

On 23 February, the Health Systems Trust released the latest versions of its annual District Health Barometer and South African Health Review. www.hst.org.za/district-health-barometer-dhb

Although in its sixth year of publication, this year's barometer is the first to include data on early infant HIV testing for babies born to HIV-positive mothers and shows that about half of all babies born to HIV-positive mothers are now being tested for the virus at six weeks of age, an important step to ensuring they access the early HIV treatment recommended for all children younger than one under national guidelines. In 2009, only about a quarter of such babies were being tested using the sensitive polymerase chain reaction - tests that confirm whether HIV-exposed infants are HIV-positive.

The report also found that almost all pregnant women are now tested for HIV, which has helped lower mother-to-child HIV transmission to below 4 percent in the country.

The latest barometer is also the first to include data on tuberculosis (TB) screening among newly diagnosed HIV patients. In 2008, only about a third of new HIV patients were screened for TB; in 2011 about 70 percent were checked.

People who have both HIV and carry latent TB are up to 30 times more likely to develop active TB as their HIV-negative peers and TB remains the leading cause of death in South Africa and among people living with HIV worldwide.

Funding shortage 

The HST also launched the South African Health Review, an independent review of the public health sector funded by the South African government. While the report notes that HIV/AIDS spending has increased substantially since 2007, it predicts the country will need up to US$5.3 billion extra every year to sustain its HIV/AIDS response, particularly treatment.

The review notes that this year alone the government will spend about $3.1 million on HIV and AIDS; less than a fourth of this comes from donors such as the Global Fund to Fight AIDS, TB and Malaria or the US President's Emergency Plan for AIDS Relief (PEPFAR).

The South African government already shoulders about 80 percent of its HIV treatment costs domestically and authors of the review predict that treatment will be the main driver of the escalating costs of the country's HIV/AIDS response.

In late 2009, the World Health Organization revised its HIV treatment guidelines to recommend that people living with HIV start treatment sooner, at CD4 counts - a measure of the immune system's strength - of 350 or below. Since then, South Africa has gradually fallen into line, first extending earlier treatment to at-risk groups, such as pregnant women and TB patients in 2010 and finally to all patients in 2011. While activists bemoaned the wait, policy-makers argued they had to make sure the country, which shoulders about 80 percent of its treatment costs domestically, could afford it.

As of March 2011, about 1.5 million people were on ARVs in South Africa. The review expects that number to rise to about three million by 2015.

llg/kn/mw

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94968</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2007/200708221t.jpg"/></td><td valign="top">JOHANNESBURG 27 February 2012 (IRIN) - Mothers, babies and newly diagnosed HIV patients are receiving more of the services they need but progress comes at a cost, according to a new report that predicts a funding shortfall for HIV treatment in South Africa.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Global Fund monies finally released</title><pubDate>Wed, 22 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2008/2008061313t.jpg" />]]>CAPE TOWN 22 February 2012 (IRIN) - More than seven months overdue, the Global Fund to fight AIDS, Tuberculosis and Malaria grant will finally be released to key South African AIDS organizations that have been struggling to survive. Some were on the verge of shutting down.</description><body><![CDATA[CAPE TOWN 22 February 2012 (IRIN) - More than seven months overdue, the Global Fund to fight AIDS, Tuberculosis and Malaria grant will finally be released to key South African AIDS organizations that have been struggling to survive. Some were on the verge of shutting down.

The Global Fund released US$7,106,426.91 to the South African National Treasury on 6 February, the same day seven of the grant's sub-recipients delivered an open letter to Minister of Health, Aaron Motsoaledi [ http://www.plusnews.org/report.aspx?reportid=89140 ], pleading for intervention to bring the Fund's "life-threatening delays" to an end.

Signed by the Treatment Action Campaign (TAC) [ http://www.plusnews.org/report.aspx?reportid=93876 ] and six other sub-recipients of the Fund's Round 6 HIV grant to South Africa, the letter warned of imminent closure of vital community-response programmes across South Africa, a country with one of the world's highest HIV burdens.

The payment, of which US$2,722,555 will be released this week to the sub-recipients, represents about half the total owed by the Global Fund to these community organizations for July-December 2011. It covers human resources only and no programmatic costs. 

Funding crisis

The Fund cancelled its Round 11 funding last November after a funding crisis and allegations of corruption, and early this year executive director, Michel Kazatchkine, resigned. The new general manager, Gabriel Jaramillo, is expected to spearhead a reform process.

The South African sub-recipients of Round 6 funding would like to see some change. "Almost every tranche has been late since the beginning," said TAC treasurer Nathan Geffen. He said that when the July 2011 tranche failed to appear, TAC was initially unsurprised. However, as weeks and then months passed, the situation became untenable.

The blame game

"What has become patently clear is that the Global Fund systems are so complex that neither the Fund nor its principal recipient, the Department of Health, is able to manage the system properly," Geffen told IRIN/Plus News.

Organizations such as TAC, which deliver services on the ground, are not funded directly by the Global Fund. Instead it contracts with a single principal recipient [ http://www.theglobalfund.org/en/performancebasedfunding/actors/1/ ], the health department, encouraging organizations from different sectors to work together.

In theory, this system should simplify administration. But with multiple organizations trying to meet complex reporting requirements, the result appears to have been additional complications that TAC says the health department is not adequately equipped to administer.

Complications 

According to the Global Fund Observer [ http://www.aidspan.org/index.php?page=gfo ] (an independent newsletter on the Global Fund produced by Aidspan), the situation was further complicated by the South African Country Coordinating Mechanism's (the implementing body for the grants, made up of government and local stakeholder organizations, including TAC) desire to consolidate the Round 6 grant with its Round 9 and new Round 10 funding, all of which would then be managed by the health department.

Thus the department and Fund embarked on implementing a "singe-stream-of-funding" negotiation, a process that took longer than expected and was not finalized until 15 December 2011.

"Yesterday, in a formal meeting, the Global Fund people admitted that the main reason for the delay was the attempt to consolidate the round 6, 9, and 10 grants into a single system," Geffen told IRIN/Plus News.

The Fund acknowledges that the single stream funding did slow the grant disbursement, but maintains the fault lay with the grantees. "The Single-Stream-of-Funding grant was delayed as the grant documents did not contain information requested by the Global Fund," Fund spokesperson Marcela Rojo told IRIN/Plus News by email.

Meanwhile, Minister Motsoaledi, who acts as chair of the Country Coordinating Mechanism, told IRIN/Plus News he was not "very sure" if the funding stream was the reason. "We are looking at what [caused] the delay, and we tried to correct everything that could have been wrong," Motsoaledi said.

David Garmaise, a senior analyst at Aidspan, told IRIN/Plus News that most people working on Global Fund programmes agreed that single stream funding was preferable, but that in practice, it was not easy to realize. "The Global Fund, as the agency pushing for this change, has a responsibility to ensure that the transition is handled smoothly, and that care, treatment, prevention and other services are not disrupted in the process," Garmaise said.

Under pressure

Regardless of who is at fault, services in South Africa have been disrupted, and the reality on the ground is grim. Nearly all the sub-recipients have dug deep into reserve funds. Furthermore, the ability to plan activities has been hamstrung.

One of the casualties of the delayed funds has been Soul City, an organization that uses mass media for public health. Soul City's HIV prevention radio programme, broadcast in nine languages across the country, has been scrapped for the time being. "It means that we're not reaching poorer, more rural people in their own languages.
There's a whole range of things we're having to do away with," said programme director Sue Goldstein.

Jack Lewis, director of the Community Media Trust (CMT), a fellow Round 6 sub-recipient, is concerned that the ultimate result of the collapse of programmes like Soul City's and CMT's own popular "edu-tainment" offerings, as well as major programmes such as TAC's treatment literacy campaign, will mean reversing gains in reducing new infections and increasing ART adherence.

"If all these programmes were to collapse, there's no doubt in my mind that there would be a negative impact on the reduction in new infections, which is the holy grail of HIV programmes. We'd also see a worsening of adherence. The need to maintain adherence through motivation versus policing is a vital component of these programmes, so you'd expect to see more problems with that, which means more people have to go on second-line treatment, which is more expensive and adds the possibility of the passing on of the resistant virus," Lewis said.

Meanwhile, the sub-recipients still do not know when they can expect the balance owed from 2011, or 2012's first payment. "I don't see any light at the end of the tunnel. After the meeting [with the Global Fund], we are feeling as hopeless as when we entered," said Geffen.

The Fund maintains that now that single stream funding is in place, recipients will see some change. "The Global Fund is working with the [primary recipient] to improve the quality of grant documents so that the disbursement processes can go more smoothly in the future," said Rojo.

lm/kn/mw

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94927</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2008/2008061313t.jpg"/></td><td valign="top">CAPE TOWN 22 February 2012 (IRIN) - More than seven months overdue, the Global Fund to fight AIDS, Tuberculosis and Malaria grant will finally be released to key South African AIDS organizations that have been struggling to survive. Some were on the verge of shutting down.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Outrage over HIV-positive journalist&apos;s dismissal and deportation</title><pubDate>Mon, 20 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2008/200812015t.jpg" />]]>JOHANNESBURG 20 February 2012 (IRIN) - Allegedly tested for HIV without consent, found positive and subsequently dismissed, detained and deported, a South African journalist is attempting to take his case against Qatar to the International Labour Organization (ILO) to change the country&apos;s HIV travel and employment laws.</description><body><![CDATA[JOHANNESBURG 20 February 2012 (IRIN) - Allegedly tested for HIV without consent, found positive and subsequently dismissed, detained and deported, a South African journalist is attempting to take his case against Qatar to the International Labour Organization (ILO) to change the country's HIV travel and employment laws.
 
More than 100 protestors gathered on 14 Feb outside the Johannesburg offices of Qatari state-owned media company Al-Jazeera to protest the journalist's alleged dismissal due to his HIV-positive status. 
 
The international news agency has denied allegations that the reporter was removed from his post due to his HIV status, but Section27, a South African human rights organization, has lobbied South Africa's delegation to the ILO to lodge a complaint against Qatar for its failure to abide by international labour conventions.
 
Qatar is a signatory to one of the ILO's eight fundamental conventions, the 1958 Discrimination (Employment and Occupation) Convention, which requires states to enact legislation prohibiting employment discrimination on the basis of race, colour, sex, nationality, or religious or political beliefs. [ http://www.ilo.org/ilolex/cgi-lex/convde.pl?R111 ]
 
The 1958 declaration does not address discrimination based on HIV status, but its preamble references the Universal Declaration of Human Rights, which can be interpreted to include HIV, and Section27 attorney Nikki Stein is arguing that the two declarations should be read together.
 
Stein says the South African Ministry of Labour has agreed, but Section27 has not received a response to its request that South Africa lodge a complaint against Qatar at the ILO.
 
If South Africa successfully pursues a complaint, the ILO could issue recommendations to bring Qatar in line with international law, and could then try to ensure they were adopted. This could not only remove HIV travel and employment bans but set a precedent for action against other countries with similar bans that are also signatories to the 1958 convention.
 
Qatar is one of about five countries that deny visas to people living with HIV, and one of about 20 that can legally deport HIV-positive foreigners.
 
