http://www.irinnews.org/irin-fp.aspxUpdated everydayen-gbTue, 09 Mar 2010 17:13:57 GMTKYAKA II Tuesday, March 09, 2010 (IRIN) - A project using papyrus and waste paper to make sanitary pads has changed the life of Evelyne Banyamisa, who fled rebel violence in Bunia, north-eastern Democratic Republic of Congo (DRC) in 2003 when she was only 13. KYAKA II Tuesday, March 09, 2010 (IRIN) - A project using papyrus and waste paper to make sanitary pads has changed the life of Evelyne Banyamisa, who fled rebel violence in Bunia, north-eastern Democratic Republic of Congo (DRC) in 2003 when she was only 13.

After leaving the DRC, Bamanyisa ended up in south-western Uganda where she has been living as a refugee. She was separated from her parents as they fled Bunia, and Banyamisa, her elder brother, a younger sister and a niece, arrived in the Kyaka II refugee camp where they lived together as a family until 2008 when her brother disappeared.

“I don’t know where he went; I have reported his disappearance but I have not so far heard anything; right now I am taking care of my sister, my niece and an orphan who I decided to take in as she did not have anyone to help her,” Banyamisa, now aged 20, told IRIN on 7 March.

With the help of the UN Refugee Agency (UNHCR), Banyamisa managed to continue with her schooling while in Uganda, dropping out in the third year of secondary school.

"I was idle for about two years with nothing to do here in Kyaka,” she said. “Fortunately, I got employed in June 2009 by Makapad where I am now the quality controller,” Banyamisa said. “I get a monthly salary of 80,000 shillings [US$40] which I use to sustain my family; where would I have gotten such money without Makapads?”

Set up in 2008 by a Makerere University professor, UNHCR and its implementing partner GTZ, the Makapads project has not only transformed the livelihoods of its employees, it has also made available sanitary pads for tens of thousands of refugees – most of them Congolese – living in settlements in south-western Uganda.

Moses Kizza Musaazi, a senior lecturer at Makerere University, initiated the project to help disadvantaged girls access affordable sanitary pads. The project later received support from UNHCR and GTZ, leading to the establishment of two sites in Kyaka II refugee settlement where the pads are produced, purchased by UNHCR and distributed among refugees.

The Makapads are also produced in the capital, Kampala, at the faculty of technology at Makerere University.

Inside the 209 sqkm Kyaka II refugee settlement, the Makapads project is run on two sites, employing dozens of refugees, mostly women. The site where Banyamisa is employed has 29 workers, 24 of whom are women.

"The project has also attracted the interest of nationals living close to the refugee settlement. They want to be involved as they realize it is beneficial but right now we only have refugees working here,” Ibrahim Rumanyika, the project manager for the Makapads project in Kyaka II said.

Rumanyika is a Congolese refugee who arrived in Uganda six years ago.

Production process

The production process begins with the collection and delivery of papyrus reeds, Rumanyika said. “Once we have the papyrus, it is peeled, cut up into small pieces and ground into a powdery form,” he said. “Then we sieve it to remove the coarse particles. This is then taken to another container filled with water, where it is mixed with waste paper pulp; we get the paper from UNHCR in Kampala.

“From there, we place the mixture on drying racks; it takes a few hours to dry when the weather is OK, on rainy days we hardly dry anything,” Rumanyika said. “Thereafter we take the dried sheet into the production room where it is softened and smoothed, and cut into pad-sizes; then combined with a paper-only dried pulp [which is softer], packed in soft outer material, sealed and sterilized.”

With just two buildings and 50 drying racks lined up outside, the project runs on solar-powered electricity. “Even sterilization becomes a problem because we depend on solar power to do it; sometimes we do not produce as much as the day’s capacity because of this,” he added.

On average, the site makes at least 3,000 packages a day – each with 10 sanitary pads.

“UNHCR buys the pads from us for distribution among the refugees here in Kyaka and Nakivale settlements but we also make pads for sale in local retail outlets,” Rumanyika said.

Most of the equipment used is locally produced, Rumanyika said, with only the adhesive tape and soft outer cover imported.

He said a Makapad package retails at 1,000 Uganda shillings [US$0.50) whereas the prices for the other varieties on the market start at 2,000 shillings [$1].

Banyamisa said her life and that of other refugees using the pads has changed for the better. “Previously, many of us used cloth or toilet paper; the problem with the cloth was that one may not have soap with which to wash it, sometimes water is hard to come by, so you could end up with a bad smell as a result,” she said.

“Since the Makapads were introduced, the days of periods being depressing are gone; the only problem right now is the pads are too thin for those with heavy flows. I think we should make some pads specifically for such women.”

Expansion plans

According to UNHCR, the Kyaka II Makapads project has the potential to become self-sustaining. At the moment, the agency supplies it with the waste paper which is mixed with the papyrus to make the pads.

Needa Jehu-Hoyah, associate external relations officer for UNHCR Uganda, said: "The Makapads project is one of the most beautiful examples of refugees coming together to respond to the needs of women and children in a manner that sustains their dignity. We recently reached the 50 percent mark in the procurement of Makapads for female refugees of reproductive age in the refugee settlements.”

Maria Mangeni, UNHCR's Makapads expert, said due to increased interest in the project, UNHCR was considering plans to replicate the project in other refugee settlements in the country.

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http://www.irinnews.org/report.aspx?ReportId=88359BOSASSO Tuesday, March 09, 2010 (IRIN) - The number of people seeking mental health treatment has increased in Bosasso, the commercial capital of Somalia's self-declared autonomous region of Puntland, despite the existence of only one small health unit, officials said.BOSASSO Tuesday, March 09, 2010 (IRIN) - The number of people seeking mental health treatment has increased in Bosasso, the commercial capital of Somalia's autonomous region of Puntland, despite the existence of only one small health unit, officials said.

"We have only two rooms; one for males and one for females, with five beds each," Abdulkadir Khalif Ali, the nurse who manages the Bosasso general hospital's mental health wing. "The demand is rising; there are days when I have 20 or 30 patients, some requiring hospitalization, but I have to release them because there is no space."

Ali, the only qualified medical employee in the unit, told IRIN there was no psychiatrist. "I do almost everything a doctor would do," he added. "But we could do with one, no question."

The hospital recorded some 844 patients in 2009, despite the lack of mental health facilities and staff.

Francesca Rivelli of the protection sector, psycho-social support and mental health, of the NGO Gruppo per le Relazioni Transculturali (GRT), told IRIN the hospital was far too inadequate for the number of people it served.

"It is too small if we consider the inhabitants of Bosasso and moreover if we consider that the MHD [mental health department] at Bosasso hospital also serves people from all over Puntland and south-central Somalia," she said.

GRT set up the mental illness unit in 2004 and supported it up to 2008 when it stopped the support due to lack of donor funding. "There is support for malaria, TB and HIV/Aids but not so much for mental health," Rivelli.

Cases of post-stress traumatic syndrome have increased in Somalia mainly because there has been an increase in insecurity since the fall of the Siad Barre government in 1991, coupled with sporadic clashes, displacement and the daily uncertainty and violence in an impoverished environment, she said.

"In Somalia we're also talking about a long-standing and unique combination of harsh conditions..." said Rivelli.

Lack of interest

Ali said most of his patients displayed an array of mental illnesses such as psychosis, mood disorders, substance abuse, depression, neurosis and epilepsy.

Unfortunately, not many aid organizations in Puntland, he added, were interested in mental health issues. "I think they are more comfortable in other areas, such as FGM/C [female genital mutilation/cutting] and other easier-to-understand diseases."

Rivelli, however, said it should not be too difficult or costly to work in the mental health sector "through fine-tuned support initiatives at secondary health system level, namely strengthening the services provided by the local MHD.

"At the outset of the intervention, it is necessary to rely on motivated and qualified medical staff providing incentives both money-wise and in terms of motivation in coordination with the hospital system, to stop the turnover and brain-drain of the already few human resources," she added.

Secondly, having psychotropic drugs provided by international agencies and donors would boost the quality of treatment offered to the patients.

There was also a need to carry out the clinical and social work side by side with professional workers such as health workers and counsellors.

Running out of drugs

Ismahan Nur had brought her 30-year-old brother-in-law from the town of Galkayo, 750km south of Bosasso, to the hospital. He had been sick for more than two years and the family tried traditional means to cure him. "We tried everything but he only got worse. He stopped eating, was not sleeping and was suspicious of everybody."

They brought him to the hospital in January and he was put on medication for schizophrenia, according to Ali. "He is much better now. He is lucid, eating and sleeping well."

Ali, however, warned that the hospital was running out of drugs. "We have started telling people to buy the drugs from the town," adding that most of the patients could not afford medicines.

According to Rivelli, in the past three years only the European Union and World Health Organization had allocated funds to some interventions in mental health in Somalia; "thus the overall budget allocated is negligible compared to the needs".

Most of that supported running costs of existing but neglected facilities, drugs, training and education campaigns, such as the initiative to free patients from being chained.

A great deal had to be done to improve mental health in Somalia. "Referral mechanisms to bridge the gap between rural and urban areas; community-based mental health programmes and research on the use of khat, gender and mental health, ex-combatants and mental health," she said.

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http://www.irinnews.org/report.aspx?ReportId=88364JOHANNESBURG Tuesday, March 09, 2010 (IRIN) - An outbreak of Rift Valley Fever (RVF) in two South African provinces has killed one person, while five others have tested positive for the disease, which has also caused "extensive livestock deaths", the National Institute for Communicable Diseases (NICD), said in a statement on 9 March. JOHANNESBURG Tuesday, March 09, 2010 (IRIN) - An outbreak of Rift Valley Fever (RVF) in two South African provinces has killed one person, while five others have tested positive for the disease, which has also caused "extensive livestock deaths", the National Institute for Communicable Diseases (NICD), said in a statement on 9 March.

