http://www.irinnews.org/irin-fp.aspxUpdated everydayen-gbThu, 11 Mar 2010 14:13:58 GMTLUSAKA Thursday, March 11, 2010 (IRIN) - Parity Zulu, 17, constantly recited a Biblical verse asking God for protection from her persecutors while her mother ferried her to hospital following complications from the teenager's illegal abortion.LUSAKA Thursday, March 11, 2010 (IRIN) - Parity Zulu, 17, constantly recited a Biblical verse asking God for protection from her persecutors while her mother ferried her to hospital following complications from the teenager's illegal abortion.

Her mother, Margaret, was unaware that her daughter had paid K350,000 (US$74) for a back-street abortion three days earlier. "All the way to the hospital I asked my child what happened. She wouldn't tell me. Then she began to sing Psalm 57, a cry for help. I began to suspect she was aborting a pregnancy," she told IRIN.

At the hospital's emergency admission desk, Zulu's medical condition was immediately apparent to Nurse Serephina Moonde. "I can tell a botched abortion as they come in through the doors - on average I see up to ten new patients a day. Women and young girls coming in, bleeding - sometimes we can save them; other times, like in Parity's case, it's too late - their wombs are rotting and they have lost too much blood."

Moonde said she had seen the results of the horrific methods women sometimes used to induce abortion: drinking crushed glass boiled with coca-cola, inserting crudely sharpened wooden sticks into the cervix, taking heavy doses of anti-malaria tablets, and even ingesting poisons such as battery acid.

Zambia's maternal mortality rate of 591 per 100,000 live births is one of the highest in the world, according to the 2008 Demographic Health Survey (DHS), the most recent.

One-third of maternal deaths are thought to be the result of abortion, but a shocking statistic is that 80 percent of the women who die from abortions are under the age of 19.

Abortion law

The Zambian Termination of Pregnancy Act 1972 is based on British colonial legislation, which permits abortion when continuation of the pregnancy can be proved to be detrimental to the mother, or the child, or both.

The law states that those wanting a termination must seek the consent of three physicians, but this requirement may be waived, if the abortion is deemed an emergency, to save the woman's life or prevent grave permanent injury to her physical or mental health.

In 2009 the University Teaching Hospital (UTH) in the capital, Lusaka, the country's largest medical facility, recorded 5,295 abortions, of which 5,246 were a consequence of incomplete abortions; 31 women died as a result of complications.

Only nine terminations of pregnancies were performed at UTH in 2009, according to the provisions of the law, down from the 2008 figure of 126 legally performed terminations.

Dr Peter Mwaba, UTH's managing director, told IRIN that the hospital was a place of last resort, and the statistics did not include women seeking help for complications from an abortion at other public or private clinics.

He said many women did not have access to effective contraception, and there were gender inequalities as well as deeply entrenched stigmas around abortion, which contributed to women practicing self-abortion or seeking other unsafe procedures. Women seeking to terminate pregnancies were also making use of the greater availability of a variety of drugs at pharmacies and private clinics.

It was the attempts to procure abortions this way [unsafely] that brought on the complications - it was basically guesswork, and that was why women arrived at hospitals "half dead", he said.

Holo Hachoonda, a clinical director at the Planned Parenthood Association (PPAZ), told IRIN that many health practitioners did not understand the abortion law, and were reluctant to provide these services.

"People still do not see abortion as a right backed by law. They still also have not gotten used to the thinking that a woman has rights over her own body, and can make decisions about something like abortion," he said.

Mary Beth Jones, 46, decided to seek an abortion after falling pregnant with her fifth child. At the clinic she was asked why, as a married woman who had no health issues, she wanted an abortion. Had she had committed adultery?

"They wanted me to tell my husband, go through couple counselling, etc. I also felt they were judging me, and I was afraid that there would be no confidentiality, as we were being lumped together like naughty children and lectured. I can imagine how horrible it must be for a young girl seeking an abortion," she told IRIN.

Jones resorted to a herbal remedy from a traditional healer to induce a miscarriage. "I haemorrhaged so badly I ended up in hospital and had to have my womb removed. Needless to say, I am now a divorcee."

Religious barriers

In an effort to improve the efficacy of the Act, in June 2009 the government launched the Standards and Guidelines for Reducing Unsafe Abortion Morbidity and Mortality in Zambia, for interpreting the 1972 legislation.

The guidelines provided for abortions to be performed in the interests of a women's physical or mental health; nurse practitioners had been trained to provide medical abortions and first-trimester abortions; women no longer had to stay overnight in hospital after the procedure. Family planning services, including abortion services, have been extended throughout the country.

However, the biggest challenges to abortion are the deeply held religious views that think girls engage in sex when they should not, and see abortion as a sign of promiscuity.

Zambia's more than 11 million people are predominantly Roman Catholic, but conservative evangelical churches have grown considerably in recent years; in combination these represent a formidable degree of social disapproval of terminating pregnancy.

Suzanne Matale, Secretary-General of the Christian Council of Zambia (CCZ), the Catholic Church's mother body in Zambia, told IRIN that life began at conception. "There are no grey areas, no room for discussion. We condemn abortion. It's an absolute no-no."

Government spokesman Ronnie Shipakwasha, a Pentecostal church elder, told IRIN the abortion law would not be touched until there had been wide consultations with medical authorities, policy-makers and religious bodies.

He did not provide a timeframe, and there has been no call for this dialogue; he said the law, read in conjunction with the guidelines, was sufficient to ensure safe abortions.

"We just need to make this information available," he said. "We are a Christian country, so the church's teachings on morality are a major factor in how we deal with the issues of abortions."

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http://www.irinnews.org/report.aspx?ReportId=88393NAIROBI Tuesday, March 09, 2010 (IRIN) - Global funding shortfalls for fighting AIDS could make it impossible for developing countries to implement new World Health Organization treatment guidelines, activists have said. NAIROBI Tuesday, March 09, 2010 (IRIN) - Global funding shortfalls for fighting AIDS could make it impossible for developing countries to implement new World Health Organization treatment guidelines, activists have said.

WHO released new guidelines on antiretroviral therapy (ART) in December 2009, raising the CD4 count - a measure of immune strength - at which HIV-positive people should start ART from 200 to 350. Research has shown that starting ART earlier reduces the rate of death and opportunistic disease.

"WHO's new recommendations are excellent in theory, but they did not give us a practical way of implementing the guidelines - already we have shortages of drugs in trying to put people with CD4s below 200 on treatment," said James Kamau, coordinator of the Kenya Treatment Access Movement.

"How will we now put so many more people on ARVs? The increased number of people on drugs means not just more drugs, but more labs, more health centres and health workers, more general care - the expense is enormous."

An estimated four million people around the world are currently on ART - a 10-fold increase since 2003, when the drugs became widely available - but this figure still represents just over one-third of the people who need the medication.

"If WHO's new recommendations are not implemented, the international community risks subsidising less expensive yet sub-standard care for developing countries," said Sharonann Lynch, MSF's HIV/AIDS policy advisor, in a press release.

"Avoiding this will depend on the willingness of donors to make new commitments. Although this is not easy in today's financial environment, donor countries cannot back away from supporting the promise of universal access to treatment made five years ago."

"The situation is now an emergency"

In Uganda, where the government plans to release new treatment guidelines reflecting WHO's recommendations, officials said the number of people needing treatment would rise from 300,000 to about 750,000. The country recently suffered drug shortages in its public health sector, partially caused by funding problems.

"The numbers will be too great for us to manage," said Dr David Kigawalama, head of prevention services at the Uganda AIDS Commission. "We need to sit with our AIDS development partners to forge a way forward."

Ahead of a high-level meeting between Group of Eight (G8) leaders and AIDS advocates in London on 10 March, AIDS activists met with British International Development Minister Gareth Thomas on 9 March and called on the world's wealthiest nations to honour their 2005 Gleneagles pledge to achieve universal access to HIV prevention, treatment and care by 2010.

"Instead of building on progress, some donor nations and governments of highly affected countries are backing away from the universal access commitment with a series of poorly funded half-measures on AIDS," the executive director of the International AIDS Society, Robin Gorna, said in a press statement.

"The situation is now an emergency: new treatment enrolments in many countries are coming to a standstill, the risk of drug resistance is increasing, and fragile gains made over the last 10 years may soon erode, with potentially serious consequences for future efforts to control this epidemic."

The activists singled out Canada - the only G8 nation firmly opposed to the Financial Transactions Tax, a tiny tax on financial transactions that could raise the billions of dollars needed to fulfil the universal access pledge.

The global economic downturn forced the Global Fund to Fight AIDS, Tuberculosis and Malaria, the world's largest funder, to cut disbursements by 10 percent in 2008, while the US President's Emergency Plan for AIDS Relief (PEPFAR) has flat-lined funding to many countries, limiting the growth of PEPFAR-funded treatment programmes.

kr/kn/he http://www.irinnews.org/report.aspx?ReportId=88368NAIROBI Friday, March 05, 2010 (IRIN) - Here are the most popular new articles on the IRIN website over the last 24 hours. Updated hourly. This feature was launched on 18 July, but will display the latest, most popular items of today.NAIROBI Friday, March 05, 2010 (IRIN) - ---http://www.irinnews.org/report.aspx?ReportId=73277NAIROBI Tuesday, March 02, 2010 (IRIN) - Medical male circumcision is now widely recognized as an important HIV prevention tool, and several African countries have included it in their national HIV strategies.NAIROBI Tuesday, March 02, 2010 (IRIN) - Medical male circumcision is now widely recognized as an important HIV prevention tool, and several African countries have included it in their national HIV strategies.

IRIN/PlusNews lists the progress of 13 nations in eastern and southern Africa identified as priority countries for male circumcision scale-up by the UN World Health Organization.

Kenya: An estimated 85 percent of men are circumcised, but just 40 percent of those in Nyanza province, which has the country's highest prevalence, have had the procedure. In 2008 the government launched a national campaign and by the end of 2009 more than 90,000 men had been circumcised, 40,000 of them during a two-month "rapid results" initiative in Nyanza.

The government aims to have all uncircumcised men - an estimated 1.1 million http://www.plusnews.org/Report.aspx?ReportId=87074 - undergo the procedure by 2013. Kenya is the only African country to have successfully rolled out male circumcision on such a large scale.

Zambia: Male circumcision prevalence is 13 percent, and Zambia aims to circumcise about 250,000 men every year. More than 16,000 men were circumcised at 11 sites in 2009, and the goal is to have 300 sites offering the services by 2014.