Other countries in the region - United Arab Emirate and Kuwait - which depend on migrant labour, all have laws allowing deportation of any HIV-positive foreigner, according to UNAIDS. The reporter says the experience has driven home the discrimination facing many HIV-positive immigrants in the Middle East.
 
"You see this sort of thing in movies and you react with disbelief; you see it happen to other people and it still seems unbelievable," the journalist, who has chosen to remain anonymous, told IRIN/PlusNews. 
 
Chased off and out
 
The reporter relocated to Qatar to take up employment with Al-Jazeera in October 2010. Two months later he was sent for medical tests to finalize his Qatari residence permit, which included an HIV test, but was not informed that he was being tested for the virus. The test results were delayed and he tested again at a clinic in Qatar's capital, Doha. 
 
He alleges that when he returned to collect his results the staff chased him off the premises, and then at a meeting at Al-Jazeera's headquarters he was allegedly ordered into a car and without explanation driven to Doha Prison, where he was detained for several hours and given a public, full-body search before being released. He claims that an Al-Jazeera employee told him he had been dismissed and should leave the country within 48 hours to avoid arrest.
 
Al-Jazeera has denied that the reporter's HIV status was the basis for his dismissal. "Al Jazeera was not privy to his HIV status and at no point was it communicated to the company by either the authorities or by the candidate himself," the news network told IRIN/PlusNews [in an email]. "His HIV status therefore could not have been, and was not, a consideration for us."
 
The news service has also maintained that although it is an equal opportunity employer, its offices must abide by local labour and immigration laws, and employment is conditional upon meeting the requirements for legally working and living in a country.
 
"Al Jazeera was informed that the candidate was denied a residence permit and work visa by the Qatari authorities," Al-Jazeera said in a statement. "Without a work visa a candidate may not pursue employment in the country and due to this, Al Jazeera was under the legal obligation to withdraw the conditional offer of employment which was made to the candidate, a risk which the candidate was made aware of and accepted prior to his acceptance of the offer."
 
No legal recourse 
 
Susan Timberlake, a UNAIDS senior advisor for human rights and law, says people legally residing in a country should be offered the chance to contest deportation, but this is seldom granted to HIV-positive people in countries like Qatar.
 
"So many of the cases we hear about are handled in a very cruel and inhuman way. Summarily deported, they are not able to take their goods back, they don't get their last pay cheque, and if they have money in the bank, they lose it," she told IRIN/PlusNews.
 
"To make matters worse, the reason for their deportation is not kept confidential so... discrimination starts to follow them into their own country," said Timberlake, who added that HIV tests and informing patients of the results is often done without counselling. "It's one of the most devastating experiences people can go through."
 
Stein's client called his deportation one of the most traumatic events in his life. "What Al-Jazeera did to me makes a mockery of their so-called commitment of fair treatment and giving a voice to the voiceless," he told IRIN/PlusNews. 
 
When the law fails
 
UNAIDS has been calling on countries to end HIV travel and employment bans for years, but countries continue to justify them on economic and public health grounds that Timberlake says are flawed. 
 
International law offers recourse when national laws provide none, but she noted that labour-sending countries, like South Africa, may need to start difficult bilateral negotiations to end bans on their citizens.
 
"It's very hard because, from a political point of view, the countries that receive hundreds of thousands of migrants every year call the shots," she said. "The labour-sending countries don't want to challenge these types of practices because their citizens [and economic opportunities] will be affected."
 
llg/kn/he

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94906</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2008/200812015t.jpg"/></td><td valign="top">JOHANNESBURG 20 February 2012 (IRIN) - Allegedly tested for HIV without consent, found positive and subsequently dismissed, detained and deported, a South African journalist is attempting to take his case against Qatar to the International Labour Organization (ILO) to change the country&apos;s HIV travel and employment laws.</td></tr></table>]]></content:encoded></item><item><title>HEALTH: Spending your way out of TB infection</title><pubDate>Fri, 17 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2010/201009201359000234t.jpg" />]]>LONDON 17 February 2012 (IRIN) - A hundred years ago there was no way to treat tuberculosis (TB) except with rest, fresh air and nutritious food. Forty years later the discovery of antibiotics transformed treatment and TB has been a curable disease for more than half a century, but the disease still kills nearly 4,000 people a day. The goals set by the World Health Organization (WHO) to halve the incidence of TB by 2015 and eliminate it as a public health problem by 2050 seem far out of reach.</description><body><![CDATA[LONDON 17 February 2012 (IRIN) - A hundred years ago there was no way to treat tuberculosis (TB) except with rest, fresh air and nutritious food. Forty years later the discovery of antibiotics transformed treatment and TB has been a curable disease for more than half a century, but the disease still kills nearly 4,000 people a day. The goals set by the World Health Organization (WHO) to halve the incidence of TB by 2015 and eliminate it as a public health problem by 2050 seem far out of reach.
 
Mario Raviglione, the head of the WHO Stop TB department, told a meeting of TB experts in London on 15 February: “The incidence is coming down at one percent or so a year, which will ensure TB elimination in several millennia, in my perception.”
 
TB is a disease often associated with poverty because latent infections are more easily activated by malnutrition and lowered immune systems, and more quickly passed on in badly ventilated, overcrowded living conditions. As people in Western Europe got richer, ate better, and housing conditions improved, TB became increasingly rare, even before there were effective drugs to treat it.
 
Now there is interest in seeing whether a new generation of social protection schemes, aimed at reducing poverty and often using cash transfers to the poorest, can be harnessed to bring down the rate of TB in developing countries.
 
Brazil has achieved a steady decrease in TB and has halved the death rate since 1990, despite not achieving the conventional benchmarks for a successful control programme.
 
Draurio Barreira, who coordinates Brazil’s national programme, told the meeting: “To control TB they say we need to detect 70 percent of those infected, treat and cure at least 85 percent of those… and have default rates not bigger than 5 percent. In Brazil we haven’t reached many of these standards, but we have had very good indicators in TB for more than 15 years. So how we can explain that?”
 
He attributes the achievement to political commitment. “The big news was the transformation of social policy… by a real increase in minimum wage, and cash transfer programmes for the poor - in the last sixteen years poverty in Brazil decreased by 67 percent.” And, just as in Europe in the 1800s, as poverty declined, TB declined as well.
 
Cash works

A study in Malawi, also presented at the meeting, showed clear health benefits from even very modest cash transfers to the most disadvantaged households. A pilot scheme gave regular monthly payments to around 10 percent of households, ranging from just over $4 for an elderly person living alone, to nearly $13 for larger families. Children grew better and were less likely to be malnourished, there was less illness in these families and they had more choice of health providers, with the possibility of sometimes using private clinics.
 
An evaluation of the pilot looked at what happened to recipients of cash transfers living with HIV and AIDS, and found the money was being used to pay for the more nourishing food they need to support drug treatment, and for transport to get their antiretroviral (ARV) medication. The effect on TB Patients was not specifically monitored, but the need for a better diet and the cost of travel for tests and to collect drugs also affects TB patients. “The impacts that we are seeing with these people living with AIDS and HIV could absolutely translate over to people living with TB,” says Candace Miller of Boston University, who presented the study.
 
The close association of TB with HIV infection and the emergence of multidrug-resistant (MDR) strains are modern complications since the days when eliminating poverty was enough to get rid of the disease. “[But] HIV-TB globally is 12 percent or 13 percent of all cases, so nearly 90 percent are not HIV related,” Raviglione told IRIN.
 
“If you go outside of Africa - and TB is 75 percent outside of Africa - it doesn’t have the same impact… 60 percent of TB is in Asia, and HIV has little to do with those [cases]. MDR-TB is mostly in the former Soviet Union. Multidrug-resistance is a big scare, but we are talking about less than five percent of all cases of TB - 95 percent are not drug resistant.”
 
Cash payments and incentives specifically aimed at TB patients are more problematic. A trial in South Africa offering shopping vouchers to patients who complied with the protracted drug regime found no clear difference in the success rate of their treatment. However, the trial was partly undermined by clinic staff who felt the vouchers should be given to the poorest, even those randomly selected for the control group.
 
This highlights another issue in targeting social support: the perceived unfairness of giving cash or food to people living with TB while denying it to those who - in the words of another speaker - were ‘sick and struggling’ with other diseases.
 
Targeted interventions may also not be very effective from the public health point of view. Peter Godfrey-Faussett of the London School of Hygiene and Tropical Medicine, which hosted the meeting, argued that the problem with TB control was not the patients in treatment, even if they stopped taking their medicine. The people spreading TB were those who hadn’t been diagnosed but had symptoms and were infectious, and money would be better spent finding those cases and treating them.
 
Rather than targeting known TB sufferers, Brazil will now specifically target some of its anti-poverty programmes at the social groups where the disease is most prevalent to help control TB - the Afro-Brazilian and indigenous communities, those infected with HIV, and especially prisoners, ex-prisoners and the homeless.
 
In most countries the people designing social protection programmes do not prioritize TB control and the initial meeting this week is being followed by smaller working meetings on shifting the focus. “Social protection issues are fundamental in TB control, and that is why TB control now has to go beyond working with national TB programmes… they are too low in the hierarchical agenda of countries,” Mario Raviglione told IRIN.
 
“It is those above who set the real policies… we are talking about a quintessential disease of poverty, which is determined by a bunch of factors which go well beyond health.”
 
eb/he
 
]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94889</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2010/201009201359000234t.jpg"/></td><td valign="top">LONDON 17 February 2012 (IRIN) - A hundred years ago there was no way to treat tuberculosis (TB) except with rest, fresh air and nutritious food. Forty years later the discovery of antibiotics transformed treatment and TB has been a curable disease for more than half a century, but the disease still kills nearly 4,000 people a day. The goals set by the World Health Organization (WHO) to halve the incidence of TB by 2015 and eliminate it as a public health problem by 2050 seem far out of reach.</td></tr></table>]]></content:encoded></item><item><title>FILM: Out of Sight: Blind migrants in Johannesburg</title><pubDate>Wed, 15 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201202161235530807t.jpg" />]]>NAIROBI 15 February 2012 (IRIN) - IRIN’s latest film, Out of Sight, explores the lives of blind undocumented migrants from Zimbabwe as they try and eke out a living begging on the streets of Johannesburg.</description><body><![CDATA[NAIROBI 15 February 2012 (IRIN) - IRIN’s latest film, Out of Sight, explores the lives of blind undocumented migrants from Zimbabwe as they try and eke out a living begging on the streets of Johannesburg.
 
"Life was tough [in Zimbabwe] because of sanctions. There was no food, everything was complicated, no food, no cash," explains Elizabeth, a blind former school teacher. "A friend just told me they are going to South Africa. It’s better when we beg there."
 
But it is a precarious existence for Elizabeth and her companions who share a room in one of the city's many dilapidated and abandoned buildings. After the danger and difficulty of crossing the border, they are confronted by xenophobia in South Africa, which often blames migrants for the country's stubbornly high rates of poverty and unemployment.
 
In the aftermath of xenophobic violence, the South African government put in place a moratorium on deportations to Zimbabwe in 2009, enabling undocumented migrants to regularize their status. But none of the women in this film were able to take advantage of that dispensation. Deportations resumed in October 2011, and to date, more than 10,000 undocumented migrants have been expelled to Zimbabwe, according to the International Organization for Migration.
 