As of 4 March 2010, the livestock disease - which can be transmitted to humans by handling infected animal tissue during butchering - had been reported on 14 farms in Free State and one farm in the neighbouring province of Northern Cape.

Initial estimates by veterinarians in the affected region are that more than 1,000 livestock have perished. High mortality rates are experienced among young animals and the disease causes pregnancies to be aborted.

NICD director Dr Lucille Blumberg told IRIN the authorities had responded well to the outbreak, but RVF was "difficult to control", and "lots of rain recently" had resulted in ideal breeding conditions for mosquitoes - the vector of the disease.

Investigations were being carried out by the health and agricultural departments, supported by the South African Field Epidemiology and Training Programme, and NICD.

Outbreaks of RVF are common; in 2009 more than 50 animals died in KwaZulu-Natal Province, but the most serious occurrence of the disease in South Africa was between 1974 and 1976, when an estimated 10,000 to 20,000 humans were infected.

"The current outbreak is within the same area, highlighting the importance of timely interventions to prevent further spread," the NICD said.

Blumberg said the disease was "asymptomatic", or mild, in the vast majority of people, but about one percent of those infected could experience a more severe reaction.

According to the NICD website, "complications include: ocular (retinal) disease, meningo-encephalitis, [and] or haemorrhagic fever. Onset of retinal lesions usually occurs one to three weeks after the first symptoms appear, and may lead to permanent loss of vision, necessitating continual follow-up of patients for a one-month period after symptoms resolve. Disease is rarely fatal."

Molefi Sefularo, the deputy minister of health, said in a statement on 8 March that "A 45-year-old patient, who was admitted to a mine hospital on 26 February 2010 with a provisional diagnosis of Congo fever, died a day later and confirmation of RVF was made on the 4th of March."

RVF was first identified by a British veterinary surgeon in Kenya more than 50 years ago, and is endemic to South Africa and the rest of the continent, as well as the Indian Ocean islands of Comoros and Madagascar.

go/he http://www.irinnews.org/report.aspx?ReportId=88367DAKAR Tuesday, March 09, 2010 (IRIN) - A polio vaccination campaign in the violence-wracked central Nigerian city of Jos has been delayed until 13 March due to the violence and a recent health worker strike, aid workers said.DAKAR Tuesday, March 09, 2010 (IRIN) - A polio vaccination campaign in the violence-wracked central Nigerian city of Jos has been delayed until 13 March due to the violence and an on-going health worker strike, aid workers said.

"We needed more time to plan because of the displacement that happened after the previous violence [in January] said Mathew Dabup, The International Federation of Red Cross and Red Crescent Societies (IFRC) polio immunization manager in Plateau State, which includes Jos.

IFRC has been conducting training for health workers who did not join the strike in Plateau State he told IRIN. IFRC is one of the agencies running a weeklong regional campaign to vaccinate at least 85 million children in West Africa against polio, a highly infectious viral disease that invades the nervous system and can cause total paralysis in a matter of hours.

The Nigeria Red Cross has estimated that some 20,000 people were displaced by violence in Jos during January. When asked if the latest violence, which has again displaced unknown numbers and killed hundreds, would disrupt the campaign, Dabup said he hoped the vaccinations would take place as planned. "We have taken into consideration in our ... [vaccination plan] the camps for the displaced, along with the other sites to target."

Violence and polio

Chris Maher, head of country operations for polio eradication at the World Health Organization (WHO), told IRIN: "Implementing vaccination activities in security-compromised areas is both logistically and operationally challenging, and it is obviously more dangerous for the staff working on the ground."

He said strategies in southern Afghanistan and the conflict-affected areas of Pakistan and Somalia included quick campaigns carried out during "lulls in conflict".

In areas like Jos, where there were "periodic acute flare-ups of civil unrest, rather than the constant levels of insecurity", WHO's strategy was to adjust the timing of vaccinations so as to reach as many children as possible while protecting health workers.

"Their dedication to ensuring that all children, even in security-compromised areas, are reached with vaccine and protected from polio, is heroic." he told IRIN.

Two hundred thousand vaccinators are trying to vaccinate 43 million children younger than five, the age group most vulnerable to infection. In Jos the goal is to reach 215,000 children - the official census of under-five children - although the actual number of children is higher, based on the more than 300,000 children vaccinated against polio in December 2009, according to IFRC.

Nigeria is the epicentre of the current outbreak in the region that erupted again in the second half of 2008. After multiple rounds of vaccinations, in 2009 the number of reported cases in Nigeria fell by half to 387, according to the multi-agency global polio eradication initiative.

Neighbouring countries in West Africa have discontinued polio vaccination campaigns in recent years, making them vulnerable to re-infection during Nigeria's 2008 outbreak. Benin, Burkina Faso, Côte d'Ivoire, Guinea, Liberia, Mali, Mauritania, Niger, Senegal, Sierra Leone and Togo have reported polio cases in the past 12 months.

pt/he http://www.irinnews.org/report.aspx?ReportId=88369CAIRO Monday, March 08, 2010 (IRIN) - Egypt is moving to curb the spread of avian influenza (H5N1) after a recent upsurge in infections, the Egyptian Health Ministry says. CAIRO Monday, March 08, 2010 (IRIN) - Egypt is moving to curb the spread of avian influenza (H5N1) after a recent upsurge in infections, the Egyptian Health Ministry says.

The sale of poultry between any of Egypt’s 29 governorates is to be banned, and a major Health Ministry-led awareness campaign will alert the public to the dangers of raising birds at home, Sabir Galal, deputy chief of the Veterinary Medicine Section at the Health Ministry, told IRIN. “Bird flu has become endemic in this country… The fear now is that the virus can assume more dangerous forms in the days to come,” he said.

The Ministry also said it would stop inoculating birds after vaccines had proved incapable of stopping the virus from spreading.

With 105 infections to date, including 30 deaths, Egypt is the world’s third most affected country by avian influenza, according to the World Health Organization.



ae/ed/cbhttp://www.irinnews.org/report.aspx?ReportId=88350CAIRO Monday, March 08, 2010 (IRIN) - “It is a day I don’t want to remember. Whenever it comes to my mind, it sends shivers down my spine,” said Aya Abdel Aati, aged 17, recalling the painful experience of her circumcision at the age of 12. She says she bled for several days. CAIRO Monday, March 08, 2010 (IRIN) - “It is a day I don’t want to remember. Whenever it comes to my mind, it sends shivers down my spine,” said Aya Abdel Aati, aged 17, recalling the painful experience of her circumcision at the age of 12. She says she bled for several days.

Despite efforts by the authorities, NGOs, and international agencies to eliminate Female Genital Mutilation/Cutting (FGM/C), the practice is still widespread in Egypt and deeply rooted in the minds of the people, according to a study funded by World Health Organization (WHO) entitled Investigating Women’s Sexuality in Relation to Female Genital Mutilation in Egypt.

“The main reason we found for the continuation of the practice is a drive to control a woman’s sexuality before marriage as a means of ensuring her virginity and therefore her marriageability by delivering an intact bride to her prospective husband,” the study said.

The study said many of those surveyed saw FGM/C as a “family affair” and a personal decision, in which the government should not interfere. “Therefore they are highly skeptical that regulations and laws recently introduced to stamp out the practice will actually succeed,” it said.

In 2008, Egypt passed a law criminalizing FGM/C with punishments ranging from three months to two years in prison, and a fine of 1,000-5,000 Egyptian pounds (US$183-912).

Experts believe that although female circumcision is widespread, considerable progress has been achieved. “The Demographic Health Survey of 2008 [published in 2009] showed that 72 percent of girls aged 15-30 were circumcised, compared to 96 percent of the same age group in the Demographic Health Survey of 1995,” said Azza Shalaby, gender adviser at Plan Egypt, a children’s development NGO.

However, the Demographic Health Survey of 2008 also indicated that 91 percent of women aged 15-49 were circumcised.

Elaine Bainard, head of UNICEF Egypt’s Child Protection Section, believes the prevalence of FGM/C is high but decreasing. “We believe that as more and more families publicly declare their position not to cut, and as their daughters are successfully married, the momentum will grow further.”

Religious leaders, both Muslims and Christians, are playing an important role fighting in FGM/C, preaching that the practice is not related to Islam or Christianity.

However, there are conflicting views among them, according to the WHO-funded study. “This was particularly true for Muslim leaders, who are bombarded with contradictory messages from official religious scholars and so-called 'tele-sheikhs', religious figures on TV and other media,” the study said.

Physical, psychological damage

Meanwhile, circumcised girls and women are suffering physically and psychologically.

“The process of FGM/C can be very traumatic for girls, as they are compelled or forced to comply with the procedure. They must endure the physical pain but also the emotional aftermath of being subjected to the cutting by those she loves,” Bainard said.

In extreme cases, where the cut has been extensive, girls could face increased risks during childbirth, and incontinence, she added.

“Some women have urinary tract problems and others severe bleeding during delivery,” said Plan Egypt’s Shalaby. “But circumcised women worry less about health complications than the psychological effect and shock. They say they became more secluded and fearful.”

“Giving them [people] solid information about the benefits of abandoning FGM/C within the context of social pressure to abandon it, is achieving success, but it takes time,” Bainard said.

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http://www.irinnews.org/report.aspx?ReportId=88352MBABANE Monday, March 08, 2010 (IRIN) - The myriad crises afflicting Swaziland can only be solved with a holistic approach, not a piecemeal one, the World Food Programme (WFP) deputy executive director, Sheila Sisulu, said during a recent tour of the country.MBABANE Monday, March 08, 2010 (IRIN) - The myriad crises afflicting Swaziland can only be solved with a holistic approach, not a piecemeal one, the World Food Programme (WFP) deputy executive director, Sheila Sisulu, said during a recent tour of the country.