Swaziland: The Ministry of Health and Human Services plans to provide circumcision to 80 percent of men aged 15 to 24 by the end of 2014 http://www.plusnews.org/Report.aspx?ReportId=86444. Just eight percent of Swazi men are circumcised. The country - which has the world's highest HIV prevalence - developed a male circumcision strategy in 2008; by the end of 2009 more than 5,000 men had undergone the surgery.

Botswana: Five centres of excellence have been identified to scale-up circumcision services, and Botswana's Ministry of Health aims to reach at least 460,000 HIV negative men and boys below the age of 49 by 2012. More than 4,300 men have been circumcised since April 2009.

Zimbabwe: In April 2009 the pilot phase of service delivery began, during which 1,818 men were circumcised at four sites. A national male circumcision policy was launched in November 2009.

Rwanda: Since 2008 the government has been rolling out male circumcision in the army, where prevalence is 4.5 percent compared to a national rate of three percent. A recent study http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000211 suggested that Rwanda should also be scaling up circumcision across a broad range of age groups, especially the very young, where the procedure was found to be highly cost-effective.

South Africa: The government has been criticized for moving too slowly http://www.plusnews.org/Report.aspx?ReportId=87315 in developing a national circumcision strategy. By December 2009 the country had a draft policy but no mechanisms for training, quality assurance, or monitoring and evaluation.
South Africa has the world's largest HIV-positive population.

About 35 percent of men are circumcised. Data from the only site currently providing free circumcision - Orange Farm, near Johannesburg - reveals that 14,253 men were circumcised in 2009.

Namibia: A draft policy was submitted to parliament and training of surgical health professionals is underway. Five circumcision pilot sites have been identified, two of which are in operation. A 2009 field analysis http://www.malecircumcision.org/programs/documents/Namibia11209.pdf showed that the unit cost per procedure was very high: US$88 for adults and $72 for newborns.

Lesotho: About 4,000 men are circumcised annually at government and private clinics. A policy has been approved but is yet to be launched, and formal scale-up has not yet started. The Puisano Outreach Organization, a local NGO, is engaged in male circumcision campaigns throughout the country.

Tanzania: A 2009 situation analysis http://www.malecircumcision.org/programs/documents/TanzaniaMaleCircumcisionSituationAnalysis_September_09.pdf found male circumcision was accepted, even among traditionally non-circumcising communities, and 70 percent of Tanzanian men were circumcised. A national policy is being developed and three demonstration sites have been set up.

Mozambique: No formal policy for male circumcision has been developed, but an existing operational plan for HIV prevention includes circumcision. Five pilot sites have been selected for scale-up in 2010.

A 2008 study found that rolling out adult male circumcision in Mozambique would put undue pressure on health workers, which would limit the scale and effectiveness of the programme.

Malawi: The country is conducting data analysis to inform its male circumcision strategy. A local NGO, Banja la Mtsogolo, http://www.banja.org.mw is providing male circumcision services in its clinics, where it has 19 trained clinicians performing the procedure.

Uganda: This is one of the three countries where studies showed the link between male circumcision and HIV, but only 25 percent of men are circumcised and HIV prevalence is rising. There has been some criticism for failing to start male circumcision quickly enough - the country still has no policy, nor has it started service delivery.

A 2009 situational analysis http://www.malecircumcision.org/programs/documents/MC_situation_analysis_Uganda_full.pdf found that most practitioners would need additional training to perform male circumcision.

kr/he http://www.irinnews.org/report.aspx?ReportId=88286JOHANNESBURG Monday, March 01, 2010 (IRIN) - When a crisis strikes, access to antiretroviral (ARV) drugs can be among the first casualties, particularly in countries where many people are on treatment. JOHANNESBURG Monday, March 01, 2010 (IRIN) - When a crisis strikes, access to antiretroviral (ARV) drugs can be among the first casualties, particularly in countries where many people are on treatment.

But experience in Southern Africa has shown that although preventing treatment disruptions may be wishful thinking, preparing for them has become a pressing need.

New research by the Health Economics and HIV/AIDS Research Division (HEARD) at South Africa's University of KwaZulu-Natal compared three recent crises that caused treatment disruption - Mozambique's 2008 floods, Zimbabwe's ongoing public healthcare crisis, and South Africa's 2007 public sector strike – to identify potential strategies for keeping patients on treatment during emergencies.

The HEARD report, Unplanned ARV Treatment interruptions in southern Africa: what can we do to minimise the long-term risks?, identified poor planning as the biggest weakness in responding to gaps in treatment access, and suggested that doctors and patients receive better training on what do during disruptions.

"Despite crises – whether political, economic or environmental – being relatively common in southern Africa, there has been very little systematic planning for them within ARV programmes," said HEARD's Andy Gibbs, who co-wrote the report. The region's weak health systems were often the cause of disruptions.

"Strong health systems have strong planning capacity, an ability to monitor what's happening and [to mobilize] the skills and resources to cope with unexpected issues," Gibbs said. Research has linked disrupted treatment to increased risks of drug resistance and treatment failure.

Weathering the storm

Southern Africa has some of the highest HIV prevalence rates in the world, while droughts, floods and cyclones typically spark humanitarian emergencies in this chronically vulnerable region. The Southern African Development Community (SADC) has pushed member states to integrate ARV treatment into national disaster preparedness planning.

The UNAIDS regional humanitarian response advisor for East and Southern Africa, Mumtaz Mia, said Mozambique, Zimbabwe and Namibia had taken the lead in ensuring that people did not miss ARV doses amid disasters.

Mozambique experienced some of the worst flooding in the country's history in 2007, and more than 56,000 people were affected by floods in 2008, but Mia noted that planning by UNAIDS, the national AIDS council and the National Institute for Disaster Management had helped minimize treatment disruptions.

HEARD found that Mozambique had mapped the location of ARV patients in flood-prone areas, and had educated community outreach workers in the vicinity in ARV provision ahead of the devastating floods in 2008.

Dr Mit Philips, a health policy analyst at the international medical and humanitarian organization, Medicines Sans Frontiers (MSF), pointed out the importance of giving patients information before and during treatment interruptions. MSF has been working in Mozambique, Zimbabwe and South Africa, and also provided ARV treatment during Kenya's 2008 post-election violence.

"When the [post-election violence] happened in Kenya, we set up a free hotline, we used radio spots and peer networks so that patients knew how to find us to pick up their pills and continue treatment," she told IRIN/PlusNews.

"You don't need to go and find patients, you need to make sure patients know how to go and find you. If you can foresee it, it's important that the patients know how to deal  with possible disruptions at their usual health centres – it should be part of treatment literacy."

When the public sector isn't so public

In 2007, South Africa was rocked by a public servant strike that lasted for a month and affected up to half a million employees, including health workers. Data from South Africa's Gauteng Province showed that the number of patients initiated on treatment in areas like Johannesburg's inner city dipped to one of the lowest in four years.

Testimony gathered in the Western Cape Province by Treatment Action Campaign, an AIDS lobby group, showed that during the strike some pharmacies were so short-staffed they were only able to fill 25 percent of orders.

Patients and doctors used varying coping strategies to deal with the treatment disruptions and the South African HIV Clinicians Society released guidance on how to cope with treatment interruptions. Some patients were able to get more than one month's supply of drugs.

HEARD researchers argued that the South African authorities could have foreseen such an interruption and provided both patients and doctors with better training on what to do when ARVs cannot be obtained.

In Zimbabwe ARV treatment in the public health sector has also seen its share of hard times. The economic crisis sparked migration among doctors and nurses as well as patients, while hyperinflation and high levels of unemployment meant the tests required before starting ARVs were often unavailable or prohibitively expensive.

To help migrants continue treatment in other countries, MSF gives patients portable copies of their medical records, including which ARV regimen they are on.

SADC has received funding to implement a similar regional "health passport" system, but national health ministers would have to get draft legislation passed to implement it. Access to treatment, even for documented migrants like asylum seekers and refugees, is problematic.

Funding flows pose their own threat

MSF's Philips said interruptions in financial flows posed as big a threat to ARV programmes as any flood or bout of civil unrest, and might become a threat of increasing importance as HIV and AIDS funding constricted in the global financial crisis.

"What we have been seeing in the last six months to one year are increasing disruptions to programmes ... many of these are due to delays in funding, or delays in the supply chain," she commented. "IN a way, it's more difficult to prepare for these [than for natural disasters] because the information on the risk of treatment disruption isn't always shared with implementing partners in a transparent way ahead of time."

In 2009, South Africa's Free State Province experienced widespread treatment disruption due to a combination of funding problems and allegations of poor management.

Philips noted that several countries including Malawi, Mozambique and Uganda  had experienced problems with funding or drug procurement, and were more vulnerable to disruptions not only because of weak health systems but also because of a heavy reliance on a single funding source. According to an MSF report, Punishing Success, the bulk of Malawi's ARV funding as of 2009 came from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

"What we are seeing is that quite a lot of donors seem to see the Global Fund as a main channel of international funding for HIV treatment. If there is only one channel and something happens, there's nothing you can do," she said. "Countries depend on the timely arrival of supplies; when money for drugs was delayed in Malawi, there was no buffer."

Few countries carry ARV buffer stocks - surplus drugs kept aside and used in the event of a drug shortage. Philips said this strategy was successfully employed in the Democratic Republic of Congo, which put a pool of donor-funded ARVs under World Health Organization management.

Fareed Abdullah, director of the Fund's Africa Unit, said the Global Fund had begun addressing funding delays after the issue was raised at the organization's highest level.

"Clearly, the reasons behind stock-outs are multi-factorial, and responsibility for them lies with various donors and implementing agencies, not least of all, governments," he told IRIN/PlusNews. "Having said that, there are certainly a number of steps within our financing process where the Global Fund considers the risk of drug stock-outs."

The Fund offers countries emergency disbursements to cover unexpected treatment shortages, and allows two years of gap funding to cover ARV treatment specifically, between grant disbursements, Abdullah said. The Fund has also taken on additional responsibilities in an effort to reduce treatment disruptions due to problematic procurement.

"Sometimes we finance drugs that make their way to the central store, and they don't get from the central store to the clinics – that's really for countries to address, alongside implementing partners," Abdullah commented.

"However, in some countries we have a failure of procurement and, even though we have resisted taking over those functions because we believe in country ownership, we now have a mechanism where we will procure drugs for a country."