Of the undocumented migrants in South Africa, the disabled are among the most vulnerable. "They just talk, 'We want to send you back, we want to send you back'," says Rachel. "It’s their country, we can’t do anything."
 
For further information:
 
Asylum-seekers resort to border jumping
http://www.irinnews.org/report.aspx?reportid=94820

Deportations of Zimbabwean migrants set to resume
http://www.irinnews.org/report.aspx?reportid=93912

Blind beggars go south
http://www.irinnews.org/report.aspx?reportid=92969
 
]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94869</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201202161235530807t.jpg"/></td><td valign="top">NAIROBI 15 February 2012 (IRIN) - IRIN’s latest film, Out of Sight, explores the lives of blind undocumented migrants from Zimbabwe as they try and eke out a living begging on the streets of Johannesburg.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Migrants face unlawful arrests and hasty deportations</title><pubDate>Tue, 14 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2008/2008022736t.jpg" />]]>MUSINA 14 February 2012 (IRIN) - Four months ago, Clemence Uzizo, 21, a welder living in Soweto, Johannesburg&apos;s most populous suburb, made the mistake of venturing out to a local shop without his asylum-seeker permit. Neither the police who arrested him, nor the immigration officials who detained him, verified Uzizo&apos;s legal status before deporting him to Zimbabwe, the country of his birth.</description><body><![CDATA[MUSINA 14 February 2012 (IRIN) - Four months ago, Clemence Uzizo, 21, a welder living in Soweto, Johannesburg's most populous suburb, made the mistake of venturing out to a local shop without his asylum-seeker permit. Neither the police who arrested him, nor the immigration officials who detained him, verified Uzizo's legal status before deporting him to Zimbabwe, the country of his birth.
 
"My permit was at home but I didn't have a cell phone to call to ask someone to bring it," he told IRIN not long after making a risky and expensive return to South Africa via the Limpopo River. "Since my father brought me [to South Africa] in 1992 I've lived here, so I don't know anyone in Zimbabwe."
 
Uzizo's story is not unusual. In October 2011 South Africa lifted a moratorium that had protected undocumented Zimbabweans from arrest and deportation for more than two years. Since then nearly 10,000 have been forcibly returned, according to the International Organization for Migration (IOM), which runs a reception and support centre for returnees at the Beitbridge border between the two countries.
 
An internal directive issued by the Director-General of South Africa's Department of Home Affairs says deportation should only be carried out after verifying that a suspect has not applied for asylum or any other permits. However, Kaajal Ramjathan-Keogh, who heads the Refugee and Migrant Rights Programme at Lawyers for Human Rights (LHR), said officials at Lindela Repatriation Centre outside Johannesburg, where the vast majority of migrants are held before being deported, often fail to screen new arrivals to establish that they really are undocumented.
 
"We find people with documents who shouldn't have been admitted [to Lindela]," she told IRIN. "It is a huge struggle to have [them] released; we usually have to resort to high court litigation which is time consuming and we can only assist a few people."
 
In a recent submission [ http://www.lhr.org.za/publications/lhr-submission-special-rapporteur-human-rights-migrants ] to the UN Special Rapporteur on the Human Rights of Migrants, LHR noted that "Despite the legal protections afforded to asylum seekers, refugees and other migrants in South Africa, the detention and deportation of foreign nationals is often carried out in an unlawful manner."
 
In the busy border town of Musina, about 10km south of Beitbridge, newly arrived migrants, many of them border jumpers like Uzizo [ http://www.irinnews.org/report.aspx?reportid=94820 ], sleep rough in the vicinity of the Refugee Reception Office where they start queuing in the early hours of the morning in the hope of securing asylum-seeker permits. Despite waiting all day, not all of them reach the front of the queue and those who leave without documents risk arrest by police waiting outside, according to Jacob Matakanye, director of the Musina Legal Advice Office (MLAO).
 
On a recent Friday, three cells at Musina Police Station contained 106 migrants, of which 102 were men held in just two cells. Among them were Zimbabweans, Ethiopians, Somalis, Bangladeshis, Congolese and one Tanzanian, Cassim Mustapha, who had attempted to enter the country via the Beitbridge border post. "I'm claiming asylum because of my sexuality," he told IRIN. "I had a paper from the UN but they just said, 'Where is your passport?' and when I didn't have it, they arrested me."
 
Arresting someone who is claiming asylum because they cannot produce a passport is "completely unlawful", said Ramjathan-Keogh of LHR, but "quite common" at Beitbridge.
 
While the practice of arresting undocumented migrants first and asking questions later appears common in Musina, several organizations, including LHR, IOM and the UN Refugee Agency (UNHCR) have regular access to detainees at the police station and often help secure the release of those with pending asylum applications or lost permits.
 
Access to detainees at Lindela is much more limited. The South African Human Rights Commission is the only organization with an official mandate to monitor immigration detention facilities, but according to LHR, such monitoring has been "haphazard and infrequent".
 
"We rely on clients to tell us who is there and what is going on. It's extremely laborious and frustrating," said Ramjathan-Keogh, adding that the organization was being forced to scale back its assistance to detainees at Lindela due to resource constraints.
 
LHR's submission to the Special Rapporteur notes that detainees at Lindela regularly complain about conditions at the facility, in particular the lack of medical care, but also dirty bedding, inadequate meals, and beatings by security guards and immigration officials.
 
South Africa's immigration law stipulates that detention for the purpose of deportation should not exceed 120 days, but a number of detainees told LHR that they had been at Lindela much longer.
 
The cells at the Musina Police Station are often overcrowded, so deportations to Zimbabwe occur almost every day and detainees from further afield usually spend no more than two weeks there, according to Matakanye of MLAO. The downside of migrants being detained so briefly is that some are deported before agencies like LHR can determine the lawfulness of their case, said Ramjathan-Keogh, noting that there had been several instances of unaccompanied minors being deported from Musina.
 
Médecins Sans Frontières (MSF) has expressed concern about conditions in the police cells, in particular the lack of access to health care [ http://www.irinnews.org/report.aspx?reportid=94511 ] and the absence of screening to determine which detainees are on medication for infectious diseases like tuberculosis (TB) or HIV. "There's still no screening happening," said Christine Mwongera, MSF's project coordinator in Musina, "so there are TB patients being kept in cells with others."
 
Migrants with TB whose treatment is interrupted can develop multidrug-resistant (MDR) strains of the disease. Mwongera noted that "At some point, these people who are being deported might return and they will bring MDR-TB back to South Africa, so it really needs to be deal with."
 
ks/he

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94865</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2008/2008022736t.jpg"/></td><td valign="top">MUSINA 14 February 2012 (IRIN) - Four months ago, Clemence Uzizo, 21, a welder living in Soweto, Johannesburg&apos;s most populous suburb, made the mistake of venturing out to a local shop without his asylum-seeker permit. Neither the police who arrested him, nor the immigration officials who detained him, verified Uzizo&apos;s legal status before deporting him to Zimbabwe, the country of his birth.</td></tr></table>]]></content:encoded></item><item><title>ZIMBABWE: Deportations rob vulnerable of remittances</title><pubDate>Fri, 10 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2007/200710227t.jpg" />]]>HARARE 10 February 2012 (IRIN) - Thousands of Zimbabwean households are feeling the effects of lost remittances from family members forcibly returned from neighbouring South Africa since that country resumed deportations of undocumented Zimbabwean migrants in October 2011.</description><body><![CDATA[HARARE 10 February 2012 (IRIN) - Thousands of Zimbabwean households are feeling the effects of lost remittances from family members forcibly returned from neighbouring South Africa since that country resumed deportations of undocumented Zimbabwean migrants in October 2011.

Makaita Gwati, 60, from rural Chirumhanzi, about 90km from the provincial capital of Masvingo in southeastern Zimbabwe, relied on the income her son and daughter sent from South Africa to support the rest of the family, until both were deported in November last year.

“I counted on them for money to buy food and other essential items, but now that they are here and they can’t find jobs, I don’t know how we will survive,” Gwati told IRIN.

In the last two years, Chirumhanzi has experienced poor rainfall and Gwati has harvested little from her plot of land, forcing her to buy food to feed her family. The remittances from South Africa had also helped support her five grandchildren and pay for medical costs.

“I am worried that given my poor state of health, there is no more money to send me to hospital. As I speak, the [grand]children’s school fees have not been paid and we have been forced to have one meal a day,” she said.

Zimbabwe suffered a decade-long economic crisis characterized by a near collapse of industry, hyperinflation, critical shortages of commodities, poor social services and the migration of millions of Zimbabweans to neighbouring countries and other parts of the world.

The formation of a coalition government and the adoption of multiple currencies to replace the weak Zimbabwean dollar in early 2009 set the economy on a recovery path, but levels of unemployment are still high and large numbers of Zimbabweans continue to try their luck in South Africa.

In April 2009, the South African government announced a moratorium on deportations of undocumented Zimbabwean migrants and the following year gave them the opportunity to regularize their stay by applying for work and study permits through the Zimbabwe Documentation Project (ZDP). The International Organization for Migration (IOM) estimates that 1-1.5 million Zimbabwean migrants are living in South Africa, but only 275,000 had applied to be regularized through the ZDP by the 31 December 2010 deadline. 

IOM, WFP assistance

Since the deportations resumed in October 2011 [ http://www.irinnews.org/report.aspx?reportid=93912 ], IOM has helped nearly 10,000 deportees passing through the reception and support centre it mans at the Beitbridge border post with food, medical care and free transport home. 

According to Felon Murapa, a communications officer with IOM, the organization is prepared to provide similar assistance to as many as 4,000 returnees a month.

The bigger problem for both the government and the donor community will be finding ways to provide longer-term assistance to poor households that depended on remittances from breadwinners who had sought economic refuge in South Africa.

UN World Food Programme (WFP) country director Felix Bamezon described remittances as “an important source of income for vulnerable people, particularly those affected by seasonal food shortages… Most returnees are coming to food insecure hosts or homes and this will certainly put a strain on the already burdened homes," he said.

A 2010 Reserve Bank of Zimbabwe report indicated that Zimbabweans in the diaspora remitted more than US$263 million through formal means alone; most migrants in nearby countries, however, opt to send money through informal channels such as friends and relatives. 

Starting in February, WFP will collaborate with IOM to provide food commodities to deportees coming through the Beitbridge reception centre.

WFP will also include deportees and their dependants in its ongoing programme targeting vulnerable households with food during periods of severe hunger.

Pregnant and breastfeeding returnees may also benefit from WFP's health and nutrition programme, but the increased numbers of people needing help are likely to strain the organization's limited resources.

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]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94830</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2007/200710227t.jpg"/></td><td valign="top">HARARE 10 February 2012 (IRIN) - Thousands of Zimbabwean households are feeling the effects of lost remittances from family members forcibly returned from neighbouring South Africa since that country resumed deportations of undocumented Zimbabwean migrants in October 2011.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Asylum-seekers resort to border jumping</title><pubDate>Thu, 09 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201202090800340187t.jpg" />]]>MUSINA 09 February 2012 (IRIN) - At the Beitbridge border post between Zimbabwe and South Africa, asylum-seekers from all over the continent used to jostle with Zimbabwean migrants to gain entry into a country widely perceived as a place of freedom and safety.</description><body><![CDATA[MUSINA 09 February 2012 (IRIN) - At the Beitbridge border post between Zimbabwe and South Africa, asylum-seekers from all over the continent used to jostle with Zimbabwean migrants to gain entry into a country widely perceived as a place of freedom and safety. 

