The struggle for flooded families in Chad

From IRIN, a story on the struggle for families displaced by flooding in Chad.

Scores of families recently displaced by flooding in the Chadian capital N’djamena face a daily struggle against local thugs, wild animals, a lack of toilets and night winds that knock down makeshift tents.

The Chad government announced in late October that it would relocate thousands of people hit by flooding when the River Chari burst its banks, but any such move will take time; in the meantime families whose homes crumbled are just getting by - new hardships adding to what were already tough living conditions in their neighbourhood of Walia.

“We are exposed to too many dangers here,” said Obed Langkal, seated with other residents of the tents and makeshift shelters set up on a stretch of land between a main road and the river. “We cannot rest comfortably at all.”

Neighbourhood thugs locally called “colombians” - residents say because of their drug use - are always nearby and regularly threaten people living in the tents and makeshift shelters, displaced families told IRIN.

“Just the other day - in broad daylight - one of these drugged youths was walking around nude, carrying a knife,” Langkal told IRIN. “When he saw a young girl near the tents, he started running after her. Fortunately we were able to grab him. We called the police and they came and arrested him.” Another man said he saw the youth again near the camp days later.

Residents said they had asked local authorities to have at least two policemen permanently posted at the site.

Residents also said women traders do not want to leave their tents for fear of theft during the day; already several families have had their few belongings stolen when they were away. And men said they do not like leaving during the day to find work. “Our wives and children are not safe,” Ousmane Thomas said.

A number of men who had steady work have lost their jobs, including Sabour Kebgue. "You're absent for two or three days and they fire you," he said. "I was trying to save my home and my family - but they don't want to hear it."

Hygiene

One man pointed to a nearby ditch. “Voilà - our toilet, Madame.” People have set up a couple of makeshift latrines in the tent area for urinating - piles of small rocks encircled by plastic mats or scraps of aluminum, but people defecate in the open. This is a concern, say health workers, as cholera has struck many areas of Chad including the capital. Cases have decreased sharply in recent weeks, "but we have to remain vigilant and continue prevention efforts," Salha Issoufou, emergency coordinator with Médecins Sans Frontières-France, told IRIN.

Women here told IRIN they wait till dark to bathe - out in the open along the perimetre of the tent site.

Residents said they had received soap, bleach, blankets and other supplies from Red Cross, Action Against Hunger, Rotary International and other NGOs. But they said many things were lacking: Apart from better security, they needed more tents, more blankets, and containers to store drinking water.

On a positive note, they said, recently a pump was installed nearby; before that, families used the river for drinking water, but now they use the pump.

But most families don't have a way to protect their drinking water, Liliane Remadji said. “In our homes we had covered [clay containers] in which we kept water clean and protected. But those containers broke in the flooding.”

These are families with meagre means who already faced hardship before the floods forced them out of their homes. Manegue Celestine introduced IRIN to her eight-year-old daughter, whose stomach was swollen and arms and legs nothing but skin and bones.

Manegue said the girl had been ill for about seven months. Has she been to a doctor? “We cannot afford to take her to hospital.”

Hippos

Something else keeps the displaced families up at night: hippopotamuses. They often come up from the water and approach the tent area, residents said.

“Last night, no one slept,” Remadji said. “Several hippos were right there near the tents and we had to chase them back towards the water. We need a fence or something to keep them away from us.”

In many parts of Walia the remnants of mud-brick homes poke up from mud and debris; metre-high walls of sandbags surround rubble in many areas where people’s efforts failed to block the floodwaters.

In one area of Walia young men were making mud bricks - with no cement mixed in with the dirt - to rebuild a part of a home that collapsed. Resident Etienne Banda said: “They can't afford to buy cement so they make do with what they have."

Riots preventing health care from reaching cholera patients

The rioting in Cap-Haitien, Haiti has prevented cholera patients from receiving much needed care. Most humanitarian aid workers have stopped providing services until the risk subsides. OXFAM has stopped a water purification program, and flights carrying medicine and medical supplies have been halted.

From Reuters Alert Net, we read more about this consequence of the rioting.

Riots that flared on Monday have forced the United Nations to ground flights carrying soap, medical supplies and staff to Cap-Haitien and Port de Paix, cities in a northern region where the cholera fatality rate is highest.

The violence in Cap-Haitien saw protesters burn and loot 500 tonnes of food from a World Food Programme warehouse.

The insecurity, which restricted movement in Haiti's second city, also forced aid agency Oxfam to suspend a project to chlorinate water for 300,000 people, and the World Health Organisation to stop training medical staff, the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) said in a statement.

Oxfam said its staff were on standby to resume operations as soon as possible. Demonstrators who have set up roadblocks are preventing people from getting to hospital for treatment, it added.
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The hindrances to aid work come at a time when medical charity Medecins Sans Frontieres (MSF) is warning that the outbreak is stretching it and other relief groups to the limit. It has called for other organisations to step in to help tackle water, hygiene, sanitation and medical issues.

"MSF is worried about the limited response to the epidemic," Stefano Zannini, MSF's head of mission in Haiti, told AlertNet. "More medical staff are arriving, but there's a chronic lack of personnel here in Haiti and we are close to being overwhelmed."

Cholera spreads into the Dominican Republic

The first reported case of cholera has been found in the Dominican Republic. The case indicates that the epidemic has a chance of jumping the border from Haiti, as the two countries share the island of Hispaniola.

From CNN, we read more about the new case of cholera.

The first confirmed case is a 32-year-old Haitian construction worker who returned to the Dominican Republic last Friday with symptoms of the intestinal illness, the health ministry said Tuesday night.