Swaziland, a small landlocked country with a population of about one million people, is ruled by King Mswati III - sub-Saharan Africa's last absolute monarch - while contending with the world's highest HIV/AIDS prevalence, food insecurity, poor education systems, extreme poverty and a moribund economy.

Miriam Dlamini, a widowed mother of five living in rural Mliba, about 60km north of Swaziland's second city, Manzini, personifies the plight of many Swazis.

"My husband died of AIDS and left me alone to work the fields, but I am HIV positive. I need food for my children, and for myself so my ARVs work properly, but I cannot do the farm work alone, and I have no money to hire helpers or to pay for seeds and fertilizer and a team of oxen to plough," she told IRIN.

In the largely rural economy, where 70 percent of Swazis survive in a state of chronic poverty, her daily burden - like that of many others - is overwhelming. "I don't know where to begin. I wake up tired and when the day is over, so little has been done, and that makes me more tired," Dlamini said. "I receive [WFP food] packages and ARVs from the clinic, but I must travel to both places with no money for transport."

A change for the better could be on the way. On 3 March 2010, Swaziland became a member of the Common Africa Agriculture Development Programme (CAADP) - an initiative by the African Union (AU) and the New Partnership for Africa's Development (NEPAD) to address food security and agricultural production.

At the signing ceremony in the Swazi capital, Mbabane, Sisulu told a round table discussion that the spill-over of one crisis into another compounded the effects of each crisis, and the country would be hard pressed to meet the UN Millennium Development Goals (MDGS).

Interconnectiions

"Agricultural production, HIV and AIDS, food security and poverty are interconnected and cannot be tackled in isolation of each other. We believe a comprehensive approach is key to achieving the underlying objective of CAADP ... meeting Goal One of the Millennium Development Goals of eradicating extreme poverty and hunger ... at current trends, Swaziland is unlikely to achieve [this] by 2015."

Swaziland is no longer a net exporter of foodstuffs: drought and a population that has tripled since independence from Britain in 1968 have forced people to farm marginal lands, while HIV/AIDS has decimated the agricultural workforce. According to UNAIDS, about 26 percent of Swaziland's sexually active population are infected with HIV.

Membership of CAADP paves the way for the establishment of an Agricultural Development Bank of Swaziland, which could be used to provide loans or grants for subsidising agricultural inputs.

Such an eventuality would necessitate a sea change in relations between the government and non-governmental organizations (NGOs), which provide vital support in most of the country's social and agricultural spheres.

"Laudable as this show of support is, the question remains whether government can indeed work with NGOs, the private sector and the beneficiaries," said a director - who declined to be identified - of an NGO affiliated to the Congress of Non-Governmental Organisations (CANGO), an umbrella organization for NGOs.

"The [government] ministries have always worked independently - they are territorial. It will be interesting to see if they can work together, and if the voices of the rural farmers will be heard, or whether solutions will be imposed," he told IRIN.

UNAIDS Country Coordinator Sophia Monico noted that "All the UN agencies are coordinating our work on AIDS. We're setting an example by forging an alliance between specialties."

She said the UN would adopt a comprehensive approach: food security issues would be handled by WFP, AIDS issues would be handled by UNAIDS, the UN Children's agency (UNICEF) would deal with issues concerning children affected by HIV and AIDS, and poverty reduction issues, under the authority of the UN Development Programme, would be strategically coordinated.

"It's like getting relief supplies to areas hit by disaster - it's not enough to put food on the plane, you have to get the delivery infrastructure working, the beneficiaries' needs sorted out, and rebuild the agriculture sector to make food production sustainable again," said Charles Ndwandwe, a food aid distributor in Mliba.

"That's what must be done in Swaziland," he commented. "It's harder when AIDS complicates things, but this is being factored in."

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http://www.irinnews.org/report.aspx?ReportId=88355NAIROBI 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=73277DAKAR Friday, March 05, 2010 (IRIN) - No more vaccinations or trained medical staff to administer the shots - that is the hope driving new research in Germany into vaccines that could be sniffed. The "c-di-IMP" molecule being tested on mice might one day be able to bring down vaccination costs, boost immunity, and be used in nasal vaccine sprays, according to the Helmholtz Centre for Infection Research.DAKAR Friday, March 05, 2010 (IRIN) - No more needles or special medical training to administer vaccines - that is the hope driving new research in Germany into vaccines that could be sniffed. The "c-di-IMP" molecule being tested on mice might one day be able to bring down vaccination costs, boost immunity, and be used in nasal vaccine sprays, according to the Helmholtz Centre for Infection Research.

"Mucosal [nasal] vaccines can prevent not only diseases, but also to block infections before they even take place, thereby protecting also non-vaccinated contacts against disease," said Carlos A. Guzmán, head of the vaccine department.

Although these sprays are promising, people may be reluctant to sniff, WHO's director of vaccine research, Marie-Paul Kieny, told IRIN. "[It is] good for people afraid of needles ... but there is a certain reluctance of the public - [nasal sprays] look new. They like shots, after all, it looks more 'medical'."

The World Health Organization (WHO) has only approved one nasal spray vaccine, MedImmune Flumist, for preventing influenza.

Of mice and men

Aluminium salts are commonly added to vaccines to increase efficacy, but their impact is waning; WHO said efforts were underway to find new molecular helpers - also called adjuvants - to create vaccines for diseases like malaria and HIV.

The "c-di-IMP" molecule has only been shown to boost immunity in mice thus far, and Kieny told IRIN it was not clear for how long the molecule could protect humans. "The lifespan of this animal does not extend a year, so for the time being the best evidence might be that immunity lasts for one year."

Two and a half million children died in 2004, the most recent year for which data was analyzed, from diseases that could be prevented by vaccines recommended by WHO.

Maintaining and expanding immunizations from 2006 to 2015 in 72 countries eligible for subsidized vaccines would cost an estimated US$35.5 billion, which is less than $50 for every child born in those countries, according to WHO.

The Bill & Melinda Gates Foundation has pledged US$10 billion over the next decade, with most of the funds going to the Global Alliance for Vaccines and Immunisations, which subsidizes vaccine costs for the 72 countries.

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http://www.irinnews.org/report.aspx?ReportId=88328AGADEZ Wednesday, March 03, 2010 (IRIN) - The unusually large-scale migration of southern Nigerien farmers and pastoralists, heading north to look for work, has prompted concerns about food shortages in the northern Agadez region, according to local authorities.AGADEZ Wednesday, March 03, 2010 (IRIN) - The unusually large-scale migration of southern Nigerien farmers and pastoralists, heading north to look for work, has prompted concerns about food shortages in the northern Agadez region, according to local authorities.

"This seasonal migration always happens during the period between [harvests] and Agadez always welcomes people with open arms," said Almoumoune Ibrahim, son of the region’s highest ranking traditional leader.

“Normally after the harvest [in the south], the men leave the women and children with a stock of food and they come here to find work as farm labourers,” said Alhadji Guichem Kari, a member of a government committee set up after last September’s floods in the Agadez region, which displaced thousands and destroyed more than 3,000 homes

But this year’s increase in the number of migrants is testing the north’s perennial hospitality.

"Due to the shortages [of food] in the south, people have come earlier and in greater numbers… This year entire families have been coming. Some have found work and others beg," Kari told IRIN.

Flood damage around Agadez is still evident: Destroyed crops and homes, dead cattle, and sand-infested vegetable gardens no longer able to employ seasonal migrants.

Near the airport, Mariama Adao camps out with hundreds of other migrants. Originally from the southern town of Matameye near the Nigerian border, she arrived in Agadez three months ago with six of her eight children.

"This year when we saw that the rain was not coming I came here very quickly," she told IRIN. "Normally we harvest 20-25 sacks [of millet, sorghum, cow peas and peanuts], but this year we did not even harvest five… We needed to make headway and get here quickly to find a way to survive."

Abnormal rains in several parts of the country, including Agadez have led to crop deficits, forcing families nationwide to dip into their food stocks earlier than normal. Over half the population had only two months of food reserves left as of February - to last them until the next harvest in October, according to the UN Office for the Coordination of Humanitarian Affairs.

Mariama Adao found work cleaning homes, as did her 17-year-old son. "I come here every year but this year there are a lot more of us than usual. Everyone [from the Matameye region] has had problems," she said.

"People who come here would never die of hunger because there is a real sense of solidarity [between people from the south and the Agadez region]," Hama Dilla Abdoulaye, the mayor of Agadez, told IRIN.

Food prices up

However, the local population is already facing higher food prices as a result of the region's poor harvest and higher demand prompted by the influx of migrants.

Two and a half kilograms of millet, a local food staple, which previously cost at most 500 CFA francs (US$1) between harvests, is now sold for 600 CFA francs in Agadez, according to residents

"Agadez is a small town; we feel the pressure of food and rent prices straight away," said Ousmane Issouf, a driver.

A recent national survey on household food security classified Agadez as one of the least vulnerable regions in the country - 7 percent of households faced problems getting food compared to the national average of 20 percent.

But the authorities were only able to carry out the survey in three urban areas of a 660,000sqkm desert region. A government travel ban and state of alert were recently lifted in the northern half of the country after years of rebel fighting, but rural zones - filled with pastoralists and farmers cut off from markets, hemmed in by sporadic fighting and hit by flooding - are still largely inaccessible.