But since border officials began turning away or arresting so-called “third-country nationals” seeking asylum in April 2011, [ http://www.irinnews.org/report.aspx?reportid=93403 ] they have joined the steady stream of undocumented Zimbabweans who brave dense bush, ruthless gangs, razor wire and the aptly named Crocodile River, to enter the country illegally.

“I paid R290 (US$38) for someone to drive me from Beitbridge to the bush,” said Simeon Mulekezi, a 24-year-old refugee from Burundi. “There were people from Zimbabwe who said they’d help us cross the river but they wanted money so I decided to cross by myself even though the water was up to my neck. I was with four Zimbabweans but none of us knew the way. We got lost for 24 hours and saw a lot of animals. I was scared, but luckily I didn’t meet a lion.”

While Mulekezi survived his ordeal unscathed, “some were robbed in that bush, some were raped,” he told IRIN.

Prior to April 2011, third-country nationals like Mulekezi were able to enter the country via Beitbridge where they were issued with a temporary permit, known as a section 23, which gave them 14 days to report to a refugee reception office and formally apply for asylum. 

Mohamed Hassan, who heads the International Organization for Migration (IOM) office in Musina, noted that since an apparent change in the attitude towards asylum-seekers last April, “we’ve received reports that many people from Somalia and Ethiopia were coming through the bush… They cross the river with the help of guides, but sometimes these very people rob them and many times they find a group of thugs waiting for them.”

Médecins Sans Frontières (MSF), which runs mobile clinics in and around Musina, has been treating migrants who have suffered violent attacks by border gangs known as `guma-guma’ for years, but according to Christine Mwongera, MSF's project coordinator in Musina, staff have seen an increase in trauma cases since the end of 2011.

"The Zimbabweans have been going through this for more than a year, but now it's other nationalities as well," she told IRIN. 

Her observation was confirmed by Christopher Sibanda, head of security for Maroi Farm, 25km west of Beitbridge, who regularly picks up migrants who have wandered onto the property after climbing through one of the many holes in the nearby border fence.

"Every day we find border jumpers. It's worse this year, we see people from other nations [besides Zimbabwe] - Somalis, Congolese, Rwandese," he said. "Most are in a bad state. A week ago we found four people dead; maybe they got lost in the bush and died from hunger and exhaustion."

Robbed and abandoned

He added that some drowned trying to cross the river, particularly during the rainy season, and that he found others stripped of their clothing and possessions after having been robbed and abandoned by their guides or the `guma-guma’. 

"We feel pity for them. Sometimes we make them food or give them directions to the road." Other times, Sibanda hands the migrants over to the army which took over border security from the police in 2010 [ http://www.irinnews.org/report.aspx?reportid=89262 ]

Owner of Maroi Farm, Hannes Nel, said the migrants cut his fences, poached animals and posed a fire risk, but that the army troops deployed along the border lacked the resources to stem the flow. "The fence is in such a poor state, they might as well leave the gates open," he commented.

Indeed, while accompanying Sibanda on one of his patrols, IRIN observed a group of some 10 migrants walking through an open gate in the fence and getting into a waiting vehicle.

Captain George Mills of the Musina police admitted that only a fraction of the vehicles smuggling people from the border were intercepted. "Since the new year... there's been an increase. We don't have the manpower, so most are passing us."

If the purpose of discouraging third-country nationals from approaching the official border post was to improve security, the result may have been the opposite. “When they are coming through the border, you have the opportunity to obtain biometric information,” Hassan of IOM commented. “However, if they come through irregularly, that is when you don’t know who is in the country.”

More border jumpers also means more potential victims for the `guma-guma’. Mills said that police operations targeting their activities rarely resulted in convictions as few illegal migrants were willing to open cases, let alone testify in court. "When we make an arrest and the case comes to court, you can't find the complainant or witnesses so we can't proceed and have to release them," he told IRIN.

Fear of authorities also prevents many of the migrants attacked or injured while crossing the border from seeking health care. "Their aim is to get an asylum permit. Health is not their priority, even if they've been sexually abused or had trauma," said Mwongera of MSF. "If you're undocumented, you want to stay invisible."

MSF partners with the local health department to provide medical and counselling services to survivors of sexual assaults at the Thuthuzela Care Centre in Musina Hospital, but knowing that the first port of call for most of the asylum-seekers is the Refugee Reception Office in Musina, the organization has set up a mobile clinic across the street. Staff also make nightly visits to the town's four shelters where migrants waiting for documents or lacking the funds to continue on to urban centres like Johannesburg and Cape Town are given a place to sleep and one hot meal a day.

Shelter

The shelter for male migrants run by a local church on the outskirts of town consists of little more than a row of tents, and conditions at the women's shelter are only slightly better with one large room accommodating dozens of women and their children in bunk beds. Two more shelters take in unaccompanied children. All are church run, although UNHCR provides meals at the men's shelter and other organizations such as MSF and IOM donate blankets and other non-food items.

"There is no government capacity to provide these services," said Maureen McBrien, who heads the UNHCR office in Musina. "However basic, these churches are doing all they can to provide."

During January, many asylum-seekers were forced to prolong their stay in Musina as officials at the Refugee Reception Office began refusing to assist those without section 23 permits [ http://www.irinnews.org/report.aspx?reportid=94692 ] despite the fact that such permits were no longer being issued at the border. In a 1 February press release, [ http://www.msf.org.za/publication/south-african-immigration-policy-entraps-asylum-seekers ] MSF described the situation as a “cruel Catch-22”, and on the same day, Lawyers for Human Rights won a court case which forced the Department of Home Affairs to accept an asylum application from a Zimbabwean woman who had been arrested after being turned away from Musina’s refugee office for not having a section 23 permit. 

Following the case, large numbers of newly arrived asylum-seekers who had been hanging around Musina for fear of proceeding any further without documents were finally admitted to the Refugee Reception Office and allowed to apply for asylum.

“Yesterday they gave us the forms, so today we’re hoping to make our applications,” said Mulekezi, who was waiting for the office to open its gates early on Friday morning. “I’m wishing to go to Cape Town because there’s freedom there.”

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]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94820</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201202090800340187t.jpg"/></td><td valign="top">MUSINA 09 February 2012 (IRIN) - At the Beitbridge border post between Zimbabwe and South Africa, asylum-seekers from all over the continent used to jostle with Zimbabwean migrants to gain entry into a country widely perceived as a place of freedom and safety.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Refugee children miss out on school</title><pubDate>Tue, 31 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201311400500759t.jpg" />]]>JOHANNESBURG 31 January 2012 (IRIN) - In the inner-city Johannesburg neighbourhood of Berea, where a large proportion of residents are refugees and asylum-seekers, it is not uncommon to see children playing football in the street or killing time at one of the local parks on a weekday. Judith Manjoro, an out-of-work teacher from Zimbabwe, teamed up with some other community workers two years ago to quiz the children about why they were not in school.</description><body><![CDATA[JOHANNESBURG 31 January 2012 (IRIN) - In the inner-city Johannesburg neighbourhood of Berea, where a large proportion of residents are refugees and asylum-seekers, it is not uncommon to see children playing football in the street or killing time at one of the local parks on a weekday. Judith Manjoro, an out-of-work teacher from Zimbabwe, teamed up with some other community workers two years ago to quiz the children about why they were not in school.

“They told us [the schools] asked them to produce ID documents and permits which they don’t have," she said. "We also found the parents weren't working and couldn't afford to pay school fees, even for public schools."

In early 2011, Manjoro and several other unemployed teachers from Zimbabwe and elsewhere, decided to start a project that would go some way towards meeting the need of local refugee and migrant children for affordable schooling with no bureaucratic strings attached. Word quickly spread and today iTemba Study Centre accommodates about 140 children in five cramped classrooms on the first floor of an office building in Berea. In the mornings the centre is open to pre-primary pupils and in the afternoons, seven volunteer teachers teach grades 1-8 using donated textbooks. 

"It's a good school, but we don't have enough supplies," said Duduzile Zulu, 15, from Zimbabwe, who started coming to the centre about a year ago after her mother's income as a waitress failed to cover the cost of her attending a nearby private school. To progress to Grade 9 she will need to transfer to another school, "but I don't have a birth certificate and my Mum can't get time off work to go to [the Department of] Home Affairs," she told IRIN, adding that she knew of other migrant children who did not attend school at all.

The UN Refugee Agency (UNHCR) released a report on refugee education in November 2011 [ http://www.unhcr.org/4ebd3dd39.html ] highlighting the limited access refugee children have to education, particularly at secondary levels and for those living in urban areas. 

Barriers

While the quality of education available in refugee camps varies, the difficulties of accessing education in urban settings are generally greater. In addition to legal and policy barriers and the often prohibitive costs of sending a child to a local school, the UNHCR report noted that: "refugee children often have less support than in a camp-based school in adjusting to a new curriculum, learning a new language, accessing psychosocial support, and addressing discrimination, harassment, and bullying from teachers and peers. They may also encounter a lack of familiarity by local school authorities for the processes of admitting refugee children and recognizing prior learning."

A year-long, yet-to-be published study by the Centre for Education Rights and Transformation at the University of Johannesburg into the rights of refugees, asylum-seekers and migrants to education in South Africa found that schools often demanded documents to enrol a child which are not legally required. 

"Often the students don’t have, according to the schools, the right papers," said Ivor Baatjes, one of the study researchers, adding that school principals and staff at public schools were often ignorant of South Africa's actual policy which grants every child the right to access education. "Even for children of undocumented migrants, children have the right to be in school and nothing should be a barrier," he told IRIN.

Demands that parents pay fees at government schools which have been designated as no-fee schools, create a further barrier, said Baatjes, especially for refugees who are often unaware of the law or of their rights. The study also found that those children who are admitted sometimes have to contend with xenophobic attitudes from both teachers and other pupils.

"They treat people equally here," commented Antonia Tshili, a 16-year-old from Zimbabwe, who left a government school last year after the fees became too much for her mother, and started attending iTemba. "At the other school there is this thing that Zimbabweans should go back to their country; they bullied me."  

UNHCR changes tack

Historically, UNHCR provided scholarships for refugee children to study in government or private schools in urban areas, but with nearly half of refugees now living in urban areas and only 4 percent of UNHCR's total budget in 2010 dedicated to education, this approach is no longer viable and the agency now prioritizes working with governments to advocate the integration of refugees into national school systems. 

In South Africa, UNHCR channels funding through local NGOs which educate refugees about their rights and school principals about their obligation to admit refugee children. Additional funding goes to helping refugee children with school books, uniforms and transport while a new approach, being piloted in Durban, is experimenting with donating lump sum contributions to inner-city government schools on the understanding that they will not turn away any refugee child seeking admission.  

"When you look at most of these schools, they host a number of under-privileged children, not only refugees, and the subsidy from government is not great," said Mmone Moletsane, UNHCR community services officer in South Africa. "While no child should be refused education because there’s no money, schools have to survive."

Despite such efforts by UNHCR and the NGO community, Baatjes said that centres like iTemba and a similar project based at Sacred Heart College in the nearby neighbourhood of Observatory, provided "a much needed space and service" to local migrant and refugee communities.