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http://www.irinnews.org/report.aspx?ReportId=88272PRETORIA Friday, February 26, 2010 (IRIN) - Zimbabwe's still-limping economy can provide few essential services, so children living along the border cross into South Africa to attend school during the day or even to see a doctor, often at great risk to their personal safety.PRETORIA Friday, February 26, 2010 (IRIN) - Zimbabwe's still-limping economy can provide few essential services, so children living along the border cross into South Africa to attend school during the day or even to see a doctor, often at great risk to their personal safety.

The UN Children's Fund (UNICEF) regional child protection advisor for East and Southern Africa, Cornelius Williams, said the movement of unaccompanied child migrants from Zimbabwe was one of the biggest problems confronting humanitarian agencies in the region. Between 3,000 and 15,000 Zimbabwean children are known to move into and out of their country every month.

"Unfortunately, governments continue to devote most of their resources to child trafficking, where much smaller numbers of children are involved," Williams told IRIN at a meeting of officials from 15 countries in Pretoria from 23 to 25 February to discuss ways of strengthening cross-border co-operation to protect children at risk.

William Duncan, deputy secretary-general of the Hague Conference on Private International Law, the Netherlands-based world organization for cross-border cooperation in civil and commercial matters, said an even bigger issue was that "There is no central authority in Zimbabwe to contact to help repatriate the child."

The Chief Family Advocate in South Africa's Department of justice and Constitutional Development, Petunia Seabi, said a solution to the problem was being worked out. "We are in talks with the Zimbabwean authorities to set up protocols to protect these children."

She said neither of the governments would prevent children from accessing services across the border, but would rather try addressing the risks the children took while crossing the border unaccompanied.

Duncan pointed out that the numbers of Zimbabwean children moving around the region only underlined the need for close cooperation between child protection agencies and "between judges in different countries, and the Hague Children's conventions make this possible."

Many African countries have yet to ratify the Hague Conventions pertaining to children, which seek to standardize international legislation and provide a comprehensive legal framework to for the cross-border movement of children; more governments have ratified the African Charter on the Rights and Welfare of the Child and the UN Convention on the Rights of the Child.

Duncan acknowledged that most countries did not have the resources or the capacity to ratify the Hague Conventions, which include treaties on child abduction, inter-country adoption, protection of children and the international recovery of child support. He said the Hague Conference was trying to build capacity.

Delegates at the meeting said the discussion on the need for better cooperation between governments couldn't have come at a better time than on the eve of the FIFA World Cup, which kicks off in South Africa in June.

"We will probably see a flood of child migrants to South Africa, not only attracted by economic benefits but a chance to spot their football hero," said Williams.

The South African government was gearing up for the challenge, he said. They were planning safe areas for unaccompanied child migrants around the various stadia, and an advertising campaign aimed at visitors, which, they hoped, would deter child prostitution.

jk/he http://www.irinnews.org/report.aspx?ReportId=88249JOHANNESBURG Wednesday, February 24, 2010 (IRIN) - Temperatures seem set to soar to perilously high levels because of climate change. In another 40 years, would maize still be the staple food in Kenya, already hit by five failed rainy seasons? If not, what could people grow and eat? And if you could grow maize, how much water and fertilizer would it need? JOHANNESBURG Wednesday, February 24, 2010 (IRIN) - Temperatures seem set to soar to perilously high levels because of climate change. In another 40 years, would maize still be the staple food in Kenya, already hit by five failed rainy seasons? If not, what could people grow and eat? And if you could grow maize, how much water and fertilizer would it need?

If you live in the remote semi-arid Karamoja region of northeastern Uganda - beset by 14 droughts in 25 years - you might also want to know what your options are for continued food security.

For the first time, a customized regional climate model linked to crop growing and water models, run on a supercomputer at Michigan State University (MSU), will help provide crop breeders in three East African countries - Kenya, Uganda and Tanzania - with detailed answers on crop yields.

Many research institutions have been working on models to predict the impact of climate change on food production in Africa, but in a few months the MSU model will help scientists and breeders to zoom in at a regional level on the possible impact of climate change on a wide variety of crops in these countries.

The research could help produce climate-resilient varieties of food crops, said Jennifer Olson, lead researcher and associate professor at MSU's College of Communication Arts and Sciences.

"East Africa is already experiencing the impact of climate change - food crops are experiencing extreme water stress," she commented. People living in Kenya's highlands, who have traditionally grown tea and coffee, have begun experimenting with maize and beans as the climate has grown warmer.

Work on the model began 10 years ago with the recording of relevant data, such as the impact of nutrients on a certain food crop, or the impact of water stress on another, which were subsequently fed into the model. "The model is still being perfected," said Olson.

The model can experiment with the impact of climate change, such as high temperature and water stress on a certain crop variety, saving the time that would have been spent on field trials, "which will help speed up the agricultural research cycle", she noted.

The researchers intend to launch the model at a workshop in June. Concern about increasing food insecurity in East Africa has prompted two institutions to set up a research grants to encourage innovative solutions.

The New Partnership for Africa's Development (NEPAD), based in South Africa, and the International Livestock Research Institute (ILRI), in Nairobi, Kenya, announced a US$10.67 million grant from the Swedish International Development Agency (SIDA) to support the establishment of a multidisciplinary competitive funding mechanism for biosciences in Burundi, Ethiopia, Kenya, Rwanda, Tanzania and Uganda.

ILRI's Bruce Scott said they would be looking for innovative solutions using bioscience to improve crop resilience to climate change, or perhaps to improve the shelf-life of a food product.

jk/he http://www.irinnews.org/report.aspx?ReportId=88225JOHANNESBURG Thursday, February 18, 2010 (IRIN) - Cervical cancer is a leading killer among women living with HIV, but a low-cost screening programme developed in Zambia is proving that simple techniques can go a long way in saving lives. JOHANNESBURG Thursday, February 18, 2010 (IRIN) - Cervical cancer is a leading killer among women living with HIV, but a low-cost screening programme developed in Zambia is proving that simple techniques can go a long way in saving lives.

New research presented this week at the 17th Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco has shown that cervical cancer screening among HIV-positive women prevented one death for every 32 women screened.

Presented by Dr Groesbeck Parham of the University of Alabama at Birmingham, the research originated from a pilot study of about 6,600 HIV-positive women examined as part of the Cervical Cancer Prevention Programme in Zambia (CCPPZ), an ongoing low-cost screening project. More than half the women had abnormal results, and about 20 percent were diagnosed as having lesions at varying stages from pre-cancerous to advanced cancer.

According to the World Health Organisation, cervical cancer - which is caused by the human papilloma virus (HPV) - is the second biggest cause of female cancer mortality worldwide.

It is thought that women living with HIV are at a higher risk of cervical cancer, but the number of women being screened for the cancer remains low, especially in developing countries.

Results raising awareness

Dr Mulundi Mwanahamuntu, CCPPZ co-director alongside Parham, said screening was virtually nonexistent before the programme was set up.

"The [cancer] was still found, but usually at a stage where it was untreatable," he told IRIN/PlusNews. "In Zambia, cervical cancer is the biggest gynaecological burden we have, and the numbers of doctors that are equipped to handle it are few."

He said the programme had helped propel cervical cancer onto the national health agenda, and had prompted high-level discussion about the possible introduction of the HPV vaccine in the public health sector.

Screening by the programme's service costs about US$1 as compared to pap smears that cost about $15 and remain prohibitively expensive even in richer countries like South Africa. To keep costs this low, the programme enables health workers and nurses to carry out screening and treatment, allowing doctors - already in short supply - to perform other tasks.

The technique has been implemented nationally by training staff members at organizations like the Marie Stopes clinics for women's health, and the Zambian armed forces. The screening programme has also drawn interest from other countries, including Botswana, Tanzania and Cameroon, which have sent delegations for training.

The benefit of early cervical cancer screening seems to be undeniable, but Mwanahamuntu said questions remained as to how the cancer progressed in HIV-positive women, and how women at different clinical stages of HIV reacted to treatment for cervical cancer.

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http://www.irinnews.org/report.aspx?ReportId=88156JOHANNESBURG Friday, February 05, 2010 (IRIN) - Economic conditions in most southern African countries declined as a result of the global recession, pushing many more people towards greater food insecurity. According to a new food security update which focused on some southern African countries, food prices have risen and are still climbing in several countries.JOHANNESBURG Friday, February 05, 2010 (IRIN) - Economic conditions in most southern African countries declined as a result of the global recession, pushing many more people towards greater food insecurity. According to a new food security update which focused on some southern African countries, food prices have risen and are still climbing in several countries.

The price of most fertilizers doubled in 2008 and continued to rise through 2009, affecting the quantity of crops planted throughout the region. High input costs prompted many governments to either extend their input subsidy programme or consider implementing one.

Here is a snapshot of food security in the region, based on an update compiled by the Famine Early Warning System Network (FEWS NET), the UN Food and Agriculture Organization (FAO), the UN Children's Fund (UNICEF), the UN Office for the Coordination of Humanitarian Affairs (OCHA) and the UN World Food Programme (WFP).


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Zimbabwe

Agriculture

Area planted increased since 2008, but most parts of the country have experienced dry spells since December 2009. About 57 percent of communal farmers received input support, but input schemes face critical shortages of ammonium nitrate, which has compromised crop quality.

Food availability

Farmers' stocks have been depleted. Food aid and purchases are now major sources of cereals. Basic foodstuffs easily available in markets. Tax-free import of food items extended to 31 July 2010.

Food access/Prices

Declining supplies driving up maize prices. Around 1.6 million people will be food insecure between January and March 2010, with about 1.9 million receiving food aid.

Nutrition/Health

At least 35 percent of children are severely malnourished. Measles outbreaks reported in 16 of 62 districts. A few cholera cases reported in 10 districts by 3 January 2010.

Comments

Economic recovery sluggish. Amount of foreign currency in circulation still limited. Provision of basic services still problematic.


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Lesotho

Agriculture

Rains were on time, but area planted by end of December 2009 dropped by 25 percent compared to previous season. Government subsidized seeds and fertilizer by between 30 and 50 percent.

Food availability

The only country in southern Africa where food production fell in 2009, perhaps because farmers could not afford inputs. Government will have to import cereals from South Africa.

Food access/Prices

Between 400,000 and 450,000 of Lesotho's 2.1 million people will need food aid before the next harvest in April 2010.

Nutrition/Health

Data from a food consumption survey by WFP, UNICEF and the National University of Lesotho yet to be analyzed.

Comments

Government income from the Southern African Customs Union, a major source of revenue, fell by 35 percent in 2009/10 and is expected to shrink further in 2010/11.