Meanwhile, some say increased migration to the Agadez region has also been stimulated by rumours of free food handouts in the wake of the flooding. "People heard that food was being distributed in Agadez so they came here, [but that food] was only for people who been affected [by the floods],” Mayor Abdoulaye told IRIN.

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http://www.irinnews.org/report.aspx?ReportId=88296AGADEZ Wednesday, March 03, 2010 (IRIN) - Mariama Adao, aged 40 and a mother of eight, makes the 400km journey from Matameye in the south of Niger to Agadez in the north almost every year to make ends meet between growing seasons. However, this year’s poor harvest forced her to leave earlier - and bring six of her children with her. AGADEZ Wednesday, March 03, 2010 (IRIN) - Mariama Adao, aged 40 and a mother of eight, makes the 400km journey from Matameye in the south of Niger to Agadez in the north almost every year to make ends meet between growing seasons. However, this year’s poor harvest forced her to leave earlier - and bring six of her children with her.

She told IRIN about her life:

"My husband is a farmer [in the Matameye region]. We grow millet, sorghum, cow peas and peanuts. Normally we produce 20-25 sacks, but this year we did not even get five. There was not enough rain. We have only known one other year like this [in 2005].

"When we saw that the rains were not coming I came here very quickly... with six of my children. I could not just stay there with my arms folded. I had to make headway and come here quickly [to Agadez] to make money to survive. My husband is old. He stayed with our two eldest daughters, who are married. They manage to provide him with food.

"We travelled for more than two days in a truck. A month after we arrived I managed to find a job doing housework in someone’s home. My [17-year-old] son was also employed in another house. My youngest is two years old. The children do not go to school.

"We come to Agadez because, of the eight regions [of Niger], we feel that we will find the most solidarity here. You can find more food here too. We were told that there was a food distribution [intended for people in the Agadez area affected by the September 2009 floods] here, but we have not received anything yet.

"I come here every year but this year there are a lot more of us than usual. Everyone has had problems [in the Matameye region]. Among my neighbours [in Agadez], a few have managed to find work and the others beg.

"At the moment we are getting by; we help each other. If one person has nothing to eat, we share with them. There is a sense of goodwill, but it is hard. I will not go back before the next rainy season in the south [May]. We need rain."

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http://www.irinnews.org/report.aspx?ReportId=88297BOSASSO Tuesday, March 02, 2010 (IRIN) - Prolonged and persistent droughts have drastically changed the fortunes of Hujale Jama, 80. Originally from the village of Has Wanaje, 480km east of Bosasso, commercial capital of the self-declared autonomous state of Puntland, Jama was once considered fairly well-off. Then the drought slowly decimated his livestock. Today, he lives with relatives in Bosasso, without any livestock to his name. BOSASSO Tuesday, March 02, 2010 (IRIN) - Prolonged and persistent droughts have drastically changed the fortunes of Hujale Jama, 80. Originally from the village of Has Wanaje, 480km east of Bosasso, commercial capital of the self-declared autonomous state of Puntland, Jama was once considered fairly well-off. Then the drought slowly decimated his livestock. Today, he lives with relatives in Bosasso, without any livestock to his name.

Jama is one of thousands of people in Bosaso displaced by drought who have moved to urban centres where they depend on relatives. He spoke to IRIN in Bosasso:

“Three years ago I had 600 heads of goats and sheep and more than 30 camels. I was a man of means and would be asked to help those with less. I was one of the leaders of my community and never needed help, I was the one helping.

"Nowadays, I am the one asking people for help. I have seen many people lose all their animals but I never thought I would be one of them. It is not what I expected to be doing at my age. My livestock died one by one until there was nothing left.

"Unfortunately I am not the only one suffering. Many people in this town were once herders but have since lost everything. The droughts are becoming longer and more devastating. When there was no pasture or water in our area we would move to another part of the country but all areas are now the same; no pasture no water.

"If the situation continues like this, there will be no more people left in the countryside. The young ones can adjust and maybe find something to do but what is there for an old man like me? We are almost invisible; nobody is talking about rural people who are destitute.

"Today I am sick but I don’t have the money to go to the doctor. I never thought I would depend on anyone but look at me now. I used to be a respected man but I don’t feel like a man.

"What will I do? I cannot beg at my age."

ah/mw http://www.irinnews.org/report.aspx?ReportId=88274DAKAR Tuesday, March 02, 2010 (IRIN) - The government of Sierra Leone has announced that from Independence Day (27 April) it will abolish user fees for pregnant women, lactating mothers and children under five, but will this, on its own, improve their lot? DAKAR Tuesday, March 02, 2010 (IRIN) - The government of Sierra Leone has announced that from Independence Day (27 April) it will abolish user fees for pregnant women, lactating mothers and children under five, but will this, on its own, improve their lot?

IRIN looks at Sierra Leone for the third part of its series on maternal and child health.

Sierra Leone has the world’s highest maternal mortality rate - 1,800 women die per 100,000 live births, according to UN Children’s Fund (UNICEF).

C.T.H. Bell, a gynaecologist with the privately owned New Life hospital in Sierra Leone’s capital, Freetown, says that more critical than free treatment is speed of decision-making in the home, an efficient transport infrastructure, and prompt treatment on arrival at a health centre.

He suggested that the expansion of free health required more preparation, and should not be seen as a cure-all. “Have we put our house in order before inviting the guests? Women will go for free treatment - where? You are inviting people to your house, but do you have the drugs? Do you have the IV [intravenous] fluids you need? Do you have blood? Are your staff motivated?”

Abolishing user fees will not address life-threatening delays in delivering maternal care - even in the woman’s own community, he said.

“At times, the husband - who has to decide - is not there. Or maybe the mother will say: ‘No, let’s wait. Or maybe there is an old woman in the community who will say: ‘Wait, wait, wait’ - until it is too late,” Bell told IRIN.

Monir Islam, head of WHO’s Making Pregnancies Safer Programme, told IRIN poor roads and a lack of ambulances made it hard for people from rural areas to get to a city for emergency care. “Free care means little on its own. If women cannot make it to a centre, what good is free care?”

Traffic jams further slow down those trying to reach Sierra Leone’s only hospital handling obstetric and gynaecological emergencies, in east Freetown, said Bell. “If somebody has an emergency in the west, that person has to drive through the city to the east… By the time the person gets to the hospital, maybe [the woman or baby] is dead.”

Prompt treatment

Bell said there were often delays at clinics. “The patient… gets to the facility - no doctor, no nurse, no medicine, no blood and the patient has to wait until a doctor is called on duty.”

He said poorly paid public servants - the average monthly doctor’s salary is around US$100, while a 50kg sack of rice costs $34 - are worn out because they do multiple jobs to survive.

In June 2008 NGOs operated more than half the country’s health facilities, according to the Health Ministry. There are almost as many international doctors employed by NGOs (50) as there are local doctors (60). Nursing graduates are only able to find temporary work, when someone resigns or dies, according to the UN Population Fund. Many emigrate to foreign countries in search of better jobs.

Lack of trained government healthcare workers is all too often an excuse by governments to delay improving maternal health care, WHO’s Islam told IRIN.

In addition to training more health workers, governments should provide existing workers with the equipment and power supplies they need to do their jobs, he said. “If a woman makes it to the clinic, will there be trained midwives, an electricity generator?”

“Unless there is a comprehensive overhaul and improvement of maternal health care, poor people will continue to get only poor options, whether user fees exist or not.”

No-cost medical care will do little to make pregnancies safer unless health centres are better equipped to serve expectant mothers, according to WHO.

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http://www.irinnews.org/report.aspx?ReportId=88280KABUL Tuesday, March 02, 2010 (IRIN) - Hundreds of families who fled fighting in the Marjah area of Helmand Province, southern Afghanistan, in February have started returning home; conditions are difficult but steps are being taken to help them, government officials say. KABUL Tuesday, March 02, 2010 (IRIN) - Hundreds of families who fled fighting in the Marjah area of Helmand Province, southern Afghanistan, in February have started returning home; conditions are difficult but steps are being taken to help them, government officials say.

Over 4,000 families were displaced by a major anti-Taliban offensive by NATO and Afghan forces which began on 13 February, according to the provincial authorities.

“Over 600 displaced families have returned to Nad Ali and Marjah [both towns in Nad Ali District] from Lashkargah over the past four days,” Ghulam Farooq Noorzai, director of Helmand’s refugee affairs department, told IRIN, adding that more people would return in the days ahead.

Dawood Ahmadi, a spokesman of the governor of Helmand, gave a bigger return figure: “About 2,500 families have returned to their homes and only 1,000-1,200 families are in Lashkargah.”

The government said it is not providing transport assistance to the returning families. Most people were using small cars as they had few belongings.

However, roads around Marjah have been risky because of improvised explosives planted by the insurgents.

“The main Lashkargah-Marjah road is closed due to mines and bombs but people are using alternate routes,” said Ahmadi, adding that NATO and Afghan soldiers were working to remove improvised bombs and reopen the main road.

The Interior Ministry said three car passengers were killed in an improvised explosion in the outskirts of Lashkargah city on 1 March.

Having announced the end of the military phase of the operation, NATO and Afghan government officials have vowed swiftly to deliver security, good governance and services.

People would also receive financial assistance from the government and NATO if their houses or other property was damaged or destroyed as a result of the offensive, Ahmadi said.

Health centres

“We have reopened and supplied with medicines four basic health centres in Marjah and Nad Ali,” Enayatullah Ghafari, head of Helmand’s public health department, told IRIN, adding that plans are under way to conduct a polio immunization campaign in the area because in February a sub-national immunization drive was not implemented there.

Government officials said schools will be reopened in Marjah and Nad Ali in the near future. Over the past two years, under the Taliban, all schools in the area had been closed.