The donor-funded Three2Six Project at Sacred Heart College, now in its fifth year, uses classrooms vacated by the school's regular pupils during the afternoons, to teach refugee children up to Grade 6 level. The project also employs teachers who are refugees themselves and able to overcome language and cultural barriers.  

"While the parents are busy organizing their lives and trying to get papers from Home Affairs, the children come here," explained project coordinator Esther Oliver Munonoka. "The aim is not to keep the children here, but prepare them for proper school. By the time they leave, they can understand English and integrate into any school."

In reality, however, many of the students stay for as long as they can. Nzanga Kapena, 11, from the Democratic Republic of Congo (DRC), who has been coming to the Three2Six Project since 2008, said her mother could not afford "regular schools" and that she does not know what will happen next year when she finishes grade six and will have to leave. "My sisters and brother, when they left here, they just stayed at home," she said.  

Future uncertain

The future of iTemba and the Three2Six Project are also uncertain. Neither are recognized by the Department of Education or receive any public funding. The Three2Six Project receives enough donations from faith-based organizations in Europe that its 150 students can attend for free and are given uniforms, stationery and books, but is still not fully-funded for 2012 and will likely have to cut its Grade 6 class next year despite what Munonoka describes as an ever increasing need for its services.

iTemba charges those parents who can afford it R200 (US$26) a month to cover rental of the building and to pay teachers a small stipend, but according to Manjoro, "a number are failing to afford it."

"My aunt doesn't pay anything for me to come here," said Sarah Dube*, a 16-year-old from Zimbabwe, whose mother sent her and her sister to South Africa "to get a better education".

"I'd like to go to a proper school, but I don't trust myself that I can make it," she added. "I think I'm behind."

*Not her real name

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]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94766</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201311400500759t.jpg"/></td><td valign="top">JOHANNESBURG 31 January 2012 (IRIN) - In the inner-city Johannesburg neighbourhood of Berea, where a large proportion of residents are refugees and asylum-seekers, it is not uncommon to see children playing football in the street or killing time at one of the local parks on a weekday. Judith Manjoro, an out-of-work teacher from Zimbabwe, teamed up with some other community workers two years ago to quiz the children about why they were not in school.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Red tape ensnares asylum-seekers</title><pubDate>Fri, 20 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2009/200904301429520334t.jpg" />]]>JOHANNESBURG 20 January 2012 (IRIN) - Asylum-seekers entering South Africa are no longer being issued with the necessary documents to apply for refugee status. Without a so-called section 23 permit, they are being turned away from Refugee Reception Offices (RROs) and denied the opportunity to legalize their stay in the country.</description><body><![CDATA[JOHANNESBURG 20 January 2012 (IRIN) - Asylum-seekers entering South Africa are no longer being issued with the necessary documents to apply for refugee status. Without a so-called section 23 permit, they are being turned away from Refugee Reception Offices (RROs) and denied the opportunity to legalize their stay in the country.

“We keep coming back here but they won’t help us without those papers,” said Abdul, a Somali national in one of the queues that had been forming in a patch of wasteland across the street from the Marabastad RRO in Pretoria since the early hours of a recent Wednesday morning. “They tell us to just go back to the border and get deported back to our country.”

“I heard it was easy to get asylum here and I was tired of conflict,” said Mohammed, another Somali who had arrived at Marabastad at 2am to join the queue. “I’ve been here three weeks and this is my fourth time here, I’m just trying my luck. They’re asking for the 14 days (section 23) paper, which I don’t have.”

The section 23 permit is normally issued to anyone entering the country who wants to apply for asylum. It gives them 14 days to report to an RRO and formally apply for refugee status, although following an amendment to South Africa’s immigration law, [ http://www.irinnews.org/report.aspx?reportid=92286 ] the section 23 permit will soon only be valid for five days.

Several observers IRIN spoke to at Marabastad said that since the beginning of December 2011, newly-arrived asylum-seekers had been coming to the office without section 23 permits and were turned away by home affairs officials before they even reached the entrance to the building. 

“They used to take about 100 newcomers a day, but now they turn everyone away, it doesn’t matter what nationality you are,” said Abdi Abdullahi, a Somali national who comes to Marabastad to assist his fellow Somalis with translation every Wednesday - the only day of the week when new applications from East Africans are accepted. “Newcomers have no access so fewer people are coming. Too many people just stay at home without legal permits.”

Refugee office closures

The new and unannounced policy of not issuing section 23 permits appears to have gone into effect just as refugee rights activists were celebrating two high court decisions which questioned the legality of the closure of RROs in Johannesburg and the east coast city of Port Elizabeth by the Department of Home Affairs. 

The Crown Mines RRO in Johannesburg closed in May 2011 following litigation by local businesses who complained about the influx of migrants to the area. Lawyers for Human Rights, on behalf of the Consortium for Refugees and Migrants in South Africa (CoRMSA), an umbrella organization for local refugee and migrant rights groups, challenged the Department’s decision not to open a new RRO in a city which attracts the largest number of refugees and asylum-seekers in the country. 

The court found that the decision had in fact been taken in line with a long-term government policy to eventually move all refugee reception services to the country’s borders, but that the lack of any public consultation on the matter had been unlawful.

Home Affairs’ attempts to close down another RRO in Port Elizabeth in November, also ostensibly due to complaints from local businesses, was again met with court action from local refugee rights groups. A December high court ruling required the department to continue providing services to holders of asylum-seeker and refugee permits pending a full hearing on the matter scheduled for February.

Move to the borders

In December, Amnesty International issued a statement [ http://www.amnesty.org/en/library/asset/.../007/.../afr530072011en.pdf ] registering its alarm at the decision to move all asylum services to ports of entry, noting that “such a move is likely to have a profoundly detrimental effect on the ability of applicants seeking international protection to pursue their claims effectively.”

Following pressure from civil society groups, the Home Affairs Department held a meeting with several NGOs on 21 December in which Lindile Kgasi, chief director of refugee affairs, elaborated on the Department’s intention to move all refugee reception services to the borders as part of a three-year roadmap for “effective and efficient processing and management of asylum-seekers and refugees”.

The roadmap schedules the first of two refugee reception centres to be established at border posts by 2013, with the remaining centres opening in 2014. According to CoRMSA Acting Director Roshan Dadoo, who was present at the meeting, Kgasi said the centres would carry out some initial screening of asylum-seekers for health and security purposes before admitting them into the country, but was vague on the degree of refugee status determination that would take place at the centres and whether asylum-seekers would be detained at borders.

According to Dadoo, Kgasi emphasized that although there were no current plans to detain refugees and asylum-seekers in camps, as many other countries in the region do, she did not rule out this possibility in the future if the current system continued to allow large numbers of economic migrants posing as asylum-seekers to be issued with permits.

“There’s no clarity from them,” commented Dadoo. “They’ve shown us this plan, but they’re not clear at all about what this means in the interim, and now suddenly it seems they’re not giving section 23s.”

A method of exclusion?

The Department of Home Affairs was invited to comment on the non-issuance of section 23 permits, but up until the time of publishing had not responded. However, Dadoo said CoRMSA had received many reports of asylum-seekers without travel documents not being issued with section 23 permits at borders, and that, with the exception of Cape Town, all RRO offices were turning away people who could not produce the permits.

Tina Ghelli, a spokesperson with the UN Refugee Agency (UNHCR) in South Africa, said that according to the 1951 Refugee Convention, an individual is not required to produce identification documents in order to apply for asylum and that UNHCR had raised the issue with Home Affairs.

David Cote of Lawyers for Human Rights pointed out that in terms of South Africa’s Refugees Act, a section 23 permit was also not a requirement for applying for asylum. “It seems to be a method they’re using to exclude people without dealing with the inefficiencies within the Department [of Home Affairs] which are part of the problem,” he told IRIN.

Cote added that the issuing of section 23 permits would in any case become virtually redundant once asylum-seekers were given only five days to report to an RRO, a change likely to be implemented from the beginning of April. As each office assigns only one day of the week to a particular nationality group, most applicants would need to wait up to a week to apply, even once they had managed to get themselves to one of only four remaining RROs in the country.

Corruption

Another significant barrier exists in the form of endemic corruption at the RROs. At Marabastad, many of the asylum-seekers IRIN spoke to claimed it was almost impossible to get an asylum-seeker permit, otherwise known as a section 23, without paying bribes to officials and security guards.

“No one gets a permit without money,” said Halima, who was accompanying a recently arrived Somali woman suffering from malaria. “They give you a newspaper to put money in or they go to the bathroom and look for the money when they come back. Even me, I paid R2,000 (US$252) for a two-year permit.”

Halima’s friend had already been turned away from one hospital because of her lack of a permit, but a home affairs official saw her lying on the ground with little interest, claiming that he could not help her without the section 23 paper. 

“These people are trying to fulfil their obligations according to the law, but the Immigration Act doesn’t provide them with alternatives to seeking asylum,” said Cote.

ks/cb

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94692</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2009/200904301429520334t.jpg"/></td><td valign="top">JOHANNESBURG 20 January 2012 (IRIN) - Asylum-seekers entering South Africa are no longer being issued with the necessary documents to apply for refugee status. Without a so-called section 23 permit, they are being turned away from Refugee Reception Offices (RROs) and denied the opportunity to legalize their stay in the country.</td></tr></table>]]></content:encoded></item><item><title>AFRICA: Snake oil salesmen and dodgy HIV &quot;cures&quot;</title><pubDate>Thu, 19 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/200641010t.jpg" />]]>NAIROBI/JOHANNESBURG 19 January 2012 (IRIN) - Uganda&apos;s National Drug Authority recently arrested sales representatives of a company selling a drug that purports to cure HIV; the firm&apos;s owners are not licensed to sell medicine and are being sought by the police.</description><body><![CDATA[NAIROBI/JOHANNESBURG 19 January 2012 (IRIN) -  Uganda's National Drug Authority recently arrested sales representatives of a company selling a drug that purports to cure HIV; the firm's owners are not licensed to sell medicine and are being sought by the police.  

 The drug, known as Virol ZAPPER, was being sold in 37ml liquid doses, each costing about US$210; patients were advised to take 10 drops daily. It was being advertised on local radio and TV stations as a miracle cure for HIV.  

 The sale of such "cures" is a profitable racket for charlatans willing to take advantage of desperate HIV-positive people; here is a collection of some dodgy treatments that have made the news in Africa over the years:  

 Tanzania - In 2011, tens of thousands of people from all over East Africa flocked to the tiny village of Loliondo [ http://plusnews.org/report.aspx?ReportID=92360 ] in Tanzania seeking a cure for several diseases, including diabetes, tuberculosis and HIV. Ambilikile Mwasapile, a former Lutheran pastor, was charging 500 Tanzanian shillings - about $0.33 - for a cup for his concoction.  

 Several sick people died in the queues, which at their peak numbered 15,000 people. Studies are being conducted to determine the properties of Mwasapile's treatment.  

 South Africa - A 2008 Cape High Court judgment ruled that clinical trials of multivitamins in the treatment of HIV/AIDS by controversial vitamin salesman Matthias Rath [ http://plusnews.org/report.aspx?ReportID=78739 ] were unlawful, and stopped them. The court also prohibited Rath from publishing any more advertisements claiming that his product, VitaCell, cured AIDS, pending further review by the Medicines Control Council.  

