<?xml version="1.0" encoding="UTF-8"?><rss xmlns:content="http://purl.org/rss/1.0/modules/content/" version="2.0"><channel><title>IRIN - Uganda</title><link>http://www.irinnews.org/</link><description>Updated everyday</description><language>en-gb</language><lastBuildDate>Tue, 14 May 2013 15:31:50 GMT</lastBuildDate><item><title>Uganda grapples with paediatric vaccine shortages</title><pubDate>Tue, 14 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/2009030318t.jpg" />]]>KAMPALA 14 May 2013 (IRIN) - Ugandan children are going unimmunized as the country grapples with persistent and widespread vaccine shortages, the result of insufficient funds and inefficient procurement and supply systems, officials say.</description><body><![CDATA[KAMPALA 14 May 2013 (IRIN) - Ugandan children are going unimmunized as the country grapples with persistent and widespread vaccine shortages, the result of insufficient funds and inefficient procurement and supply systems, officials say.

“We are getting reports and calls from all the districts about the stock-outs of all types of anti-immunization vaccines. They don’t have anti-TB [tuberculosis] vaccines, anti-tetanus, polio [vaccines]. The ministry is faced with inadequate funding for most of our programmes,” Asuman Lukwago, permanent secretary in the Ministry of Health, told IRIN.

“The current major problem on the vaccines is the distribution issue. We are working around the clock to have the problem solved and sorted out immediately.”

Most of the health centres across the country are facing critical shortages of vaccines to protect against tuberculosis, polio, tetanus, diphtheria, rotavirus and pneumonia, putting children at risk of largely preventable diseases.

Health officials now fear these frequent shortages could prevent mothers from bringing their children in for immunizations.

“You can’t [ask] mothers to move to health facilities three to four times and they don’t find vaccines. This practice discourages some of them to go back to the hospitals,” said Huda Oleru Abason, chairperson of the Parliamentary Forum on Immunization.

Procurement woes

In 2011, the government of Uganda shifted the procurement of vaccines and drugs from the Uganda National Expanded Programme on Immunization (UNEPI), under the Ministry of Health, to the National Medical Stores (NMS), an autonomous government corporation. The move was intended to inject efficiency into the country’s drug procurement system, but the drug shortages have continued.

Yet officials at NMS are blaming the shortages on late requisitions for vaccines by UNEPI. The procurement of drugs is the responsibility of NMS.

“Placing of orders is not the responsibility of NMS, it’s [the job of] UNEPI,” Dan Kimosho, a spokesperson at the NMS, told IRIN. “So if they don’t put request in time or under-quantified for the supplies, it’s not our problem. Our responsibility is to procure, store and deliver the requested vaccines. We can’t begin delivering vaccines to districts and health [facilities] if the orders have not been placed to us. We have the competency to deliver the requested drugs and vaccines.”

An estimated 48 percent of children under age five in Uganda are either unimmunized or under-immunized, meaning they do not complete their immunization schedules, according to the 2011 Uganda Demographic and Health Survey [ http://www.measuredhs.com/pubs/pdf/PR18/PR18.pdf ].

Uganda has recently experienced a decline in immunization levels, in part due to inadequate funding, health staff shortages and [parents’] poor adherence to vaccination schedules.

In April 2013, the government launched http://www.unicef.org/esaro/5440_12563.html a countrywide rotavirus and pneumococcal vaccination program targeting over 1.7 million children.

In an interview with IRIN, Director General of Health Services Ruth Achieng noted that, “Uganda is not doing very well in [its] immunization programme… We don’t want our children to die from preventable diseases. We need to act now. Otherwise, we shall get an outbreak of polio and tetanus.”

Uganda’s budget support for the Expanded Programme on Immunization, EPI, - which had been hailed for increased vaccination coverage between 2000-2007 - decreased by more than half in recent years, falling from 7.7 percent in the 2006-2007 financial year to 3.6 percent in 2009-2010 [ http://www.irinnews.org/Report/97413/Uganda-s-immunization-programme-needs-a-shot-in-the-arm ].

Officials say the government has plans to revitalize the country’s immunization programs.
“We have worked out the revitalization plan, and if implemented well, we shall be able to change the low status of immunization in Uganda. The government has mobilized some funds and, with support from GAVI, everything is revisable. We are going to embark on [an] aggressive campaign to ensure there are no vaccine stock-outs in the country and ensure all the children are immunized,” the Ministry of Health’s Lukwago said.

There is also a legal push to improve immunization. An immunisation bill currently pending in parliament will make it illegal for parents and guardians to fail to have their children immunized. It also seeks to punish health officials who fail to offer immunization services to children.

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]]></body><link>http://www.irinnews.org/Report/98033/Uganda-grapples-with-paediatric-vaccine-shortages</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/2009030318t.jpg"/></td><td valign="top">KAMPALA 14 May 2013 (IRIN) - Ugandan children are going unimmunized as the country grapples with persistent and widespread vaccine shortages, the result of insufficient funds and inefficient procurement and supply systems, officials say.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Sending the right message on mHealth</title><pubDate>Wed, 08 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201208091451120607t.jpg" />]]>NAIROBI 08 May 2013 (IRIN) - We’ve read the stories: From bedridden patients sending text messages to their health workers, to young people receiving HIV prevention messages via SMS, the mobile phone seems to have morphed from communications device to essential life-saver. But is the evidence there yet that mHealth is an effective health delivery intervention for the developing world?</description><body><![CDATA[NAIROBI 08 May 2013 (IRIN) - We’ve read the stories: From bedridden patients sending text messages to their health workers, to young people receiving HIV prevention messages via SMS, the mobile phone seems to have morphed from communications device to essential life-saver. But is the evidence there yet that mHealth is an effective health delivery intervention for the developing world?

IRIN, like others, has been reporting for years on mHealth’s potential: This communication technology could provide the answer to distant and under-resourced health services, in particular for Africa’s poor. Kenyan health workers have recounted [ http://www.irinnews.org/Report/88653/KENYA-R-U-OK-2day-SMS-check-up-takes-off ] how mobile phones have made it easier to track their patients’ progress; there have been anecdotal reports of lower maternal mortality rates as a result of Ghanaian mothers [ http://www.irinnews.org/Report/87261/GHANA-Cell-phones-cut-maternal-deaths ] being able to call for ambulances during labour.

In Africa, with some 63 mobile phones per 100 inhabitants (compared to Asia and the Pacific’s 89 per 100 inhabitants), the cell in your pocket can become a direct channel [ http://www.irinnews.org/Report/91287/AFRICA-Mobile-phones-for-health ] for receiving public health messages, improving communication between patients and health providers, boosting data collection and, increasingly, assisting in diagnosis.

But a systematic review - published in January in PLOS Medicine [ http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001363 ] - into the effectiveness of mHealth technology in improving health delivery found mixed results from 42 trials of mHealth interventions. SMS appointment reminders, for example, were found to have modest programmatic benefits, while using phones to send digital images for diagnosis actually led to a drop in the correct analysis in two trials examined.

A 2012 study by the mHealth Alliance [ http://mhealthalliance.org/images/content/baseline_evaulation_report2013.pdf ], which advocates the use of mobile technologies in health care, found that sub-Saharan Africa had a higher number of mHealth projects compared to Asia and Latin America, with more than half of all mHealth projects related to communicable diseases such as HIV and malaria.

Insufficient evidence

Despite the rapid growth, "there is currently a gap in terms of evidence linking mHealth to improved health and operational benefits, and this is particularly true when it comes to studies in low- and middle-income countries," Patricia Mechael, executive director of the mHealth Alliance, told IRIN.

The PLOS review found that “none of the trials were of high quality - many had methodological problems likely to affect the accuracy of their findings - and nearly all were undertaken in high-income countries.”

Rajesh Vedanthan, an assistant professor at New York’s Mount Sinai Medical Centre who is currently working with AMPATH [ http://www.ampathkenya.org/ ], an academic health programme involved in research and health care in Kenya, told IRIN via email that some of the practical challenges with the use of mHealth technology included “optimizing the user interface, ensuring that users have an easy and error-free working experience with the mHealth device, not impeding the workflow of clinicians, issues related to network connectivity, access to a central server, coordination of individual devices with a central coordinating office, systems integration, etc…

“mHealth has the potential to assist with several aspects of the ‘supply chain’ of care for non-communicable diseases - including screening/diagnosis, linkage to care, treatment/decision support, retention and follow-up, systems coordination, etc.,” he added. “Whether mHealth will be effective in all of those arenas is still not robustly known, and rigorous research is still required.”

A need for standards

The mushrooming of mHealth pilot projects has caused concern around monitoring. Uganda has declared a moratorium on pilot mHealth initiatives as it seeks to bring them in line with national health policies.

“We first needed to study them [mHealth and mHealth initiatives]… Some of these people are duplicating what is already there,” Asuman Lukwago, the permanent secretary in Uganda’s Ministry of Health, told IRIN. “As a ministry, we only implement innovations that have been tested and approved. At the moment, we are suggesting reforms to put into practice for these new innovations.”

The mHealth Alliance recently released a review [ http://www.mhealthalliance.org/images/content/state_of_standards_report_2013.pdf ] of standards in the use of mHealth among low- and middle-income countries, which found that as mobile health systems “move towards scale, existing guidelines and strategies will need to be revised to reflect new demands on executive sponsorship; national leadership of eHealth programmes; eHealth standards adoption and implementation; development of eHealth capability and capacity; eHealth financing and performance management and eHealth planning and architecture maintenance”.

Scaling up mHealth

Mechael noted that mHealth could only meet its potential if it was fully integrated into general health programmes, becoming “so much a part of health systems that we no longer need to use ‘m’ as a designation”, something that cannot happen unless mHealth projects move beyond the pilot phase and really reach scale at a national or regional level.

Importantly, experts say, the use of mHealth and other humanitarian technology should be allowed to be driven by the communities who benefit from it.

“There has been a recognition - belatedly, in some cases - of the ways beneficiaries are using technology, voting with their wallets and their feet... We can see that the most innovative models of humanitarian technology are driven by communities themselves,” Imogen Wall, the coordinator of communications with affected communities for the UN Office for the Coordination of Humanitarian Affairs, told IRIN.

She noted that humanitarian agencies would increasingly need to increase their engagement with the private sector as partners in preparedness and response, recognizing that the private sector is no longer merely a support system, but a humanitarian service provider as well.

OCHA recently released a report, Humanitarianism in the Network Age [ https://ochanet.unocha.org/p/Documents/WEB%20Humanitarianism%20in%20the%20Network%20Age%20vF%20single.pdf ], which stresses the importance of information and communication in humanitarian work and urges new ways of thinking that adapt to the changing realities of communities around the world.

“In order for humanitarian technology to meet its full potential, there must be a willingness - an openness - to innovate, to think outside the box, to test new ideas and to risk failure and success in both the processes and the deliverables - essentially, a willingness to accept change,” Wall said.

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]]></body><link>http://www.irinnews.org/Report/98001/Analysis-Sending-the-right-message-on-mHealth</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201208091451120607t.jpg"/></td><td valign="top">NAIROBI 08 May 2013 (IRIN) - We’ve read the stories: From bedridden patients sending text messages to their health workers, to young people receiving HIV prevention messages via SMS, the mobile phone seems to have morphed from communications device to essential life-saver. But is the evidence there yet that mHealth is an effective health delivery intervention for the developing world?</td></tr></table>]]></content:encoded></item><item><title>Aiming for climate change-resilient coffee in Uganda</title><pubDate>Fri, 03 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201107202046420353t.jpg" />]]>KAMPALA 03 May 2013 (IRIN) - In Uganda, a new pilot project seeks to understand the threat climate change poses to coffee, which will enable growers to enhance the crop&apos;s resilience to extreme weather events.</description><body><![CDATA[KAMPALA 03 May 2013 (IRIN) - In Uganda, a new pilot project seeks to understand the threat climate change poses to coffee, which will enable growers to enhance the crop's resilience to extreme weather events. 

Coffee contributes about US$400 million of Uganda's total annual export revenue, directly or indirectly employing at least two million people. But coffee production, like other export crops in Uganda, is mainly rain-fed, making it vulnerable to climate variability. 

"The economy of Uganda remains largely dependent on a few agro-commodities (coffee, tea, cotton), predominantly rain-fed and grown by smallholders with limited external inputs, making the country highly sensitive to climate risks," Julie Karami Dekens, the International Institute for Sustainable Development's (IISD) project manager for climate change and energy, told IRIN via email. 

The six-month pilot project, which was launched on 5 April, is a collaboration between Uganda's Ministry of Trade, Industry and Cooperatives (MTIC), the local Makerere University and IISD. 

The programme will explore climate vulnerabilities across the coffee value chain - the movement of coffee from farming to processing to marketing - with a view to expanding these assessments to other agricultural value chains. It reflects growing recognition that climate change will have far-reaching effects across the agricultural, administrative and economic sectors. 

"Climate change is a multi-sector challenge, which calls for concerted efforts of not only the environment sector, but also the trade sector," Norman Ojamuge, MTIC senior commercial officer, told IRIN. 

Value chain development 

According to a recent government briefing on the project, value chain development is crucial to the growth of agricultural commodities. But limited work has been done to understand the impact of climate risks along the levels of value chains. The project hopes to help bridge this gap. 

A separate 2013 study [ http://www.iisd.org/pdf/2013/crm_uganda.pdf ], Climate Risk Management for Sustainable Crop Production in Uganda, noted: "There is a need to understand how climate risks are distributed and transmitted (or not) among all the stakeholders of value chains (not just at production level) to identify solutions that benefit all actors along the value chain and opportunities for investments." 

Incorporating climate change into agriculture will mean that "there will be a coherent and thorough integration of climate change adaptation and the associated disaster risk management agendas and structures. into sectoral and national strategies," said Betty Namwagala, the executive director of the Uganda Coffee Federation. 

Climate risks 

Climate risks facing coffee production in Uganda include the increased prevalence of pests and diseases. For example, coffee leaf rust [ http://coffeeleafrust.ning.com/ ] has been reported in many arabica coffee growing areas, with the black twig borer pest emerging as a threat in robusta coffee growing areas. 

There has also been a fluctuation in coffee production in Uganda over the past 40 years, a situation attributable to climate variability, reduced soil fertility and mismanagement, according to Uganda's Coffee Development Authority (UCDA). 

Droughts and floods are also challenges. 

"Water stress in the dry season affects the physiological activity of the arabica plant, causing a reduction in photosynthesis," explained Namwagala. 

"Some farmers have lost their plantations and lives to landslides that are attributed to climate change. Areas that depend on rain-fed agriculture may sometimes require irrigation, and taking into consideration the nature of our producers, many have abandoned their farms since they cannot afford irrigation or access to sources of water that can support irrigation," she added. 

"If climatic events, such as exceedingly high temperatures, occur during sensitive periods of the life of the crop, for example during flowering or fruit setting, then yields will be adversely affected, and particularly if accompanied by reduced rainfall, thereby reducing incomes of all sector players," she said. 

David Mafabi, a coffee farmer in the eastern Uganda district of Mbale, said: "Coffee production depends on nature. We suffer if there is too much [rain] or drought. As a result of drought, coffee does not mature well, and the harvest will be disappointing." 

Climate change can affect links further up the value chain, as well. 

"More frequent or intense extreme weather events may deteriorate infrastructure such as storage facilities and roads, leading to reductions in crop quality and limited access to markets," said IISD's Dekens. 

Development planning 

The management of these climate risks is key to development planning. 

Uganda's development strategy relies heavily on exports - including coffee - to achieve the country's 'Vision 2040' national development plan that aims to transform the nation from a low-income country to a competitive upper-middle-income country with a per capita income of about $9,500. 

At present, some of strategies being used to minimize the negative impacts of climate hazards on coffee production include the breeding and selection of more disease-resistant and drought-tolerant varieties. Through the UCDA, coffee farming is also being introduced into new areas, especially in northern Uganda, to boost production and to test potential growing locations. 

Coffee farmers are also adopting best practices such as crop diversification, intercropping and agroforestry. Still, further support in managing climate risk is still needed. 

According to IISD's Dekens, "Further studies are required assess the economic impacts of climate hazard[s] on coffee production. It is difficult to differentiate the costs associated with the impacts of climate risk on coffee production from that of other factors, such as reduced soil fertility and mismanagement, which also contribute to reduce coffee production in Uganda." 

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]]></body><link>http://www.irinnews.org/Report/97971/Aiming-for-climate-change-resilient-coffee-in-Uganda</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201107202046420353t.jpg"/></td><td valign="top">KAMPALA 03 May 2013 (IRIN) - In Uganda, a new pilot project seeks to understand the threat climate change poses to coffee, which will enable growers to enhance the crop&apos;s resilience to extreme weather events.</td></tr></table>]]></content:encoded></item><item><title>Uganda pilots mobile courts for refugees</title><pubDate>Tue, 23 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201203281125310596t.jpg" />]]>KAMPALA 23 April 2013 (IRIN) - Uganda&apos;s government and the UN Refugee Agency (UNHCR) have launched a pilot mobile court system to improve access to justice for victims of crimes in Nakivale, the country&apos;s oldest and largest refugee settlement.</description><body><![CDATA[KAMPALA 23 April 2013 (IRIN) - Uganda's government and the UN Refugee Agency (UNHCR) have launched a pilot mobile court [ http://www.unhcr.org/516d29359.html ] system to improve access to justice for victims of crimes in Nakivale, the country's oldest and largest refugee settlement.

The magistrate's court, whose first session began on 15 April, will hear cases of robbery, land disputes, child rape, sexual and gender-based violence, attempted murder, and murder. The project - a collaboration of the Uganda government, UNHCR, Makerere University's Refugee Law Project (RLP) and the Uganda Human Rights Council - aims to benefit some 68,000 refugees and 35,000 Ugandan nationals in the settlement.

“With the nearest law court currently 50km away in Kabingo, Isingiro, access to justice has been a real problem for refugees and locals alike. As a result many fail to report crimes and are forced to wait for long periods before their cases are heard in court,” said a UNHCR briefing on the programme.

The mobile court will hold three sessions a year. Each session will last 15 to 30 days and hear up to 30 cases. Officials hope to extend the project to other refugee settlements in Uganda to enable more refugees to access speedier justice.

"Most of the courts are far away from the settlements, and refugee complainants faced challenges of transportation for themselves and witnesses," Charity Ahumuza, programme manager for access to justice at RLP, told IRIN. "With the courts brought to them, the cost of seeking justice is reduced. The courts will also reduce the backlog of cases that exist of cases that arise in the settlements."

"Refugees have welcomed this initiative since it is about bringing justice closer to them," John Kilowok, UNHCR Protection Officer in Uganda, told IRIN.

Operational challenges

Experts say the project could face a number of operational challenges, including a need for funding and a shortage of trained court interpreters. Uganda has over 165,000 refugees from the Burundi, Democratic Republic of Congo, Eritrea, Kenya, Rwanda, Somalia and South Sudan.

"The settlements are far away, and distance in accessing the court is likely to become a challenge. Language, too, will be a problem. The service providers through UNHCR are conducting training for interpreters to help in this issue," said RLP's Ahumuza. "The sustainability of the courts, I believe, will depend on availability of finances. However, the judiciary continues to face financial constraints."

Angelo Izama, a Ugandan fellow at the Open Society Institute, says the shortage of justice in the refugee settlements is a reflection of poor access to justice across the country, a situation that needs to be addressed.

