Military delivers health care in bid to change image

Four years after a massive military crackdown during a presidential election in Togo, the army is trying to change its image by offering for the first time free health care in some of the country’s poorest regions, according to its medical unit.



After a week of delivering free health care in the country’s northern Kara district from 31 March until 4 April, the army’s chief of surgery, Badjona Songne, told IRIN that health care is one way to overcome the army’s abusive reputation. “Before these [military] medical campaigns, the army has always been seen by locals as a symbol of repression – a brute force.”



As part of a 2006 peace process, Togo’s government agreed to create a truth and reconciliation commission to examine alleged human rights abuses that date back to independence in 1956. Of the more than 25,000 people recently surveyed by the UN Office of the High Commissioner for Human Rights in Togo, 70 percent said they wanted the commission to be able to punish offenders.



Health needs 



FACTS on Kara's children 
25.2% chronic malnutrition
7.6% acute malnutrition
Source: UNICEF, 2008

The government estimates that in 2006 three-quarters of the nearly 50,000 people living in the country’s northern Kara district earned less than the US$300 government-calculated annual minimum required to cover basic needs. A quarter of Kara’s children suffer from chronic malnutrition, and more than seven percent of all children have acute malnutrition, according to a 2008 joint UN-government survey.



Military surgeon Songne told IRIN the 1,200-strong military force delivering health care, backed by 100 vehicles and a plane, was “overwhelmed” with requests. “The patients were so numerous that we could not assist everyone.”



Songne said the army, in coordination with the Ministry of Health, conducted 27,000 free consultations, performed 132 operations – of 484 requests – and vaccinated 15,000 people against yellow fever, meningitis and measles, at a cost of $130,000 funded by the Ministry of Defence.



The World Health Organization (WHO) representative in Togo, Kadri Tankari, told IRIN he sees no problem with the military delivering health care. “In most African countries the national health systems are very weak and Ministries of Health [government]-based institutions cannot do it alone.”



He said given the “magnitude” of health problems in Togo, the military working with the Health Ministry can help. “Military-owned facilities could provide useful support especially in remote areas,” Tankari said.



According to the government in 2006 almost seven of every 100 babies died in childbirth, 49 percent of births were unattended and there was less than one doctor per 10,000 residents – the minimum recommended by WHO to guarantee basic health service.


''Reconciliation is a process that consists of many elements and not just isolated acts''

Togo’s army surgeon Songne told IRIN he would like to see local leaders turning to the military for free care, which he said the military will continue to offer in location s to be determined. “We want, for example, one day a canton chief to get up a nd say ‘these hernias and goitres [lymph node swelling] – I no longer want to see them in my canton.’” He said it is his “dream” that civilians would come to trust the army.



For Ajavon Zeus, president of the NGO Collective of Associations against Impunity in Togo (CASIT), establishing trust is a long process. “Reconciliation is a process that consists of many elements and not just isolated acts.” Zeus told IRIN that CASIT is preparing hundreds of lawsuits related to alleged military abuses during the 2005 crackdown.



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