However, not everyone is happy: “The Taliban were just and efficient but the Karzai government is corrupt and bad,” said one man in Lashkargah city.

Shops are reopening in Marjah but food and other prices are high because of shortages: Roadside bombs and insecurity are a disincentive to local truckers.

“We have asked the UN and other international aid agencies to help us quickly deliver food aid to 6,000 families in Marjah and Nad Ali and we hope they will respond soon,” said Noorzai.

Some of the displaced children attending health centres in Lashkargah town in mid-February were acutely malnourished, according to Ghafari, who added that food insecurity threatened the health of many children and pregnant women.

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http://www.irinnews.org/report.aspx?ReportId=88285JOHANNESBURG Tuesday, March 02, 2010 (IRIN) - Long dry spells in parts of Africa and erratic rainfall in Asia have cast uncertain clouds over crop yields for 2010 in the world's poorest countries. Food prices in most developing countries are down from their 2008 crisis levels, but still higher than they were in 2007. JOHANNESBURG Tuesday, March 02, 2010 (IRIN) - Long dry spells in parts of Africa and erratic rainfall in Asia have cast uncertain clouds over crop yields for 2010 in the world's poorest countries. Food prices in most developing countries are down from their 2008 crisis levels, but still higher than they were in 2007.

In the first of a four-part series on food security in some of the world's most vulnerable countries, IRIN asks, "Are we heading for another crisis?"

It would take "two consecutive bad years" for a repeat of the 2008 food and fuel crisis to arise, said Abdolreza Abbassian, economist and secretary of the Intergovernmental Group on Grains at the UN Food and Agriculture Organization (FAO). Unlike the situation in 2008, global cereal stocks are at comfortable levels.

But there were "many factors at play" in food prices. "In fact, we're projecting prices to stay firm, even in the medium term (the next 10 years), although they may not exceed the highs witnessed in 2008," Abbassian commented.

It is still a matter of adequate supply to meet growing demand, and the supply of food cereals has been declining. The gradual reduction in subsidies and support for the world's biggest producers in the Organization for Economic Cooperation and Development (OECD) countries - the US and the European Union (EU) in particular - has meant smaller surpluses.

"On the other hand, population growth and economic prosperity fuel demand - as in Asia, especially in China and India - therefore, we are moving into a situation whereby supply expansion could decelerate, while demand will continue to grow - sometimes even faster than in the past," said Abbassian. 

A paper by the OECD suggested that food prices would start rising again, "(albeit not to 2008 peaks) once economies come out of the recession, as the basic structural demand and supply-side determinants are still very much present ... [with] demand growing faster than supply. Food prices should therefore no longer be seen as a 'shock' or short-term 'crisis', but rather as a longer-term structural issue."

Biofuels still a threat

Some of the structural changes that brought about the 2008 food price crisis, such as diverting agricultural land from producing food cereals to grains for biofuel, had yet to be addressed, Abbassian said.

ActionAid, an international NGO, calculated in its new report, Meals per gallon: the impact of industrial biofuels on people and global hunger, that by 2020 biofuel consumption in the European Union (EU) would jump nearly four-fold, and that two-thirds would be imported, mainly from the developing world.

"Biofuels are conservatively estimated to have been responsible for at least 30 percent of the global food price spike in 2008," said ActionAid, which warned that a repeat of crisis could be in the offing, with the supply of food cereals likely to be compromised by a demand for biofuels in the EU.

"Up to 100 million more people could go hungry if Europe commits itself to a huge increase in biofuels consumption in order to meet new European Union legislation," said the report.

The legislation dates back to an agreement between the EU states in 2008 to meet 10 percent of their transport fuel needs from renewable sources, including biofuels, hydrogen and green electricity, by 2020.

In a scenario that takes into account a planned and predictable biofuel expansion in some countries, the US-based International Food Policy Research Institute (IFPRI), projected maize prices rising by more than 20 percent by 2020, and by more than 71 percent in a drastic expansion scenario.

C. Ford Runge and Benjamin Senauer, academics at the University of Minnesota, wrote in an article published in 2007 in Foreign Affairs, an American magazine, that if the prices of staple foods continued to increase as per the IFPRI projections, the number of food-insecure people in the world would rise by over 16 million for every percentage increase in the real prices of staple foods.

ActionAid noted that "If all global biofuel targets are met, it is predicted that food prices could rise by up to an additional 76 percent by 2020." The NGO said it found that EU companies had already acquired, or were negotiating for, at least five million hectares in developing countries, which could threaten food supplies of some of the most vulnerable populations.

According to FAO, one in six people in the world are now hungry, with the 2008 crisis having pushed another 100 million into poverty and food insecurity.

There could be a solution. The global stock of cereals, which has relied on countries in the western hemisphere, has begun to look towards the Commonwealth of Independent States (CIS), a regional organization comprising the Russian Federation, Belarus, Ukraine, Armenia, Azerbaijan, Kazakhstan, Kyrgyzstan, Moldova, Turkmenistan, Tajikistan, Uzbekistan and Georgia.

Abbassian pointed out that Russia has become the world's second largest exporter of wheat after the US. "Unfortunately, they [the CIS] are located in a part of the world which is extremely vulnerable to environmental shocks."

Weaker international prices for sugar, dairy and cereals have caused FAO's Food Price Index, released on 2 March, to register a decline: "The index is down 21 percent from its peak in June 2008, but up 22 percent from the corresponding period a year ago," said Abbassian.

There was always a chance that prices might spike "as a result of market imbalances but, overall, high prices will encourage more investment in agriculture, which in turn will help in closing the gap between supply and demand", he noted.

Liliana Balbi, a senior economist at the FAO Global Information and Early Warning System, said she thought speculation was contributing to price volatility. "The fact is, prices go up quickly but don't come down fast."

Nevertheless, Abbassian was optimistic. "Technological progress and changing diets will help in maintaining a stable global food situation, even though developments at country/local level may not always be as rosy!"

The percentage hike in food prices varies between countries, as do the causes. Balbi's unit identified 33 countries that were the world's most food insecure in its Crop Prospects and Food Situation report for February - the first in 2010. Many were going hungry because they could not afford food.

Most countries on the February list have been there before; new entries are rain-poor Niger, conflict-torn Yemen and earthquake-hit Haiti.

The ActionAid report found that "each 10 percent increase in the prices of cereals (including rice) adds nearly US$4.5 billion to the aggregate cereals import cost of those developing nations that are net importers."

In the next three parts of the series, IRIN will provide a snapshot view of food vulnerability in the 33 countries spread across Africa, Asia and the Caribbean.

jk/he http://www.irinnews.org/report.aspx?ReportId=88287MANILA Monday, March 01, 2010 (IRIN) - The controversial issue of family planning is taking a prominent role in campaigning for the general election in the Philippines.MANILA Monday, March 01, 2010 (IRIN) - The controversial issue of family planning is taking a prominent role in campaigning for the general election in the Philippines.

Family planning advocates in the predominantly Catholic country are calling on voters to ditch candidates opposed to government funding of contraceptives before the 10 May poll for presidential, legislative and local representatives.

“If they want us to vote for them, they should allocate funding for contraceptives. We want a real reproductive health programme here in Manila,” said Fe Nicodemus, 50, a reproductive health campaigner.

Nicodemus has been fighting Manila’s local government over an executive order issued in 2000 by then Mayor Lito Atienza, which prohibits the provision of modern contraceptives and sterilization at the city’s public health facilities.

The city has since selected a new mayor, but calls to repeal the order have been ignored - which Nicodemus said was contributing to a worsening reproductive health situation in the capital.

"In Manila, girls as young as 14 get pregnant. There are 18-year-old girls who already have four children,” Nicodemus told IRIN. “They come to my house to ask for help. In spite of the [order], we make a stand to help these children, even if the village officials threaten to arrest us."

Unwanted pregnancies

The availability of contraception is hotly contested in the Philippines, where the Catholic Church holds sway over 80 percent of the population.

Reproductive health advocates, however, say family planning and modern contraceptive methods such as condoms and birth control pills are sorely needed.

"The poorest are [most] affected because of the lack of contraceptives," said Clara Rita Padilla, executive director of EnGendeRights, a women’s rights NGO. [http://engenderights.wordpress.com/about/]

In a 2008 national demographic survey [http://www.census.gov.ph/data/pressrelease/2010/pr1027tx.html] released on 14 January 2010, the National Statistics Office said about one in three births in the Philippines was either unwanted or unplanned.

It also said the country’s total fertility rate was 3.3 children per woman, but that four out of 10 women said they preferred to have only two children. Poorer women, or those with less education, wanted more children.

The Philippines’ population is projected by the National Statistics Office to have reached 92.2 million in 2009, compared with neighbouring countries Malaysia, with 28.3 million, and Thailand, with 65.4 million.

Family planning advocates are now pressing presidential candidates – including incumbent President Gloria Macapagal Arroyo - to support a comprehensive nationwide family planning programme.

“Presidential candidates should make a clear stand on reproductive health now,” said Ramon San Pascual, executive director of the Philippine Legislators Committee on Population and Development [http://plcpd.org.ph/], a non-profit group that assists lawmakers in pushing for reproductive health legislation.

“We need a national policy on reproductive health that will make sure that the likes of Mayor Lito Atienza will not be able to curtail our reproductive health rights," he said.

Lost opportunity

Reproductive health advocates almost scored a victory when a bill was presented to Congress in January this year that mandated the government to fund modern contraceptives. The government only supports natural forms of birth control.

An October 2008 nationwide survey conducted by polling firm Pulse Asia showed that 63 percent of Filipinos supported the bill.

However, intense debate among legislators, including pro-Church lawmakers, delayed a vote on the bill, which expired after the congressional session ended.