"Improving the delivery of justice helps tremendously given that, ordinarily, the severe case backlog makes matters worse for nationals - let alone foreigners. The real crisis now is not providing refugees and nationals in western Ugandan fast relief but filling the many vacancies in the judiciary so that, nationally, justice is expedited," he said. "While justice processes improved on our side can help communities - both Ugandan and foreign - live better governed lives, the ultimate investment would be in improving governance across the border."

"There is need for a holistic approach to look at the refugee issues in Uganda. We have to look at policy, immigration and defence lawyers for fair trials. Will the suspects have access to defence lawyers, or will they be accorded with lawyers to defend them in court?" asked Nicholas Opiyo, a constitutional and human rights lawyer in Kampala, Uganda’s capital. "Sustainability is a very crucial element in this court... If they don't put good and proper systems to support this court, it will be a waste of time and money."

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]]></body><link>http://www.irinnews.org/Report/97903/Uganda-pilots-mobile-courts-for-refugees</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201203281125310596t.jpg"/></td><td valign="top">KAMPALA 23 April 2013 (IRIN) - Uganda&apos;s government and the UN Refugee Agency (UNHCR) have launched a pilot mobile court system to improve access to justice for victims of crimes in Nakivale, the country&apos;s oldest and largest refugee settlement.</td></tr></table>]]></content:encoded></item><item><title>In East Africa, heavy rains test emergency preparedness</title><pubDate>Thu, 11 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201304040922550914t.jpg" />]]>NAIROBI 11 April 2013 (IRIN) - Unusually heavy rains have caused havoc across much of east Africa, displacing thousands of people and damaging important infrastructure.</description><body><![CDATA[NAIROBI 11 April 2013 (IRIN) - Unusually heavy rains have caused havoc across much of east Africa, displacing thousands of people and damaging important infrastructure.

“Above-normal rains have occurred in several areas, including northern and western Tanzania; Rwanda; Burundi; the Lake Victoria Basin; western, southern and northeastern Kenya; southern and central Somalia; and eastern and south-eastern Ethiopia,” states an update by the Famine Early Warning Systems Network (FEWS NET) [ http://reliefweb.int/sites/reliefweb.int/files/resources/East%20Africa%20Seasonal%20Monitor%20April%208%202013.pdf ].

Even normal rains can cause flooding and damage in areas with poor drainage; this year’s heavy rains are already beginning to test the emergency responses in many flood and disaster-prone areas.

The rains, which have “caused significant flooding in the Lake Victoria basin in Uganda and Kenya, the southern Maasai rangelands in Kenya, and along the Wabi Shabelle in Ethiopia in late March and early April”, according to the update, started between mid-March and early April and are likely to continue through May.

Kenya 

In Kenya, at least 18,633 people have been displaced by flooding since the onset of the rains, according to the Kenya Red Cross Society (KRCS) [ https://www.kenyaredcross.org/PDF/REPORTED%20sitrep%202013%20FLOODS%209th%20April%202013-1.pdf ]. Some 32 deaths have also been recorded, with others being injured.

The number of people displaced could rise to about 30,000 before the rainy season ends, said Nelly Muluka, the KRCS communications manager. 

“We are also working on searching for the unaccounted people and sensitizing communities on the need to move to safer areas,” said Muluka. KRCS is distributing food and non-food items to affected families, but there is a need for medical care and additional food and shelter.

Ahead of the rains, Kenya’s meteorological department had warned of generally enhanced rainfall over the western highlands, Lake Basin, central Rift Valley and the central highlands, including Nairobi, in March and April. 

“We expected floods in areas like Nairobi, Central, Coastal and Western Kenya, and have already put aside food and non-food items for potential victims,” Andrew Mondoh, the permanent secretary in the Special Programmes Ministry, told IRIN. 

In the coastal area of Tana River, hundreds of families marooned by floods have been rescued by helicopter and moved to safer areas, added Mondo. 

The rains have also destroyed roads in the Rift Valley areas of Kajiado and Narok and in the western area of Kisumu. 

In northeastern Kenya’s Dadaab refugee complex, home to about 463,000 mainly Somali refugees, the rains have displaced some families and affected commodity prices. 

Parts of a 90km road, linking the main region of Garissa to the Dadaab refugee complex, have been rendered impassable, affecting transport and commerce. 

Movement within the Ifo-1 and Ifo-2 camps becomes especially difficult during the rainy season due to flooding, which makes aid delivery difficult.

“It is a mixture of sad[ness] and happiness during the rainy season in Dadaab; we really need the rain because it is always very hot and we get more milk from the neighbouring locations, but we have no proper shelter and the prices of some foodstuffs become higher,” said Muhubo Aden Kusow, who runs a grocery store at one of the Ifo camps. 

The heavy rains are expected to continue over the next two weeks, according to Ayub Shaka, the deputy director of Kenya’s Department of Meteorological Services. “It is difficult to say where floods will occur in the next two weeks for example, but the best we can do is to ask people living in flood-prone areas to stay alert and safe,” said Shaka.

Somalia 

In neighbouring Somalia, heavy rains were recorded in the first week of April.

“Robust precipitation accumulations (>75mm) were again observed over central and southern Somalia,” states an Africa Hazards Outlook report for 11-17 April [ http://reliefweb.int/sites/reliefweb.int/files/resources/afr_Apr11_2013.pdf ]. 

“Many local areas have already experienced more than three times their normal rainfall accumulation since the beginning of April, sustaining the risk for localized flash flooding and downstream river inundation over the Jubba and Shabelle River basins in eastern Ethiopia and southern Somalia.”

The Shabelle has already burst its banks in some places, according to a 10 April Shabelle River flood update by the UN Food and Agriculture Organization [ http://reliefweb.int/report/somalia/flood-update-shabelle-river-10042013 ]. 

“SWALIM [Somalia Water and Land Information Management] field reports in the last two days indicate river breakages at Hurway (about 8m wide), Eji (about 6m wide) and Maadheere (about 14m wide) villages all in Middle Shabelle Region. This has led to inundation of large areas, causing destruction of cropped area[s] of unconfirmed acreage, and displacement of several families.”

Ethiopia 

The southern and eastern regions of Ethiopia have also received “heavy and well-distributed precipitation totals”, according to the Africa Hazards Outlook, “with lesser amounts observed in the west and higher elevations of the country.” 

“This has already negatively affected cropping activities, with a reduction of planting over many local Belg [February-May rains]-producing areas of Ethiopia,” it says.

With the rains expected to continue, efforts are underway to mitigate their adverse effects.

Uganda 

According to Uganda’s chief weather forecaster, Deus Bamanya, there is an increased likelihood of near-normal to above-normal rainfall over most parts of Uganda, with the rains peaking between mid-April and early-May. Flash flooding could also occur in areas expected to receive below-normal rainfall due to sporadic heavy downpours.

“The expected impacts include increased lightning, hailstorms, floods and landslides,” Bamanya told IRIN.

The government plans to relocate vulnerable populations living in the eastern Mount Elgon region, which is prone to flooding and landslides [ http://www.irinnews.org/Report/88283/UGANDA-300-feared-dead-as-landslides-bury-villages-in-the-east ]. 

“We are worried [about] landslides, mudslides and flooding. There are already signs in the low-lying and hilly and mountainous areas,” Musa Ecweru, Uganda’s state minister for relief, disaster preparedness and refugees, told IRIN.

“The effects of the heavy rains last year were very devastating. We don’t want [a]repeat. We are going to relocate people in these vulnerable areas. We are only waiting for resources from our development partners to start the relocation exercise,” said Ecweru. The Ugandan government requires some 35 billion shillings (about US$13.5 million) for the exercise.

“We are going to de-gazette some government land to relocate these vulnerable populations. We are negotiating with [the] Uganda Wildlife Authority to have this done immediately. We must [re]settle these people as quick[ly] as possible,” he added. 

The districts of Mbale, Tororo, Kalangala, Bundibugyo and Masaka are among those most affected by hailstorms, according to Catherine Ntabadde-Makumbi, the Uganda Red Cross Society assistant communications director, who added that at least 8,362 people remain without assistance, with 5,681 of them displaced. The displaced are in urgent need of shelter kits, household items and water purifying tablets. 

Burundi 

In Burundi, flood-affected areas include the northwestern region of Bubanza, Bujumbura City and the plains of Imbo along the shores of Lake Tanganyika. 

"We have a problem with rain in the town of Gihanga [in Bubanza]. Houses and plantations were destroyed, causing the displacement of people and stopping work in the fields," Anselme Wakana, governor of Bubanza Province, told IRIN. 

At least 1,000 hectares of rice has been damaged there, raising food security fears. "We are harvesting rice that was not yet mature due to fear of flooding," said farmer Olive Ngayimpenda. 

Several homes have been destroyed in the areas of Gihanga.

According to Mbonerane Albert, the president of the local NGO Green Belt Action, the situation could worsen due to environmental degradation: deforestation in Bubanza has increased surface runoff, increasing the risk of flooding. 

Rwanda 

In neighbouring Rwanda, authorities have issued disaster warnings to those living in risk-prone areas.

"High-risk-zone dwellers have [been] given [a] new eviction ultimatum to relocate since we noticed that expected heavy rainfall could affect the vulnerable populations," Antoine Ruvebana, the permanent secretary in the Ministry of Refugees Affairs and Disaster Management, told IRIN. 

Rwanda, due its hilly terrain, is susceptible to erosion, flooding and landslides. 

According to the Rwandan meteorological services department, several western parts of the country could get ''above-normal rainfall'' during the mid-April to May 2013 period. 

rk-mh-dn-at-so/aw/rz

]]></body><link>http://www.irinnews.org/Report/97830/In-East-Africa-heavy-rains-test-emergency-preparedness</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201304040922550914t.jpg"/></td><td valign="top">NAIROBI 11 April 2013 (IRIN) - Unusually heavy rains have caused havoc across much of east Africa, displacing thousands of people and damaging important infrastructure.</td></tr></table>]]></content:encoded></item><item><title>Uganda’s midwives struggle to meet demands</title><pubDate>Mon, 08 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201207180632310850t.jpg" />]]>GULU/SOROTI 08 April 2013 (IRIN) - Despite the significant role midwives play in Uganda’s maternal health programmes, they face numerous challenges, including lack of training, inadequate facilities and poor pay.</description><body><![CDATA[GULU/SOROTI 08 April 2013 (IRIN) - Despite the significant role midwives play in Uganda’s maternal health programmes, they face numerous challenges, including lack of training, inadequate facilities and poor pay.

According to the Africa Medical Research Foundation (AMREF) just 38 percent of Uganda’s estimated 11,759 midwives are either registered or have a college education. Yet they attend to 80 percent of all births in the country’s urban areas and 37 percent of all births nationally.

Esther Madudu, a midwife in Uganda’s rural Soroti District, explained to IRIN that many go to great lengths to help women deliver.

“Health centres lack electricity, water and other essential medical commodities to assist in delivery. In the past, I used to [hold] my cell phone in my mouth [and use its] torch to [assist delivering] mothers at the health centre,” she said.

A 2009 analysis by the UN Population Fund (UNFPA) [ http://www.unfpa.org/sowmy/resources/docs/library/R107_UNFPA_2009_UGANDA_MidwiferyNeedsAssessement_final_reportNov09.pdf ] found Uganda’s health system “unsupportive to midwives, as characterized by poor remuneration, poor health service infrastructure, lack of essential equipment and supplies, eg, gloves, drugs - especially in public health facilities - inadequate protection from infections, high workload owing to few qualified staff” and lack of supervision or training opportunities.

Maternal deaths

Uganda grapples with high rates of pregnancy-related complications and maternal deaths, consequences of poor healthcare investment by the government, low education levels and an unmet need for reproductive health services.

Uganda’s 2011 Demographic and Health Survey showed the maternal mortality rate at between 310 and 480 deaths per every 100,000 live births.

According to the Ministry of Health, 24 percent of these deaths are the result of severe bleeding, and many are due to infection, unsafe abortion, hypertensive disorders and obstructed labour.

Experts say much more must be done if Uganda is to meet Millennium Development Goals 4 and 5 - the goals on reducing child and maternal mortality and achieving universal access to reproductive healthcare - by the 2015 deadline.

“Death resulting from pregnancy-related [complications] is a big issue in Uganda that requires urgent attention,” health commissioner Anthony Mbonye said, noting that these deaths are preventable “with improved access to [quality] healthcare to the population and… positive attitudes towards… health workers.”

Too few health workers

Midwives say their small number has them struggling to meet demand. They have called on the government to recruit more midwives.

“We are only three midwives working day and night with [the] assistance of two nursing assistants,” said Lydia Tino, a health supervisor and midwife working at a centre with 20 maternity beds in the rural Gulu District.

In 2006, the government stopped midwifery trainings, arguing that nurses could be given additional skills to take up the roles played by midwives. This has not happened.

And the few who have midwifery skills often leave the country.

“Uganda has trained many midwives, but [the] majority opt to work in places outside the country where facilities and remuneration are better,” Mary Gorettie Musoke, senior midwife and trainer, told IRIN.

In a progress report by Uganda’s Ministry of Health, tabled before a parliamentary committee in February, the government indicated that it had employed an additional 5,707 health workers to help plug the gap.

But many rural health facilities are still unable to perform either basic or comprehensive emergency obstetric and newborn care.

Government obligation

Government officials told IRIN it plans to carry out a countrywide maternal health audit as part of its efforts to deal with the problem.

“We are under obligation to perform our duties, so the government doing everything possible to address problem,” said Sarah Kataike, the health minister.

While government health facilities in Uganda are supposed to provide free services, they are understaffed and lack essential medical supplies. At times, patients are forced to pay extra fees before they can receive services.

Florence Akio, 34, had to be transported to a private facility some 45km away after failing to receive any assistance at a nearby government facility.

“My labour started in the middle of the night, but I couldn’t make to Atiak Health Center III. I waited until morning, when my husband borrowed a bicycle and carried me to the health centre. But, reaching the health centre, there was no sight of any staff to attend to me,” she told IRIN.

In a landmark 2011 case, civil society organizations sued the government over the high maternal mortality rate, but the case was dismissed. The organizations had argued the government had failed to provide essential medical commodities and services to pregnant women.

ca/ko/rz

]]></body><link>http://www.irinnews.org/Report/97807/Uganda-s-midwives-struggle-to-meet-demands</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201207180632310850t.jpg"/></td><td valign="top">GULU/SOROTI 08 April 2013 (IRIN) - Despite the significant role midwives play in Uganda’s maternal health programmes, they face numerous challenges, including lack of training, inadequate facilities and poor pay.</td></tr></table>]]></content:encoded></item><item><title>Briefing: M23, one year on</title><pubDate>Wed, 03 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201303271154440060t.jpg" />]]>NAIROBI 03 April 2013 (IRIN) - The M23 rebellion, the latest of a string of armed insurgencies in the Democratic Republic of Congo’s (DRC) North Kivu Province, has been active for one year now, during which hundreds of thousands have fled their homes and many have lost their lives.</description><body><![CDATA[NAIROBI 03 April 2013 (IRIN) - The M23 rebellion, the latest of a string of armed insurgencies in the Democratic Republic of Congo’s (DRC) North Kivu Province, has been active for one year now, during which hundreds of thousands have fled their homes and many have lost their lives. 

The Mouvement du 23-Mars, or March 23 Movement [ http://www.irinnews.org/report/95715/DRC-Understanding-armed-group-M23 ], came into existence in April 2012, when hundreds of mainly ethnic Tutsi soldiers of FARDC, the national army, mutinied over poor living conditions and poor pay. Most of the mutineers had been members of the National Congress for the Defence of the People (CNDP) [ http://www.irinnews.org/Report/76275/DRC-Nkunda-s-rebel-group-spells-out-demands ], another armed group that in 2009 signed a deal with the government, which the dissidents felt Kinshasa had not fully implemented. M23 is named after the date the agreement was signed.

In November 2012, M23 captured Goma, the provincial capital, but withdrew and subsequently entered into peace talks with the government. Neighbouring Rwanda and Uganda were accused of backing M23 by a UN Security Council Group of Experts report [ http://www.reuters.com/article/2012/10/17/us-congo-democratic-rwanda-uganda-idUSBRE89F1RQ20121017 ], charges both countries strongly deny.

In this briefing, IRIN outlines the group’s impact on the province over the past year, its current position and avenues for peace in eastern DRC.

What is the humanitarian situation in North Kivu?

Although clashes between M23 and FARDC have subsided, “North Kivu remains highly insecure due to the proliferation of weapons, sporadic fighting between armed groups and the army, and inter-community tensions,” according to the UN Office for the Coordination of Humanitarian Affairs [ http://reliefweb.int/sites/reliefweb.int/files/resources/OCHA%20PRESS%20RELEASE%20-%20GOMA%20RESPONSE%20PLAN%20%28ENGLISH%29.pdf ] (OCHA).

OCHA notes that since the beginning of the M23 rebellion, more than half a million people have been driven from their homes in North Kivu. The figure accounts for more than half of the 914,000 displaced people in the province. Tens of thousands more fled to refugee camps [ http://www.irinnews.org/Report/97742/Congolese-refugee-camps-in-Rwanda-full ] in Rwanda and Uganda.

According to Amnesty International [ http://www.amnesty.org/en/news/drc-bosco-ntaganda-must-be-surrendered-icc-2013-03-19 ], M23 has been responsible for human rights abuses “including violations of the duty to care for the civilian population when launching attacks, forced recruitment of children who were either trained to take part in hostilities or forced to work to build military positions, unlawful killings, and acts of sexual violence”. The organization also blamed FARDC for widespread abuses against civilians. 

Where are M23’s leaders?

The movement’s leadership now looks significantly different than it did in April 2012. 

In February 2013, a rift was reported in M23’s leadership, with one of the founders, Bosco Ntaganda, and M23’s political leader, Jean-Marie Runiga, on one side and M23’s military chief, Sultani Makenga [ http://www.congoforum.be/upldocs/RVI%20Briefing%20-%20Usalama%20-%20Makenga%20Profile%20%E2%80%93%203%20December%202012.pdf ], on the other. The two factions clashed in North Kivu, and Makenga sacked Runiga, who was the group’s representative at the peace talks taking place with the DRC government in the Ugandan capital, Kampala. Following more fighting in March, Ntaganda’s faction surrendered. Both he and Runiga, along with several senior commanders and close to 700 fighters, fled to Rwanda.

On 18 March, Ntaganda surrendered himself to the US Embassy in the Rwandan capital, Kigali, and asked to be transferred to the International Criminal Court for trial over alleged war crimes and crimes against humanity. He made his first appearance in court on 26 March. According to a paper [ http://riftvalley.net/resources/file/RVI%20Usalama%20Project%20-%20Briefing%20-%20Ntaganda%20Profile.pdf ] by the Rift Valley Institute, Ntaganda had fallen out with fellow commanders early in the rebellion and had been effectively relegated to the sidelines. 

Experts have lauded Ntaganda’s arrest as a positive step in the fight against impunity in DRC, but warn that it does not mean an end to violence in the region.

Runiga has been placed under house arrest [ http://bigstory.ap.org/article/congo-m23-faction-leader-arrested-rwanda ] in Rwanda; the Rwandan government has disarmed [ http://reliefweb.int/report/democratic-republic-congo/dr-congo-rebels-rwanda-moved-away-border?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+ReliefwebUpdates+(ReliefWeb+-+Latest+Updates) ] the M23 troops who surrendered and moved them to a refugee camp more than 50km from the DRC-Rwanda border.