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Namibia

Agriculture

Rainfall has been erratic and insufficient. Few farmers have ploughed their fields.

Food availability

Rural households have no food stocks. Namibia will need to import between 150,000mt and 156,000mt of grain according to various estimates - almost its entire requirement of 159,000mt.

Food access/Prices

Most households have depleted their stocks and depend on markets and or government food aid.

Nutrition/Health

African swine fever was reported in the Ohangwena region of northern Namibia, affecting transportation of inputs to the neighbouring fertile Kavango region.

The report on the 2008 Demographic Health Survey is still being finalized; the 2010 survey is being planned.

Comments

Chronic food insecurity in the northern communal crop-producing areas was worsened by shocks such as droughts and floods in 2009. Namibia is a net cereal importer.


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Mozambique

Agriculture

Irregular and poor distribution of rainfall and very high temperatures have affected crops, mainly in the south and central provinces.

Food availability

Food is available because of the good 2008/09 season, but food security could become critical in the southern and central provinces.

Food access/Prices

Maize prices have risen. At least 267,000 people will need food aid until the harvest in April 2010.

Nutrition/Health

Chronic malnutrition levels are high - 44 percent- according to the last survey in 2008.

Comments

The National directorate of water has forecast a high risk of flooding until March 2010 in the Zambezi River basin in the central region, and the Messalo River basin in the far north.


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Malawi

Agriculture

Long dry spells have affected crops in most districts. An attack of army worms has also affected maize, rice, millet and sorghum crops.

Food availability

The food security situation remains favourable in most parts of the country.

Food access/Prices

Most markets have recorded a slight increase in maize prices but generally it is affordable and accessible.

Nutrition/Health

The findings of a 2009 micronutrient survey have yet to be released.

Comments

Food is available in the Karonga district of northern Malawi, which experienced a series of earthquakes in December 2009


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Madagascar

Agriculture

Input prices have gone up by between five and 10 percent but subsidies have been suspended, which could adversely affect food production. The cyclone season began in December 2010 and the island will remain under threat until April 2010.

Food availability

Supplies of the staple cereal, rice, are adequate.

Food access/Prices

A good harvest in 2009 reduced the number of food insecure among poor and vulnerable households from 65 percent in 2008 to 40 percent in November 2009. Local rice prices are stable.

Nutrition/Health

The country has the highest levels of acute malnutrition (15 percent) and chronic malnutrition (53 percent) in southern Africa

Comments

More than 200,000 jobs were lost in 2009 as a result of the economic and political crisis. The USA has terminated its trade benefits because of the political situation and another 500,000 jobs could be lost. The UN Country Team has raised concerns over the approaching cyclone season, which usually affects some of the poorest regions of Madagascar.


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Zambia

Agriculture

Government increased the number of people receiving subsidized fertilizer by halving the amount given to each household.

Food availability

The country has surplus food and will not require imports.

Food access/Prices

Maize prices stable until the end of 2009, yet remain high compared to previous surplus years, probably because of high input costs. High prices are expected to affect low-income households.

Nutrition/Health

High food prices and recurrent floods have pushed up child malnutrition levels, according to the Jesuit Centre for Theological Reflection in Zambia.

Comments

Food has been pre-positioned for the current rainy season in the three most flood-prone districts.


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Swaziland

Agriculture

Government has announced a plan to subsidize inputs later in 2010.

Food availability

Annual maize harvest improved but the country still needs to import around 90,000mt to meet requirements.

Food access/prices

At least 256,000 people are facing food shortages.

Nutrition/Health

The last nutritional survey in 2008 found chronic malnutrition of around 40 percent. Maternal nutrition figures indicate a problem of over-nutrition rather than under-nutrition among women.

Comments

Trend analysis shows that increasing levels of stunting could result from both economic decline and continued high HIV prevalence rates.


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South Africa

Agriculture

Most of the country received good rainfall but some drought conditions related to El Nino experienced in central and western parts.

Food availability

The country is expected to produce a surplus.

Food access/prices

Food prices have come down slightly but remain high.

Nutrition/Health

Infant mortality is high - 49 out every 1,000 infants born every year die, largely because of HIV/AIDS.

Comments

Government is working with agriculture and health institutions to improve existing food security initiatives.

jk/he

http://www.irinnews.org/report.aspx?ReportId=88014JOHANNESBURG Monday, February 01, 2010 (IRIN) - Heavy rains in early 2009 caused one of the worst floods in four decades to hit Namibia, pushing the semi-arid Southern African country into second place in a list of countries most affected by natural disasters last year.JOHANNESBURG Monday, February 01, 2010 (IRIN) - Heavy rains in early 2009 caused one of the worst floods in four decades to hit Namibia, pushing the semi-arid Southern African country into second place in a list of countries most affected by natural disasters last year.

The only other African country on the list, released by the Belgium-based Centre for Research on Epidemiology of Disasters (CRED), is Zambia, where vast tracts of agricultural land were flooded by the bloated Zambezi River.

The list is based on a scale measuring the impact of the disaster according to the number of people killed and affected per 100,000 inhabitants.*

"Remember that the number of dead in the tsunami [caused by an undersea quake in 2004] in Indonesia was 135,000 or so, and the numbers in Haiti [hit by an earthquake in January 2009] will probably also be that," said CRED director Debarati Guha-Sapir.

"But Indonesia is a country of ... [230] million people and Haiti has ... [around] 10 million. The burden is much higher for Haiti than it is in Indonesia for the numbers of dead - that is why we need to standardize before we compare."

The floods in Namibia - with a total population of 2.2 million - destroyed the livelihoods of least 350,000 people. The Zambian floods disrupted at least 600,000 lives in a population of 12.9 million people.

Guatemala, in Central America, tops the list; it was hit by the worst drought in 30 years, affecting 2.5 million of its 14 million people.

*The population figures in this IRIN report are those used by the UN Population Fund in its report, State of the World Population 2009.

jk/he http://www.irinnews.org/report.aspx?ReportId=87950DAKAR Wednesday, January 27, 2010 (IRIN) - Health experts hope the release of data showing the success of rotavirus vaccine will help compel policymakers to ensure all children will be immunized. DAKAR Wednesday, January 27, 2010 (IRIN) - Health experts hope the release of data showing the success of rotavirus vaccine will help compel policymakers to ensure all children will be immunized.

Rotavirus – the top cause of severe and often fatal diarrhoea and dehydration in children – kills some 527,000 children a year globally, nearly half of them in sub-Saharan Africa.

“It is our hope that these data will catalyze action so that one day we can live in a world where no child dies from diarrhoea,” Kathy Neuzil, senior clinical advisor for vaccines at the international health non-profit PATH, said in a 27 January statement.

Published on 27 January in the New England Journal of Medicine, results from first-ever clinical trials in South Africa and Malawi show that a live, oral rotavirus vaccine significantly reduces the episodes of severe rotavirus gastroenteritis in African children during the first year of life.

The data “provide policymakers with the critical information they need to make decisions about rotavirus vaccine introduction,” George Armah, professor and rotavirus expert at Ghana’s Noguchi Memorial Institute for Medical Research, said.

The trial results led the World Health Organization in June 2009 to recommend global use of the vaccine.

The Africa trials focused on the vaccine’s performance in high mortality, low-income settings, according to a 27 January communiqué by PATH and GAVI Alliance.

Health experts point out that while rotavirus infection in treatable, it has devastating and deadly impact in rural and poor areas where people cannot access medical care. “Vaccines represent the best hope for preventing the severe consequences of rotavirus infection,” Nigel Culiffe of University of Liverpool said in statement.

The trials were coordinated and co-funded through a partnership between GlaxoSmithKline Biologicals and the GAVI Alliance-funded Rotavirus Vaccine Trials Partnership – PATH, WHO and the US Centers for Disease Control and Prevention.

np/ajhttp://www.irinnews.org/report.aspx?ReportId=87899LUSAKA Monday, January 25, 2010 (IRIN) - A raft of fuel price hikes that will affect agricultural production costs as well as consumer pockets is expected to drive food price inflation in Zambia, where about two-thirds of the population live on US$1 or less a day. LUSAKA Monday, January 25, 2010 (IRIN) - A raft of fuel price hikes that will affect agricultural production costs as well as consumer pockets is expected to drive food price inflation in Zambia, where about two-thirds of the population live on US$1 or less a day.

The government has announced an immediate petrol price rise of 15 percent, soon after a 10 percent excise duty on diesel came into effect on 1 January 2010.

According to a World Bank study citing average prices when the oil crisis peaked in 2008, the landlocked country had the highest fuel prices in southern Africa.

With the new hike, petrol in the capital, Lusaka, will cost about US$1.53, an increase of US$0.50, while diesel - primarily used in the mining and agricultural sectors - will now cost about US$1.20 a litre.

The harvest in April/May 2009 produced a surplus of 200,000 tons, but the Zambia National Farmers Union (ZNFU) said the diesel price hike was likely to "adversely" affect maize production in the coming season.

"You don't have to be a genius to know that every time fuel prices go up in Zambia, so do prices of mealie-meal [maize-meal], cooking oil, bus fares, and of course taxi fares," a taxi driver told his colleagues during a discussion at a rank in Lusaka.

"Perhaps we should demonstrate against the fuel-price hikes - take to the streets and let the system know we are very unhappy - in a peaceful manner?" he said.

Maize is the staple food of about 80 percent of Zambians; a 25kg bag of maize currently retails for about US$14, but it is expected that this will soon rise to reflect the increase in fuel prices.

About 500,000 formal jobs exist in Zambia, which has a population of about 11.7 million, and government is one of the largest employers - most government workers in the lower income bracket earn about US$200 a month.

Opposition parties have seized on the fuel price hikes ahead of scheduled elections in 2011, while the government of President Rupiah Banda has maintained that the increases were in line with global fuel prices rising from around US$40 per barrel in 2009 to about US$80 per barrel in 2010.

Michael Sata, leader of the Patriotic Front, the largest opposition party, told local media: "This is a clear indication that Banda and his cronies have failed to run things in this country, starting from the public service to the delivery of simple services such as fuel supply."

tm/go/he http://www.irinnews.org/report.aspx?ReportId=87865JOHANNESBURG Tuesday, January 19, 2010 (IRIN) - The best search and rescue workers have stamina, a phenomenal sense of smell, and sharp hearing - they usually also have four legs. JOHANNESBURG Tuesday, January 19, 2010 (IRIN) - The best search and rescue workers have stamina, a phenomenal sense of smell, and sharp hearing - they usually also have four legs.