“That's why it's important to have a president who can stand up to the Catholic Church in favour of reproductive health rights," said Benjamin de Leon, president of the Forum for Family Planning and Development Inc, an NGO [http://www.forum4fp.org/html/about-us.html].

The advocates have vowed to file the same bill in the next Congress after the elections.

Church campaign

In December, the Catholic Bishop's Conference of the Philippines (CBCP) issued a paper advising Catholics not to vote for candidates who support government funding for contraception [http://www.cbcpnews.com/?q=node/12037]. "It would not be morally permissible to vote for candidates who support anti-family policies, including reproductive health … Otherwise one becomes an accomplice to the moral evil in question,” it said.

Out of nine presidential candidates, only one, Benigno Aquino III, son of the late president Corazon Aquino, favours government funding of contraceptives.

Former Department of Health Secretary, Alberto Romualdez, lamented that the presidential candidates appeared to have “meekly acquiesced to the CBCP dictates”.

"Not a single politician has dared to question any of the contents of the issuance while at the same time avoiding the subject as much as possible,” Romualdez told IRIN.

“Interference of a religious body in civil and political affairs is a violation of our constitution's section on the separation of church and state and candidates should take a stand on this issue,” he said.

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http://www.irinnews.org/report.aspx?ReportId=88257KABUL Monday, March 01, 2010 (IRIN) - Up to 25 million tree seedlings will be planted in Afghanistan this year by the government, NGOs and private entities to combat soil erosion and desertification, and help improve air quality in urban environments, says the Ministry of Agriculture, Irrigation and Livestock (MAIL).KABUL Monday, March 01, 2010 (IRIN) - Up to 25 million tree seedlings will be planted in Afghanistan this year by the government, NGOs and private entities to combat soil erosion and desertification, and help improve air quality in urban environments, says the Ministry of Agriculture, Irrigation and Livestock (MAIL).

Funding for the project is from various government departments and NGOs, including the US Agency for International Development.

The seedlings would be planted mostly in and around urban areas. Air pollution hastens the deaths of over 3,000 people in Kabul every year, says the Health Ministry.

“We must revitalize forests and expand green areas because they are essential for the future of our country,” MAIL spokesman Abdul Majid Qarar told IRIN, adding that three million seedlings would be planted by MAIL, but warned that they had to reckon on 45-50 percent of them dying due to lack of water or care. Afghanistan has lost up to 80 percent of its forests in the past three decades, according to the government.



ad/cbhttp://www.irinnews.org/report.aspx?ReportId=88259DAR ES SALAAM Monday, March 01, 2010 (IRIN) - A Tanzanian project is integrating family planning and HIV messages via community health workers who teach HIV-positive couples how to avoid unwanted pregnancies or infecting their unborn children.DAR ES SALAAM Monday, March 01, 2010 (IRIN) - A Tanzanian project is integrating family planning and HIV messages via community health workers who teach HIV-positive couples how to avoid unwanted pregnancies or infecting their unborn children.

“I talk to them and they tell me they are afraid,” Margaret Mapunda, a trained community health worker in Tanzania’s commercial capital, Dar es Salaam, told IRIN/PlusNews. “Some want [children] but they don’t know what to do and just conceive and go to traditional birth attendants to deliver.

“Many are taking antiretrovirals and they don’t even know which contraceptives are good and bad,” she added. “They do not ask because of stigma. Some say they are abused at health facilities.”

Since 2008, more than 3,000 couples have received family planning services from home-based care service providers in the areas of Dar es Salaam, Arusha and Kilimanjaro under the Tutunzane – Swahili for “let’s care for each other” - project, run by reproductive health NGO, Pathfinder International [http://www.pathfind.org/site/PageServer?pagename=Programs_Tanzania_Projects_Tutunzane].

Family planning needs

A 2009 study [http://journals.lww.com/aidsonline/pages/articleviewer.aspx?year=2009&issue=11001&article=00004&type=abstract] conducted in the northern Tanzanian region of Mwanza and published in the journal, AIDS, found numerous potential benefits of offering family planning counselling as a part of antenatal services, particularly in clinics offering HIV testing.

According to Children and AIDS, Fourth Stock Taking Report 2009 [http://www.unicef.org/aids/files/B230stocktaking_06Nov09_FINAL_loRes.pdf], by the UN Children’s Fund, as many as 130,000 HIV-positive Tanzanian women become pregnant every year; 53 percent of these have access to prevention of mother-to-child transmission services.

A study carried out by Pathfinder International in 2008 found that 90 percent of home-based care providers were willing to add family planning services to their activities but lacked adequate training. So far the project has trained about 250 community health workers to integrate family planning messages into their HIV counselling.

“Community home-based care service providers are very low cost and they interact more with people living with HIV than anybody else; they therefore provide a perfect opportunity to reach out to them, including with family planning services,” said Judith Rwakyendela, reproductive health and family planning programme officer at Pathfinder International.

“When you give people antiretrovirals, the objective is to make them live longer, yet many of them become strong, active and engage in sex without necessarily aiming at having a baby,” she added. “It is important that they are given the opportunity to prevent unwanted pregnancies, which plays the twin role of improving their health and preventing mother to child transmission.”

Johannes and Vivian Murliryianga*, from the Dar es Salaam suburb of Sinza, have five children; they are now receiving counselling from a community health worker as they try to prevent more pregnancies. Unfortunately, they learned about prevention of mother-to-child transmission too late to stop their youngest child from contracting HIV.

“I normally did not go to a government hospital, I just had my babies at a clinic run by some lady to whom we give small money and she allows you to give birth at her place. We just call her shangazi [auntie],” Vivian said. “I was surprised when my child tested positive; I didn’t even know children could get HIV.”

Under the Pathfinder programme, couples like Vivian and Johannes are given family planning advice according to their situation and needs.

“As you know family planning methods are many - we just give them choices depending on what they prefer and the situation,” Mapunda said. “You will get some married couples telling you they prefer condoms, especially among discordant ones; some want pills. We counsel them on the merits and demerits of each.”

Involving men

She noted that while counselling had been largely successful, encouraging men to participate had been a challenge. “We have seen more success where fathers agree to join the programme but not all are willing and it becomes very difficult because it means the mother does many of the things secretly,” she said.

“Imagine trying to give these services to a woman who fears disclosing her status or whose husband’s status is unknown; it is a challenge but we try what we can,” she added.

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http://www.irinnews.org/report.aspx?ReportId=88263QUETTA Monday, March 01, 2010 (IRIN) - Significant development and poverty challenges in Balochistan Province, southwestern Pakistan, are being exacerbated by growing security concerns, according to aid workers. Decades of nationalist unrest, underdevelopment and the scaling down of UN and NGO activity have left residents feeling neglected and fearful for their safety, they say. QUETTA Monday, March 01, 2010 (IRIN) - Significant development and poverty challenges in Balochistan Province, southwestern Pakistan, are being exacerbated by growing security concerns, according to aid workers.

Decades of nationalist unrest, underdevelopment and the scaling down of UN and NGO activity have left residents feeling neglected and fearful for their safety, they say.

President Asif Zardari on a recent visit to the province, which is nearly as big as Germany but has a population of only 10 million, said he was aware of the problems but urged people not to resort to violence.

In April 2009 ethnic violence led to a wave of killings and riots.

“We know there is a feeling of sadness in Balochistan. The people here do not sob, and prefer to pick up guns,” he said in a statement on 25 February. He called for patience: “I have good knowledge of the problems of Balochistan. I need some time to solve these problems… There might not be any immediate relief, but over a period of time, you will witness significant change in your lives.”

Abductions

In recent years, there have been a number of abductions of aid workers, causing the UN and many NGOs to scale down operations, making life even harder for the most vulnerable. There have also been recent media reports of Taliban militants operating in the province.

“A few years ago, many NGOs were active here, running schools or offering aid. Now many have pulled out,” said Naimat Khan, 60, a resident of a village a few miles outside Quetta, the provincial capital. “This has also led to unemployment, because some NGOs have let local staff go.”

The head of the UN Refugee Agency (UNHCR) office in Quetta, John Solecki, was kidnapped in February 2009 and released a few months later. Because of concerns over the safety of its staff, the UN scaled back operations in Balochistan in July 2009, and in October the World Food Programme (WFP) closed 20 food hubs, though Amjad Jamal, a spokesman for WFP in Pakistan, told IRIN WFP projects in the province were continuing “as usual”.

The reported abduction on 18 February 2010 of four Pakistani employees of US-based NGO Mercy Corps while visiting projects in Balochistan has added to concerns.

“Our programmes in Balochistan have been temporarily interrupted as we determine the nature of this incident,” Joy Portella, director of communications for Mercy Corps in Seattle, told IRIN.

Impact on health care

Access to health care is limited in Balochistan and officials in Islamabad and Quetta accept there is a need to improve the situation.

“There was good work going on for us here. Doctors came in to take care of women, but now after this latest incident where people have been abducted, we are worried no one will come,” local resident Azmatullah Jalal told IRIN from the town of Zhob, some 300km north of Quetta.

“Security concerns further handicap people, since few volunteers or NGO activists are now willing to travel in Balochistan,“ said Robina Mughul, who runs a voluntary clinic in Quetta.

Meanwhile, I.A. Rehman, secretary-general of the Human Rights Commission of Pakistan, told IRIN: “The problem in Balochistan is the perception of injustice as well as the reality of deprivation that people suffer.”

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http://www.irinnews.org/report.aspx?ReportId=88267MANILA Friday, February 26, 2010 (IRIN) - Humanitarian agencies and rights groups are concerned about overcrowding in Philippine prisons, where tuberculosis (TB) is now taking a toll.MANILA Friday, February 26, 2010 (IRIN) - Humanitarian agencies and rights groups are concerned about overcrowding in Philippine prisons, where tuberculosis (TB) is now taking a toll.