Various reports [ http://www.guardian.co.uk/world/2013/mar/27/democratic-republic-congo-sultani-makenga ] indicate that Makenga is now consolidating his fighters, thought to number about 1,500, and M23-held territory in North Kivu, but he may also be preparing for further negotiations with President Joseph Kabila’s government. According to Congo expert Jason Stearns [ http://congosiasa.blogspot.com/2013/03/m23-split-and-join.html ], “The internal M23 split may have provided the break they [DRC representatives] needed to make the deal acceptable for the rebels.” 

Any deal is likely to involve the integration of Makenga’s fighters into FARDC, with lower cadre fighters automatically integrated and higher ranking officers considered for integration on a case-by-case basis. However, analysts say the re-integration method has not worked in the past and must be rethought.

“M23 integration in FARDC is feasible but is not suitable. The policy of repeated integration of armed groups in FARDC is [contributing] to the fragmentation and militarization of FARDC,” Marc-Andre Lagrange, DRC senior analyst for the International Crisis Group, told IRIN via email. “Since that approach has proven, with M23, to be a failure, the DRC government with MONUSCO and UNSC should look for another option.” 

According to a recent article in the newsletter Africa Confidential: “Experts broadly agree that some kind of agreement between Kinshasa and M23 is in the offing and will be signed soon, but reliable sources in North Kivu diverge on what the outcome will be. Some feel that Makenga will reintegrate his troops into the FARDC, while others suggest that Makenga and [new] M23 political leader Bertrand Bisimwa can stay independent of the army while not being seen as a ‘negative force’.” 

What is the fate of the peace talks?

The Kampala peace talks between M23 and the DRC government began in December 2012 [ http://www.irinnews.org/Report/97075/Analysis-Seeking-civilian-and-military-solutions-in-the-DRC ], under the auspices of the International Conference on the Great Lakes Region (ICGLR). The talks have made little progress and have been put on hold due to the rebel group’s internal problems. Bisimwa has urged Ugandan President Yoweri Museveni to revive the talks [ http://allafrica.com/stories/201304021191.html ].

On 24 February, a UN-brokered peace agreement [ http://www.peaceau.org/uploads/scanned-on-24022013-125543.pdf ] aimed at ending conflict in eastern DRC was signed in the Ethiopian capital, Addis Ababa, by 11 African countries - Angola, Burundi, the Central African Republic, DRC, the Republic of Congo, Rwanda, South Africa, South Sudan, Tanzania, Uganda and Zambia. Dubbed the Peace, Security and Cooperation Framework for the DRC, the deal’s goals include the reformation of the DRC’s army and an end to regional interference in the country. Among the decisions reached was the formation of a neutral intervention force aimed at fighting “negative forces” in eastern DRC - referring not only to M23 but other armed groups as well.

While the deal was lauded as a breakthrough by African countries, analysts are more sceptical, criticizing the agreement as being long on rhetoric and short on detail and solid action plans. A Foreign Policy Association blog post [ http://foreignpolicyblogs.com/2013/02/28/regional-peace-to-settle-violence-in-the-drc-shows-progress-not-so-fast/ ] noted that since the 1990s, a number of similar regional agreements had failed to bring peace to DRC. It pointed out that the some key players were not mentioned or involved - including armed groups like Raia Mutomboki [ http://www.irinnews.org/report/96899/DRC-Civilian-population-in-Masisi-at-risk ] (Swahili for “angry citizens”), Mai Mai Cheka and the Hutu-dominated FDLR, whose presence in eastern DRC is perceived as a threat by Rwanda.

“The primary aggressors present in the country for the last 10 years, the militia groups that patrol the eastern provinces, were not even included in the discussion,” said the author, Daniel Donovan. “By excluding these groups, they hold no commitment to such an agreement, which begs the question: How does this move signify a guarantee for peace?”

What is next for the region?

On 28 March, the UN Security Council authorized [ http://www.un.org/apps/news/story.asp?NewsID=44523&Cr=democratic&Cr1=congo ] an offensive “intervention brigade” to “address imminent threats to peace and security” as part of the UN Stabilization Mission in the DRC (MONUSCO).

“The objectives of the new force - which will be based in North Kivu Province in eastern DRC and total 3,069 peacekeepers - are to neutralize armed groups, reduce the threat they posed to State authority and civilian security, and make space for stabilization activities,” according to the UN News Centre. It also aims to support the Addis accord.

Following the announcement, the DRC government said it supported the intervention brigade and warned M23 rebels to disband. M23’s Bisimwa has rejected [ http://www.bbc.co.uk/news/world-africa-21993655 ] the UN’s decision to send the force, but said [ http://www.youtube.com/watch?v=_YAzl8128kE ] the group would neither fight nor flee the UN forces. 

The International Federation of Human Rights [ http://www.fidh.org/DRC-An-intervention-brigade-within-MONUSCO-would-require-further-human-13106 ] has warned of a potential “escalation in military confrontations and increased risk of retaliatory attacks by armed groups against civilians” as a result of the force’s entry into the fray, and urged MONUSCO to “mitigate against the increased risks that communities will face”. 

Experts say reforms in eastern DRC must go beyond military solutions. “The intervention brigade… should not be seen as the only solution but one element of a comprehensive solution,” said ICG’s Lagrange.

“After last year’s fall of Goma and rise of the Mai Mai [rebel] threat, there is a serious need for a new approach against the armed groups. Such an approach should include the use of military force; a targeted policy of arrest on armed groups' leaders; a DDR [disarmament, demobilization and reintegration] offer focusing on civilian reintegration; the investigation and neutralization of the logistical networks of the armed groups; and development work in the communities that generate armed groups,” he told IRIN. 

“Groups like M23 are not a cause but a symptom of what's going wrong in the DRC,” he added. “The Congolese government must commit to implement the security sector reforms, especially the reforms concerning the FARDC. It must also abandon its policy of peace prevailing over justice.” 

kr/rz

]]></body><link>http://www.irinnews.org/Report/97779/Briefing-M23-one-year-on</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201303271154440060t.jpg"/></td><td valign="top">NAIROBI 03 April 2013 (IRIN) - The M23 rebellion, the latest of a string of armed insurgencies in the Democratic Republic of Congo’s (DRC) North Kivu Province, has been active for one year now, during which hundreds of thousands have fled their homes and many have lost their lives.</td></tr></table>]]></content:encoded></item><item><title>Kony hunt still on after CAR coup</title><pubDate>Tue, 26 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201011051154390753t.jpg" />]]>KAMPALA 26 March 2013 (IRIN) - The search for the Ugandan rebel group the Lord&apos;s Resistance Army (LRA) in the rainforests of the Central African Republic (CAR) will continue despite the ouster of President François Bozizé by rebel group Séléka, officials say.</description><body><![CDATA[KAMPALA 26 March 2013 (IRIN) - The search for the Ugandan rebel group the Lord's Resistance Army (LRA) in the rainforests of the Central African Republic (CAR) will continue despite the ouster of President François Bozizé by rebel group Séléka, officials say.

Séléka overran the capital, Bangui, on 24 March, putting Bozizé to flight. The rebels named their leader, Michel Djotodjia, the new head of state.

“I don’t think the overthrow of President Bozizé by Séléka will change our mission and position in the hunt down of LRA rebels. We are in CAR with the mandate from [the] AU [African Union] and UN [United Nations],” Uganda’s state minister for international relations, Henry Okello Oryem, told IRIN, adding that his country is committed to capturing LRA leader Joseph Kony.

Uganda has some 2,500 soldiers deployed around the border areas of CAR, the Democratic Republic of Congo (DRC) and South Sudan, where Kony and his fighters are thought to spend most of their time. The Ugandan troops are joined by 500 Congolese fighters, 500 South Sudanese and 350 CAR troops, all operating under the auspices of the AU. In late 2011, the US deployed 100 special forces to the region as military advisers to the effort.

Ploughing on

According to Thierry Vircoulon, Central Africa project director for the think tank International Crisis Group (ICG), “the fall of Bozizé will not change much the situation on the ground, except if the Séléka leaders insist on the departure of the foreign troops as stipulated in the Libreville agreement [a peace agreement brokered in January and breached by the latest fighting? but never successfully implemented].”

Potential problems

Some analysts say, however, that the AU’s decision to suspend CAR from the organization following the coup could have negative consequences for the hunt for the LRA.

“The AU’s suspension of CAR poses a great challenge and will slow down the hunt for Kony and his rebels. Uganda has to re-negotiate with Séléka rebels… in order for its troops to have the mandate to operate in their territory,” Ronald Ssekandi, a regional political analyst based in the Ugandan capital, Kampala, told IRIN.

Angelo Izama, a political affairs analyst at the US-based Open Society Foundation, said the hunt for Kony and the LRA would largely depend on Séléka’s control of the country.

“The deterioration of government in CAR is a significant complication for the hunt against Joseph Kony. The LRA's asymmetrical, low-tech survival strategy thrives in conditions of lawlessness and violence, especially in the hinterland,” he told IRIN.

“Already the geographical terrain, as well as the size of CAR, has been a practical constraint against the forces hunting Kony. If Séléka is unable to consolidate control, it would further the physical and tactical net within which LRA can seek opportunities to rebuild weapons caches,” he added. “The Séléka rebels do not have the capacity [to limit LRA activities]… In addition, Kony is not their problem; there are much more important emergencies to deal with.”

According to Lt Gen Edward Katumba Wamala, commander of the Uganda People’s Defence Forces’ (UPDF) Land Forces, Kony’s fighters currently number about 400, and they continue to roam around CAR, DRC, Sudan and South Sudan. He said some LRA defectors recently reported that Kony was in Sudan’s western region of Darfur, while his senior commanders, Dominic Ongwen and Okot Odhiambo, are thought to be in CAR.

Kony, Odhiambo and Ongwen are wanted by the International Criminal Court (ICC) [ http://www.icc-cpi.int/en_menus/icc/situations%20and%20cases/situations/situation%20icc%200204/Pages/situation%20index.aspx ] for alleged war crimes and crimes against humanity committed in Uganda.

LRA still a threat

“The LRA no longer pose a big threat, but there are still [a] few pockets of LRA rebels operating in CAR under Odhiambo and Ongwen. They are a nuisance. They have continued to abduct, maim and kill unarmed people,” Katumba told IRIN.

“It is important to recall that, despite [the] relatively small number of remaining elements, the LRA continues to pose a serious threat to civilians, with dire humanitarian consequences, in the affected areas in CAR, DRC and South Sudan,” Abou Moussa, head of the UN Regional Office for Central Africa (UNOCA), told IRIN via email.

In February, the UN Office for the Coordination of Humanitarian Affairs reported [ http://www.hdptcar.net/sites/www.hdptcar.net/files/Bulletin%20humanitaire%2001%20eng-1.pdf ] that in the country’s southeast, “there has been an increase in the LRA attacks against communities and hostages being taken.”

According to LRA Crisis Tracker [ http://www.lracrisistracker.com ], the LRA was responsible for 13 civilian deaths and 17 abductions in CAR February 2013. UNOCA says an estimated 443,000 people are currently displaced in LRA-affected areas, many of them depending on international assistance for food, shelter, health care, water and sanitation. This includes an estimated 347,000 people in Province Orientale’s Haut-Uélé and Bas-Uélé districts in DRC.

Fatou Bensouda, the ICC’s chief prosecutor, recently sent a message [ http://www.icc-cpi.int/fr_menus/icc/press%20and%20media/press%20releases/Pages/statement-OTP-18-03-2013.aspx ] to the LRA, assuring them that, should they be arrested, they would not be “tortured or killed” and would receive a fair trial.

Commitment to the cause

Analysts say if the LRA threat is to be laid to rest once and for all, countries in the region must show more commitment to finding Kony.

“It requires committed governments to arrest Kony. The ICC can only base its optimism in this practical possibility. There is no government in CAR, soft states in South Sudan and Chad, and support for LRA from Sudan. It’s plausible that the situation above favours the LRA and not the ICC,” said Open Society Foundation’s Izama.

“Kony's continued existence, and that of his entire group, is part of a much larger problem in the Great Lakes region: failure by governments to resolve internal political problems and to work together in a concerted way to bring to an end cross-border insurgencies in the region,” said Frederick Golooba-Mutebi, a political scientist and senior research fellow at Makerere University’s Institute of Social Research. “Their proliferation points to the existence of problems or grievances that ought to be addressed - questions to do with citizenship and nationality, land ownership, access to services and opportunity.”

so/kr/rz

]]></body><link>http://www.irinnews.org/Report/97737/Kony-hunt-still-on-after-CAR-coup</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201011051154390753t.jpg"/></td><td valign="top">KAMPALA 26 March 2013 (IRIN) - The search for the Ugandan rebel group the Lord&apos;s Resistance Army (LRA) in the rainforests of the Central African Republic (CAR) will continue despite the ouster of President François Bozizé by rebel group Séléka, officials say.</td></tr></table>]]></content:encoded></item><item><title>In Africa, corruption dirties the water</title><pubDate>Thu, 14 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201302011339570855t.jpg" />]]>NAIROBI 14 March 2013 (IRIN) - Collusion among government officials, unscrupulous water vendors and large farm owners results in diverted water supply lines, misappropriated funds, and failure to implement laws on protecting water sources from encroachment and pollution. These are just some of the ways corruption is denying millions of poor people in Africa access to safe and clean drinking water, experts say.</description><body><![CDATA[NAIROBI 14 March 2013 (IRIN) - Collusion among government officials, unscrupulous water vendors and large farm owners results in diverted water supply lines, misappropriated funds, and failure to implement laws on protecting water sources from encroachment and pollution. These are just some of the ways corruption is denying millions of poor people in Africa access to safe and clean drinking water, experts say.

“The impact of corruption on the water sector is manifested by lack of sustainable delivery, inequitable investment and targeting of resources, and limited participation of affected communities in developmental processes,” Bethlehem Mengistu, regional advocacy manager at the NGO Water Aid, told IRIN.

In a 2010 report, the UN World Health Organization (WHO) [ http://www.who.int/water_sanitation_health/publications/2012/jmp_report/en/index.html ], estimated that around 780 million people around the world, including 343 million in Africa, did not have access to an “improved drinking water supply”, meaning a running water network, public drinking fountains, protected wells or springs, or rainwater tanks.

Globally, an estimated 3 million deaths result from water-borne diseases annually, according to WHO.

According to the World Bank, 20 to 40 percent of public finances worldwide meant for the water sector are lost due to corruption and dishonest practices.

Denied water

In Africa, climate change and burgeoning populations have caused competition over scarce water resources, at times leading to communal conflicts. Experts say corruption exacerbates Africa’s water problems.

“More specific examples of how corruption denies poor people access to water include situations where wealthy or politically connected people use their position to unduly influence the location of a water source at the cost of the poor,” Maria Jacobson, programme officer at the UN Development Programme’s Water Governance Facility (WGF), at the Stockholm International Water Institute, told IRIN.

According to Jacobson, the poor “don’t have the resources to participate in a corrupt system that relies on bribes”, and therefore “lose out in terms of poor water services”.

“Poor people also have few, if any, means to enter alternative markets when corrupt public systems fail to deliver,” she added.

A 2008 report [ http://www.transparency.org/whatwedo/pub/global_corruption_report_2008_corruption_in_the_water_sector ] by Transparency International (TI), a global corruption watchdog, estimated that corruption denied more than a billion people access to safe drinking water and kept 2.8 billion from accessing sanitation services.

In Tanzania, a 2012 study [ http://www.water-alternatives.org/index.php?option=com_docman&task=doc_download&gid=173 ] published in the peer-reviewed journal Water Alternatives revealed that a large-scale agricultural and livestock farming project - on a 14 hectare plot of land in the Iringa area leased out by the government to a private company, allegedly without following the legal process - led to contamination of nearby water sources serving some 45,000 people.

The study, conducted by the Italian NGO ACRA (Cooperazione Rurale in Africa e America Latina), said fertilizers, pesticides and animal waste from the farm washed downstream to the water points.

“While there are mechanisms within Tanzanian law to limit potentially polluting activities, establish protected zones around water sources, and empower water-user organizations to exercise control over activities that damage the quality of water, in practice, in the Iringa region, these were not effective as many procedures were not followed,” the authors said.

In developing countries, corruption is estimated to, according to the TI report, “raise the price for connecting a household to a water network by as much as 30 per cent,” which leads to an inflation of the “overall costs for achieving the Millennium Development Goals for water and sanitation, cornerstones for remedying the global water crisis, by more than US$48 billion.”

In Kenya, for instance, poor people in the capital, Nairobi, pay 10 times more for water than their wealthier counterparts, according to TI.

Incompetence

The incompetence of national and local authorities, too, is to blame.

“Because the revenue that is collected from the water sector is not ring-fenced, it is not ploughed back in to improve services. It is not uncommon to see leaking and broken pipes and water pumps in many parts of urban and rural regions of Africa countries,” Barrack Luseno, a Kenyan water sector analyst, told IRIN.

In Malawi, according to the TI report, water collection points constructed between 1988 and 2002 were mostly placed in areas where such facilities already existed, largely due to “political patronage.”

“The key drivers [of corruption] are limitations of participation, transparency and accountability. It is usually the case that the details of sector resourcing is confined, there is limited participation of right holders in critical issues of development, and the checks and balances to key decision-making roles are weak,” Water Aid’s Mengistu added.

Water Aid recommended in a 2012 report [ http://www.wateraid.org/what%20we%20do/our%20approach/research%20and%20publications/~/media/Publications/WaterAid_Keeping_Promises_Synthesis_Report.ashx ] that governments invest more but also put measures in place to fight the runaway graft in the water sector.

“Governments and donors must ensure that rigorous checks and balances are in place to tackle corruption and minimize waste,” said the report.

It gave the example of the Ugandan government and donors moving quickly to tackle the misappropriation of funds that occurred in the country’s water sector at the end of 2012.

“There is a continuing need to enhance the accountability of governments in delivering services and fulfilling their obligations as duty bearers. Community service organisations have an important role to play as watchdogs to ensure rights holders receive their entitlements,” it added.

Involving communities in decision making and putting more investment into the sector are some of the ways to ensure access for more people.

“We must ensure integrity by ensuring more openness in dealing with issues of land and water. Remember, for rural communities, access to land is commensurate with access to water. This explains the conflict between pastoralist and farming communities,” Luseno added.

Privatization?

Some have advocated for the privatization of water services. In Africa, Senegal and Cote d'Ivoire are cited as privatization success stories. But critics, fearing increased prices, say that putting life-sustaining resource in the hands of for-profit companies would be dangerous.

Karen Bakers says in her 2010 book Privatizing Water: Governance failure and the world’s urban water crisis, “an increasing consensus has developed that private sector participation in water supply will not be able, as some proponents has hoped, to succeed where governments have failed to provide water for all.”

According to the WGF [ http://www.watergovernance.org/ ], the ideological debates over the privatization of water services “do not benefit those lacking sustainable drinking water supply and sanitation.”

The World Bank estimates by 2007, some 160 million people were being served by private water operators globally [ http://www.ppiaf.org/sites/ppiaf.org/files/FINAL-PPPsforUrbanWaterUtilities-PhMarin.pdf ]. About 50 million of these people are served by public-private partnerships that can be considered successful.

But privatization has produced different results for different countries.

In Mozambique, a World Bank study revealed that access to water in the capital, Maputo, had improved since the delegation of water management to private companies.

In Uganda, water sector reforms included more funding from the government and better management of the National Water and Sewerage Corporation - a privately managed but publicly owned water company responsible for the 15 largest cities in the country. According to Water Aid, in just five years after the reforms, it had transformed from being a highly inefficient, underperforming and loss-making body to a healthy and financially sustainable public corporation. Service coverage grew from 48 to 74 percent between 1998 and 2010. The same period witnessed household connections increase from 53,000 to 246,259.