Highly trained dogs and their handlers can offer the best chance of survival to people buried in the rubble of an urban search and rescue (USR) site, where there are often no outward signs of life.

The dog

Intelligence and a remarkable nose make dogs ideal for the job, according to Ann Christensen, Canine Committee Chair at the US-based National Association for Search and Rescue. Most dogs have better vision than humans, particularly in the dark, and more acute hearing. But it is their sense of smell - said to be a thousand times more sensitive than that of people - that really sets them apart.

Popular breeds are German Shepherds, Border Collies and Golden or Labrador retrievers, with trainers looking for a specific combination of talents. "There are only a few dogs can do this type of work, that have the right stuff. The average family pet can't do this, no matter what training you give them," Christensen told IRIN.

Disaster sites are usually extremely dangerous and stressful, so "a disaster dog has to be confident, courageous and agile"; it must be able to focus while sniffing through the wreckage and ignore all other scents and noises, no matter how tempting.

The training

"It takes a minimum of around 18 months to two and a half years to train a ... team [consisting of a dog and handler]. Normally, if you have a dog that has the ability, the drive, the focus to carry out the job, it actually takes longer to train the handler," said Chris Pritchard, Coordinator for USR Dog Teams at the International Search and Rescue Team of the United Kingdom Fire and Rescue Service.

Handlers are an integral part of the dog's training and by the end of it, if the chemistry is right, they are partnered for the duration of the dog's working life - about 10 years.

"When a handler certifies with a dog, they certify as a team and they work together. You develop a very strong bond with the dog because you spend a lot of time training with the dog, travelling with the dog, going on missions with the dog – you spend almost more time with your dog than you do with your family," said Christensen.

According to Wolfgang Zörner, president of the International Rescue Dog Organisation, the global umbrella body that ensures members comply with the standards set by the UN International Search and Rescue Advisory Group (INSARAG), international teams must pass a mission readiness test to qualify for deployment.

"Once you pass, the certification is valid for three years, but the test is very hard - it goes on continuously day and night for two days, and not more than 40 percent pass," he commented.

The Equipment

Canine-handler teams need to be completely self-sufficient for up to 10 days after deployment. That means they arrive on site with tents, food, medical and veterinary equipment or water. The dogs need at least one litre per day - more in hotter climates - to maintain workable levels of hydration. Appropriate kennelling is also important to keep the dogs secure on site.

Besides their leash and collar, equipment can range from lifting harnesses and cooling jackets to dog boots. "You want to protect the dog so that it can do its job - they are as important as the rescuers," said the UK's Pritchard.

The deployment

The first 24 hours after a disaster has struck is the "golden day", Pritchard commented. "The ability of the individuals that may be trapped to survive starts to decrease dramatically after that."

Zörner noted that "every disaster is different, but the main objective is to be on site as soon as possible. In every catastrophe there are always some miracles, and some people survive longer, but normally a person cannot stay alive without water for more than four days."

His last mission was the Padang earthquake in Indonesia. "When the call comes in we can be ready to deploy with the dogs within eight hours," he said. Typically, a call will come through the INSARAG Virtual On Site Operations Coordination Centre (OSOCC) – an online information exchange and coordination tool for disaster managers and international response organisations.

The canine-handler teams become part of a larger group of USR specialists. Once medical checks are passed, teams are briefed, equipment is checked and palletised for transportation, and the team heads off, either on civilian or military aircraft.

The search

On arrival the teams report to the OSOCC, usually set up by INSARAG in cooperation with the local emergency management authority. "The problem on the spot is always transportation. To get from the airport to the [OSOCC] and then to the sites," said Zörner.

Given the limited time and resources, initial reconnaissance to identify priority areas is essential. "It is important that they [OSOCC] already know where it is useful to search with dogs; that they have conducted an initial assessment," he noted.

The dogs are one part of the "technical search element", the others are highly sensitive acoustic equipment that can pick up minute sounds, and tiny cameras that can be manoeuvred through tiny cracks or holes drilled in concrete.

"It's a big game of hide and seek - that's the only reason the dogs go out and find. If the dog locates a scent source it will demonstrate that by either scratching, or through a focused bark, and will continuously bark at that point where the scent is most strong," said Pritchard.

"But that does not necessarily mean that the person is buried right under them - the scent can travel a considerable distance. We then work the dog at different angles to see if the scent is coming out somewhere else." A second dog is often brought in to verify a find.

The dogs are used in more than one phase of the rescue operation. "Once rubble is removed from an area and dogs can get closer, that may open a scent channel and allow the dogs to pick up on the scent of a person that is trapped. We recommit dogs to the building as we remove large pieces of rubble," Prichard said.

The rescue

"They recognize a human scent picture made up of many different scents - like the clothing that people wear ... the food that they ate, the polish of their shoes, sweat glands." It is generally understood that they also home in on skin rafts – scented skin cells that drop off human beings at a rate of 40,000 a minute.

Once a find is confirmed, the dogs are removed so that the victim can safely be taken out. Because searching is essentially a game, a find is always rewarded – usually with a toy – to ensure the dogs remain motivated.

Zörner said a dog worked for 20 minutes, because "If it works too long the dog loses interest and the work is no longer secure – he can give an indication even when it is not absolutely sure," and then rested for the same amount of time.

"We search only for live people - that is the priority." When the search is called off - usually 10 days after the disaster began - the dog-handler teams are sent home.

Then, as the humanitarian phase of the relief operation intensifies, another specialist sniffer dog - the cadaver dog - is brought in to search for the dead.

tdm/oa/hehttp://www.irinnews.org/report.aspx?ReportId=87790NAIROBI Tuesday, January 19, 2010 (IRIN) - More than two-thirds of African countries have laws criminalizing homosexual acts, and despite accounting for a significant percentage of new infections in many countries, men who have sex with men tend to be left out of the HIV response. NAIROBI Tuesday, January 19, 2010 (IRIN) - More than two-thirds of African countries have laws criminalizing homosexual acts, and despite accounting for a significant percentage of new infections in many countries, men who have sex with men tend to be left out of the HIV response.

"[They] are going underground; they are hiding themselves and continuing to fuel the epidemic," UNAIDS executive director Michél Sidibé told IRIN/PlusNews recently. "We need to make sure these vulnerable groups have the same rights everyone enjoys: access to information, care and prevention for them and their families."

IRIN/PlusNews has compiled a short list of human rights violations against gay Africans:

Malawi - On 28 December 2009, soon after a traditional engagement ceremony, Steven Monjeza and Tiwonge Chimbalanga were arrested and charged with "unnatural offenses", which carries a maximum prison term of 14 years, and "indecent practices between males", which carries five years.

The men deny that they have had sexual relations, but the state prosecutor has applied for them to be sent to hospital to prove they have had sex, which rights activists and their lawyers say would violate their constitutional right to dignity. The trial has been postponed until 25 January 2010.

Uganda - In October 2009, David Bahati, parliamentary representative of the ruling party, tabled the Anti-homosexuality Bill (2009), a private member's Bill. It proposes, among other things, the death sentence for the crime of "aggravated homosexuality" when an HIV-positive person engages in homosexual sex with someone disabled or below the age of 18.

Homosexuality is illegal in Uganda and punishable by a maximum sentence of life in prison.

AIDS advocates and human rights groups have strongly criticized the Bill as violating the privacy of gay people, and after pressure from several international leaders, President Yoweri Museveni has distanced himself from it, reducing the likelihood that it will be passed in its current form.

Nevertheless, a local tabloid, The Red Pepper, routinely releases lists of alleged Ugandan homosexuals.

Tanzania - In May 2009, a local newspaper, Ijumaa, featured a photograph of two men in bed together with the headline, "Caught Live!" A report by several gay rights groups http://www2.ohchr.org/english/bodies/hrc/docs/ngos/LGBT_Tanzania96.pdf noted that the accompanying article included derogatory and discriminatory language about men who have sex with men.

An Ijumaa reporter, accompanied by three policemen, had followed the men from the street into a private hotel, where they had invaded their room and taken the photographs that later appeared in the newspaper.

According to the International Gay and Lesbian Human Rights Commission http://www.iglhrc.org/cgi-bin/iowa/article/takeaction/resourcecenter/993.html, more than 40 gay and lesbian activists in Tanzania were arrested on charges of debauchery in 2009.

Burundi - In April 2009, President Pierre Nkurunziza signed into law a bill criminalizing homosexuality for the first time in Burundi's history. Anyone found guilty of engaging in homosexual activity faces imprisonment for two to three years and a fine of up to US$80.

Paradoxically, other articles in the same legislation take steps to protect human rights, including abolition of the death penalty and the outlawing of torture, genocide, war crimes and crimes against humanity.

Senegal - In December 2008, the Senegalese government arrested nine men involved in providing HIV prevention, care and treatment services to the country's lesbian, gay, bisexual and transgender community http://www.plusnews.org/Report.aspx?ReportId=82453.

The men were later sentenced to eight years in prison on charges of "membership of a criminal organization and engaging in acts against the order of nature", but in April 2009 an appeals court overturned this verdict http://www.plusnews.org/Report.aspx?ReportId=84064.

Arrests for homosexual activity are not uncommon in Senegal; in August 2008 two men were arrested at their home in Dakar and charged with "homosexual marriage" and acts against the order of nature. According to rights groups, a total of 30 men were arrested on charges of homosexuality in 2009.

Egypt - In May 2008, a court in the Egyptian capital, Cairo, convicted five HIV-positive men of "habitual practice of debauchery", a phrase that encompasses consensual sexual acts between men.

The convictions were part of a crackdown on people living with HIV/AIDS, during which 12 men suspected of being HIV-positive were arrested; while in custody, they were subjected to HIV tests and anal examinations to determine whether they had had sex with other men. Earlier in the crackdown, in January 2008, four HIV-positive men sentenced to one-year prison terms for debauchery.

Gambia - In May 2008, Gambian President Yahya Jammeh gave gay people 24 hours' notice to leave the country. He promised stricter laws on homosexuality than in Iran, and threatened to behead any gay people discovered in the country.

Jammeh's statements were thought to have been in response to a number of Senegalese gay men fleeing across the border into Gambia to escape persecution in their own country.

South Africa - In April 2008, Eudy Simelane, the openly gay star of South Africa's Banyana Banyana national female football squad, was found murdered in a park on the outskirts of Johannesburg. She had been gang-raped and brutally beaten before being stabbed to death.

Rights groups said the attack was likely to have been an incident of "corrective rape", in which men rape lesbian women on the pretext of trying to "cure" them of their sexual orientation.