At the Manila city jail, every available space has been appropriated. Men and youths angrily jostle each other, while some sleep standing up as a medical worker walks the corridors to check on their condition.

The oppressive heat creates a nauseating smell of humanity, but there is a bigger problem - TB - an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs.

Otherwise treatable, the disease is spreading rapidly through the prison population, officials say.

"We have seen that the overcrowding of jails and prisons has serious consequences for detainees," Jean-Daniel Tauxe, the International Committee of the Red Cross (ICRC) head of delegation in Manila, told reporters recently after numerous prison visits across the Philippines.

"Access to safe water, sanitation, healthcare, and acceptable living conditions are a major problem in overcrowded detention facilities," he said, adding that the steady spread of tuberculosis had become "a serious concern".

Built in the 1940s, the Manila City Jail was designed to accommodate about 1,000 inmates. It currently houses more than 5,000 prisoners, adult men mixing with teenage boys awaiting trial, on trial or awaiting transfer to a penal colony after conviction.

The women's section is equally grim.

According to the Bureau of Jail and Management Penology (BJMP), which has administrative control over all the country's 1,132 city, district and municipal jails, the total inmate population has doubled to nearly 70,000 from about 35,000 a decade ago.

In Metro Manila, some 22,000 inmates are now registered, over an actual capacity of 16,000, the same agency reports.

And with cases, including petty offences, taking years to resolve in backlogged, understaffed courts, the number of inmates will likely rise to more than 115,000 this year, the penology bureau says.

Tauxe said concern over tuberculosis spreading in Philippine jails had prompted his group to support local authorities to implement a national programme to help combat the disease, a pilot project involving some 30,000 inmates in seven prisons.

"Legal and procedural problems, which delay the processing of cases, are the root causes of overcrowding," Tauxe said.

"Criminal neglect"

In one highly publicized case in 2008, Melvic Lupe, a factory worker jailed with 18 others in a labour dispute, died due to tuberculosis.

One of the surviving 18 meanwhile died in September last year, although the cause of death remained unclear, according to the Asian Human Rights Commission, which was following the case.

"It is appalling that anyone should die of tuberculosis today. It is no longer the dreaded affliction that has killed millions of people over the past decade," the commission said in its letter to the BJMP last year.

"It has been for many years now a treatable disease and the fact that prisoners have died of it while in custody speaks of the criminal neglect of the prison authorities."

Lawyer Rita Arce Alfaro, in a study for Manila's Far Eastern University on the problems facing inmates, said the situation had become so dire that inmates "fall easy prey to outbreaks of skin diseases such as boils, infections and various allergies.

"Tuberculosis proliferates inside prison walls," she said, stressing that the Philippine government allots less than US$1 a day per prisoner to cover three meals and water. This harsh reality contravenes the UN's Standard Minimum Rules for the Treatment of Prisoners [see: http://www2.ohchr.org/english/law/treatmentprisoners.htm] , she wrote.

"The main thrust of the present-day prison system has not evolved from the time of the guillotine. But if urgent needs are to be addressed, reform in the prison system is a must," she said.

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http://www.irinnews.org/report.aspx?ReportId=88241DAKAR Thursday, February 25, 2010 (IRIN) - Nutrition experts in Guinea are studying options for treating moderately malnourished children, as funding shortages disrupt normal programmes using fortified flour.DAKAR Thursday, February 25, 2010 (IRIN) - Nutrition experts in Guinea are studying options for treating moderately malnourished children, as funding shortages disrupt normal programmes using fortified flour.

In recent months local health centres ran out of supplies and had to refer families to remote facilities for corn-soya blend (CSB), used for the treatment of moderate acute malnutrition and provided by donors through the UN World Food Programme (WFP).

WFP is seeking funds to maintain CSB stocks in Guinea. “We recently received some CSB but needs still outweigh supply,” WFP-Guinea head of programme Foday Turay told IRIN. While recent unrest in the country led some donors to pull back, a lack of funding for WFP nutritional programmes pre-dates the latest instability.

Humanitarian workers told IRIN the current situation reflects the overall difficulty of attracting aid funding for Guinea and underlines the need to find alternative and long-term solutions.

“The break in WFP’s pipeline is representative of the problem everyone has finding [aid] funding for Guinea,” Reza Kasraï, head of Action contre la Faim (ACF) in Guinea, told IRIN.

“We’re in a no-man’s land between a politically stable country where donors would like to give development funds and a full-on emergency where humanitarian donors contribute regardless of the political situation.”

Stop-gap measures

The funding and supply breaks are forcing aid agencies and the Health Ministry to turn to temporary solutions – like using therapeutic foods designed for severe acute malnutrition – but a more sustainable strategy is needed, nutrition experts say.

When CSB stocks ran out, ACF used Plumpy’nut for some moderate malnutrition cases, Kasraï said.

“These are stop-gap measures… Using Plumpy’nut for moderate acute malnutrition is not in the national [malnutrition treatment] protocol, and just because the product is on hand does not mean it’s a long-term solution.” The product is more expensive than foods used to treat moderate acute malnutrition (MAM), he said.

Nutrition workers in Guinea are debating the viability of using Plumpy'nut for moderate cases if the need arises; another option being discussed is using local foods, prepared specially for children’s nutritional needs.

“Stop-gap measures may be better than nothing but a plan is needed to assure adequate funding for the CSB supply and access to contingency funds to mitigate the impact of CSB shortages,” Sheryl Martin of Helen Keller International in Guinea told IRIN.

“We are all frustrated by the lack of funding and are doing the best we can in the short term.”

Integrated

ACF’s Kasraï said it is important to use an integrated approach – not only therapeutic feeding but also programmes to address the principal causes of undernutrition in Guinea, by boosting people’s livelihoods, ensuring proper breastfeeding and weaning practices and improving home hygiene and access to health services, sanitation and safe water.

He said there is a growing movement towards community- and even household-based management of MAM, which would also reduce the strain on health centres. "The challenge is in finding a reliable way of ensuring that moderately malnourished children receive fortified [with vitamins and other micronutrients] and high-caloric diets in the home."

A January 2010 ACF nutritional survey in Conakry’s Matoto commune shows a global acute malnutrition rate of 7.3 percent, with 1.6 percent severe acute malnutrition, he said.

“While these percentages are not alarming, if you look at absolute numbers you’re talking about some 10,000 children suffering acute malnutrition – and that is in just one of five Conakry communes.”

Mamady Daffé, Health Ministry head of nutrition, said the combination of poverty and a lack of knowledge of children’s nutritional needs contributes to child malnutrition. He said even if families understand children’s nutritional needs, many do not have the means to meet them.

“People’s living conditions must improve. Without this we will not be able to tackle malnutrition," he told IRIN. "The cost of living is up; people cannot buy what they need to eat properly.”

In the Dixinn commune of Conakry, health workers conducting a nutritional survey in January saw a malnourished four-year-old girl. Her father is unemployed and her mother barely makes ends meet doing petty commerce.

“Sometimes I go for days without preparing a proper meal,” the mother, Fatoumata Keita, told IRIN. She said she often gives her daughter quinine to ease stomach pain.

The latest monthly nutritional survey in Conakry – carried out by HKI and the Health Ministry – showed a rise in moderate acute malnutrition among under-five children from 3.8 percent in January to 5.5 percent in February.

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http://www.irinnews.org/report.aspx?ReportId=88233NUSA DUA Thursday, February 25, 2010 (IRIN) - The use of pesticides in Asian countries has exposed communities across the region to unacceptably high health risks, according to a study conducted by the international Pesticide Action NetworkNUSA DUA Thursday, February 25, 2010 (IRIN) - The use of hazardous pesticides in Asian countries has exposed communities across the region to unacceptably high health risks, according to a study conducted by the international Pesticide Action Network (PAN) [http://www.panap.net/].
 
PAN Asia and the Pacific said interviews with peasant farmers in eight Asian countries revealed that 66 percent of pesticide-active ingredients used on vegetables, paddy and other crops were highly hazardous according to the group's classification criteria.
 
“Exposure to these pesticides puts communities at high risk of developing severe permanent health problems such as endocrine disruption, which can be caused at low doses of exposure to certain pesticides,” said Bella Whittle, coordinator of the project and author of the report, [http://www.panap.net/panfiles/download/asrep_lowres.pdf] launched to coincide with an environmental conference organized by the UN Environment Programme (UNEP) in Bali, Indonesia, from 22 to 26 February.
 
The interviews with more than 1,300 farmers were conducted in 2008 in China, Cambodia, Sri Lanka, the Philippines, Vietnam, India, Indonesia and Malaysia, said PAN, an umbrella group for more than 600 NGOs worldwide.
 
Poison symptoms
 
Respondents said they experienced one or more symptoms, such as headaches, when using pesticides or being exposed to them, with reports ranging from 5 percent in one area to 91 percent in another.
 
In Bangladesh, pesticide poisoning was recorded in 2008 as a leading cause of death, and officially recorded as the second-highest cause of death among 15-49 age group, the PAN report said.
 
Given that previous studies have found that up to 98 percent of cases of pesticide poisoning were under-reported, many agricultural communities may be suffering acute and chronic health effects of chemicals, the group said.
 
“It is essentially distressing that the most vulnerable populations, such as women and children, the sick, the malnourished and the elderly are disproportionately affected and cannot escape the sources of exposure,” Whittle told reporters in Bali.
 
Several pesticides used in the Asian countries have been banned elsewhere, even in countries that are home to the agrochemical companies' headquarters, the PAN report said.
 