Still, corruption has been a challenge.

“In a study of corruption in Uganda’s water sector, private contractors estimated the average bribe related to a contract award to be 10 percent [of the total cost]. The same study showed that 46 per cent of all urban water consumers had paid extra money for connections,” said WGF’s Jacobson.

Kenya, on the other hand, abandoned plans to open up Nairobi’s water supply to private companies, fearing it would inflate water prices.

In 2008, Mali experienced anti-privatization protests that left one person dead and five others injured in the capital, Bamako.

In Ghana, water tariffs increased by 80 percent after privatization [ http://www.vitensevidesinternational.com/projects/ghana/case-study-book-ghana-5.pdf ], and a third of the country’s population still has no access to safe and clean water.

“Experience suggests that to make private sector engagement work, effective government regulatory powers are required,” says WGF.

Ending corruption in the sector, experts like WGF’s Jacobson say, would require diagnosing the effectiveness of anticorruption interventions, creating legal and financial reforms, and building public sector capacity.

ko/rz

]]></body><link>http://www.irinnews.org/Report/97642/In-Africa-corruption-dirties-the-water</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201302011339570855t.jpg"/></td><td valign="top">NAIROBI 14 March 2013 (IRIN) - Collusion among government officials, unscrupulous water vendors and large farm owners results in diverted water supply lines, misappropriated funds, and failure to implement laws on protecting water sources from encroachment and pollution. These are just some of the ways corruption is denying millions of poor people in Africa access to safe and clean drinking water, experts say.</td></tr></table>]]></content:encoded></item><item><title>Uganda government under pressure to boost ARV funding</title><pubDate>Thu, 14 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201210031338410066t.jpg" />]]>KAMPALA 14 March 2013 (IRIN) - The Ugandan government&apos;s draft 2013/2014 budget allocates US$38.5 million to enrol a further 100,000 people living with HIV on life-prolonging antiretroviral (ARV) drugs. But activists say the money, while welcome in a country still largely dependent on donor funds for its HIV programmes, is not sufficient to meet treatment needs.</description><body><![CDATA[KAMPALA 14 March 2013 (IRIN) - The Ugandan government's draft 2013/2014 budget allocates US$38.5 million to enrol a further 100,000 people living with HIV on life-prolonging antiretroviral (ARV) drugs. But activists say the money, while welcome in a country still largely dependent on donor funds for its HIV programmes, is not sufficient to meet treatment needs.

"With the current allocation and funding, we still have a long way to go," said Raymond Byaruhanga, the executive director of the AIDS Information Centre (AIC). "We need the government‘s commitment to increase the number of people on ARVs and decrease the number of those getting HIV if we are to achieve universal access."

The country enrolled an estimated 65,493 new HIV patients on ARVs in 2012, bringing to 356,056 the number of those on ARV therapy (ART), according to Uganda AIDS Commission statistics. However, this figure represents less than 70 percent of those in need of treatment. The government has set a target of reaching 80 percent of HIV-positive people with ARVs by 2015.

"The government efforts to contribute more funding for adding more patients on ART is commendable. However, we still need additional resources for scaling up on evidence [-based] interventions in order to be in position to halve the new infections," Monica Dea, senior programme advisor for the US Centres for Disease Control in Uganda, told IRIN.

Playing catch up

Uganda has seen its HIV prevalence rise from 6.4 to 7.3 percent over the past five years. Experts say the rising prevalence [ http://www.plusnews.org/Report/95116/UGANDA-Higher-HIV-rate-cause-for-concern ] means the government must work doubly hard to ensure even more people are placed on treatment, especially given recent research showing ARVs have a role in preventing HIV transmission [ http://www.plusnews.org/Report/93251/HIV-AIDS-Treatment-as-prevention-the-tough-road-ahead ].

But limited funding, frequent drug stocks outs, too few CD4 count machines - which measure patients’ immune strength - and understaffing in the public health sector continue to hamper plans to achieve universal ART access.

According to Alex Ario, programme manager at the health ministry’s AIDS control programme, the financial gap in the public sector for 2013/2014 is about $29 million.

"WHO [the UN World Health Organization] is changing its treatment guidelines in the coming months in order to act on exciting new science that shows that treatment saves lives and is one of the most powerful HIV-prevention tools available. This means that in 2013, the number of people in Uganda clinically eligible for treatment will expand beyond just those whose CD4 is less than 350," Asia Russell, director of international policy at the Health Global Access Project (Health GAP), told IRIN. "Despite this, the draft Budget Framework Paper for the health sector proposes no increase in investment for HIV treatment."

"Ugandan civil society is calling on the government to substantially increase its investment in ART for financial year 2013/14 in order to save lives, slash rates of new infections, and begin to end the AIDS epidemic," she added.

Corruption

Activists have also expressed disappointment in a local pharmaceutical plant [ http://www.plusnews.org/Report/74715/UGANDA-Factory-to-boost-ARV-rollout ] - started in 2007 and jointly owned by a local company, Quality Chemicals Industries Limited (QCIL), and Indian generics giant Cipla Limited - that was expected to improve treatment access by providing cheaper ARVs locally. However, the factory's drugs have remained overpriced, and the plant is currently embroiled in a $17.8 million corruption scandal.

In a 20 December 2011 report to Uganda's President Yoweri Museveni, then acting government anti-graft boss Raphael Baku noted that between December 2009 and October 2010, the government’s National Medical Stores (NMS) paid $17.8 million more than it should have to QCIL, in violation of its Memorandum of Understanding (MoU) with the government. The funds allocated for ARV procurement in the budget are intended for purchasing drugs manufactured by QCIL.

QCIL and NMS are accused of manipulating the MoU in order to achieve a 15 percent mark-up on imported drugs; the mark-up had actually been intended only for locally produced drugs. QCIL is also accused of continuing to sell imported drugs manufactured by Cipla to the government at inflated prices even after it started producing its own drugs.

QCIL denies the allegations.

The inspector general of government, anti-corruption activists and HIV activists have demanded the government recover the funds and prosecute those involved. 

"Our government is good at creating institutions, but when it comes to implementing their recommendations, it fails," said Cissy Kagaba, the executive director the Anti-Corruption Coalition Uganda (ACCU). "We demand for an immediate action on the reports of the oversight government organs to specifically recovery all the monies lost. This is the taxpayers’ money."

Asuman Lukwago, the permanent secretary at the Ministry of Health, told IRIN that action would be taken on the reports.

"[ARVs] should be readily available to all who need them because they are life-saving drugs. I think it is treacherous for someone to overprice the drugs because this makes them inaccessible to the most vulnerable, who will most likely end up dying," said Stephen Watiti, a senior medical officer at Mildmay Uganda, an HIV treatment centre close to the capital, Kampala.

New ways to fund HIV programmes

According to Ario, the government is seeking alternative ways to fund ARVs. "Strategies are being explored to increase domestic HIV funding, such as establishing the HIV Trust Fund," he said.

The Ugandan government recently developed a draft working paper on establishing this $1 billion fund [ http://www.plusnews.org/Report/96443/UGANDA-HIV-trust-fund-in-the-works ] for its HIV/AIDS programmes.

"I support the establishment of a trust fund by adding a levy on such items like beer, cigarettes, airtime or introducing an AIDS tax to make sure all money needed to sustain ART is available instead of depending on donors [for] 80-90 percent, as is the case at the moment," said Watiti.

so/kr/rz

]]></body><link>http://www.irinnews.org/Report/97651/Uganda-government-under-pressure-to-boost-ARV-funding</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201210031338410066t.jpg"/></td><td valign="top">KAMPALA 14 March 2013 (IRIN) - The Ugandan government&apos;s draft 2013/2014 budget allocates US$38.5 million to enrol a further 100,000 people living with HIV on life-prolonging antiretroviral (ARV) drugs. But activists say the money, while welcome in a country still largely dependent on donor funds for its HIV programmes, is not sufficient to meet treatment needs.</td></tr></table>]]></content:encoded></item><item><title>Aid for Trade - does it help the poor?</title><pubDate>Tue, 12 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2007/200705162t.jpg" />]]>LONDON 12 March 2013 (IRIN) - Since the World Trade Organization launched its Aid for Trade initiative in 2005, an estimated US$200 billion dollars of development funding has been mobilized for the programme. But some NGOs are asking whether Aid for Trade really helps reduce poverty.</description><body><![CDATA[LONDON 12 March 2013 (IRIN) - Since the World Trade Organization launched its Aid for Trade initiative in 2005, an estimated US$200 billion dollars of development funding [ http://www.wto.org/english/news_e/sppl_e/sppl262_e.htm ] has been mobilized for the programme. But some NGOs are asking whether Aid for Trade really helps reduce poverty.

Two of those NGOs, Traidcraft and the Catholic Agency For Overseas Development, commissioned a study of British and European Aid for Trade assistance, looking at whether the donors have assessed the impacts of these projects on the poor. 

The study, carried out by Saana Consulting [ http://www.traidcraft.co.uk/Resources/Traidcraft/Documents/PDF/tx/Aid%20for%20Trade%20Report%202012.pdf.pdf ], points out that the majority of funding goes to middle-income countries rather than low-income countries, and finds little evidence to demonstrate what impact the programmes have had on poverty.

The study reveals most reviews are completed within the lifetime of a project or at the end - too soon to see any real impact. It adds that “by and large, causal linkages between what a project delivers and the impact on poverty are based on a series of assumptions, and in some cases a leap of faith.”

Little known about poverty effects

The assumption underlying Aid for Trade is that “a rising tide floats all boats,” that more trade brings greater national wealth, and that everyone - including the poor - will benefit. 

Liz Turner, one of the study’s authors, does not dispute this notion. She says that, generally speaking, trade is good. But, she says, “looking at the effects of Aid for Trade in the long term, we end up defaulting back to macro-economic analysis and this issue around the winners and losers from growth. Even if you know that the net effects of a project are going to be positive, wouldn’t it be wiser to find out if there are going to be any losers?” 

Aid for Trade supports all kinds of projects: road building and port upgrading, providing technical support for trade negotiations and regulatory frameworks, designing better border posts, and teaching Ugandan farmers how to produce dried fruit for the lucrative European breakfast cereal market. But only the latter kinds of projects are likely to get evaluated for their effects on poverty reduction.

Kerry Hamilton manages the UK’s Food Retail Industry Challenge Fund, which supports such projects. She told IRIN, “The whole idea is that by doing this, there will be a developmental impact on the farmers and workers involved in that trade. All our projects have a monitoring and evaluation framework, and we ask for baseline data and a set of indicators against which we can measure its success. 

“The difficulty is in the time scales. Projects included in our fourth round of funding have to be completed within 18 months, and by the end of that period, the impact on poverty is going to be minimal. Ideally we should go back in two years’ or five years’ time, but because of the way the funding works, once the project has finished we probably won’t.” 

Hidden losers

Asked by IRIN for an example in which trade support was shown to have an impact on poverty, the head of Aid for Trade at the UK Department for International Development (DFID), Adaeze Igboemeka, cited a project to speed border and customs procedures in the Democratic Republic of Congo. 

“What it focused on was gender and the informal traders,” Igboemeka said. “We used methods like changing the actual structure of the border offices, adding glass panels. Officials working at the border were less likely to ask for bribes, and some of the sexual violence that affects women traders - we saw a very important decrease there. And just having clear procedures made it easier for poor, informal traders to trade.” 

But at a meeting to discuss the study at the Overseas Development Institute (ODI) in London, ODI researcher Yurendra Basnett used border post projects as an example of aid that produces losers as well as winners, notably in the communities that spring up to provide services to people waiting at congested borders.

“I was involved in designing a project in South Sudan aimed at improving customs administration,” said Basnett. “Now, from improving customs capacity, how do you go to saying this will have a poverty impact? In the long term it may, and you can make these assumptions, but it is a massive leap of faith, and there are tensions… Now if, for example, you are working on a border post and reduce the transit time from three days to three hours, then a lot of informal traders lose their livelihoods.” 

The University of Manchester also found both winners and losers emerging from trade programmes [ http://www.capturingthegains.org/ ]. After trade sanctions on South Africa were lifted in the early 1990s, its fruit growers became major exporters and a lot of work was done to meet the standards demanded by European supermarkets. Growers were under pressure meet social standards, which had some positive effects for workers, including higher wages and the provision of clinics.

But the demand for cheaper produce also led growers to cut staff and use more temporary workers, often migrants from Zimbabwe or Mozambique, who are paid less and enjoy fewer benefits.

Not enough information

Donors admit that poverty impacts are very hard to track, especially for broader attempts to support trade.

William Hynes, of the Organisation for Economic Co-operation and Development (OECD), says most smaller donors don’t even attempt to evaluate these impacts. They only monitor that the money was spent on what it was intended for.

“Impact evaluations are costly. They are burdensome, lengthy, and not necessarily aligned with the project managers’ incentives. They do help get across this idea that we should prioritize learning over accountability. But getting at the poverty impacts of a project would probably involve a household survey. A baseline and final survey for 500 households would cost around $300,000, so for most activities that is simply off the table straight away.”

And Igboemeka concedes that, in most cases, the effects of Aid for Trade on the poor are difficult to nail down. “The poverty impact is indirect, and we are very clear about that. The assumption is - and there is a lot of evidence to support it - that if a country is able to trade more, it will grow, and that will create jobs and increase incomes and lead to poverty reduction. That’s a very long results chain, so we don’t try to make a direct attribution of the direct poverty reduction impact. We don’t have enough information to do that robustly.”

All this uncertainty worries campaigners like Gareth Siddorn of Traidcraft. “I know Aid for Trade is just one part of an aid portfolio,” he told IRIN, “but I was struck by the recognition, by colleagues from both DFID and OECD, that it might not be the most effective way of directly benefitting poor people. And from an NGO perspective, that isn’t just one indicator among many - it’s the primary purpose of aid and development policies.” 

eb/rz

]]></body><link>http://www.irinnews.org/Report/97630/Aid-for-Trade-does-it-help-the-poor</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2007/200705162t.jpg"/></td><td valign="top">LONDON 12 March 2013 (IRIN) - Since the World Trade Organization launched its Aid for Trade initiative in 2005, an estimated US$200 billion dollars of development funding has been mobilized for the programme. But some NGOs are asking whether Aid for Trade really helps reduce poverty.</td></tr></table>]]></content:encoded></item><item><title>Imprisoned Eritreans complain of being forced to leave Israel</title><pubDate>Mon, 11 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2007/2007081431t.jpg" />]]>TEL AVIV 11 March 2013 (IRIN) - Testimonies of jailed Eritrean migrants and asylum seekers (collected by a local NGO) say officials at Saharonim prison in Israel’s Southern Negev desert are coercing them to sign “voluntary repatriation” forms.</description><body><![CDATA[TEL AVIV 11 March 2013 (IRIN) - Testimonies of jailed Eritrean migrants and asylum seekers (collected by a local NGO) say officials at Saharonim prison in Israel’s Southern Negev desert are coercing them to sign “voluntary repatriation” forms.

In one of the many testimonies a 28-year-old Eritrean detainee reported being repeatedly visited by a translator telling her to accept deportation to a third country (Uganda).

“He said we would not be free from the prison and we can only go to Uganda or Eritrea. I was frustrated and depressed. I do not want to go to Uganda. Today they called me and gave me a handwritten form in Tigrinya which said: `I came from Eritrea to Israel illegally and now I want to go to Uganda voluntarily. To do this I would like the Eritrean embassy to issue me a passport and all the necessary documents.’ They asked me to sign it and wanted to take my picture on video. I refused.”

Israel is a signatory to the 1951 Refugee Convention but does not recognize Eritreans as refugees, although it does not officially deport Eritreans and allows them to stay in Israel under a group defence (temporary group protection).

Staff at the Hotline for Migrant Workers [ http://www.hotline.org.il/en_drupal/english/about.htm ], who collected the testimonies, say the government is forcibly trying to repatriate Eritreans: “These people have no access to a refugee status determination process, they are detained under the new amendment to the infiltration law that came into effect in June 2012, which allows detention of `infiltrators’ for an unlimited amount of time; now they are told they will never be allowed to leave the prison and their only option is to go back to Uganda/Eritrea. How can this be considered voluntary?” one staff member told IRIN.

The UN Refugee Agency (UNHCR) representative in Israel, William Tall, told IRIN the Ministry of Interior made an attempt to offer relocation to some 23 Eritreans to Uganda but without any result so far.

At the end of February he told Israeli newspaper Ha'aretz there was nothing voluntary about this process [ http://www.haaretz.com/news/national/un-refugee-official-slams-israel-over-eritrean-repatriation.premium-1.505563 ].

One Eritrean, Tesfamihret Habtemariam, was reportedly deported from Israel earlier this month and is now in detention at Cairo airport after five years in Israel, and may be returned to Eritrea.

UNHCR advises against repatriating Eritrean nationals because of the likelihood of their being punished on return to their country.

Israel’s stance

Under an updated Anti-Infiltration law passed in January 2012, all illegal border crossers are labelled “infiltrators” and can be detained for up to three years.

The Eritreans being held in detention camps in the south are generally not notified about their right to claim asylum or given the application forms needed to do this, report NGOs.

On 18 February, official documents from the Israeli assembly, the Knesset, quote Interior Minister Eli Yishai saying deportations (by definition forced) were not yet taking place.

He said more than a 1,000 nationals of northern Sudan and Eritrea had already left voluntarily and said he hoped a lot more would decide to leave.

“And if it won't be voluntary leave, it will be involuntary - to their country or to a different third country, and there is still no third country to sign an agreement with, but I hope we do find other third countries that we'll have an agreement with, and we can transfer the infiltrators from here, from the Land of Israel, to their country or to another country, whether it is done willingly or not.”

Last week the Israel’s Attorney-General Yehuda Weinstein sent a letter widely reported in the local press to the director of the Interior Ministry’s Population, Immigration and Border Authority, Amnon Ben Ami, saying that under no circumstances should Eritrean nationals in Israeli custody be sent “to any destination outside Israel’s borders” until he (Weinstein) further clarifies these legal issues.

td/jj/cb

]]></body><link>http://www.irinnews.org/Report/97623/Imprisoned-Eritreans-complain-of-being-forced-to-leave-Israel</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2007/2007081431t.jpg"/></td><td valign="top">TEL AVIV 11 March 2013 (IRIN) - Testimonies of jailed Eritrean migrants and asylum seekers (collected by a local NGO) say officials at Saharonim prison in Israel’s Southern Negev desert are coercing them to sign “voluntary repatriation” forms.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Condoms continue to confound Uganda</title><pubDate>Fri, 01 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200907170659220562t.jpg" />]]>KAMPALA 01 March 2013 (IRIN) - The condom has played a central role in Uganda’s official HIV prevention strategy for over two decades, but the country has yet to get it right, with condom use declining and the government unable to meet what demand does exist.</description><body><![CDATA[KAMPALA 01 March 2013 (IRIN) - The condom has played a central role in Uganda’s official HIV prevention strategy for over two decades, but the country has yet to get it right, with condom use declining and the government unable to meet what demand does exist.

The country's ‘ABC’ strategy for HIV prevention - Abstinence, Being faithful and Condom use - had early success in lowering HIV prevalence, but the government later faced accusations [ http://www.americanprogress.org/wp-content/uploads/issues/2010/01/pdf/pepfar.pdf ] of bowing to US pressure to emphasize abstinence over condom use, which experts say has hurt prevention efforts.