Since then there has been a spate of similar attacks http://www.plusnews.org/Report.aspx?ReportId=85268 on lesbian women in the country, but few ever reach the courts. According to a 2009 report by the NGO, ActionAid, there have been 31 recorded murders of lesbian women since 1998, with just three cases reaching the courts, and only one conviction.

Cameroon - In January 2008, a Cameroonian court sentenced three men accused of homosexuality to six months' hard labour. Homosexual acts are punishable by up to five years in prison, and gay men are routinely imprisoned.

Although the penal code does not give the state the power to arraign someone unless the person was caught in flagrante delicto, rights groups say people suspected of being gay are often arrested in public restaurants and bars.

Nigeria - In August 2007, 18 men - all allegedly cross-dressers - were arrested in Bauchi State, a predominantly Muslim state in the north of the country; they were charged with sodomy, the charges were later changed to vagrancy or idleness. The men were eventually freed on bail, but in March 2009 the case was still pending.

kr/kn/he http://www.irinnews.org/report.aspx?ReportId=87793LUSAKA Tuesday, January 05, 2010 (IRIN) - New research has found that Voluntary Counselling and Testing (VCT) services in Zambia are squandering the opportunity to reach clients with information about how to reduce their HIV risk.LUSAKA Tuesday, January 05, 2010 (IRIN) - New research has found that Voluntary Counselling and Testing (VCT) services in Zambia are squandering the opportunity to reach clients with information about how to reduce their HIV risk.

The study, conducted by Private Sector Partnerships–One, (PSP-ONE), a USAID project aimed at increasing the private sector's capacity to provide quality health services in developing countries, looked at VCT services offered by the private, non-governmental, government and faith-based sectors in one urban and one rural province of the country - Copperbelt and Luapula.

In a report compiling the study findings, the researchers emphasise that VCT services form a critical opportunity to provide risk reduction counselling and HIV prevention information and to act as a gateway to HIV/AIDS services for clients who test positive.

Zambia has an adult HIV prevalence of 14.3 percent, but the infection rate is as high as 20 percent in some urban areas. New HIV infections rose from an estimated 70,000 in 2007 to 82,000 in 2008 - the majority of them through heterosexual sexual contact.

"In a generalized HIV epidemic where multiple concurrent sexual partnerships are a significant driver of new infections, discussion of risk-reduction methods should be a main focus of pre-test and post-test counselling," comment the researchers.

However, the study found that across all sectors, while condom use was emphasized, only one in three clients received counselling on reducing their number of sexual partners and even fewer were advised on how to disclose their HIV test results to partners.

Pre-test counselling tended to over-emphasise the risk of contracting HIV through blood exchange, which is not a major driver of Zambia's HIV epidemic, and of living positively with HIV, even before a client's status was known.

The research also found that VCT services across all sectors were mainly accessed by the most educated segments of the population, and were largely failing to reach the 65 percent of women and 51 percent of men in Zambia who have no or only primary school education.

The study found the quality of VCT services provided by private sector clinics was on a par with or better than those provided by public and NGO clinics, despite the lack of HIV prevention training opportunities offered to private providers. This raised the question of how beneficial those trainings were and whether their cost was justified.

One positive finding that emerged from the study was that most people sought VCT services close to their homes indicating they did not fear being stigmatized by their communities. This is in contrast to other studies from the region in which clients reported choosing VCT and treatment sites far from home to avoid detection and stigma from neighbours.

Although most of the clients reported being satisfied with the qualify of VCT services they received, this often had more to do with the friendliness of counsellors than their technical competence at emphasizing risk reduction and behaviour change.

The researchers conclude: "A renewed focus on adapting counselling topics to the realities of Zambia’s HIV epidemic will improve the efficacy of VCT across all sectors."

zg/ks

http://www.irinnews.org/report.aspx?ReportId=87633LUSAKA Friday, December 18, 2009 (IRIN) - As the rainy season in Zambia picks up, so does the threat of Cholera; around 60 cases have been recorded since mid-November, but the authorities and aid agencies hope education and improved infrastructure will help keep the waterborne disease at bay. LUSAKA Friday, December 18, 2009 (IRIN) - As the rainy season in Zambia picks up, so does the threat of Cholera; around 60 cases have been recorded since mid-November, but the authorities and aid agencies hope education and improved infrastructure will help keep the waterborne disease at bay.

Most of the recent cases were reported in the southern province of Sinanzogwe, but the disease has also resurfaced in the capital, Lusaka, where two-thirds of the 7,000 cases in 2008 were recorded. In June 2009 cholera claimed 162 lives nationwide, 30 of them in Lusaka.

Jatal Zulu, whose family lives in the sprawling township of Mandevu, north of Lusaka, said cholera affected the area every year, "but people don't know much about it."

Some 75 percent of Lusaka's 2.5 million people live in peri-urban conditions. Unplanned high-density settlements have mushroomed around the capital, and Mandevu is no different: water pours from the tarmac main road into the dirt tracks between the shacks to mix with garbage and excrement from the open lavatories and settle in stagnant pools - ideal breeding conditions for the Vibrio cholerae bacterium that causes the disease.

Cholera is an intestinal infection that causes acute diarrhoea and vomiting and, if left untreated, can cause death from dehydration within 24 hours. It is spread by eating or drinking contaminated food or water. Contamination often occurs when faeces from someone with the disease comes in contact with a community water supply.

Cholera is easily treated with rehydration salts, but starting treatment early is critical; prevention is the best option. Lusaka District Commissioner Christah Kalulu is well aware of the health risks that come with the rainy season, but while others eagerly anticipate the first rains, she becomes anxious.

"We don't have enough money to put in place sanitation for everyone," she told IRIN. "The biggest problem seems to be the garbage ... In terms of disaster management, we had to do something about this," Kalulu said.

Together with members of parliament, her office launched Lusaka's District Disaster Reduction (DDR) programme in August 2009 to take measures to prevent an epidemic and "lessen the impact on communities".

About US$1.1 million of a proposed $2.6 million package to cover health, water and sanitation, bridges and crossings, garbage collection and drainage clearance has been raised, she said.

Other efforts by the DDR programme include installing dry toilets that separate urine and faeces, and replacing temporary water stands - put up last year in collaboration with the Lusaka Water and Sewerage Company - with eleven permanent water pipes.

Ongoing education and sensitization are essential to preventing the spread of the disease. Government and the UN Children Fund (UNICEF) have launched an awareness campaign called: "Your Life is in Your Hands".

UNICEF country representative Lotta Sylwander said education was vital in addressing cholera outbreaks, and the programme promotes hand-washing with soap at four critical times: before eating, before preparing food, after using the toilet, and after changing babies' diapers (nappies).

Popular entertainers are spreading the campaign messages in the high-risk areas of Lusaka, backed up by town-hall meetings, schools events, and public service announcements on radio. According to UNICEF, such campaigns are highly effective because they rely on peer-to-peer advocacy and education.

gs/tdm/hehttp://www.irinnews.org/report.aspx?ReportId=87486JOHANNESBURG Tuesday, December 15, 2009 (IRIN) - The "humanitarian nature" of the mass movement of Zimbabweans to neighbouring Southern African countries has blurred the distinction between what is a "refugee" and an "economic migrant", because such people fit neither category perfectly and fall between the cracks, a new report says. JOHANNESBURG Tuesday, December 15, 2009 (IRIN) - The "humanitarian nature" of the mass movement of Zimbabweans to neighbouring Southern African countries has blurred the distinction between what is a "refugee" and an "economic migrant", because such people fit neither category perfectly and fall between the cracks, a new report says.

"Official responses to Zimbabwean migration in Botswana, Malawi, Zambia and Mozambique are still premised on this distinction, and so are failing to protect both Zimbabweans and [their own] citizens," noted Zimbabwean Migration into Southern Africa: New Trends and Responses, a report released in early December by the Forced Migration Studies Programme (FMSP) at the University of the Witwatersrand.

Neighbouring countries have been an essential lifeline for thousands of poor Zimbabweans, said Monica Kiwanuka, the main researcher for the report. Those crossing the border were not refugees - most did not even apply for refugee status – and, given the extent of economic collapse at home, could hardly be considered "voluntary" economic migrants.

"Many Zimbabweans who qualify for refugee status ... do not apply for asylum due to the need to move back and forth across borders to support families left behind. They resist the category of refugee, which connotes dependency, and they emphasize their ability to work," Kiwanuka told IRIN.

"Yet there are currently no legal instruments in the region, or in specific countries, that address the needs of this forced, mixed and livelihood-seeking migration," she commented. Only recognized refugees and asylum seekers qualify for humanitarian assistance and legal protection in a host state.

"So many Zimbabweans are not legally protected, nor do they receive humanitarian support, as they fall outside the mandates of these support structures," Kiwanuka commented.

With the exception of South Africa, protection and access to services in most countries in the region is contingent on receiving refugee status, and require asylum seekers to stay in isolated camps, unable to work or travel, and thus send money home.

South Africa is considering the introduction of a special permit for Zimbabweans but the policy is still under review.

"These [conditions] are unsuited to [their] needs," Kiwanuka said, and defeated the purpose of crossing the border, so most Zimbabweans did not apply for asylum. The alternative of having to fend for themselves allowed the flexibility to move back and forth between countries as shoppers, labourers and traders.

Despite persistent deportations, xenophobic attacks and other means of exclusion, poor Zimbabweans have been prepared to risk anything to earn an income in a host country.

A Zimbabwean interviewed in Botswana explained: "To accept to return home after being dropped [for deportation] at Plumtree [on the Zimbabwe/Botswana border] means I have agreed to let my people die ... you [would] rather die trying to get back inside [Botswana] and find money to keep them alive."

Kiwanuka said responses to Zimbabwean migrants were not harmonized among the four countries: "In Botswana, Zambia and Malawi, asylum is available to Zimbabweans; in Mozambique, the few people who have applied for asylum have been rejected due to the state's decision to consider Zimbabweans as 'economic' and not forced humanitarian migrants."

Obtaining a Zimbabwean passport was not only very difficult but also extremely expensive, which contributed to the problem. "We all want to be out of trouble, but where can we find the passports these people want from us?" another migrant in Botswana complained.

"Since undocumented migrants fall outside the mandates of the two key support structures in humanitarian assistance – government and non-government institutions," the needs of undocumented Zimbabweans remained "invisible and unmet". Migrants lived precariously, "earning meagre incomes in the host countries and barely covering their basic human needs for shelter and food," the researchers found.