Paraquat, an acutely toxic herbicide with no antidote, is banned in Europe, where it is produced, while endosulfan is banned in over 62 countries, the group said.
 
Deadly exposure
 
However, Hedi Surya, 51, a farmer in Bali, told IRIN: “I've sprayed pesticides for 20 years and I have not been sick because of poisoning. I always use a towel to cover my mouth when spraying and face the direction of the wind.”
 
The PAN report said people were exposed to the deadly chemicals for various reasons, including a lack of protective equipment, spills during mixing and spraying, and spraying against the wind.
 
PAN is urging countries to make huge efforts to implement international regulations on pesticides and stop the registration of pesticides that require personal protective equipment, saying its shortcomings and cost made proper use unfeasible.
 
“Governments should phase out highly hazardous pesticides and progressively phase in non-chemical pest-management approaches,” said PAN Asia and the Pacific director Sarojani Rengam.
 
Lucrative Indonesian market
 
In Indonesia, six out of 100 farmers interviewed in the Central Java district of Wonosobo as part of the PAN study had experienced serious poisoning, said Rossana Dewi, an activist with Gita Pertiwi, an NGO which conducted the survey.
 
“Indonesia is a lucrative market for pesticides,” Dewi told IRIN. “Indonesian farmers use pesticides extensively, many of them using several pesticides for their crops.”
 
In 2009, there were 1,832 brands of pesticides sold in the country, an increase from 1,702 brands in the previous year, she said.
 
Farmers usually wear long-sleeve shirts, trousers and hats when spraying pesticides, but few use proper protective equipment, she said.
 
The use of pesticides as mosquito repellants is also widespread in Indonesian households, she said.
 
“Our survey in seven cities on Java shows that each household used two types of pesticides as mosquito repellants. That means it's highly likely the food we consume is contaminated with pesticides,” she said.
 
In Bali, environmentalists also expressed concern that the heavy use of pesticides on farms had contaminated lakes. “The government is not taking action to seriously address the problem of chemical pollution in lakes,” Children of Nature Community, a local NGO, said on its website anakalam.org.  “One hundred percent of locals still use chemical pesticides.”
 
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http://www.irinnews.org/report.aspx?ReportId=88234SANAA Thursday, February 25, 2010 (IRIN) - Cereal production in Yemen has declined for the second consecutive year due mainly to a lack of rainfall, according to Deputy Minister of Agriculture and Irrigation Abdulmalik al-Thawr.SANAA Thursday, February 25, 2010 (IRIN) - Cereal production in Yemen has declined for the second consecutive year due mainly to a lack of rainfall, according to Deputy Minister of Agriculture and Irrigation Abdulmalik al-Thawr.

Yemen’s grain production, including sorghum and wheat, declined to 675,000 tons in 2009 from 715,000 in 2008, according to the government’s Central Statistics Organization (CSO).

While aggregate cereal production in 2009 was only slightly lower than in the previous year, it was about 24 percent less than the 2007 bumper crop, according to a report [http://www.fao.org/docrep/012/ak342e/ak342e00.htm] by the UN Food and Agriculture Organization (FAO).

“Most of the water sources in valleys producing grain dried up… About 97 percent of the country’s agricultural land is threatened by desertification," al-Thawr said.

Ismail Muharram, head of the Agricultural Research & Development Authority based in the central governorate of Dhamar, said agriculture in Yemen largely depended on rainwater.

"The rainfall season was three weeks late, and as a result many crops withered, particularly in the central highlands," he said, pointing out that 2009 rainfall was much lower than average.

Impact of northern conflict

According to Muharram, conflict in the north is another factor behind the decline in food output.

"Many farmers from various districts in the northern governorates of Saada and Amran fled their farms, which have been left untended,” he said, noting that those farmers used to be responsible for about 20 percent of the country's cereal production.

FAO estimates that two million people - including conflict-affected civilians, refugees, and other vulnerable people - are likely to face increased food insecurity, requiring targeted food assistance estimated at about 100,000 tons during 2010.

Increasing `qat’ burden

`Qat’, a mildly narcotic leaf chewed by many Yemenis, accounts for one third of the value of agricultural production, and its plantation area is expanding every year - a fact that is also contributing to the steady drop in grain production, according to environmental specialist Mohamed al-Ariqi.

"Arable land used for `qat’ is expanding by 9 percent a year, whereas land used for grain and other crops is steadily shrinking,” he said, adding that `qat’ trees take up to 40 percent of annually consumed water supplies in the country.

Even the poorest households try and find money for ‘qat’. A recent WFP/UNICEF survey found that nearly half of pregnant and breastfeeding women consume the leaf, with detrimental effects on the nutritional status of mothers and children.

Food insecurity “severe”

A 19 February report [http://www.ifpri.org/sites/default/files/publications/ifpridp00955.pdf] by the International Food Policy Research Institute (IFPRI) said the vast majority of Yemeni households are net food buyers, even in rural areas, and only 4 percent of rural households are net food sellers. With cereal imports accounting for up to 80 percent of consumption requirements (90 percent for wheat and 100 percent for rice), the recent surge in international food prices has significantly affected domestic prices and affordability.

"Chronic household food insecurity is widespread and severe, and the country has one of the worst malnutrition rates in the world," Mohammed Bashir, head of local NGO Agricultural Cooperation Union, told IRIN.

A 25 February press release by the World Food Programme (WFP) set out preliminary results from its comprehensive food security survey:

- 32 percent of the population is food insecure, i.e. suffering from acute hunger;
- 12 percent of the population suffers from severe food insecurity;
- One in 10 children under five are acutely malnourished;
- 25 percent of all women of child-bearing age are malnourished.

Meanwhile, the government - supported by international donors such as the European Commission, World Bank and German Agency for Technical Cooperation - is developing a national food security strategy, which is expected to be finalized in May 2010, al-Thawr said.

Al-Thawr also called for the development of a water management strategy and a food security information system.

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http://www.irinnews.org/report.aspx?ReportId=88235BELETWEYNE Wednesday, February 24, 2010 (IRIN) - Displaced and ostracized, his drug supply cut off because of conflict, Ade Sheikdon Negeye, a resident of the town of Beletweyne in central Somalia, is caught up in a cycle of suffering. He is one of 49 leprosy patients displaced from the town when fighting between two Islamist groups intensified in early February in Hiran region, central Somalia. He spoke to IRIN about his plight:BELETWEYNE Wednesday, February 24, 2010 (IRIN) - Displaced and ostracized, his drug supply cut off because of conflict, Ade Sheikdon Negeye, a resident of the town of Beletweyne in central Somalia, is caught up in a cycle of suffering. He is one of 49 leprosy patients displaced from the town when fighting between two Islamist groups intensified in early February in Hiran region, central Somalia. He spoke to IRIN about his plight:

"Like many other patients, my life is in danger because it is now very difficult for us to access drugs or to be treated like other human beings deserving of human rights.

"But even before I got displaced, I had been without medication because aid agencies that used to supply the drugs pulled out of the region six months ago, citing insecurity.

"People with leprosy are more affected by the weather than other displaced people because the intense heat during the day and the extreme cold at night causes our wounds to fester and the skin to crack.

"Since we fled our homes we have suffered so much; our skin is damaged and cracked and, even worse, getting food has become even more difficult.

"In Beletweyne, most of us depended on well-wishers to give us food, ordinary people even helped provide bread, but here in the countryside, where we thought we had escaped fighting, our lives have become worse because people run away from us. There is this myth that people with leprosy eat human flesh; the isolation we are facing is amazing.

"The most unforgettable and heartbreaking thing is the deadly isolation; everybody we come close to runs away; even drivers we asked to help us flee Beletweyne could not - other passengers would shout at them to move on whenever we flagged down a car. This has forced many of us to trek on foot for long distances.

"For me the trekking was terrible, I kept dragging my feet until I was bleeding all over, my limbs looked like raw meat.

"One day, my family told me I could no longer sit with them under one shelter and that I could no longer sleep in the same hut as them. They dragged me out, far away from them. Since then, I have moved from trouble to trouble.

"Everywhere I go, fingers are pointed at me as if I am a criminal. I have identified one tree under which I sit when no one is around; I have made it my home since I can't rejoin my family. My people [Somalis], unsurprisingly, believe that any person suffering from this disease is a man-eater; I think this is why everyone runs away from me."

as-mshm-js/mwhttp://www.irinnews.org/report.aspx?ReportId=88223KHARTOUM Tuesday, February 23, 2010 (IRIN) - After the polio virus re-emerged in Sudan two years ago, nine million children are being vaccinated in a project run by the Ministry of Health, with the UN Children’s Fund and World Health Organization. KHARTOUM Tuesday, February 23, 2010 (IRIN) - After the polio virus re-emerged in Sudan two years ago, nine million children are being vaccinated in a project run by the Ministry of Health, with the UN Children’s Fund (UNICEF) and World Health Organization (WHO).

"The virus does not have a passport, and so it can be transmitted to Sudan through Chad. There are similar programmes [being] conducted in all Sudan's neighbours," Setena Ahmed Sayed, vaccination advocacy and communications officer at WHO, and based in the Ministry of Health, said.

The main obstacle to the full eradication of polio, according to UNICEF representative in Sudan, Nils Kastberg, is the inability to reach all children under five in the remote areas of Southern Sudan, which has less than 50km of tarmac road. "It's extremely difficult to reach everywhere. And you have a lot of population movements."

The disease had been eradicated in Sudan, Africa's largest country, until 27 cases were discovered in an outbreak in 2008. Last year, 45 cases were registered, 40 in Southern Sudan, UNICEF said.

"Sometimes you might do a round and you reach most but a few might not be reached. That's why we are constantly doing new rounds," Kastberg said. "We hope 2010 will be a year in which we see no new cases."

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