Now experts say that if the country is to roll back rising HIV prevalence [ http://www.irinnews.org/Report/95116/UGANDA-Higher-HIV-rate-cause-for-concern ], the condom must reclaim its place as one of the main components of Uganda's HIV prevention strategy. 

"The fact that there is a recorded increase in new HIV infections is a proxy indicator that the tool that is known to prevent HIV has been used in a relaxed manner. Condoms have been long established as one of the most effective technologies for the prevention of not only HIV but also STIs [sexually transmitted infections] and unwanted pregnancies," said Milly Katana, a long-time HIV activist and one of the inaugural board members of the Global Fund to fight HIV, Tuberculosis and Malaria.

"In order to have consistent condom use among sexually active populations that are at risk of HIV infection, the country needs to go back to basics - people who have scientific evidence of the efficacy of condoms [should] work with communities in providing accurate information that is not based on moral judgments and biases."

"This is a crisis"

Research shows that while high-risk sex is common, condom use is not. According to the 2011 AIDS Indicator Survey [ http://health.go.ug/docs/UAIS_2011_REPORT.pdf ], "among respondents age[d] 15-49 who were sexually active in the preceding 12 months, 17 percent of women and 34 percent of men engaged in sex with a non-marital, non-cohabiting partner. Of them, 29 percent of women and 38 percent of men reported using condoms at the most recent high-risk sex."

This represents a sharp decline from the 47 percent of men and women in this age group who used condoms during high-risk sex in 2005.

"This is a crisis government must not ignore. The government must support all efforts to increase access to and use of condoms through aggressive condom promotion, fixing chronic procurement delays and reforming the outmoded post-shipment batch testing requirement," Alice Kayongo Mutebi, HIV/AIDS policy adviser for the Community Health Alliance Uganda, told IRIN.

The post-shipment testing requirement was introduced following a scandal in 2004 in which government-subsidized ‘Engabu’ (meaning “shield”) condoms failed a "free from holes" and "smell" test [ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)71861-4/fulltext ]; the requirement has, in the past, lead to delays in condoms reaching the public, sometimes resulting in condom shortages [ http://www.plusnews.org/Report/38009/UGANDA-New-import-measures-lead-to-condom-shortage ].

According to Vastha Kibirige, the Ministry of Health’s condom programme coordinator, although Uganda requires some 240 million condoms annually, the public sector procures just half that, and some years, as few as 80 million.

"Condom use is erratic in Uganda, partly because they are not always available to users," Kibirige told IRIN. "Condoms are not on the essential drugs list and therefore, for the public sector, condoms are [supplied] as per available resources from UNFPA [the UN Population Fund] and USAID [the US Agency for International Development] or the Global Fund... This support is given when the resources are available rather than when the country needs condoms."

But critics say the government must reduce its reliance on donors and increase domestic spending on vital HIV services such as the purchase of condoms.

Kibirige said the government was currently working to launch a new brand of condoms - the first since the Engabu fiasco - within three months.

"We are still doing research, design and branding in order to produce attractive and more appealing condoms for the public," she added. "We need to step-up social mobilization... condom promotion and education for the key populations, as well as programmes targeting the vulnerable populations, including married people." 

Denis Kibira, medicines adviser at the Coalition for Health Promotion and Social Development Uganda, cast doubt on the efficiency of the government's condoms delivery channels.

"Condoms are also mainly distributed through the public health facilities, and it is questionable that if one wants a condom, they will endure and queue up at a health facility," he told IRIN. "In contrast, you will not find condoms in places where they should be... such as public entertainment places like bars and restaurants. We need to make use of dispensing facilities for condoms in the restrooms of all public places."

Leadership

But, Kibira adds, placing condoms in the right venues without a clear message on their use would be counterproductive. "The condom campaigns are hurt by the lack of support and mixed messages sent out by, especially, the political leadership," he said. 

"Our HIV prevention strategy lists ABC, but political leadership - and, in particular, the president - comes up to frequently emphasize A and B, and has openly spoken against safe medical male circumcision," he added. "This confuses the public."

President Yoweri Museveni has criticized [ http://www.youtube.com/watch?v=T5j9dLnu25w ] the emphasis placed on condom use in Uganda's HIV strategy, saying that rather than having three equal prongs, the ABC strategy should focus on abstinence first, faithfulness second and condoms third.

And in a country where the vast majority of people are strongly religious [ http://features.pewforum.org/africa/country.php?c=228 ], religious institutions' objection to condom use plays a part in the public's perception and use of them.

"For the Catholic faith, condoms are absolutely out. The church will not advocate for the use of condoms," Vincent Karatunga, secretary for inter-religious dialogue and ecumenism at the Roman Catholic secretariat, told IRIN. "Sex is a gift from God and [should take place] strictly in marriage. It's abstinence for the unmarried and faithfulness for those who are married."

Many leaders of the increasingly popular Pentecostal churches are also vehemently anti-condom; popular preachers like Martin Ssempa [ http://www.irinnews.org/Report/39474/UGANDA-Abstinence-the-safest-or-most-dangerous-HIV-strategy ] - who has set fire to condoms during his sermons - are not only against condom use, but are also heavily critical of high-risk populations they consider immoral, including men who have sex with men (MSM) and sex workers.

High-risk populations

The Crane Survey [ http://www.uhspa.org/wp-content/uploads/downloads/2011/06/Crane-Survey-Report-Round-1-Dec10.pdf ], a 2009 study of high-risk groups in Uganda, reported that the HIV prevalence among MSM respondents was 13.7 percent, more than twice the national prevalence of about 6.4 percent. A 2011 study [ http://journals.lww.com/stdjournal/Abstract/2011/04000/HIV_and_Other_Sexually_Transmitted_Infections_in_a.13.aspx ] published in the Journal of the American Sexually Transmitted Diseases Association found that 37 percent of 1,027 female sex workers surveyed in Kampala's red-light districts were HIV-positive, compared to that year’s average national prevalence of 7.3 percent.

Widespread discrimination against MSM [ http://www.plusnews.org/Report/93586/UGANDA-Calls-for-inclusion-of-MSM-in-new-HIV-strategy ] and sex workers [ http://www.plusnews.org/Report/89771/UGANDA-Sex-workers-demand-rights-not-rescue ], including by health workers, keeps them from accessing vital HIV prevention services, including condoms and safe personal lubricant [ http://www.irinnews.org/Report/97517/Lack-of-lube-hurts-HIV-prevention ].

The national HIV strategy does not make any provisions for HIV prevention among sex workers and MSM; activists say including them would present legal challenges given that same-sex activity and sex work are both illegal.

"These communities have very patchy coverage of effective, high-impact prevention programmes. This is a massive missed opportunity," said an activist who preferred anonymity. "There is need to protect these key populations by scaling up condoms. The higher-than-average HIV prevalence among these populations means it is particularly crucial for the government to make sure condoms are not just available, but are being used."

According to UNAIDS [ http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/JC2434_WorldAIDSday_results_en.pdf ], “popular opinion in countries with generalized epidemics is that HIV infection is found evenly across the adult population”; however, the evidence points to large numbers of new infections driven by high-risk groups such as sex workers and MSM.

Experts also say there is a need to divorce morality from public health policy if results are to be achieved. "These new figures showing rising HIV incidence and declining condom [use] require a robust, evidence-based response," Allen Kuteesa, the executive director of the Health Rights Action Group, told IRIN. "We cannot bury our heads in the sand with ineffective, moralistic approaches." 

"However much we want them to work, such [moralistic] approaches only provide false protection," Kuteesa added. "Our communities need bold scale-up of all effective prevention tools, including women-controlled methods such as the female condom, alongside biomedical approaches such as male circumcision and HIV treatment as prevention." 

so/kr/rz

]]></body><link>http://www.irinnews.org/Report/97573/Analysis-Condoms-continue-to-confound-Uganda</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200907170659220562t.jpg"/></td><td valign="top">KAMPALA 01 March 2013 (IRIN) - The condom has played a central role in Uganda’s official HIV prevention strategy for over two decades, but the country has yet to get it right, with condom use declining and the government unable to meet what demand does exist.</td></tr></table>]]></content:encoded></item><item><title>African migrants pay high prices to send money home</title><pubDate>Wed, 27 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200909291220100610t.jpg" />]]>JOHANNESBURG 27 February 2013 (IRIN) - New data from the World Bank has revealed that African migrants pay more to send money home to their families than any other migrant group in the world.</description><body><![CDATA[JOHANNESBURG 27 February 2013 (IRIN) - New data [ http://sendmoneyafrica.worldbank.org/ ] from the World Bank has revealed that African migrants pay more to send money home to their families than any other migrant group in the world. 

While South Asians pay an average of US$6 for every $100 they send home, Africans often pay more than twice that - and in South Africa, which has the highest remittance costs on the continent, nearly 21 percent of money set aside for family members back home is spent on getting it there.

With an estimated 120 million Africans depending on remittances from family members abroad for their survival, health and education, the World Bank argues that high transaction costs are cutting into the impact remittances can have on poverty levels. 

To address this, the Bank is partnering with the African Union Commission and member states to establish the African Institute for Remittances [ http://sendmoneyafrica.worldbank.org/african-institute-remittances-air-project ], which will work towards lowering the transaction costs of remittances to and within Africa. It will also leverage the potential of remittances to influence economic and social development. 

“The World Bank’s approach supports regulatory and policy reforms that promote transparency and market competition and the creation of an enabling environment that promotes innovative payment and remittance products,” said Marco Nicoli, a finance analyst at the Bank who specializes in remittances.

Costly and difficult

Owen Maromo, a 33-year-old farmworker who lives in De Doorns, a grape-growing region in South Africa’s Western Cape Province, told IRIN that his family in Zimbabwe relies on the money he sends home every month. 

“I’ve got a house there and I need to pay rent. I’m also taking care of my youngest brother - since my mum died four years ago - and my wife’s family.

“Almost every Zimbabwean here is budgeting to send money back home,” he added. “If they could, they would send money home on a weekly basis.”

In a 2012 report by the Cape Town-based NGO People Against Suffering Oppression and Poverty (PASSOP), interviews with 350 Zimbabwean migrants revealed some of the reasons sending money home from South Africa is both costly and difficult [ http://www.passop.co.za/news/featured/press-statement ].

A key impediment is the stringent regulatory framework that governs cross-border transfers from South Africa. Exchange control legislation, for example, requires money transfer operators (MTOs) to partner with a bank. According to PASSOP, this has had the effect of stifling competition that would likely reduce transaction costs.  

Legislation intending to counter money laundering and terrorist financing requires that customers provide proof of residence and proof of the source of their funds before they can access financial services. This effectively excludes the many migrants living in informal settlements and those who are paid in cash. 

PASSOP found that even among migrants who do have access to banks and MTOs like Western Union and MoneyGram, many lack the financial literacy to make use of them. 

“Some have just come from rural areas in Zimbabwe, so it takes time for them to know about such things,” said Maromo, adding that lack of documentation was another major obstacle. “If you’re undocumented, you can’t go through the banks.”

Three-quarters of the Zimbabwean migrants interviewed by PASSOP relied instead on “informal” remittance channels, such as giving money or goods to bus drivers, friends or agents to send home. This is often not much cheaper than using banks or MTOs, and it is significantly riskier. Of the respondents who used such methods, 84 percent reported negative experiences, including theft of their money, loss or destruction of their goods and long delays in remittances reaching intended recipients. 

Maromo relayed his own experience sending money home through an agent who charged a 15 percent commission to channel the money through his South African bank account before handing it over to Maromo’s relatives in Zimbabwe. “Some time ago, I nearly lost 2,000 rand ($225) because I deposited it in [the agent’s] account and he was saying he didn’t have it and giving excuses. In the end, we got the money, but it cost us nearly 1,000 rand ($113) in airtime calling Zimbabwe,” he said.

“Some are using bus drivers or those people who are going home, and you have to trust them because you’re desperate, but there can be a lot of problems,” he added. “There are a lot of people whose money just disappears. Almost on a daily basis, you hear those stories.”

Lowering transaction fees

Now, Maromo uses a UK-based online transfer service called Mukuru.com, which is popular with many Zimbabweans living overseas. The proof of residence and source of funds requirements are the same as for traditional MTOs, but the site charges 10 percent on transfers from South Africa to Zimbabwe - less than most banks. 

The South African Reserve Bank and the treasury have committed to bringing the cost of remittances down to 5 percent by relaxing regulations for smaller money transfers, negotiating with regulators in the Southern African Development Community on exchange control regulations, and removing the requirement that MTOs partner with banks.

However, at the time of writing, the Reserve Bank has not yet responded to questions from IRIN about how these changes will be implemented and within what timeframe.

Rob Burrell, director of Mukuru.com, said achieving the 5 percent target would be tough considering the numerous costs that MTOs have to cover, including fees paid to the companies that collect and pay out the money, the cost of supporting transactions through a call centre, and licensing and reporting requirements. “We would need everyone pulling together,” he said.

Burrell noted that less stringent laws governing MTOs in the UK mean more competition but much weaker anti-money laundering controls. To operate in South Africa, Mukuru.com has to comply with the regulation that they partner with a local banking license holder.

“In the UK, it’s easier to obtain your license. There are 4,000 [MTOs operating in the UK] compared to 12 in South Africa, but the downside is that it’s very difficult to police them all,” he told IRIN. “My last audit in the UK was four years ago because they can’t handle the volume of licenses.”

ks/rz

]]></body><link>http://www.irinnews.org/Report/97557/African-migrants-pay-high-prices-to-send-money-home</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200909291220100610t.jpg"/></td><td valign="top">JOHANNESBURG 27 February 2013 (IRIN) - New data from the World Bank has revealed that African migrants pay more to send money home to their families than any other migrant group in the world.</td></tr></table>]]></content:encoded></item><item><title>The high cost of unsafe abortion in Uganda</title><pubDate>Mon, 25 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201108041258190512t.jpg" />]]>KAMPALA 25 February 2013 (IRIN) - Boosting women&apos;s access to reproductive healthcare could significantly reduce both the number of unsafe abortions and the high cost of post-abortion medical care in Uganda, experts say.</description><body><![CDATA[KAMPALA 25 February 2013 (IRIN) - Boosting women's access to reproductive healthcare could significantly reduce both the number of unsafe abortions and the high cost of post-abortion medical care in Uganda, experts say. 

Although there are few studies on the subject, experts [ http://www.guttmacher.org/pubs/journals/3118305.html ] estimate that some 297,000 abortions are performed annually, with 85,000 women treated for complications.

"Post-abortion care is estimated to cost nearly US$14 million annually in Uganda... The epidemic of unsafe abortion takes a tragic toll on women and their families. It poses a significant, avoidable economic burden on Uganda's already underfinanced health system [ http://www.irinnews.org/report/96332/uganda-patients-go-private-as-state-sector-crumbles ]," Moses Mulumba, director of the Kampala-based  Centre for Human Rights and Development (CEHURD), told IRIN.

A recent brief [ http://www.guttmacher.org/pubs/IB-Unintended-Pregnancy-Uganda.html ] by the Guttmacher Institute, a reproductive health think tank, and CEHURD estimates that post-abortion care costs nearly $130 per patient. "Most of the costs of post-abortion care arise from treating incomplete abortion; however, a significant proportion can be attributed to more serious complications, such as sepsis, shock, lacerations and perforations," the authors said.

Understanding the law

A major problem is poor understanding of Uganda’s abortion laws. A 2012 Technical Guide to Understanding the Legal and Policy Framework on Termination of Pregnancy in Uganda [ http://reproductiverights.org/sites/crr.civicactions.net/files/documents/crr_UgandaBriefingPaper_v5.pdf ], by the US-based Center for Reproductive Rights, found the country's abortion laws to be "inconsistent, unclear and often contradictory".

"The confusing content of these laws and policies is compounded by their limited interpretations by Ugandan courts and other government authorities, such as the statutory councils established to regulate the healthcare professions," the report found. "As a result, women, healthcare providers and regulators often lack comprehensive information about the content of the law and what it permits."

The guide found that, contrary to the widely held belief that abortion is illegal across the board in Uganda, "Uganda's laws and policies are more expansive than most believe, and the current legal and policy framework offers ample opportunities for increasing access to safe abortion services". For instance, abortion is not illegal when a woman's life is in danger.

According to Annociata Kampire, director of the Alliance for Integrated Development and Empowerment (AIDE), the government has a responsibility to ensure medical professionals and women understand the country's abortion policy.

"One easy step that Uganda should take to reduce death and disability from unsafe abortion is disseminating information about the existing law and implementing existing guidelines... [This] urgently needed step would dramatically improve the health and save the lives of Ugandan women," she said. "They can start by widely disseminating and popularizing the 2012 Ministry of Health's National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights, which describe circumstances under which abortion is permitted in Uganda."

"Making abortion illegal does not stop it from a occurring; it simply forces women to turn to risky procedures and methods... It is just matter of whether it is safe or clandestine and dangerous," Mulumba said. "Unsafe abortion needs to be recognized as a health crisis in Uganda that must be confronted by our policy makers, healthcare workers and communities."

Boosting contraceptive use

According to the Guttmacher brief, one of the key reasons for the high number of abortions is unplanned pregnancy. Uganda's unmet need for family planning stands at 34.3 percent, according to the 2011 Demographic and Health Survey (DHS) [ http://www.ubos.org/onlinefiles/uploads/ubos/UDHS/UDHS2011.pdf ]; women are considered to have an unmet need if they wish to space their children's births or limit childbearing but are not using contraception. Just 30 percent of married women of reproductive age use any form of contraception, according to the 2011 DHS, and only 26 percent of married women and 43 percent of sexually active unmarried women use a modern method.

"Closing the gap in access to contraceptives would save thousands of lives, promote economic development and advance the rights of women, especially in rural areas, among young women, and among women with less formal education," Peter Ibembe, director of programmes at Reproductive Health Uganda (RHU), told IRIN. "Women and men need appropriate counselling so they understand the facts about modern contraception and are not influenced by myths. They also need a choice of affordable contraceptive methods that meet their needs."

"Government should also actively promote the use of contraceptives by women and men in Uganda rather than sending conflicting messages about family planning," he added.

Advocates of family planning [ http://www.irinnews.org/Report/96437/UGANDA-Family-planning-pledges-need-on-the-ground-action ] have accused Uganda's President Museveni of working against [ http://www.newvision.co.ug/news/632902-population-growth-isn-t-a-problem-museveni.html ] efforts to promote more manageable family sizes. 

However, at a global family-planning summit [ http://www.irinnews.org/Report/95860/HEALTH-Family-planning-summit-focuses-on-mother-and-child-survival ] in July 2012, Museveni announced that his government would increase its annual expenditure on family planning supplies from $3.3 million to $5 million for the next five years. The Ministry of Health has also laid out a roadmap for providing universal access to family planning, involving the integration of family planning into other health services, and it plans to reduce the 'unmet need' for family planning to 10 percent by 2022.

so/ko/kr/rz

]]></body><link>http://www.irinnews.org/Report/97543/The-high-cost-of-unsafe-abortion-in-Uganda</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201108041258190512t.jpg"/></td><td valign="top">KAMPALA 25 February 2013 (IRIN) - Boosting women&apos;s access to reproductive healthcare could significantly reduce both the number of unsafe abortions and the high cost of post-abortion medical care in Uganda, experts say.</td></tr></table>]]></content:encoded></item><item><title>Beyond free school feeding in Uganda&apos;s northeast</title><pubDate>Wed, 13 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201111041038290431t.jpg" />]]>KAMPALA 13 February 2013 (IRIN) - With food aid programmes in Uganda&apos;s northeastern region of Karamoja once again under threat from declining financial aid, experts are calling for more sustainable solutions to the region&apos;s food security challenges.</description><body><![CDATA[KAMPALA 13 February 2013 (IRIN) - With food aid programmes in Uganda's northeastern region of Karamoja once again under threat from declining financial aid, experts are calling for more sustainable solutions to the region's food security challenges.