 Rath, who had been operating in South Africa since about 2004, claimed his multivitamins treated AIDS, heart disease, cancer, diabetes, bird flu and numerous other illnesses. Rath ran numerous advertisements aimed at convincing HIV-positive people to take his high-dose multivitamins rather than ARVs, available free-of-charge through the public health system, which he claimed were "toxic".  

 Kenya - In 2008, the government warned HIV-positive people in the country's eastern Coast Province [ http://www.plusnews.org/Report.aspx?ReportId=79915 ] to reject herbal "cures" peddled by fake herbalists who claimed their concoctions contained unique ingredients that could boost the immune system and even cure HIV.  

 An estimated 80 percent of Kenyans use traditional healers either exclusively or in conjunction with western medicine; the government is drafting regulations to stop fraudulent herbalists from practising.  

 Gambia - In 2007, President Yahya Jammeh was roundly denounced by AIDS activists when he said he had found a cure for HIV/AIDS and began treating citizens. Shortly after his announcement, Jammeh expelled [ http://www.plusnews.org/report.aspx?ReportID=70123 ] the most senior UN official in the country for questioning his "cure".  

 The programme is still running, but more Gambians are choosing ARVs over Jammeh's treatment.  

 Ethiopia - In 2007, thousands of HIV-positive patients flocked to Entoto, an ancient mountain north of the capital, Addis Ababa, seeking a "holy water" [ http://plusnews.org/report.aspx?ReportID=72375 ] cure for AIDS after local priests said they could cure HIV.  

 The Archbishop of the Ethiopian Orthodox Church, Abune Paulos, later advised patients to continue with their ARVs even as they sought healing at Entoto.  

 São Tome and Principe - In 2007, questions were raised about Dorviro-Sida, [ http://plusnews.org/report.aspx?ReportID=74543 ] or "Put AIDS to sleep" in Portuguese, an anti-AIDS herbal remedy produced by Amancio Valentim, president of the Association of Traditional Medicine of São Tome and Principe. Valentim claimed three tablespoons of the brownish syrup, taken every day before meals, could reduce the viral load and make patients feel better; he said four patients who had taken the drug for four years had tested negative for HIV.  

 AIDS activists were concerned the drug could make HIV-positive people complacent about taking their ARVs, and the health ministry said it did not support Valentim's treatment.  

 South Africa - In 2006, a clinic in South Africa's east coast city of Durban began to sell "ubhejane" [ http://plusnews.org/report.aspx?ReportID=39547 ] - a herbal mixture believed to treat HIV/AIDS.  

 The controversial traditional medicine received vast media coverage, mainly due to the backing it received from influential political figures such as the former health minister, Dr Manto Tshabalala-Msimang, and provincial health officials. Ubhejane, a dark brown liquid sold in old plastic milk bottles, had not undergone any clinical trials to test its efficacy. All that the tests confirmed was that it was not toxic.  

 But HIV-positive patients were far more willing to accept the traditional medicine as an effective remedy, flocking to the clinic to buy a full course of the herbal remedy that retailed at R374 ($40).  

 Uganda - In 2006, the Ugandan government banned the use of a popular anti-AIDS herb remedy known as "Khomeini" [ http://plusnews.org/report.aspx?ReportID=39532 ], after tests found it provided no cure. Iranian Sheikh Allagholi Elahi claimed the drug - which contained olive oil and honey and cost $1,650 per dose - could cure HIV/AIDS and TB in three weeks.  

 Studies by experts in Uganda and Kenya found that while patients had gained weight due to the nutritional content of the drug, it was incapable of curing HIV.  

 kr/kn/mw]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94679</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/200641010t.jpg"/></td><td valign="top">NAIROBI/JOHANNESBURG 19 January 2012 (IRIN) - Uganda&apos;s National Drug Authority recently arrested sales representatives of a company selling a drug that purports to cure HIV; the firm&apos;s owners are not licensed to sell medicine and are being sought by the police.</td></tr></table>]]></content:encoded></item><item><title>Analysis: South Africa - paper tiger of African peacekeeping operations</title><pubDate>Fri, 06 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2010/201005261538140561t.jpg" />]]>JOHANNESBURG 06 January 2012 (IRIN) - There is an expectation - and has been for several years - that Africa’s economic powerhouse, South Africa, would become a leading player in the continent’s peacekeeping operations, but analysts say this is wishful thinking at best, and possibly misguided.</description><body><![CDATA[JOHANNESBURG 06 January 2012 (IRIN) - There is an expectation - and has been for several years - that Africa’s economic powerhouse, South Africa, would become a leading player in the continent’s peacekeeping operations, but analysts say this is wishful thinking at best, and possibly misguided. 
 
 “The international community expects more from South Africa [in a peacekeeping role], but South Africa is not deploying the amounts of troops and equipment expected of them,” Jakkie Cilliers, executive director of Pretoria-based think-tank Institute for Security Studies (ISS), told IRIN. “It all goes back to an overstretched department [of defence], lack of funding, transformation - which bedevils discipline - and operational capacity.” 
 
 South Africa's defence policy since the end of apartheid in 1994 has prevented the country from taking a bigger role in African peacekeeping operations. The tone was set by the ruling ANC government's 1996 White Paper entitled Defence in Democracy, which made the primary role of the armed forces defence against external aggression. 
 
 The 1998 Defence Review led South Africa to conclude a multi-billion-dollar arms deal in 1999 in which it acquired a range of sophisticated weaponry - from Gripen fighters and Hawk training jets to submarines and corvettes - "inappropriate" for peacekeeping duties, Cilliers said. 
 
 The idea that South Africa faced any conventional armed threats to its territorial integrity was "mythical", he] said, in either the short or medium term, and the country’s role as regional super-power should be to stabilize the region. 
 
 Former president Thabo Mbeki was against a more active peacekeeping role on the continent: He had an "aversion" towards peacekeeping, viewing it as intervention, and preferred dialogue, Cilliers said. 
 
 The real threats to South African security were organized crime, illegal exploitation of marine resources and uncontrolled migration flows, Cilliers said. 
 
 Wrong equipment 
 
 The cost of the 1999 arms deal, which according to some independent estimates had risen to R70 billion (US$8.5 billion) by 2011, had left the country with military hardware that was both "expensive to maintain and which will probably never be used... This is the long-term tragedy of the arms deal [in that it constrains South Africa’s peacekeeping abilities],” Cilliers said. 
 
 Greg Mills, head of the Brenthurst Foundation, a South African think-thank established by diamond magnates Nicky and Jonathan Oppenheimer, said in a 2011 discussion paper entitled An Option of Difficulties? A 21st Century South African Defence Review, [ http://www.thebrenthurstfoundation.org/a_sndmsg/news_view.asp?I=118323&PG=288 ] that South Africa had fallen between two stools in its military vision. 
 
 “At the heart of any force design is the necessity of deciding which league you want to play in - and then fund at that level. Put differently, there’s no point in buying a luxury SUV if you can’t afford to fill the tank or replace the tyres.” 
 
 A 2010 Jane's Defence Weekly report said: "Perhaps the most startling illustration of under-funding is that the air force will only have 550 flying hours for its fighter force this year and 250 hours in each of the next two, just when it planned to `work up' on the new Gripen; lead-in fighter training on the Hawk has been cut from 4,000 hours to 2,000. The South African Air Force (SAAF) had planned the Gripen to be fully operational by 2012, but that is now clearly unattainable.” 
 
 2011 defence review 
 
 In 2011 South Africa, a non-permanent member of the UN Security Council, embarked on a defence review (expected to be released for public comment later this year), but it appears that a policy shift towards creating a greater peacekeeping capacity is not on the cards. 
 
 Defence Ministry spokesman Siphiwe Dlamini told IRIN the primary function of the defence force was expected to remain preparedness against external aggression. 
 
 When the ANC came to power in 1994 it inherited a disparate defence force, made up of its own soldiers; other liberation movement operatives; career soldiers from the apartheid armed forces; and various elements of the Bantustan armies of the nominally independent homelands of Transkei, Venda, Ciskei and Bophuthatswana. 
 
 The London-based International Institute for Strategic Studies (IISS) [ http://www.iiss.org/ ] which specializes in military-political affairs, said in its annual 2011 Military Balance report that South Africa had about 62,000 uniformed troops, 12,000 civilian support staff and a reserve force of 15,000. 
 
 At a media briefing in September 2011, Defence Minister Lindiwe Sisulu said 2,304 military personnel were on peace support operations in the Democratic Republic of Congo (DRC), Sudan (Darfur), and the Central African Republic. 
 
 Burundi, a comparative minnow in terms of population and economy and recently a host to South African peacekeepers, currently deploys more troops to peacekeeping operations on the continent than South Africa, according to the IISS 2011 Military Balance report. (Burundi's deployments in Somalia are peace enforcement rather than peacekeeping). 
 
 At a defence review workshop in Cape Town on 24 November 2011, Sisulu said the “emerging consensus” for African countries was to assume responsibility for managing regional conflicts, and “South Africa is expected to play a significant role in this.” 
 
 However, Brenthurst Foundation’s Mills said the South African defence force was “battling” to make ends meet. The 2011-2012 defence budget was R34.6 billion, of which R22.5 billion was for personnel, R8.65 billion was operational costs and R3.5 billion capital costs. 
 
 Constraints… like drunkenness 
 
 Emmanuel Nibishaka in a paper for the Rosa Luxemburg Foundation [ http://www.rosalux.de/english/foundation.html ] entitled South Africa’s Peacekeeping Role In Africa: Motives and Challenges of Peacekeeping [ http://www.rosalux.co.za/wp-content/files_mf/1297156628_21_1_1_9_pub_upload.pdf ] published in February 2011, cited additional constraints. He identified high HIV/AIDS infection rates, aging soldiers, a top-heavy officer class, and a “serious skills shortage”. 
 
 Nibishaka said more than half the soldiers were medically unfit, with many seen as too old for active service. He added: “Due to a lack of funds the army can deploy only one operational brigade of 3,000… Military equipment is in an appalling state with only 20 out of 168 Olifants [tanks] and 16 out of 242 Rooikat armoured cars being deployed due to budget constraints.” 
 
 Since 1994 the reputation of South African peacekeepers has been tarnished by “unruliness”, Nibishaka said, including drunkenness, public brawls, consorting with sex workers, sexual harassment and murder. 
 
 “For example, the South African military in Burundi from 2002 to 2008 recorded some 400 cases of misdemeanour and approximately 1,000 military trials were heard. In DRC, the record was equally dismal,” Nibishaka said in his paper. 
 
 The changing nature of conflict 
 
 Conventional conflicts, defined as confrontations between standing armies, are rare these days. “Warfare today has largely gone back to being a task of light infantry and modern cavalry, where numbers (and getting them there) are the important aspect, along with critical enablers of intelligence, surveillance and local knowledge,” says Mills. 
 
 Current and future instability, both internationally and in sub-Saharan Africa, was “likely to be so-called `small’ wars between ill-defined often non-state opponents, fighting for complex sets of causes ranging from greed to deeply entrenched grievances, fought at a low-intensity, employing mostly small arms. These are most likely to be fought not over territory but over ideas and symbols, among, rather [than] between peoples," he said. 
 