Beyond semantics

"Lack of protection of migrants in the region is based on a false distinction between a forced and an economic migrant, instead of focusing on the real and urgent needs some of these migrants have," Kiwanuka said.

The report suggested that a better term would be "forced humanitarian migrants", who moved for the purpose of their and their dependents' basic survival.

Underscoring the importance of a common humanitarian position on the outflow of Zimbabweans into the region, and the challenge various agencies faced in reconciling their mandates with real needs on the ground, the Regional Office for Southern Africa of the UN Office for the Coordination of Humanitarian Affairs coined the term "migrants of humanitarian concern" in 2008.

Nde Ndifonka, spokesman for the International Organization for Migration (IOM), told IRIN: "We categorize these migrant populations from Zimbabwe broadly as 'mobile and vulnerable populations'.

"Refugees have some specific needs, rights and responsibilities, which fall under the mandate of UNHCR [the UN Refugee Agency]. They also have more general needs, rights and responsibilities within the broader category migrants, which is where IOM operates, he said.

In general, "Migrants, as everyone else within the country, are the responsibility of government. As an intergovernmental organization with expertise in migration management, IOM, just like UNHCR, works with the government to address migration and migrant (including refugee) challenges, within the available resources," Ndifonka commented.

But the bottom line, said FMSP's Kiwanuka, was that interventions would "need to acknowledge the humanitarian nature of migration from Zimbabwe", and "policy response should focus on providing some measure of humanitarian support to the most vulnerable, supporting employment and self-employment, and permitting cross-border mobility."

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http://www.irinnews.org/report.aspx?ReportId=87434DAKAR Tuesday, December 08, 2009 (IRIN) - African health experts are calling on governments to vaccinate all children against rotavirus, to end an “unacceptable” yet preventable situation in which the virus kills some 1,400 children in developing countries daily.DAKAR Tuesday, December 08, 2009 (IRIN) - African health experts are calling on governments to vaccinate children against rotavirus, to end an “unacceptable” yet preventable situation in which the virus kills some 1,400 children in developing countries daily.

The West African Rotavirus Advisory Board on 3 December held a meeting in the Senegalese capital, Dakar, as part of efforts to advance the vaccine’s use after the World Health Organization recommended its inclusion in national immunization programmes worldwide.

George Armah, professor and rotavirus expert at Ghana’s Noguchi Memorial Institute for Medical Research, told IRIN the evidence is clear and must be used to push policymakers to act. “Rotavirus is one of the major causes of diarrhoea deaths and hospital admissions. There are vaccines that are very effective and can radically reduce mortality and morbidity from rotavirus infection.”

Rotavirus is the leading cause of severe diarrhoea and dehydration in children, with some 527,000 deaths of under-fives per year – 85 percent of them in Africa and Asia, according to WHO.

Following a recent rotavirus meeting in Kenya, a number of countries in southern and eastern Africa applied to the GAVI Alliance – the global public-private partnership to increase vaccine access – for assistance in introducing rotavirus and pneumococcal vaccine.

Call to action

The Dakar meeting – financed by GlaxoSmithKline, makers of one of two rotavirus vaccines – was in part a chance to present to West African countries a “call to action” from the Kenya meeting; the document says governments must immediately recognize the magnitude of the rotavirus problem and make vaccination against the virus a priority.

GAVI supports the introduction of vaccines in eligible countries, with a commitment that the country will gradually increase its contribution.

Armah said health officials are still learning about rotavirus. He said the key is making them understand the toll rotavirus takes and the importance of vaccination.

“It’s largely a question of ignorance. I’ve been to meetings where ministers have said, ‘We do not have a rotavirus problem in our country.’ But then we show them evidence and say, ‘Yes, there is a problem’.”

Health experts in West Africa say while rotavirus infection is treatable, for many people in rural areas who cannot easily access medical care, vaccination is the most effective way to avoid severe cases and deaths.

Caught early, rotavirus infection can generally be treated with oral rehydration solutions, according to a 3 December op-ed by Armah and Ousmane Ndiaye, paediatrics professor at the University of Dakar and head of paediatrics at Abass Ndao hospital.

“The main problem is that despite this simple treatment many children in West Africa continue to die of the illness. It is distressing for a mother to lose a child if a preventive measure like a vaccine is available.”

Armah and Ndiaye estimate that by 2025 the vaccine could prevent worldwide 100 million hospital stays and 2.5 million deaths.

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http://www.irinnews.org/report.aspx?ReportId=87363LUNDAZI Thursday, December 03, 2009 (IRIN) - "When you are poor and you have AIDS, you live with the threat of death above your head. However, when you have tuberculosis (TB), death moves closer and sits on your shoulder," said Max Ngoma, who used to be a peasant farmer in Lundazi, a rural town in eastern Zambia.LUNDAZI Thursday, December 03, 2009 (IRIN) - "When you are poor and you have AIDS, you live with the threat of death above your head. However, when you have tuberculosis (TB), death moves closer and sits on your shoulder," said Max Ngoma, who used to be a peasant farmer in Lundazi, a rural town in eastern Zambia.

He is now destitute and cannot afford to buy food to take with the drugs to treat TB, nor can he afford the frequent trips to the health centre, about 15km away.

Zambia has the seventh highest TB/HIV co-infection rate in the world: 70 percent of people with TB are also infected with HIV. The estimated HIV prevalence rate of 14.3 percent in the adult population makes TB treatment difficult to contain and treat.

The World Health Organisation (WHO) estimates that the incidence of TB is now about 500 cases per 100,000 people annually, making it one of the leading causes of death in Zambia.

"I could no longer tend to my fields after I fell ill, so I lost my only income. My wife tries to farm but she can only do so much; our children are small so they cannot help. Others in my village are in the same position as me, impoverished because of droughts, floods and sickness."

Ngoma's wife has been treating him with a herbal concoction she prepares, but there is little improvement. Musole Musenge, the clinical officer who runs a health centre in Chinyumba village in Lundazi district, said people taking TB drugs need high-protein foods like chicken, rice, milk and eggs, which are beyond the normal diet of most households.

The medication to treat TB is freely available in government health centres and hospitals, but is not always accessible in rural areas. "A patient can wait for anything between two months to a year for diagnosis and treatment," Musenge noted.

Not all health centres have diagnostic equipment, so specimens have to be sent to the nearest town, which might not have testing facilities; also, the necessary drugs are not consistently available and patients may have to wait.

Most TB patients have usually been too ill to work for some time before diagnosis. After diagnosis, the added costs of transport for routine visits to health facilities and special or extra food, on top of the loss of income, make the whole family suffer, Musenge told IRIN/PlusNews. Not many families are able to muster the resources for treatment and adequate care.

Poverty makes things worse

The Jesuit Centre for Theological Research (JCTR), which monitors the cost of a monthly food basket, estimates that a family of six needs about 2 million Zambian kwacha (US$400) a month to survive. But the unemployment rate is around 70 percent and, according to the World Bank, more than 70 percent of the population live below the poverty datum line.

The desperation of poverty drives many people to areas where the World Food Programme (WFP) or World Vision, an international charity, run feeding programmes. Lundazi is one such area.

Ngandu Ngandu told IRIN/PlusNews that his wife heard about the World Vision feeding programme in Lundazi and relocated the family. "Hopefully I will have completed my medication by the time WFP phases out its programme here. I feel sorry for people who cannot access any kind of feeding programme - they cannot go on treatment."

Michael Gwaba, who works at the Community Initiative for Tuberculosis and Malaria (CITAM), a Zambian organisation providing nutritional supplements to patients on TB drugs, as well as other health services, agreed that food was their biggest challenge. "We will not be able to contain TB if people cannot get food - the drugs are too strong."

Yet CITAM can only source so much food, and many TB patients fall through the cracks. Gwaba said the government should step in to provide social grants for families affected by TB.

"We have better services for ART [antiretroviral therapy] than for TB, but because the two are intertwined we should include TB; it should be that at every visit to an HIV clinic, people should be routinely screened for TB."

Minister of health Kapembwa Simbao believes not all the news is bad: Zambia now provides 100 percent of patients in all government health facilities with the standard regimen of isoniazid and rifampin for treating TB.

The Centre for Infectious Disease Research in Zambia (CIDRZ), funded by the United States, is working with the ministry of health to improve the quality of TB screening, and care for TB/HIV co-infected patients, while the Zambia AIDS Related Tuberculosis (ZAMBART) project has piloted an initiative to reduce the risk of TB becoming active in people exposed to the bacteria.

"We are also working with our partners to reduce the treatment period for TB from eight to six months," Simbao told IRIN/PlusNews. "We acknowledge that people experience many difficulties while on TB treatment, so if we can shorten the period it will encourage patients to continue with their medication."

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http://www.irinnews.org/report.aspx?ReportId=87279NAIROBI Thursday, November 26, 2009 (IRIN) - From the first goat sales about five years ago, creative NGO fundraisers have expanded a range of animal and farm-related "gifts" for sale online to benefit developing countries. NAIROBI Thursday, November 26, 2009 (IRIN) -  From the first goat sales about five years ago [http://news.bbc.co.uk/2/hi/uk_news/magazine/4078527.stm], creative NGO fundraisers have expanded a range of animal and farm-related "gifts" for sale online to benefit developing countries.
 
The approach has its detractors and not all NGOs have joined the trend. IRC [www.theirc.org], which is promoting its gift catalogue this week, for example, offers no living creatures, sticking to school supplies and mosquito nets.
 
Important: Inclusion in the list below does not imply endorsement by IRIN, nor should exclusion be interpreted as significant. Buyer beware and always read the fine print. The NGOs may not literally spend the funds on the purchase of an individual animal.  
 
Nonetheless, as the Christmas fund-raising season picks up, IRIN has rounded up a few options just to give a whiff of the livestock-related fundraising available. If you have found more "funusual" (or outrageous) charity gift ideas, drop us a line at feedback and we'll make a list  [LINK].
 