"We must stop the dependency culture in Karamoja. The Karimojong must be taught on how to grow food instead of giving them food. They can't continue depending on relief food and donations for their survival," Fagil Mandy, education consultant and chairperson of Uganda National Examinations Board (UNEB), told IRIN.

"We need more concerted efforts to help the Karimojong grow their own food. We need to marshal programmes for small- and large-scale agriculture in Karamoja. This will enable people to grow enough food for themselves and provide school meals for their children," he said.

The UN World Food Programme (WFP), which has provided food aid to the region for the last 40 years, has scaled down in recent years and is focusing its assistance in ways aimed at reducing dependency [ http://www.irinnews.org/Report/96065/UGANDA-Weaning-Karamoja-off-food-aid ]. WFP’s new approach includes a big assets-creation project and school meals and other child-focused initiatives aimed at aiding education and addressing Karamoja’s high stunting rates among children. However, WFP has been forced to reduce its school meals assistance due to a lack of funding. With a gap of US$5.5 million in its 2013 budget, WFP is providing one meal a day to students rather than two or three.

"It is true that WFP is faced with funding constraints for the programme and that for some months this year it will not be able to provide lunch and supper [for boarding children], as is the case usually," Lydia Wamala, WFP spokesperson in Uganda, told IRIN.

Affecting school attendance

Government officials admitted this could affect school attendance in a region where the illiteracy level - 88 percent - is more than twice the national average.

"The food has been a good boost in keeping children in school in Karamoja... [It will] affect education in terms of enrolment, quality, standards and performance. The children are going to drop out of school, which is a big worry for us," Education and Sports Minister Jessica Alupo told IRIN.

Some 100,000 children in 279 schools benefit from the feeding programme.

According to Specioza Kiwanuka, the executive director of the NGO Build Africa, one of the ways to ensure that school-feeding programmes are sustainable is to help them set up garden "farms" that are not only used as a source of food but also as training facilities for farmers.

"There is need for [the] establishment of school gardens. These can also be utilized as demonstration centres in good agronomic and post-harvest handling practices," Kiwanuka told IRIN.

"In a such a way, school gardens not only act as a source of food for midday school meals but also parents and pupils are able to learn and adopt agronomic practices to help them improve own household food production," she added.

Officials told IRIN the government has begun working with schools in the region to set up school gardens.

"We have asked the school authorities to identify land for establishing school gardens. We shall plough and give them seedlings for planting. This will bolster food security for schools," Barbara Nekesa Oundo, the minister for Karamoja Affairs, told IRIN. 

Households stressed

Some have called for a change from the local nomadic lifestyle to crop-based agriculture.

"There is need for the sensitization of the population... We need to turn them from nomads to farmers. This will enable parents to provide food for the schoolchildren," Daniel Nkaada, a senior education official, told IRIN.

Others say pastoralism should be preserved, with a combination of specialized livestock raising strategies and opportunistic cropping employed to make the best use of the region's dry and wet seasons and to safeguard the region's environment.

Karamoja is home to an estimated 1.2 million people scattered over 28,000sqkm in the districts of Abim, Amudat, Kaabong, Kotido, Moroto, Nakapiripirit and Napak. The underdeveloped region - which consistently registers the lowest human development indicators in the country - is prone to climate shocks, experiencing a severe drought in 2006, both a prolonged dry spell and flooding in 2007, and another prolonged dry spell in 2008. About 970,000 people were in need of food aid in 2009.

In 2012, harvests were below-average and household food stocks in most areas of Karamoja are expected to be depleted two to three months early, according to the Uganda food security outlook for January-June 2013, released in February by the Famine Early Warning Systems Network (FEWS NET).

"In most areas of Karamoja, households currently are facing stressed food insecurity conditions. Many households are relying on a combination of market purchases and food assistance, and with normal income sources falling short, poor households will only be able to meet basic food needs. Over the next six months, these households are classified as stressed," said the FEWS NET report.

so/ko/rz

]]></body><link>http://www.irinnews.org/Report/97472/Beyond-free-school-feeding-in-Uganda-apos-s-northeast</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201111041038290431t.jpg"/></td><td valign="top">KAMPALA 13 February 2013 (IRIN) - With food aid programmes in Uganda&apos;s northeastern region of Karamoja once again under threat from declining financial aid, experts are calling for more sustainable solutions to the region&apos;s food security challenges.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Girl child soldiers face new battles in civilian life</title><pubDate>Tue, 12 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201009271253370112t.jpg" />]]>JOHANNESBURG 12 February 2013 (IRIN) - Girl child soldiers are often thought of only as “sex slaves”, a term that glosses over the complex roles many play within armed groups and in some national armies. This thinking contributes to their subsequent invisibility in the demobilization processes - in fact, girls are frequently the most challenging child soldiers to rehabilitate.</description><body><![CDATA[JOHANNESBURG 12 February 2013 (IRIN) - Girl child soldiers are often thought of only as “sex slaves”, a term that glosses over the complex roles many play within armed groups and in some national armies. This thinking contributes to their subsequent invisibility in the demobilization processes - in fact, girls are frequently the most challenging child soldiers to rehabilitate. 

The broad categorization of girl soldiers as victims of sexual abuse obscures the fact that they are often highly valued militarily. While sexual abuse is believed to be widespread, girls’ vulnerability may vary, as attitudes toward women differ extensively across militias: In Colombia, the Marxist-leaning groups the Revolutionary Armed Forces of Colombia (FARC) and National Liberation Army (ELN) treated female soldiers as equal to males, while right-wing paramilitary groups were known to embrace gender stereotypes. 

Some have argued that disarmament, demobilization and reintegration programmes (DDR) are ill-equipped to address the needs of girls. DDR was designed for adult male combatants, and over the years has incorporated female combatants, followed by boy soldiers and then girls. 

A January 2013 World Bank briefing, Children in Emergency and Crisis Situations, says: “The use of girls [by armed forces] has been confirmed in Colombia, DRC [Democratic Republic of Congo], East Timor, Pakistan, Sri Lanka, Uganda and West Africa. There are some 12,500 in DRC. However, girls are generally less visible and up to now have hardly benefited from demobilization and reintegration programmes for child soldiers.” 

“No one knows what has happened after a DDR process to the large majority of girls associated with the armed groups,” the briefing said. 

About 40 percent of the hundreds of thousands of child soldiers scattered across the world’s conflicts today are thought to be girls, but the numbers of girls enrolling in child soldier DDR programmes dwindles to five percent or less. 

Girls often conceal their association with armed groups, Richard Clarke, director of Child Soldiers International [ http://www.child-soldiers.org ], told IRIN. In traditional societies, enrolling in DDR could confirm a past that imperils their future: “In contexts of entrenched gender discrimination, and in situations where a girl’s ‘value’ is defined in terms of her purity and marriageability, the stigma attached to involvement in sexual activity, whether real or imputed, can result in exclusion and acute impoverishment,” he said. 

Seeking gender equality 

Then there is the uncomfortable reality that some conflicts may actually fast-track gender emancipation. 

A 2012 report [ http://uit.no/Content/307291/Post_War_Processes_Report_Final.pdf ] by Tone Bleie of the University of Tromsø’s Centre for Peace Studies (CPS) explores this issue. During Nepal’s civil war, when Maoists conscripted “one member per house”, some parents offered their daughters to spare “sons whom they considered as their life insurance.” Of the Maoists’ 23,610 combatants at the cessation of hostilities, 5,033 were believed to be female, and of them 988 were girls. 

“Female combatants developed a new sense of pride and dignity due to personal sacrifices, military courage, feats in the battlefield and prospects of promotion in the ranks,” the report says. 

In the wake of Nepal’s 2006 ceasefire, during the cantonment of Maoists rebels and the subsequent reintegration process, girls and women were returned “to [the] very low position of women in traditional Nepalese feudal society,” Desmond Molloy, a panellist at the International Research Group on Reintegration at the CPS, told IRIN. 

“Inter-cast marriage, and marriage in general, was encouraged in the cantonment. This is taboo in Nepali society and proved a major obstacle for reintegration of young girls back into society, especially when they have children, as many do. Further there is in [Nepal’s] society a perception of a promiscuous environment in the cantonment. So many young girls were viewed with suspicion by their families, rejected by their new in-laws or ostracized by the community,” Molloy said. 

Abdul Hameed Omar, programme manager for the UN Development Programme’s Interagency Rehabilitation Programme, told IRIN that acceptance of inter-cast marriages was particularly problematic. “Children have been denied birth certificates, and women have been denied their citizenship certificates. When the community knows that a woman has been part of the PLA [People’s Liberation Army], these women sometimes face a stigma,” he said. 

He said attitudes of male Maoist ex-combatants “vary widely” but that “many voiced opinions that were not in line with their previous [gender equality] beliefs during the conflict. Other male ex-combatants who played traditionally female roles during the conflict, i.e., cooking or childcare, no longer feel that these are appropriate roles for men outside of the PLA.” 

Loss of power 

Many Colombian girl soldiers, who fought as equals to their male counterparts, struggled with the double standards of civilian life. 

“For some girls, belonging to an illegal armed group gives them a sense of power and control that they may not otherwise experience living in a relatively conservative, ‘machista’ [chauvinist] society,” said Overcoming Lost Childhoods, a Care International report about rehabilitating Colombian child soldiers [ http://www.essex.ac.uk/armedcon/story_id/000760.pdf ].

By the end of Eritrea’s 30-year-long liberation war, in 1991, females comprised between 25 and 30 percent of combatants. The gender-equality ideals espoused by the Eritrean People’s Liberation Front’s (EPLF) had proved an attractive lure for female recruits, including some who were teenagers or younger. 

But “many Eritrean female ex-fighters experienced the years of war as preferable to the time that came afterwards… They had felt respected, equal and empowered, but this was all lost after the war when women were pushed towards traditional gender roles,” said the 2008 report Young Female Fighters in African Wars, Conflict and Its Consequences [ http://www.gsdrc.org/go/display&type=Document&id=3543 ].

Eritrea’s DDR programmes initially tailored economic opportunities for women to traditional gender roles - basket weaving, typing and embroidery - but this did not provide a sustainable livelihood. Training women in traditionally male trades also proved fruitless because society’s norms ultimately dictated who could get which jobs. 

“Furthermore, female ex-fighters had a hard time getting married after the war as men usually claimed that these women had lost their femininity during the war. Many male ex-fighters also divorced their fighter wives for this reason and married civilian women,” the report said. 

Duality 

Girl soldiers’ versatility - they serve as combatants, spies, domestics, porters and “bush wives” - makes them highly valued among armed groups, which can also increase their difficulty reintegrating into civilian life. 

Despite this, punishments for girls in northern Uganda, such as whipping or caning, were meted out for the smallest infractions, Linda Dale, director of Children/Youth as Peacebuilders (CAP) [ http://www.childrenyouthaspeacebuilders.ca/About%20Us/contact.html ], told IRIN. 

“There is a strong tendency to force a kind of passivity on girls while at the same time they are expected to be combatants. This duality, as well as the effect of sexual violence, makes their rehabilitation more complicated, in my view,” she said. 

The length of captivity also differed between the sexes; average internment period for girls in northern Uganda was six to seven years, while boys faced about three years, Dale said. “Because of that, the effects of the experience, and therefore the need for more assistance in re-integration, will be higher. For example, many girl returnees are illiterate because they have been out of school so long.” 

Shelly Whitman, executive director of the Roméo Dallaire Child Soldiers Initiative [ http://www.childsoldiers.org/ ], told IRIN that some girls can be seen as suffering from Stockholm syndrome, where captives develop a sympathetic association with their abusers. 

“Girls were raped but then given to or chosen by a commander to be a ‘wife’. They are confused about their experiences, their guilt, their families’ expectations and religious beliefs. Additionally, many have children fathered by their captors. They are often rejected when they return home and viewed as non-marriageable material, damaged goods. With this kind of a homecoming, it creates confusion about your identity and your self-worth,” she said. 

Invisibility 

The assumptions and expectations of people operating DDR programmes may also affect girls’ reintegration. 

Girl soldiers are often assumed to be “‘following along’, rather than girls who have been recruited and used, however informally, for military purposes… These assumptions have resulted in tens of thousands of girls being literally ‘invisible’ to DDR programmers, although the situation has improved somewhat in recent years,” said Clarke of Child Soldiers International. 

Phillip Lancaster, former head of the DDR programme for the UN Organization Mission in DRC, told IRIN, “Boys with guns are easier to see and easier to fear.” DDR programmes might “ignore girls on the assumption that they don't present the same threat.” 

“My own experience is that girls are often invisible to DDR programmes that draw narrow categories around the notion of combat,” he said. “It's tricky to avoid getting caught up in categories as soon as one starts trying to define parameters of qualification for DDR programmes, and most of the decisions tend to have a somewhat arbitrary flavour simply because of the complexity of the subject matter. 

“Most of the Congolese armed groups… draw on local community resources… The definition of girl child soldier in this setting could, in theory, extend over all the young females in a community who were supporting, supplying, informing or directly fighting with a relevant armed group.” 

go/rz

]]></body><link>http://www.irinnews.org/Report/97463/Analysis-Girl-child-soldiers-face-new-battles-in-civilian-life</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201009271253370112t.jpg"/></td><td valign="top">JOHANNESBURG 12 February 2013 (IRIN) - Girl child soldiers are often thought of only as “sex slaves”, a term that glosses over the complex roles many play within armed groups and in some national armies. This thinking contributes to their subsequent invisibility in the demobilization processes - in fact, girls are frequently the most challenging child soldiers to rehabilitate.</td></tr></table>]]></content:encoded></item><item><title>Ugandan authorities concerned as HIV self-test kits hit the market</title><pubDate>Wed, 06 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201101050941290039t.jpg" />]]>KAMPALA 06 February 2013 (IRIN) - The sale of HIV test kits to the public by private chemists in Uganda is causing concern among health officials, who feel that HIV testing should remain in the hands of professionals and be accompanied by counselling.</description><body><![CDATA[KAMPALA 06 February 2013 (IRIN) - The sale of HIV test kits to the public by private chemists in Uganda is causing concern among health officials, who feel that HIV testing should remain in the hands of professionals and be accompanied by counselling.

A number of pharmacies in the capital, Kampala, are stocking HIV test kits imported from China, India and several European countries; they retail for as little as 3,000 Uganda shillings (US$1.12).

"There is high demand for the HIV test kits. People come to buy them here. We sell a Determine [brand] kit at 3,000 [shillings]," one dispenser at PlusMedic Pharmacy in Wandegeya, a suburb of Kampala, told IRIN.

"I personally buy the kits from the pharmacies. I do HIV self-testing monthly in order to know my status. I don't trust my husband. I believe he cheats without taking consideration of HIV," said Janat*, a local resident.

"The kits are available in several pharmacies. You just walk in and ask for them. I embrace my results, whether it's positive or negative. Once the test shows positive, I will go for a confirmatory test in a health unit," said Hillary, another resident.

Unsanctioned

Several countries are considering [ http://www.unaids.org/en/resources/presscentre/featurestories/2012/july/20120704hometesting/ ] introducing regulated over-the-counter HIV tests. In July 2012, the US Federal Drug Administration [ http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm310542.htm ] approved a rapid HIV test kit for sale to the public.

However, while the Ugandan government is keen to have more people to know their HIV status - just 45 percent of men and 66 percent of women have ever been tested and received results, according to the latest AIDS Indicator Survey [ http://health.go.ug/docs/UAIS_2011_REPORT.pdf ] - senior health officials say they have not approved the private sale of self-test kits and would prefer the public to continue to use the health provider- or client-initiated HIV counselling and testing model recommended by the country's national HIV strategy.

"People need to be careful of these kits. There are several mushrooming health service providers [pharmacies and other unqualified personnel], which are illegal, quack and not genuine at all. They are not approved by us," Christine Ondoa, Uganda's Health Minister, told IRIN.

"Our policy is HIV counselling and testing. As a ministry, we are improving and strengthening our health laboratories services across the country for reliable and accurate results," she added.

"All the HIV kits that enter Uganda through the normal channels meet the required international standards, but the danger of these test kits is misuse," said Gordon Sematiko, the executive director of the country's National Drug Authority (NDA).

"Self-testing is a complicated one. I am not sure whether those who buy the kits know how to use them," said the Wandegeya drug dispenser. "Drawing blood samples and putting them in the strip to get correct results is a hard process. It's better and advisable for the couples to go and test in a health facility."

Sematiko notes that the NDA has concerns about counterfeit test kits being imported into the country. "It's hard for us to test their quality," he said. "Those who default the law, we shall take them to the professional bodies like Uganda Medical and Dental Practitioners Council, the Council of the Pharmaceutical Society of Uganda, and Allied Health Professionals Council of Uganda for disciplinary action."

Counselling critical

Some officials say HIV testing can be highly emotional and should be managed by trained professionals.

"There are usually sentiments depending on the outcome of the results. Imagine a person conducts an individual HIV test and gets a positive result - what happens without counselling?" said Godfrey Esiru, national coordinator for the prevention of mother-to-child transmission of HIV at the Ministry of Health. "Some people can end up attacking or killing their partners if the results show HIV positive."

The country has seen a number of cases [ http://www.plusnews.org/Report/90905/UGANDA-Deadly-consequences-of-inadequate-HIV-counselling ] of people killing their spouses over HIV-positive test results, highlighting the need for proper counselling following HIV testing.

"HIV counselling offered along with testing has been demonstrated to be an effective intervention for HIV infected participants, who typically increase their safer behaviours and decrease their risk behaviours," said Dan Travis, a spokesman for the US Agency for International Development (USAID), which supports HIV testing and counselling services in the country. "HIV testing without such linkage often confers little or no benefit to the patient."

However, senior Ugandan policy makers said they would be open to the idea of self-testing down the line, as long as it was properly regulated.

"It's important for people to know their HIV status in Uganda. I see science moving fast and making it easier for us," said David Kihumuro Apuuli, director-general of the Uganda AIDS Commission. "If we are to reach many people in Uganda, we require more sophisticated means like self-testing. However, we need to regulate it."

*name changed

so/kr/rz

]]></body><link>http://www.irinnews.org/Report/97419/Ugandan-authorities-concerned-as-HIV-self-test-kits-hit-the-market</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201101050941290039t.jpg"/></td><td valign="top">KAMPALA 06 February 2013 (IRIN) - The sale of HIV test kits to the public by private chemists in Uganda is causing concern among health officials, who feel that HIV testing should remain in the hands of professionals and be accompanied by counselling.</td></tr></table>]]></content:encoded></item><item><title>Uganda&apos;s immunization programme needs a shot in the arm</title><pubDate>Tue, 05 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201207241016190211t.jpg" />]]>KAMPALA 05 February 2013 (IRIN) - Inadequate funding, a shortage of health staff and poor adherence to vaccination schedules are some of the reasons for declining immunization levels in Uganda, which experts say threatens efforts to reduce preventable deaths among children.</description><body><![CDATA[KAMPALA 05 February 2013 (IRIN) - Inadequate funding, a shortage of health staff and poor adherence to vaccination schedules are some of the reasons for declining immunization levels in Uganda, which experts say threatens efforts to reduce preventable deaths among children.