 South Africa's defence force should engage a younger, computer literate generation in order to grapple with the complexities of peacekeeping and peace-building; and use hi-tech, low cost, drones to monitor marine resources for "pollution; overfishing and piracy", he said. 
 
 Quick reaction forces 
 
 The Africa Union is currently building capacity for the establishment of an African Standby Brigade, a quick reaction force of five brigades, each comprising about 6,500 soldiers. Each brigade is expected to be drawn from contributions from members states of Africa’s economic trading blocs, such as the Southern African Development Community (SADC) and Economic Community of West African States (ECOWAS). 
 
 In September 2009, Exercise Golfinho, a training exercise for the Southern Africa Standby Brigade (SADCBRIG), saw South Africa host 7,000 troops from 12 countries, and was deemed as a success, IISS said. 
 
 "After the exercise, SADCBRIG declared that it could deploy to any location in Africa or even beyond, though the group did add the important caveat that this was dependent on available strategic lift and sustainable logistical support - two factors that remain substantial impediments for all Standby Brigade operations," the IISS 2011 Military Balance report said. 
 
 However, the Golfinho post-mortem virtually coincided with the new administration of ANC President Jacob Zuma announcing the cancellation of heavy-lift military transport aircraft, seen by military analysts as vital for reacting to mass atrocities. 
 
 Heavy lift aircraft 
 
 South Africa ordered eight Airbus military A400m transport aircraft in 2005 at a cost of about US$1 billion, but cancelled the order, citing financial constraints and associated cost increases, and was reimbursed the $407 million down-payment on 19 December 2011 by the European aircraft manufacturer. The transport aircraft was expected to enter service in 2013. 
 
 Helmoed-Romer Heitman, a military and defence analyst and senior correspondent for Jane’s Defence Weekly, told IRIN: “If you don’t have the airlift, you can’t do peacekeeping. You just can’t do it. I think they [South African government] have shot themselves in the foot.” 
 
 South Africa remains reliant on nine Lockheed Martin C-130 Hercules transporters, of which four were currently operational, Heitman said. 
 
 go/cb

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94597</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2010/201005261538140561t.jpg"/></td><td valign="top">JOHANNESBURG 06 January 2012 (IRIN) - There is an expectation - and has been for several years - that Africa’s economic powerhouse, South Africa, would become a leading player in the continent’s peacekeeping operations, but analysts say this is wishful thinking at best, and possibly misguided.</td></tr></table>]]></content:encoded></item><item><title>SOUTHERN AFRICA: Floods leave Angolan returnees stranded</title><pubDate>Fri, 06 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2008/2008111111t.jpg" />]]>JOHANNESBURG 06 January 2012 (IRIN) - Several thousand Angolan returnees from the neighbouring Democratic Republic of Congo (DRC) are stranded by floods in northeastern Angola. They are among the first casualties of what promises to be a very wet rainy season in parts of southern Africa.</description><body><![CDATA[JOHANNESBURG 06 January 2012 (IRIN) - Several thousand Angolan returnees from the neighbouring Democratic Republic of Congo (DRC) are stranded by floods in northeastern Angola. They are among the first casualties of what promises to be a very wet rainy season in parts of southern Africa. 
 
 “At least 50,000 people - 24,000 of them returnees - in 10 villages in Uige Province [northeastern Angola near border with DRC] have been affected by the flooding, rains and hailstorms in the past four months,” said Antonio Maiandi, head of the Evangelical Reformed Church of Angola, which has been trying to help those affected. The rainy season here tends to be longer than elsewhere in Angola. 
 
 “It is still pouring hard. At least 1,142 houses have been destroyed by the rains. Each family with shelter is now hosting other families,” said Maiandi, adding that the returnees, who had sought refuge from the civil war in Angola which ended in 2002, were putting enormous pressure on locals, and organizations such as his. 
 
 “The local population who are mostly farmers have been severely affected. Their cassava [staple food in Angola] and groundnut crops have been destroyed, so there is not enough food to go round.” 
 
 The UN Refugee Agency (UNHCR) restarted formal repatriation of Angolans in November 2011 after logistical and other problems forced the process to stop in 2007. DRC is home to some 80,000 Angolans refugees, according to UNHCR. 
 
 The new return initiative comes after a UNHCR survey in 2010 found that 43,000 wanted to return home, and following a tripartite agreement between Angola, DRC and UNHCR (signed in June 2011), around 20,000 people signed up for help to return. The agreement came about after years of tense relations between the two countries: Angolan and Congolese nationals have been expelled from the two countries regularly. [ http://www.irinnews.org/report.aspx?reportid=93004 ] [ http://www.irinnews.org/report.aspx?reportid=90906 ]
 
 “The local population is extremely poor and unable to support the returnees,” and “people are still coming in every day,” said Maiandi. 
 
 UNHCR in Angola told IRIN they took a break in December 2011 and would resume formal repatriation on 17 January, but did not have an update on the number of people who had already arrived. 
 
 According to aid workers, increasing instability in the DRC following the recent disputed elections could be prompting more people to leave. 
 
 Maiandi said the returnees had not received adequate support from the authorities and church organizations had limited resources. 
 
 Meteorologists for the Southern African Development Community (SADC) have predicted normal to above normal rains for most of the region from January to March 2012 largely because of the continuing effects of the 2011 La Niña event. [ http://www.irinnews.org/report.aspx?reportid=91746 ] Thousands of people in the region were displaced and scores killed in early 2011 as a result of heavy rains and flooding associated with La Niña. 
 
 Zimbabwe 
 
 As the rainy season begins here, aid workers and disaster prevention teams are closely monitoring water levels in the all-important Zambezi river, the continent's fourth largest. 
 
 The authorities have issued a flood alert after being forced to release water from the swollen Kariba Dam on the Zambezi earlier than usual in the rainy season. 
 
 The Zambezi River Authority (ZRA) which usually opens the spillway gates of Lake Kariba in the last two weeks of January was forced to open one of the gates on 3 January. It has advised people living downstream to evacuate their homes. 
 
 Zambia 
 
 Zambia is in for a mixed season. Dominicano Mulenga, national coordinator of Zambia's Disaster Management and Mitigation Unit, said a plan had been drawn up to help 368,953 people likely to be affected by rain and dry spells. While northwestern and western parts of the country had seen heavy rain, southern, eastern and parts of central Zambia were likely to receive little or no rain, he said. 
 
 The water level in the Zambezi was higher than at the same time in 2011, he added. “We have had three seasons of heavy rainfall and the ground is saturated with water, making it more prone to flooding.” 
 
 Namibia 
 
 Namibians, currently experiencing a heat wave, are eager for rain, said Guido van Langehove, chief of the Namibia Hydrological Services. Southern African Development Community (SADC) meteorologists have forecast normal to above normal rains for Namibia over the next three months. “It was the same forecast last year and we recorded three times the normal rain,” van Langehove pointed out. 
 
 The Caprivi Region, Namibia’s poorest area, is prone to annual flooding. 
 
 Japhet Itenge, director of Disaster Risk Management in the Office of the Prime Minister, said they were prepositioning essential commodities and relief tools as part of their contingency plans. 
 
 Lesotho 
 
 Lesotho has not received adequate rainfall in the past few months, a spokesman for the country’s meteorological services told IRIN. “SADC has forecast heavy rains for Lesotho in the coming weeks. We are worried it can cause early frost and destroy crops that have already been planted,” he said. 
 
 Lesotho and Namibia have food insecurity levels greater than their five-year averages due to the severe flooding experienced during the last growing season, according to FEWSNET. 
 
 Mozambique 
 
 The Mozambican authorities have begun to release water from the Cahora Bassa Dam on the Zambezi. People living mainly along the lower Zambezi basin and in Buzi, Save, and Pungue basins, including Beira city, are on alert. 
 
 Sofala Province in central Mozambique is currently distributing items such as bicycles, stretchers, masks, gloves, megaphones and boats, according to the Mozambique Red Cross; and members of seven local disaster risk management committees established in Beira City are cleaning the drainage system. 
 
 The National Institute of Disaster Management (INGC) is monitoring the rivers Montepuez, Licungo, Mutamba, Pungué, Buzi, Save, and Maputo, said FEWSNET. In the Zambezi and Limpopo river basins, FEWSNET warned of a near-average-to-high probability of flooding. 
 
 João Bobotela, CARE’s emergency response coordinator in Mozambique, said INGC and local authorities had been running flood simulation exercises since November 2011 to prepare communities for sudden evacuations. 
 
 Botswana 
 
 Arid Botswana has not received good rains in the past few months. “We are expecting average rains which might help crops,” said a spokesman for the Botswana Meteorological Services. 
 
 Malawi 
 
 More rains have been forecast for southern Malawi, where land adjacent to the River Shire, one of the most food-insecure parts of the country, is prone to flooding. Parts of the region, which has seen an outbreak of foot and mouth disease and a hike in food prices, are in crisis mode, warned FEWSNET. 
 
 South Africa 
 
 Much-needed rain has fallen in South Africa’s major maize-producing northern Free State area in the past few weeks. The government and USAID’s Famine Early Warning Systems Network (FEWSNET) say the country has adequate supplies, but global maize stocks are low, putting considerable upward price pressure on South African white maize. 
 
 jk-dd/cb 

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94598</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2008/2008111111t.jpg"/></td><td valign="top">JOHANNESBURG 06 January 2012 (IRIN) - Several thousand Angolan returnees from the neighbouring Democratic Republic of Congo (DRC) are stranded by floods in northeastern Angola. They are among the first casualties of what promises to be a very wet rainy season in parts of southern Africa.</td></tr></table>]]></content:encoded></item><item><title>SOUTHERN AFRICA: Pick of the year 2011</title><pubDate>Thu, 29 Dec 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2011/201106091122580057t.jpg" />]]>JOHANNESBURG 29 December 2011 (IRIN) - In 2011 the global economic crisis combined with poor governance, financial mismanagement and unpredictable rainfall to push several southern African countries to the point of crisis. Others responded to rising unemployment and increased pressure on national budgets by hardening their attitude towards immigrants and closing their borders to asylum-seekers. IRIN covered developments from all over the region, but the following stories consistently grabbed headlines:</description><body><![CDATA[JOHANNESBURG 29 December 2011 (IRIN) - In 2011 the global economic crisis combined with poor governance, financial mismanagement and unpredictable rainfall to push several southern African countries to the point of crisis. Others responded to rising unemployment and increased pressure on national budgets by hardening their attitude towards immigrants and closing their borders to asylum-seekers. IRIN covered developments from all over the region, but the following stories consistently grabbed headlines: 
 
 1. Swaziland's financial meltdown - As early as January, the International Monetary Fund (IMF) was warning that drastic measures were needed to stave off a financial crisis in the tiny mountain kingdom of Swaziland. [ http://www.irinnews.org/report.aspx?reportid=91609 ] The IMF's recommendations were largely ignored and the country's economic freefall continued with the main losers being the elderly whose pensions were suspended, [ http://www.irinnews.org/report.aspx?reportid=92263 ] orphans and vulnerable children whose school fees went unpaid, [ http://www.irinnews.org/report.aspx?reportid=93726 ] people living with HIV who faced an uncertain supply of antiretroviral drugs, [ http://www.irinnews.org/report.aspx?reportid=93256 ] and subsistence farmers who stopped receiving government support. [ http://www.irinnews.org/report.aspx?reportid=94113 ] The outlook for 2012 does not look any better with officials already predicting an increase in food security for most Swazis. [ http://www.irinnews.org/report.aspx?reportid=94481 ] 
 