Manure: (Oxfam Australia, from AUS$15) - [http://www.oxfamunwrapped.com.au/Product.php?productid=103] (promotional video here: http://www.oxfamamericaunwrapped.com/beep.html)
 
Sheep: (Save the Children, $30) [https://secure.savethechildren.org/01/web_cat_d_1_sheep]
 
Goat: (ADRA, $70) [https://secure2.convio.net/ccadra/site/SPageNavigator/giftcatalog10]
 
Pig: (World Vision Spain, EUR60) [http://worldvision.es/colaborar_regalos_pedido.php?action=add&id_regalo=4]
 
Alpaca: (Practical Action, £50) [http://www.practicalpresents.org/view_product.php?product_id=9]
 
Llama: (Project Concern, $100) [https://secure2.convio.net/pci/site/Ecommerce/692413658?VIEW_PRODUCT=true&product_id=1121&store_id=1141]
 
Cow: (Send a Cow, £125) [http://www.sendacowgifts.org.uk/mumstheword]
 
Camel: (£230, Muslim Hands) [http://www.muslimhands.org/en/gb/great_charity_gifts/select_gift/?gift=G1]
 
And finally:
 
Fermented cow's urine: (Farm Africa, £20) [http://www.farmafricapresents.org.uk/buy/item/9]
 
28 Farm Animals (2 sheep, 2 cows, 2 goats, 2 pigs and 20 chickens): ($2,000, World Vision) [http://donate.worldvision.org/OA_HTML/xxwv2ibeCCtpItmDspRte.jsp?section=10375&item=92]
 
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http://www.irinnews.org/report.aspx?ReportId=87197LUSAKA Monday, November 16, 2009 (IRIN) - Abigail Mwanashimba has been looking after her five siblings since the age of eight, when her parents died of AIDS-related illnesses. She is now 19 years old, and without relatives to represent her at her lobola (bride price) negotiations, she was forced to hire traditional counsellors to organise the process of marriage according to the tribal customs. They did a bad job.LUSAKA Monday, November 16, 2009 (IRIN) - Abigail Mwanashimba has been looking after her five siblings since the age of eight, when her parents died of AIDS-related illnesses. She is now 19 years old, and without relatives to represent her at her lobola (bride price) negotiations, she was forced to hire traditional counsellors to organise the process of marriage according to the tribal customs. They did a bad job.

"I don't know anything about my tribe or its culture because there has never been anyone to teach or show me," she told IRIN/PlusNews. "I got very little lobola, but the last straw was the humiliation I suffered at my in-laws' home, when I embarrassed them by performing the wrong dance."

Losing out on the bride price was one thing, but when she realised that the counsellors she had hired had taught her the wrong traditional dances, she refused to pay them their 500,000 Zambian kwacha (US$100) fee, and is now facing a lawsuit.

Agnes Ngubeni, from the central town of Kabwe, also knows this kind of humiliation; she has lived with the embarrassment of not having undergone an initiation ceremony when she came of age, and not being able to speak the language of her tribe.

"People called us goats ... they said we were 'cultureless' and were not educated in the ways of our tribe. It never occurred to them that there was no-one to teach us - we lived without elders," she said.

Ngubeni and her siblings were orphaned fifteen years ago when her oldest brother was just 10. A Norwegian family living in Zambia committed itself to looking after them, which meant they were clothed and fed, but this presented them with social problems.

Their neighbours ridiculed them for eating pasta, bread and rice, instead of the staple, nshima - thick maize-meal porridge - that neither she nor her three sisters can cook.

"The neighbours laughed at us for eating the white man's food, which they said was not real food, but what are we supposed to do? We eat what we are given. That's just how it is," Ngubeni said.

Ngubeni recommends that people helping child-headed families should consider placing an adult relative or any other person of the same tribe among them to guide and mentor them in the ways of traditional society.

Out of touch with culture

In its latest report on Orphans and Vulnerable Children (OVC), the UN Children's Fund (UNICEF) found that about 20,000 households in Zambia were led by children, but the number is increasing.

The report outlines the severe deprivations of food and shelter these children often face, and concludes that with more youngsters having to take on the responsibilities of running a household at an early age, there is every likelihood that more of them will end up on the street.

Joseph Banda heads Tisunge, a local organisation that assists child-headed households to deal with the trauma of loss, and teaches them income-generating and life skills, so that the children are able to fend for themselves and can continue their schooling.

Banda said it had never occurred to him that these children would struggle with cultural issues. "I am ashamed to say that I never saw the children's situation in this way," he admitted.

"We are so engrossed in keeping the children off drugs and alcohol, and the girls from getting pregnant, and making sure that they become good citizens, that we lose sight of the fact that children need to be socialised in the ways of their tribe."

Child psychologist Trina Mayope warned that children growing up without the value of custom and tradition would have problems in future. "It's about growing up with a cultural identity ... The children feel isolation because the communities treat them as aliens, or as something not quite right because of their seeming lack of 'traditional etiquette'."

There is also the stigma attached to being orphaned by HIV/AIDS, as is mostly the case. "If these children don't conform to the cultural norms of the society they live in they will suffer a double discrimination," she noted.

Mayope acknowledged that urbanisation and the passing of time had caused people to discard many traditions, but the basics of culture were still important and largely defined how someone was perceived.

"It's difficult for most people to comprehend how a child can grow up without knowing anything about his or culture. People think they [children] are trying to act like a muzungu [European], but when you have children whose mentor is a fellow child, how are they supposed to learn traditional norms and customs?"

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http://www.irinnews.org/report.aspx?ReportId=87056DUSHANBE Thursday, November 12, 2009 (IRIN) - Even as world food production grows, hunger is on the rise in many poor countries, according to the Global Crop Prospects and Food Situation report for November, published by the Food and Agriculture Organization (FAO) on 12 November.DUSHANBE Thursday, November 12, 2009 (IRIN) - Even as world food production grows, hunger is on the rise in many poor countries, according to the Global Crop Prospects and Food Situation report for November [http://www.fao.org/docrep/012/ak340e/ak340e00.htm], published by the Food and Agriculture Organization (FAO) on 12 November.

The report highlights a contradiction: world cereal production is at its second-highest level ever, yet food prices remain very high. It identifies 77 countries that are both low-income and food deficit.

In East Africa, cereal prices range from 68 percent to 177 percent over the 2007 numbers. In southern Africa, prices are 58-200 percent higher than in 2007, and in most of Asia prices are up 40-70 percent. Since most low-income food deficit countries are food importers, they lose far more from high prices than they gain from steady crop production.

Hunger, in most cases, is caused by lack of money rather than a shortage of food production, according to the World Food Programme (WFP). [http://www.wfp.org/hunger/causes] In 2008 the number of undernourished people in the world increased by 40 million, despite record harvests. [http://www.fao.org/news/story/en/item/8836/icode/]

The new FAO report suggests that 2009 is likely to see a similar increase in hunger.

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http://www.irinnews.org/report.aspx?ReportId=87006JOHANNESBURG Wednesday, November 11, 2009 (IRIN) - A move by donor countries to provide aid agencies with cash, allowing them the flexibility to source cheaper or more appropriate food in the region or beneficiary country and save on transport and warehousing costs, is not addressing nutritional needs, according to a new report.JOHANNESBURG Wednesday, November 11, 2009 (IRIN) - A move by donor countries to provide aid agencies with cash, allowing them the flexibility to source cheaper or more appropriate food in the region or beneficiary country and save on transport and warehousing costs, is also not addressing nutritional needs, according to a new report.

Food aid should include foodstuffs fortified with micronutrients and animal protein. "The emphasis is more on quantity rather than quality, and rarely does the food aid target the most vulnerable groups: children under five, pregnant women and lactating mothers," said Stéphane Doyon, of the international medical charity, Médecins Sans Frontières (MSF), a co-author of the organization's report, Malnutrition: how much is being spent?

"Barely 1.7 percent of interventions reported as 'development food aid/food security' and 'emergency food aid' between 2004 and 2007 actually address nutrition needs," he said.

The MSF report was published ahead of a new UN Children's Fund (UNICEF) report, which points out that the level of child and maternal undernutrition "remains unacceptable" throughout the world; 90 percent of the developing world's chronically undernourished or stunted children live in Asia and Africa.

jk/he http://www.irinnews.org/report.aspx?ReportId=86993LUSAKA Monday, November 09, 2009 (IRIN) - An estimated 82,700 Zambians will become newly infected with HIV in 2009, up from just over 70,000 in 2007, according to new figures from the National AIDS Council.LUSAKA Monday, November 09, 2009 (IRIN) - An estimated 82,700 Zambians will become newly infected with HIV in 2009, up from just over 70,000 in 2007, according to new figures from the National AIDS Council.

The 2009 Zambia HIV Prevention Response and Modes of Transmission Analysis noted that the percentage of new HIV infections had stabilized, but the absolute number of new infections increased due to population growth.

As many as 71 out of every 100 new infections occur as a result of sex with a non-regular partner, while people who reported having only one sexual partner accounted for around 21 percent of new infections.

"This shows significant HIV risk even for those who are faithful. The country is facing new and tough challenges to reduce the infection rate because the disease is threatening the foundation of families and marriages," the report commented.

Other drivers of Zambia's epidemic are low levels of male circumcision in most parts of the country and inadequate condom use, particularly among discordant couples (in which one partner is HIV-positive and the other negative).

Although Zambia has recorded successes in its prevention of mother-to-child transmission (PMTCT) programme, ensuring a safe blood supply, and behaviour-change communication campaigns, the authors recommended urgently focusing future prevention efforts on curbing common practices such as having multiple concurrent partners, transactional sex and inter-generational sex.

"Multiple concurrent partnerships are the leading cause of HIV infection in Zambia. Within these relationships, correct and consistent use of condoms remains dismally low despite condoms being readily available, in most cases free of charge," President Rupiah Banda said at the opening of the National HIV Prevention Convention in Lusaka, the capital, last week, and called for more concerted efforts to curb new infections.

However, the report revealed that the annual estimated requirement was 200 million male condoms and 2 million female condoms, yet only 96 million male and 500,000 female condoms were available.

Vice President George Kunda blamed the high number of new infections on the poor uptake of HIV/AIDS services and reluctance to change risky behaviours.

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http://www.irinnews.org/report.aspx?ReportId=86946NAIROBI Wednesday, November 04, 2009 (IRIN) - Encouraging the use of traditional African herbal medicines could prevent some of the one million malarial deaths on the continent, according to specialists attending a conference www.mimalaria.org/pamc in Nairobi. Many poor communities, especially in rural settings, cannot afford modern malarial drugs and many people die due to inaccessibility of treatment.NAIROBI Wednesday, November 04, 2009 (IRIN) - Encouraging the use of traditional African herbal medicines could prevent some of the one million malarial deaths on the continent, according to specialists attending a conference www.mimalaria.org/pamc in Nairobi. Many poor communities, especially in rural settings, cannot afford modern malarial drugs and many people die due to inaccessibility of treatment.

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

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

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

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

Preserving traditional knowledge

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

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

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

Educating the youth

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

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

Effectiveness and dangers

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

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

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

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

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