Uganda’s national measles immunization coverage declined from 71 percent in 2006 to 55 percent in 2010, according to the UN World Health Organization (WHO) and the UN Children’s Fund’s (UNICEF) 2011 estimates.

“Routine immunization decline is due to health system issues that are affecting the entire health delivery, including limitations in the resource envelope, low staffing levels, inadequate capacities to manage the available resources, [and] vaccines- and related supplies-distribution challenges from national to district to operational levels,” Eva Kabwongera, the technical officer in charge of immunization with UNICEF in Uganda, told IRIN.  

“The main challenge has been establishing an immunization programme that can function smoothly year after year as part of solid primary healthcare systems.”  

Major childhood diseases in Uganda include measles, tuberculosis, poliomyelitis, pertussis (whooping cough), diphtheria, tetanus, hepatitis B, Haemophilus influenzae and neonatal tetanus. But some 48 percent of children under the age of five are un-immunized or under-immunized - meaning they start immunization but do not complete the schedule - according to the 2011 Uganda Demographic and Health Survey.

“The re-emergence of these diseases in Uganda is due to accumulation of non-immunized children because parents and caretakers have not been taking the children for immunization,” said a government statement [ http://www.mediacentre.go.ug/details.php?catId=3&item=1693 ].

Barriers to immunization

Between 2000 and 2007, the percentage of children receiving the final dose of the DPT3 (diphtheria, pertussis, tetanus) vaccine increased from 56 percent to 85 percent under Uganda’s Expanded Programme on Immunisation (EPI). Investments into the programme, including from the GAVI Alliance and Sustainable Outreach Services, contributed to that success, according to the ministry’s Health Management Information System report.  

But Uganda’s budget support for the EPI subsequently decreased by more than half - from 7.7 percent in the 2006-2007 financial year to 3.6 percent in 2009-2010. And recent challenges in routine immunization service delivery have resulted in reduced vaccination coverage, with DPT3 coverage, for example, falling to below 80 percent over the 2007-2011 period.  

Added barriers

In rural areas, culture, religion and long distances to health centres are added barriers to immunization.  

“There are several new religions in Uganda that mislead our people. Their leaders preach to them not to immunize or treat their children when they are sick.  They believe God will heal them,” Huda Oleru, a member of parliament (MP), told IRIN.

“We have had dialogue [with] Gospel Church leaders in Mbale [eastern Uganda]. For them, they don’t want their children to be immunized. They believe that the immunization vaccines are made [from] wild animals, which will make their children sick.”

Some of the people in Karamoja in the north, and in the Mount Elgon and Mount Rwenzori regions, failed to immunize their children because of cultural reasons, Oleru added. “A majority of them have never been immunized and are still alive. So they are wondering why they should immunize their children.”

According to Philippa Musoke, the principal investigator for paediatric infectious diseases at the Makerere University-Johns Hopkins University Clinical Research Site in Kampala, most of the health centres where immunization services are carried out are very far from people’s homes.

“It requires mothers to have money for transport, which most of them don’t have. People only take children [for immunization] during national immunization days,” Musoke told IRIN.  

“The challenges need to be handled using [a] multi-approach. The Ministry of Health needs to sensitize the community about the benefits of immunization, ensure the services are taken nearer [to] where they can get them easily. We need to use the village health teams to strengthen immunization in the community.”

More health investment is also needed.

“The current government allocation to [the] health sector is too low, affecting its allocation to key programmes like immunization,” Musoke said. “We encourage the government to increase [the] health budget so that our people, especially children - our future leaders - live a healthy life.”

According to UNICEF’s Kabwongera, “The government needs to give incentives to health workers in order to encourage them to work in rural areas and strengthen the health systems. Recruit low cadres in order to strengthen the health systems in rural areas.”  

Gaps in the system

Uganda also risks losing the gains it has made in its national polio eradication programme, according to a November 2012 report, which noted that districts’ surveillance teams lack the training to help track polio and suspected polio cases at health facilities and in villages.

“There are a lot of gaps in the health system, and this requires redress for the country to realize its mandate of eradicating polio,” Joseph Munaba, a member of the Uganda Polio Eradication Team at the health ministry, told IRIN. The team is tasked with improving wild polio surveillance in districts perceived to be at high risk along the Democratic Republic of Congo, Kenya and South Sudan borders.  

A monitoring visit in the northern Agago District in 2012 revealed that health centres there lacked essentials items, including containers for collecting specimen from suspected polio cases, and that health workers also lacked necessary knowledge, Munaba said.

That many women give birth away from hospitals is also a problem.  

“There is a challenge in Uganda where so many mothers in the rural villages do not attend antenatal care, and their children miss out [on] immunizations. This presents a dangerous situation because Uganda is bordered by countries with reported cases of wild polio,” Emmanuel Tenywa, the WHO northern Uganda regional officer, told IRIN.

Uganda had been polio-free since 1996, but recorded a re-emergence of the disease in 2009, when eight cases of wild poliovirus type 1 were reported in the northern districts of Amuru and Pader.

Measures to improve vaccination

On 20 November 2012, MP Oleru submitted the Immunization Bill 2012, which seeks to impose penalties and fines on parents and guardians who fail to take their children for routine immunization against the major childhood diseases.  

“The decline of immunization in Uganda is majorly [based] on the attitude of the parents. So we need a law to force them to routinely take their children for immunization,” Oleru told IRIN. “People should support the bill. They shouldn’t look at it as a punishment. We need to protect the children; the future of this country belongs to them.”  

Expressing support for the bill, Uganda’s state minister for primary healthcare, Sarah Achieng Opendi, said, “There is no compromise on immunization of our children. As government, we shall support the bill once it comes to the floor of parliament for debate. We want to ensure that every child in Uganda is fully vaccinated with high-quality and effective vaccines against the vaccine-preventable diseases.”  

Uganda’s health ministry has established a quarterly national child-and-family day during which immunizations are carried out; it is also partnering with churches and mosques. “With national campaigns and doing immunization during Friday and Sunday prayers, we believe we shall be able to reach 90 percent coverage in immunization from the current 52 percent,” Opendi told IRIN.

The government also plans to introduce the pneumococcal conjugate vaccine to fight pneumonia in 2013. “Having realized that pneumonia is one of the major causes of infant deaths, we shall begin to vaccinate children against the disease,” Christine Ondoa, Uganda’s health minister, was quoted as saying in Uganda’s New Vision newspaper.

Vaccines for rotavirus and human papillomavirus (HPV), which causes cervical cancer, will be introduced in 2014. “If we vaccinate girls when they are still young, we shall be lowering their chances of getting cervical cancer,” Ondoa said. The HPV vaccination campaign [ http://www.irinnews.org/Report/96254/UGANDA-Government-launches-cancer-vaccination-programme ] is already being piloted in 12 of the country’s 112 districts.  

so-ca/aw/rz

 ]]></body><link>http://www.irinnews.org/Report/97413/Uganda-apos-s-immunization-programme-needs-a-shot-in-the-arm</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201207241016190211t.jpg"/></td><td valign="top">KAMPALA 05 February 2013 (IRIN) - Inadequate funding, a shortage of health staff and poor adherence to vaccination schedules are some of the reasons for declining immunization levels in Uganda, which experts say threatens efforts to reduce preventable deaths among children.</td></tr></table>]]></content:encoded></item><item><title>Uganda begins rollout of provider-initiated HIV testing</title><pubDate>Wed, 30 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2008/20080704t.jpg" />]]>KAMPALA 30 January 2013 (IRIN) - All people who seek treatment in health centres in Uganda will be offered HIV testing and counselling under a new plan to increase access to HIV prevention and treatment.</description><body><![CDATA[KAMPALA 30 January 2013 (IRIN) - All people who seek treatment in health centres in Uganda will be offered HIV testing and counselling under a new plan to increase access to HIV prevention and treatment.

The acting programme manager of the AIDS Control Programme at the Ministry of Health, Alex Ario, says the campaign, 'Know your Status', will be rolled out in phases to accommodate the country's struggling health system [ http://www.irinnews.org/report/96332/uganda-patients-go-private-as-state-sector-crumbles ] and low health worker numbers.

The system has been tested [ http://www.irinnews.org/Report/78691/UGANDA-Routine-HIV-testing-boosts-uptake ], with promising results, in selected districts since 2006. The UN World Health Organization issued guidelines [ http://www.who.int/hiv/pub/guidelines/9789241595568_en.pdf ] for healthcare provider-initiated counselling and testing in 2007.

"This is provider-initiating counselling and testing to a person attending healthcare facilities. The patient will be counselled and educated before the tests," Ario told IRIN/PlusNews. "I call upon Ugandans to embrace the campaign and accept it."

Uganda employs a number of testing strategies, including: routine HIV testing for pregnant women; client-initiated counselling and testing; home-based HIV testing; couples HIV testing; mobile HIV testing; and moonlight (night-time) testing for high-risk groups such as sex workers.

According to government statistics [ http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_UG_Narrative_Report[1].pdf ], HIV testing is available in 80 percent of county-level health centres but only 22 percent of sub-county-level health centres. The number of people tested for HIV annually has gone up from 1.1 million in 2008 to 5.5 million in 2011.

Multiple benefits

The new strategy is part of efforts to lower Uganda's HIV prevalence, which climbed from 6.4 percent to 7.3 percent between 2006 and 2011. Studies [ http://www.ncbi.nlm.nih.gov/pubmed/20059356 ] have shown that beyond the benefits of having HIV-positive people identified and referred for treatment, provider-initiated counselling and testing may also result in less risky sexual behaviour, reducing levels of HIV transmission.

"There are so many benefits of knowing their HIV status. Those who are HIV-negative will be careful and avoid engaging in risky behaviours. They will carry out preventive options such as partner notification, abstinence and safer sex," Ario said. "Those who are HIV-positive will be enrolled in antiretroviral treatment and have increased opportunities for social support to live normally."

AIDS activists have welcomed the start of the new programme, but warn that the government must improve the health system in order to cope with the likely increase in treatment numbers.

"It's a good initiative. It will enable people to guard and take care of themselves. But our health system is struggling. It has not measured up. We have serious shortages of health workers in the health facilities," Florence Buluba, the executive director of the National Community of Women Living with AIDS (NACWOLA), told IRIN/PlusNews. "The government first needs to address the challenges the health sector is facing before rolling out the programme."

She also stressed the need for adequate health worker training to ensure patients' rights were respected. "How are they going to handle the repercussions of those found to be HIV-positive? How can they handle the blame or abandonment issues? They need to educate, persuade, encourage and prepare people before the results are released," she said.

The AIDS Control Programme is currently training health workers in routine HIV testing and counselling; the training involves pre-test information, counselling, testing, disclosure of results, post-test information, initiation on HIV care, treatment and follow-up. It is hoped that by December 2013, all public health facilities will offer routine HIV testing.

Challenges

The Ministry of Health will have to conduct large-scale media campaigns to educate the public about the voluntary nature of the programme; already, a number of media outlets in Uganda have wrongly described the programme as "mandatory" or "forced" HIV testing.

An upcoming HIV prevention and control bill [ http://www.scribd.com/doc/31680838/HIV-and-AIDS-Prevention-and-Control-Bill-2010 ] criminalizes the deliberate transmission of HIV, makes HIV testing mandatory for pregnant women and allows health workers to disclose one's HIV status to their sexual partner. Analysts worry that if this bill is passed, it could affect [ http://www.plusnews.org/Report/81636/UGANDA-Draft-HIV-bill-s-good-intentions-could-backfire ] the uptake of provider-initiated HIV testing and counselling.

"Institutionalizing this practice is good, but it will not reduce the HIV/AIDS prevalence rate in Uganda unless it... makes use of other platforms like collaborating with the media and other networks to publicize the proposed strategy," said Joan Esther Kilande, administrative and programmes assistant for the NGO Action Group for Health, Human Rights and HIV/AIDS (AGHA) Uganda.

A 2010 study [ http://www.ncbi.nlm.nih.gov/pubmed/20387980 ] of the challenges of provider-initiated counselling and testing in Uganda found some of them to be: counselling HIV-discordant couples; poor follow-up of HIV-infected clients; low levels of male involvement; frequent stock-outs of supplies; and shortages of counsellors, lab personnel and referral services.

"These challenges must be addressed in order to optimize the success of [provider-initiated testing and counselling] programs at providing universal access to HIV testing and counselling services," the authors recommended.

so/kr/rz

]]></body><link>http://www.irinnews.org/Report/97367/Uganda-begins-rollout-of-provider-initiated-HIV-testing</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2008/20080704t.jpg"/></td><td valign="top">KAMPALA 30 January 2013 (IRIN) - All people who seek treatment in health centres in Uganda will be offered HIV testing and counselling under a new plan to increase access to HIV prevention and treatment.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Cash-strapped ICC takes on Mali</title><pubDate>Tue, 29 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201207301203450616t.jpg" />]]>LONDON 29 January 2013 (IRIN) - Concerns are being raised that the International Criminal Court (ICC) investigation into alleged war crimes in Mali is placing a serious strain on an already over-stretched and cash-strapped institution.</description><body><![CDATA[LONDON 29 January 2013 (IRIN) - Concerns are being raised that the International Criminal Court (ICC) investigation into alleged war crimes in Mali is placing a serious strain on an already over-stretched and cash-strapped institution.

Announcing her first formal investigation since taking office, prosecutor Fatou Bensouda on 16 January promised justice to victims of “brutality and destruction” in three northern regions of Mali. But with a shrinking team of investigators and a budget that has barely increased despite a doubling of the workload, some analysts are doubtful she can deliver.

“There are serious questions to be asked of the new prosecutor as to whether it is a drastic overstretch to have eight African countries being dealt with simultaneously with essentially the same level of staff and the same level of finance as her office was operating on before,” said Phil Clark, a lecturer in comparative and international politics at the University of London’s School of Oriental and African Studies. “Is it really feasible for the office to be dealing with so many cases?”

The ICC intervenes in countries that cannot - or will not - prosecute perpetrators of mass atrocities. It is intended as a court of last resort in countries where prosecutions are unlikely to happen without its intervention.

Total court funding in 2013 is around US$144 million, with possible access to a contingency fund of up to $9.3 million, compared with $138 million in 2010. The prosecutor’s office, which carries out the investigations, was this year allocated $37 million. This represents an increase of just $1.3 million since 2010 despite the addition of Mali, Kenya, Côte d’Ivoire and Libya to the docket - and these countries were themselves in addition to the Democratic Republic of Congo (DRC), Sudan, Uganda and the Central African Republic (CAR).

“They are really at the edge of what they can do with their resources,” said Kevin Jon Heller, associate professor and reader at Melbourne Law School.

Investigating through intermediaries

The ICC is examining claims of murder, mutilation, torture, attacks on protected objects, executions, pillaging and rape since January 2012 when insurgent groups began their campaign to take over northern Mali. French troops and the Malian army have been reclaiming captured towns this month, but ongoing fighting means ICC investigators are unlikely to be gathering evidence on the ground.

“It isn’t like anyone from the ICC is going to Mali anytime soon,” said Heller.

Court investigators will instead speak to French troops, the Malian government and so-called intermediaries - usually local human rights groups who gather evidence and contact witnesses in areas the court cannot access.

Human Rights Watch, Amnesty International and the International Federation of Human Rights, among other groups, continue to actively investigate human rights abuses in Mali.

The use of intermediaries by ICC investigators has been controversial in previous cases, particularly during the trial of the DRC’s Thomas Lubanga. He was convicted [ http://www.irinnews.org/Report/95073/DRC-Lubanga-verdict-a-first-step ] of using children to fight in his Ituri rebel group but the intermediaries who helped prosecutors build the case were accused of bribing witnesses. Mathieu Ngudjolo Chui, who fought on the opposite side in the Ituri conflict, was late last year found not guilty [ http://www.irinnews.org/Report/97079/Reactions-from-the-DRC-to-ICC-acquittal-of-militia-leader ] of war crimes. The judges in that case were not convinced by the witnesses or the evidence.

Analysts hope the ICC will not repeat past investigative mistakes in Mali.

“Using intermediaries is unavoidable in those situations, because the intermediaries will know the field very well, be able to contact witnesses in a secure manner and arrange meetings in a way that can be done safely,” said Geraldine Mattioli-Zeltner, advocacy director in the international justice programme at Human Rights Watch.

“What needs to be improved is the way it is done; [there needs to be more] understanding [that] it is not the intermediaries who are conducting investigations but the investigators, and checking who your intermediaries are - whether they are credible and what kind of promises they have made to your witnesses.”

When possible, sending ICC investigators to the scene of the alleged crimes is the best way to investigate, she said. “It takes money to be able to deploy in the field which we believe is necessary in order to do good investigations.”

The Syria question

The ICC had asked for $157 million in 2013 to reflect its growing workload but major funders including the UK, France and Germany have resisted any increases. All three, however, signed a Swiss government letter to the UN Security Council earlier this month calling on it to refer Syria to ICC.

Russia, China and the USA - none of them ICC members - are unlikely to support such a referral.

Mattioli-Zeltner questions this pressure to add new cases to the already-crowded and unfinished docket.

“There is still more work to do in Darfur and DRC and now we are piling on new situations,” she said. “We don’t think the states parties have thought through what this means. It is very important that states commit to the justice process but also commit to an institution that has the means of doing its work properly.

“At this point we don’t think the ICC has the resources to do more situations, but we think there are a number of situations that deserve ICC intervention.”

Heller goes further: “I think if the Security Council should refer Syria and not give more money to the court, then Fatou [Bensouda] should refuse to investigate.”

But a UN request to intervene in Syria would be hard to resist for a young court that has yet to make its mark. Clark says the ICC wants to be seen as an active player in the conflict zones that matter most to the international community.

“The ICC is a new institution that is trying to build its own legitimacy,” he said. “It wants to be an option the Security Council can use in times of war, but this is leading the ICC to be too available even if they don't have the resources.”

The UN has already asked the ICC to investigate in Sudan and Libya. In Côte d’Ivoire and Kenya, the prosecutor’s office initiated the cases, while the governments of Mali, Uganda, DRC and CAR referred themselves to the court.

One-sided investigations

In Mali’s case the government asked the ICC to investigate in July 2012. Once a government asks ICC investigators to come into their country, investigators in theory, under their mandate, can pursue any case they find, which means they could end up charging government officials or members of the army. But to date, self-referrals have resulted only in cases against rebels.

Heller suggests that countries such as Uganda are using the ICC to “outsource their criminal justice problems” and should prosecute their own rebel groups. “Does the ICC need to spend all its time worrying about Joseph Kony and the LRA? Of course not,” he told IRIN. “If Uganda can get their hands on Kony, with international help they can give Kony a fair trial. Uganda has a very sophisticated legal system.”

The Uganda case faced sharp criticism when investigators failed to pursue evidence of widespread human rights abuses by the Ugandan army.

Likewise, instances of alleged extra-judicial killings carried out by the Malian armed forces this month and documented by human rights groups such as the International Federation of Human Rights, and Human Rights Watch, risk remaining untouched by the ICC.

One problem is that ICC investigators rely on governments to facilitate their visit to a country, which makes it difficult for them to pursue cases on all sides, even if it is within their mandate to do so, say observers. The ICC has no police force and thus relies on the goodwill of governments to make their investigations possible.