 2. Malawi's escalating political and economic crisis - Concerns about human rights and economic mismanagement saw Malawi fall out of favour with Western donors who had provided 40 percent of the country's budget. The withdrawal of UK aid to the country in June hit the healthcare sector particularly hard. [ http://www.irinnews.org/report.aspx?reportid=92877 ] President Bingu wa Mutharika's increasingly autocratic rule, together with rising food prices and fuel shortages, contributed to widespread protests in July. The security forces' heavy-handed response, which left at least 18 people dead, [ http://www.irinnews.org/report.aspx?reportid=93325 ] did nothing to restore donor confidence in the government. Poverty looks set to worsen in rural areas where many smallholder farmers are no longer benefiting from a reduced Farm Input Subsidy Programme [ http://www.irinnews.org/report.aspx?reportid=93954 ] and in urban areas where a slew of price increases are already taking their toll on the poor. [ http://www.irinnews.org/report.aspx?reportid=94498 ] 
 
 3. Deepening poverty in Madagascar - Two years after a coup which deposed President Marc Ravalomanana, Madagascar's political crisis remains unresolved and sanctions which froze all but emergency donor aid remain in place. IRIN's coverage tracked how the country's political stalemate has made an already poor country, even poorer [ http://www.irinnews.org/report.aspx?reportid=92236 ] with the demise of free primary school education, [ http://www.irinnews.org/report.aspx?reportid=92235 ] a severely under-funded health sector and increasing levels of food insecurity made worse by a shortage of rain followed by flooding. [ http://www.irinnews.org/report.aspx?reportid=91970 ] In one impoverished town, IRIN followed a group of girls who had abandoned school to pan for a few flecks of gold. [ http://www.irinnews.org/report.aspx?reportid=92938 ] Signs that the country might finally be moving towards the restoration of democracy have not been enough to lift the sanctions, but donors have continued to find ways to deliver desperately needed aid. [ http://www.irinnews.org/report.aspx?reportid=94351 ] 
 
 4. Continuing political instability in Zimbabwe - Zimbabwe's unity government remains far from unified and incidents of political violence escalated following President Robert Mugabe's call for elections. [ http://www.irinnews.org/report.aspx?reportid=91506 ] Despite some improvements in the dire state of affairs at public health facilities [ http://www.irinnews.org/report.aspx?reportid=93765 ] and more assistance to orphans and vulnerable children, [ http://www.irinnews.org/report.aspx?reportid=93858 ] mainly due to donor programmes, many Zimbabweans still faced economic hardship in 2011. Dry weather in the country's southern provinces caused crops to fail and put an estimated one million rural Zimbabweans in need of food assistance by the end of the year. [ http://www.irinnews.org/report.aspx?reportid=94286 ] In urban areas, a shortage of clean water and sanitation caused an outbreak of typhoid [ http://www.irinnews.org/report.aspx?reportid=94237 ] and created the conditions for a potential resurgence of cholera. [ http://www.irinnews.org/report.aspx?reportid=94452 ] 
 
 5. South Africa’s borders - The region's most developed nation is a magnet for migrants, but economic pressures fuelled continuing attacks on foreigners in 2011, particularly those operating shops in townships. [ http://www.irinnews.org/report.aspx?reportid=93130 ] The government's handling of xenophobia was deemed inadequate by civil society groups [ http://www.irinnews.org/report.aspx?reportid=93130 ] while changes in policy indicated an official hardening of attitudes towards migrants. [ http://www.irinnews.org/report.aspx?reportid=94337 ] A two-year moratorium on deportations of undocumented Zimbabweans came to an end in October, [ http://www.irinnews.org/report.aspx?reportid=93912 ] new legislation created more hurdles for asylum-seekers [ http://www.irinnews.org/report.aspx?reportid=92286 ] and an unofficial policy of barring migrants from entering the country had a knock-on effect in neighbouring countries. [ http://www.irinnews.org/report.aspx?reportid=93403 ] 
 
 6. Flooding and livelihoods - Heavy rain at the beginning of the year brought localized flooding to many parts of the region, decimating crops and testing authorities' disaster preparedness. [ http://www.irinnews.org/report.aspx?reportid=91754 ] The floods claimed 104 lives in Namibia and a further 91 in South Africa, [ http://www.irinnews.org/report.aspx?reportid=93294 ] washed away the possibility of a harvest for subsistence farmers in Lesotho [ http://www.irinnews.org/report.aspx?reportid=91925 ] and threatened the food security of affected populations throughout the region. [ http://www.irinnews.org/report.aspx?reportid=91881 ] 
 
 ks/cb

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94564</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2011/201106091122580057t.jpg"/></td><td valign="top">JOHANNESBURG 29 December 2011 (IRIN) - In 2011 the global economic crisis combined with poor governance, financial mismanagement and unpredictable rainfall to push several southern African countries to the point of crisis. Others responded to rising unemployment and increased pressure on national budgets by hardening their attitude towards immigrants and closing their borders to asylum-seekers. IRIN covered developments from all over the region, but the following stories consistently grabbed headlines:</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Migrants’ health care hit by deportations</title><pubDate>Tue, 20 Dec 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2007/200710227t.jpg" />]]>JOHANNESBURG 20 December 2011 (IRIN) - While most nations are dependent to some extent on the world’s 214 million migrants for skills and labour, few ensure these migrants have access to their health systems, something that could have dire public health consequences, according to the International Organization for Migration (IOM).</description><body><![CDATA[JOHANNESBURG 20 December 2011 (IRIN) - While most nations are dependent to some extent on the world’s 214 million migrants for skills and labour, few ensure these migrants have access to their health systems, something that could have dire public health consequences, according to the International Organization for Migration (IOM). 
 
 Describing migrants’ lack of access to health services as “one of the biggest challenges facing global health today”, IOM marked International Migrants Day on 18 December by calling for more migrant-inclusive health policies. 
 
 In many countries, health care for undocumented migrants is limited to emergency care. “Such restrictions lead to poor health outcomes for the individual and increase public health risks, particularly if it concerns infectious diseases," noted IOM in a press statement [ http://www.iom.int/jahia/Jahia/media/news-releases/newsArticleEU/cache/offonce/lang/en?entryId=31032 ]. 
 
 Even in countries that do not bar migrants from accessing health services, barriers remain. "Migrants often don’t feel comfortable accessing health services in their new country," said Barbara Rijks from IOM's Migration Health Division in Geneva. Language differences, cost and administrative hurdles can also create problems, as well as negative attitudes towards migrants by healthcare workers. 
 
 For undocumented migrants, the greatest deterrent to seeking health care is often the fear of arrest and deportation. 
 
 South Africa is among the few countries which, according to its constitution, guarantees "everyone" the right to health care. In practice, HIV and human rights activists have battled to get healthcare workers to recognize those rights, particularly in the case of undocumented migrants who are HIV-positive and in need of life-prolonging anti-retroviral drugs (ARVs). [ http://www.plusnews.org/report.aspx?reportid=77493 ] 
 
 According to Jo Vearey, a researcher with the African Centre for Migration and Society (ACMS) at the University of Witwatersrand in Johannesburg, the situation of undocumented Zimbabweans, who make up by far the largest portion of South Africa's migrant population, improved slightly during a two-year moratorium on their arrest and deportation, but with the lifting of the moratorium in early October 2011, [ http://www.irinnews.org/report.aspx?reportid=93912 ] Vearey said Zimbabwean migrants were again steering clear of public health facilities. 
 
 "Since the middle of this year when the ending of the moratorium was discussed, we’ve been aware of individuals feeling forced to go underground," she told IRIN. 
 
 Public health warning 
 
 In an issue brief released by ACMS in October, [ http://www.migration.org.za/publication/issue-brief/2011/deportation-and-public-health-concerns-around-ending-zimbabwean-documen ] Vearey and her co-author warned of the public health implications of a poorly managed deportation policy, not only for the affected migrants but for the region. 
 
 They urged the departments of health and home affairs along with the South African Police Service to issue clear protocols addressing issues such as how to screen detainees to identify those on chronic treatment or with other medical needs and how to prevent infectious diseases being transmitted in crowded detention centres. They also recommended government and non-governmental monitoring of detention facilities to ensure they were equipped to provide basic health care, including HIV/AIDS and TB treatment.

 Since October, a reported 6,500 migrants have been deported via South Africa's Beitbridge border with Zimbabwe. However, according to Vearey, the government has not responded to requests for information about what health measures have been put in place, particularly at the Lindela Detention Centre near Johannesburg where most of the arrested migrants are held before being deported. A 2009 study conducted at Lindela by ACMS found that 62 percent of respondents who were on chronic medication, including ARVs, reported they could not access them there. 
 
 Patterson Njogu, senior regional health and HIV officer with the UN Refugee Agency (UNHCR), visited Lindela recently but was not able to talk to detainees. Officials there informed him that their health unit screened new detainees for serious illnesses and that of the roughly 2,000 being held, five were known to be on HIV treatment. In a region that is known to be the epicentre of the HIV/AIDS pandemic, Njogu said he would have expected more. "The other concern was TB," he told IRIN. "It’s only those who reveal themselves [who are treated] and I don’t think they’re very aggressive about screening everybody." 
 
 Undocumented migrants with TB whose treatment is interrupted as a result of being detained, can develop multi-drug resistant strains of the disease that can be spread to those around them. 
 
 Meanwhile, Médecins Sans Frontières (MSF) and several other organizations have raised concerns about the poor access to medical services for migrants detained in the border town of Musina. Until recently, a building known as the old Soutpansberg Military Grounds (SMG) was being used to hold 30-60 detainees in one large room divided down the middle for men and women. According to MSF, the SMG lacked proper sanitation facilities, beds or access to health care. 
 
 "We’ve come across [HIV-positive] patients who were arrested and detained there without their ARVs," said Christine Mwongera, MSF's project coordinator in Musina. "We also found TB cases that hadn’t been detected so we had to find a way to get them out. Some [detainees] had been sexually assaulted while crossing into South Africa and held there without any medical attention." 
 
 Following flooding at the SMG and increasing pressure from groups like MSF, the migrants were transferred to police cells until a new detention centre can be completed. Mwongera described the police cells as an improvement but said a gap in access to health care remained, and infection control measures were still lacking. 
 
 Rijks of IOM commented that Migrant Health Forums, like one IOM helped to set up in Musina in 2008, can help to facilitate dialogue and address mistrust between NGOs like MSF and local government departments, including immigration authorities. "It's really important that immigration authorities understand the health impacts of their policies," she said. "The fear of deportation is a huge factor in [migrants] not accessing health care." 
 
 ks/cb

]]></body><link>http://www.irinnews.org/report.aspx?ReportId=94511</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2007/200710227t.jpg"/></td><td valign="top">JOHANNESBURG 20 December 2011 (IRIN) - While most nations are dependent to some extent on the world’s 214 million migrants for skills and labour, few ensure these migrants have access to their health systems, something that could have dire public health consequences, according to the International Organization for Migration (IOM).</td></tr></table>]]></content:encoded></item></channel></rss>