However, the ICC Prosecutor put up the pressure on the Malian authorities on 28 January, issuing the following statement: “My Office is aware of reports that Malian forces may have committed abuses in recent days… I remind all parties to the on-going conflict in Mali that my Office has jurisdiction over all serious crimes committed within the territory of Mali, from January 2012 onwards.” [ http://www.icc-cpi.int/en_menus/icc/press%20and%20media/press%20releases/news%20and%20highlights/Pages/otpstatement280113.aspx ]

The prosecutor’s office did not respond to IRIN’s requests for an interview.

lc/aj/cb

]]></body><link>http://www.irinnews.org/Report/97359/Analysis-Cash-strapped-ICC-takes-on-Mali</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201207301203450616t.jpg"/></td><td valign="top">LONDON 29 January 2013 (IRIN) - Concerns are being raised that the International Criminal Court (ICC) investigation into alleged war crimes in Mali is placing a serious strain on an already over-stretched and cash-strapped institution.</td></tr></table>]]></content:encoded></item><item><title>Ugandan HIV campaign targets &quot;cheaters&quot;</title><pubDate>Wed, 23 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201301231226290910t.jpg" />]]>KAMPALA 23 January 2013 (IRIN) - A new Ugandan HIV-prevention campaign that frankly addresses sexual infidelity is generating heated debate over the direction the country&apos;s HIV strategy should take.</description><body><![CDATA[KAMPALA 23 January 2013 (IRIN) - A new Ugandan HIV-prevention campaign that frankly addresses sexual infidelity is generating heated debate over the direction the country's HIV strategy should take. 

Billboards erected in various parts of the capital, Kampala, by Uganda Cares - a programme of the US NGO AIDS Healthcare Foundation (AHF) [ http://www.aidshealth.org ] - bear the image of a broken heart and the lines "Cheating? Use a condom" and "Cheated on? Get tested". 

The campaign aims to address the growing vulnerability to HIV of couples in long-term relationships. Studies [ http://siteresources.worldbank.org/INTHIVAIDS/Resources/375798-1103037153392/UgandaMoTCountrySynthesisReport7April09.pdf ] show that some 43 percent of new HIV infections in Uganda occur in such unions. 

"Let's be realistic... The HIV infections among married couples are high. So what we are putting across is that if you must cheat, remember to use a condom in order to protect your partner," Mina Nakawuka, AHF's regional director of advocacy and public relations, told IRIN/PlusNews. "Those who cheat must use condoms correctly and consistently. Those who feel cheated [on] must take an HIV test. If we don't do that, we shall not be able to reduce HIV infections in Uganda." 

But the Uganda AIDS Commission (UAC), the main government body tasked with managing the country's HIV response, has ordered the billboards be removed on the grounds that they oppose the messages of faithfulness that the government is trying to promote. 

"It's totally unacceptable. It's a wrong message. They are confusing people on which HIV prevention messages to follow," said David Apuuli Kihumuro, director general of the UAC. "I have talked to them [AHF]. I have directed them to remove all their billboards. They didn't consult us or the Ministry of Health." 

He added, "We are going to talk to the Uganda Communications Commission to regulate such messages and campaigns in the media and public. They shouldn't be allowed. We need messages that encourage people to have faithful lives and live [HIV] negatively." 

AHF's Nakawuka said, "We have some issues with UAC, which [we] are sorting out." 

ABC 

Uganda's health minister, Christine Ondoa, told IRIN/PlusNews that the national HIV prevention strategy continues to embrace 'ABC' - a prescription for Abstinence, Being faithful, and consistent and correct Condom use - as well as an array of biomedical interventions. She said her ministry would be investigating "why they [AHF] jumped to C". 

The ABC strategy was largely credited with reducing HIV prevalence from 18 percent in the early 1990s to about 6 percent in 2000. However, since then, prevalence has begun to rise again, going from 6.4 percent in 2005 to 7.3 percent in 2011, according to the most recent AIDS Indicator Survey [ http://health.go.ug/docs/UAIS_2011_REPORT.pdf ]. And despite years of HIV prevention messages, condom use remains erratic [ http://www.plusnews.org/Report/96359/UGANDA-Condom-use-infrequent-despite-rising-HIV-rates ]. 

The government has, in the past, been accused of bowing to pressure [ http://www.americanprogress.org/wp-content/uploads/issues/2010/01/pdf/pepfar.pdf ] from the US President's Emergency Plan for AIDS Relief, which encouraged HIV messages to focus more on abstinence and fidelity and less on condom use, to the detriment of the country's response to the epidemic. 

Traditionally, government-backed HIV prevention campaigns targeting couples have focused on less controversial messages such as faithfulness [ http://www.plusnews.org/Report/91875/UGANDA-Can-love-wheel-stop-infidelity-in-marriage ] and getting tested [ http://www.africomnet.org/events/practicum/2010/x/Day2/GoTogetherKnowTogetherHTCUganda.pdf ]. 

A 2010 review [ http://www.ncbi.nlm.nih.gov/pubmed/18843530 ] of couples-focused behavioural HIV-prevention interventions found that while these interventions can reduce unprotected sexual intercourse, there is a need for "stronger theoretical and methodological basis for couples-focused HIV prevention". The authors also recommended that future interventions "pay closer attention to same-sex couples, adolescents and young people in relationships". 

Encouraging immorality? 

The "cheating" billboard has stirred intense debate both on the streets of Kampala and on social media networks like Facebook and Twitter; many hold the view that the campaign's message is tantamount to encouraging infidelity, while others see it as a pragmatic approach to HIV prevention. 

"What is their moral motive? I can assure you, it's absolutely wrong and inappropriate to erect such campaign billboards," said Christine Shimanya, an associate vicar at Church of Resurrection, Bugolobi Church of Uganda. "As a church, we don't encourage immorality. If couples have gone off their marriages, the most appropriate intervention is by talking to them, not encouraging cheating. We need Christian post-marital counselling to help them in their morals." 

"We don't know the audience the campaigners are targeting," Linda, a news anchor at a local radio station, told IRIN/PlusNews. "They are encouraging people to continue cheating instead of stopping the immoral act. Such messages can't help. Why should people cheat in the first place?. Why should someone risk and put your life, loved ones and relatives at stake?" 

The flip side 

But a number of Ugandans say the campaign is a welcome shot in the arm for the country's flagging HIV-prevention efforts. 

"My impression is that this is a campaign to promote condom use and HIV testing, while acknowledging that multiple, concurrent partnerships are one of the key drivers of new HIV infections in the country," Milly Katana, a long-time HIV activist, told IRIN/PlusNews. 

"It needs to be backed up by the message that it is not only those that think their partners have extra sexual partners that need to use condoms or test for HIV, but anyone who has sex with someone whose HIV status they do not know must always and correctly use a condom, and routine testing is a gateway to prevention and eventual elimination of HIV," she added. 

Florence Buluba, the executive director of the National Community of Women Living with AIDS, said the campaign's emphasis on condom use was necessary. "If we are to prevent new HIV infections in Uganda, those who cheat and engage in risky sexual behaviours should use condoms, especially if [they] don't know the other person's HIV status," she said. "We should encourage the use of both male and female condoms. The condoms should be made available to all eligible persons and consistently used. The government must invest in it." 

James Onen, a popular radio personality, said the message on the billboards was "realistic". 

"I think the message will offend the moral hypocrites out there. People tend to pretend on the surface. but cheating is rampant," he told IRIN/PlusNews. "The campaign reminds people to live responsibly and act wisely, which make sense to me." 

But both sides of the debate agree that Uganda needs a fresh take on HIV prevention in order to reduce new infections. "We need a new, aggressive and attractive campaign that will reawaken Ugandans about the high HIV infections. People are used to the past messages, which are now stale," said Shimanya. 

so/kr/rz

]]></body><link>http://www.irinnews.org/Report/97317/Ugandan-HIV-campaign-targets-quot-cheaters-quot</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201301231226290910t.jpg"/></td><td valign="top">KAMPALA 23 January 2013 (IRIN) - A new Ugandan HIV-prevention campaign that frankly addresses sexual infidelity is generating heated debate over the direction the country&apos;s HIV strategy should take.</td></tr></table>]]></content:encoded></item><item><title>Rehabilitation centre for Uganda’s LRA returnees to close</title><pubDate>Fri, 18 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201301171226140548t.jpg" />]]>GULU 18 January 2013 (IRIN) - One of the only two remaining reception centres in northern Uganda helping reintegrate former members of the Lord’s Resistance Army (LRA) is threatened with closure. This would greatly reduce psychosocial support available to those directly involved - often as a result of abduction - in one of Africa’s longest-running conflicts.</description><body><![CDATA[GULU 18 January 2013 (IRIN) - One of the only two remaining reception centres in northern Uganda helping reintegrate former members of the Lord’s Resistance Army (LRA) is threatened with closure. This would greatly reduce psychosocial support available to those directly involved - often as a result of abduction - in one of Africa’s longest-running conflicts.

“We are considering closing our reception centre by March this year, but we hope to continue supporting these children outside the centre and other communities in [the] north through our child protection, health, education and livelihood programs ,” Paddy Mugalula, World Vision’s programme manager in Gulu, told IRIN.

Since 1994, the two rehabilitation centres, the World Vision Reception Centre and the Gulu Support the Children Organization (GUSCO), have attended to some 25,000 abductees and former fighters, according to their managers. They are the only centres still in operation, out of an initial six.

“There will be a problem with the reintegration of [adult] male returnees since our reception centre handles only children and women,” Robert Okeny, GUSCO’s program director, told IRIN.

Critical services

Among the services offered at these centres are assessment and treatment for trauma, post-traumatic stress disorder, depression, anxiety and sexually transmitted diseases.

These are serious concerns among demobilized LRA members. A 2008 study [ http://www.ncbi.nlm.nih.gov/pubmed/19357739 ] of former LRA child soldiers found that more than half exhibited symptoms of post-traumatic stress distress, concluding that there is an unmet need for psychological services.

Returnees are also normally provided material support like farm implements, cooking utensils, blankets and mattresses.

The centres also provide follow-up support to the reintegrated returnees, through training programmes in construction, tailoring, mechanics, baking and small business skills, to improve their ability to engage in productive, civilian work. Even after their reintegration, many returnees - especially girls and women who returned with young children - have continued using the centres as points for referral to access support from other agencies.

The positive role these reception centres play in reintegrating former LRA members into their communities is well documented.

“Available evidence emerging, with respect to the impact of centres on children’s rehabilitation and reintegration in Northern Uganda, suggest that children who spent time in centres have better mental health and psychosocial well-being compared to children that are returned directly to communities,” a report by the Institute for Security Studies [ http://www.iss.co.za/pubs/Monographs/No92/Chap3.pdf ] said.

Lack of funds

Managers of the rehabilitation centres say this and previous closures have been occasioned by a lack of funds. Operating the centres is expensive, and though they continue to provide important services, just a handful of new returnees are currently being received.

“We are [concerned] because these centres are still relevant and doing the good work of receiving, counselling and even treating the injured children and older returnees, and engaging communities deep in villages to help them forget and foster amicable co-existence with these people [former rebels] who once tormented them,” said Mathew Alobi, a local leader in Bobi Sub-county in Gulu District.

According to the locals, the rehabilitation centres have always facilitated the first contact between returnees and the community.

“When we talk about the LRA reception centres, we are talking of children returning from the LRA, so everything here counts if we are to win the confidence of these affected persons,” Daniel Kibat, a local leader, noted.

“What do you think those rebels out in the bush will imagine if they hear that centres are closing?” he asked.

Patrick Ojok, one of the returnees, told IRIN he would find it hard to go back to his community without the aid of a reception centre. Without rehabilitation, he said he would rather seek “military work in the Uganda People’s Defence Force as a soldier because I see no other way out” of military life.

The LRA continues to abduct people in the Democratic Republic of Congo and the Central African Republic, with 66 abductions recorded between July and September 2012, 20 percent of them children, according to the UN Office for the Coordination of Humanitarian Affairs.

Often, the abductees work as porters, sex slaves or fighters. Many of them find it hard to rebuild [ http://www.irinnews.org/InDepthMain.aspx?indepthid=92&reportid=94276 ] their lives upon return.

ca/ko/am/rz

]]></body><link>http://www.irinnews.org/Report/97276/Rehabilitation-centre-for-Uganda-s-LRA-returnees-to-close</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201301171226140548t.jpg"/></td><td valign="top">GULU 18 January 2013 (IRIN) - One of the only two remaining reception centres in northern Uganda helping reintegrate former members of the Lord’s Resistance Army (LRA) is threatened with closure. This would greatly reduce psychosocial support available to those directly involved - often as a result of abduction - in one of Africa’s longest-running conflicts.</td></tr></table>]]></content:encoded></item><item><title>In Brief: Staples, not export crops, key to tackling Africa’s poverty – report</title><pubDate>Fri, 18 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201202241255060114t.jpg" />]]>NAIROBI 18 January 2013 (IRIN) - Africa could reduce its poverty levels faster by focusing more on the production of staples rather than export crops, according to a study by the International Food Policy Research Institute (IFPRI).</description><body><![CDATA[NAIROBI 18 January 2013 (IRIN) - Africa could reduce its poverty levels faster by focusing more on the production of staples rather than export crops, according to a study [ http://www.ifpri.org/sites/default/files/publications/ib73.pdf ] by the International Food Policy Research Institute (IFPRI).

Authors of the study, conducted in 10 countries south of the Sahara, noted, “One important finding is that producing more staple crops, such as maize, pulses and roots, and more livestock products tends to reduce poverty further than producing more export crops such as coffee or cut flowers.”

According to the study, while more public resources would be required to generate more agricultural growth, “such public investment in staple sectors is probably cost effective”.

The authors argued that growth in the staple sector was more likely to benefit the poor than growth in the agricultural export sector.

Enoch Mwani, an agricultural economist at the University of Nairobi, concurred. “The agricultural export sector is generally associated with large corporations, but the poor rely predominantly on staples to survive.”

Mwani added that growth in staples had the effect of not only reducing poverty but also ensuring food security.

“[Governments that] invest in staples have the opportunity to increase food availability and, at the same time, create wealth for smallholders,” Mwani told IRIN.

To spur development in sub-Saharan Africa, the study’s policy conclusions call for a focus on accelerating agricultural growth; promoting growth in large agricultural subsectors; supporting growth across several agricultural subsectors; and promoting growth in subsectors with strong linkages to the overall economy and the poor.

ko/rz

]]></body><link>http://www.irinnews.org/Report/97278/In-Brief-Staples-not-export-crops-key-to-tackling-Africa-s-poverty-report</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201202241255060114t.jpg"/></td><td valign="top">NAIROBI 18 January 2013 (IRIN) - Africa could reduce its poverty levels faster by focusing more on the production of staples rather than export crops, according to a study by the International Food Policy Research Institute (IFPRI).</td></tr></table>]]></content:encoded></item><item><title>Peace restored, but northern Uganda’s children still struggle</title><pubDate>Wed, 09 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201212210931540009t.jpg" />]]>GULU 09 January 2013 (IRIN) - It has been years since northern Uganda&apos;s children had to troop to town centres at night for safety from abduction by the rebel Lord&apos;s Resistance Army (LRA), and most have moved on from the crowded displacement camps where they were born. But while they can sleep at night and look forward to a peaceful future, their lives are rarely easy.</description><body><![CDATA[GULU 09 January 2013 (IRIN) - It has been years since northern Uganda's children had to troop to town centres at night for safety from abduction by the rebel Lord's Resistance Army (LRA), and most have moved on from the crowded displacement camps where they were born. But while they can sleep at night and look forward to a peaceful future, their lives are rarely easy.

Over the course of the 20-year-war between the government and the LRA, an estimated 30,000 children were abducted from their homes to serve as fighters, porters and sex slaves and baby-sitters.

"It was a terrible period I will never forget. It was a life of total fear, knowing that anytime you could go [get killed or abducted]," 20-year-old Welsy Ajok told IRIN. "That period [2002-2004], I and couple of other children slept in the streets of [Gulu] town on the bare floor at the shop veranda... Sometimes we heard the gunshots of the rebels raiding the vicinity of the town in the night."

Today, Ajok lives 24km south of Gulu Town, in the village of Patek. She rides a bike to school every morning, after bringing her two children - ages two and five - to an early childhood development centre.

"It's a relief, because our children have a different way of life that looks brighter. They are learning how to do things in school and at home," Patrick Ojwang, another Patek resident, said. "Forget about the LRA days. The children are happy, living a life of no violence - all we have to do as parents is provide a conducive environment for the children to learn and develop."

Yet poverty, harmful cultural practices and inadequate child protection mechanisms - both legal and community-based - continue to exact a toll on children’s welfare.

Education

Many parents struggle to afford their children's education. While primary and secondary school education is free in Uganda, related costs like transportation, uniforms, books and school supplies pose significant financial challenges to poorer families.

In Purongo Village, situated along the Gulu-Arua Road, weary children return from labouring on local commercial farms. "That's what I and other children here do during holidays to raise money," said Langol Olango, a 14-year-old pupil at Purongo Hill Primary School. "On a good day, when I harvest a big area of the rice, they pay me 15,000 shillings [about US$5.50], but it's a very tedious kind of work."

Olango spends part of his earnings on his family's basic needs and the rest on school supplies.

Government officials in the north say the region's continued poverty is causing problems for children's education. "Though enrolment is high, the dropout rate is equally high year in, year out. The worst affected are girls," said Charles Irwenyo, the district education officer in Nwoya.

In April 2012, Uganda's Daily Monitor reported that the school dropout rate for girls in Gulu District was 40 percent. Teenage pregnancy is a major reason girls leave school. Other challenges include: long distances between homes and schools; pupil-to-teacher ratios as poor as 60 to one; and lack of an adequate diet.

A visit to health centres in the region revealed a high number of children seeking treatment. Medical workers say some of the common child illnesses are malaria, malnutrition, respiratory tract infections and diarrhoea.

Child protection

Vincent Ouma, the district’s community service officer for children’s affairs in Gulu, told IRIN that child protection is also a major issue. "It's challenging for district/local government to provide direct support towards such challenges. We rely on the support of nongovernment organizations intervening in areas of child protection," he said.

A 2012 report [ http://www.cpcnetwork.org/admin/includes/doc_view.php?ID=884 ] on child protection in the northern Ugandan districts of Lira and Dokolo, by the NGO Child Protection in Crisis, found that major sources of harm include: sexual abuse, child labour, verbal abuse, unfriendly home environments, poverty, as well as harmful cultural practices like early marriage.

The Canada, Holland and UK branches of the NGO War Child are engaged in child protection programmes to keep children from being exploited.

"Our work focuses on prevention and response to issues of child protection... providing legal, advocacy... and promoting child protection in partnership with agencies like the police, district community development officers, probation officers, civil society organizations and community structures like child protection committees to address these challenges," said Beatrice Ocaya, a regional coordinator of child protection activities at War Child Holland in Gulu.

According to Johnson Kilama, the commissioner of police in northern Uganda, much more is needed to address child protection in the region.

"A lot of efforts are being undertaken, but it will take some time for people to understand that there is need to protect children wherever they are. It’s a collective responsibility," he said.

ca/kr/rz

]]></body><link>http://www.irinnews.org/Report/97206/Peace-restored-but-northern-Uganda-s-children-still-struggle</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201212210931540009t.jpg"/></td><td valign="top">GULU 09 January 2013 (IRIN) - It has been years since northern Uganda&apos;s children had to troop to town centres at night for safety from abduction by the rebel Lord&apos;s Resistance Army (LRA), and most have moved on from the crowded displacement camps where they were born. But while they can sleep at night and look forward to a peaceful future, their lives are rarely easy.</td></tr></table>]]></content:encoded></item></channel></rss>