Wilmo Louwes went back to Haiti on October 31 to take money home, according to the El Nacional newspaper.

Louwes came back Friday with symptoms of vomiting and diarrhea and was hospitalized in Higuey, near the eastern resort town of Punta Cana. He was in stable condition and will probably be released from the hospital Wednesday, the newspaper quoted Health Minister Bautista Rojas Gomez as saying.

Two other suspected cases turned out to be negative, the health ministry said.

The cholera outbreak confirmed last month in northwest Haiti has killed 1,034 of the 16,799 people hospitalized with the disease, according to Haiti's health ministry.

Missing nutrients in Asian diets

From IRIN, a story on how nutrients missing from diets in Asia could be a silent killer of the area's children.

By the time Fatima Emilova was six months old she had been hospitalized twice for 10 days at a time with debilitating bouts of diarrhoea. The disease, a worldwide killer, is often caused by a lack of zinc, one of several micronutrients dangerously deficient among infants in the impoverished Central Asian nation of Kyrgyzstan.

“After she was born, she was very weak,” said Fatima’s mother, Jazira Seitaliyeva, 34. “But after six months, that stopped. Now she walks, runs, flies around – she’s different from the other children.” Seitaliyeva attributes the changes in the youngest of her six children, now eighteen months old, to a micronutrient powder containing iron, folic acid, vitamins A and C and zinc, given free to infants aged 6-24 months in Talas Province, where the family lives in Ak-Korgon, a dusty village of about 160 homes.

“The little ones who get it cut their teeth faster,” Mahera Uruzbayeva, the local nurse-practitioner in charge of distributing the powder in the neighbouring hamlet of Kok-Kashat, told IRIN. “Their appetite is better and they’re sick less. The year before last, more children had the flu; this year we got a rest.”
The powder - Gulazyk in Kyrgyz and Sprinkles in English - has been distributed in Talas since June 2009 and is part of a larger pilot programme to fight malnutrition and promote early childhood development, implemented since 2008 by Kyrgyzstan’s Health Ministry, the UN Children’s Fund (UNICEF) and the Swiss Red Cross, with support from the US Centres for Disease Control (CDC).

Preliminary results show that the Gulazyk project is working. An initial analysis of the data - to be presented, pending final review, on 23 November in Kyrgyzstan’s capital, Bishkek - suggests it has already cut the rate of iron-deficiency anaemia in Talas Province by 20 percent.

According to the CDC the disease afflicts nearly 40 percent of the country's women and at least half the children, and the hope is to expand the programme nationally.

Hidden hunger

In Kyrgyzstan, as elsewhere, malnutrition is dangerously easy to overlook when children don’t have protruding ribs and distended bellies. Healthy eating means not only getting enough food but getting the right vitamins and minerals, or micronutrients, particularly iron, iodine, Vitamin A, folic acid and zinc. When these are absent in early childhood, the damage can be invisible at first but devastating in the long run.

“Micronutrient deficiency is the main threat to the physical health and intellectual capacity of children under two,” said Dr Tursun Mamyrbaeva, a leading nutritionist at Kyrgyzstan’s Republican Centre for Immunoprophylaxis. “A persistent deficiency, even of a tiny amount of vitamins and minerals, can provoke and exacerbate hundreds of ailments, including malignant tumours and developmental defects, and can ultimately undermine the viability of the nation as a whole.”

UNICEF saw alarming signs of chronic micronutrient deficiency in Kyrgyzstan in 2006, when it found that 13 percent of children under five were growing more slowly than normal; in Talas Province the prevalence of stunted growth was twice the national average. A survey overseen there by the CDC in 2008, before the introduction of Gulazyk, found that two-thirds of babies aged 6-24 months were iron-deficient, and just as many had too little folic acid.

Nationwide, dangerously low levels of folic acid in pregnant women leave 150 babies a year with severe birth defects, mostly of the brain and spinal cord, while 300 newborns die from insufficient Vitamin A, too weak to fight off lethal infections, according to Kyrgyzstan’s Health Ministry.

Iron, the weakest link

Micronutrients are best considered as a group, but nutrition experts in Kyrgyzstan have focused mostly on iron deficiency, which places more than 20,000 children under two – about 10 percent – at risk of mental retardation, according to the Health Ministry.

“Six months to two years is a period of very rapid growth for children. Their regular intake of iron can’t keep up with their needs,” said Elizabeth Lundeen, a health promotion adviser to the Swiss Red Cross, who has been working in Kyrgyzstan for over four years and helped develop the Gulazyk project. “In the West we have tons of fortified complementary foods, but in many developing countries these foods are either unavailable or unaffordable.”

Fatima’s household is a case in point. Like many in Kyrgyzstan, the family spends well over half its income on food, which includes buying about 100 kg of flour a month, but none of the four food shops in Ak-Korgon sells fortified cereals and a 2009 law on fortification has been hard to enforce, particularly in rural areas. Most of the mountainous country’s 3,000 flour mills are tiny private enterprises, with significant amounts of flour imported across porous borders with few controls.

Holistic approach

The collapse of the Soviet Union and its centralized economy in 1991 ushered in an era of hardship. As newly independent Kyrgyzstan sank into poverty, access to healthcare and education worsened, as did eating habits. Many people began replacing nutritious but increasingly expensive meat and dairy products with cheaper items like bread and tea, which inhibits the body’s uptake of iron.

“In the 1970s, when I visited relatives here, children weren’t allowed to drink tea,” said Jamilya Madalbekova, the UNICEF coordinator in Talas. “My grandmother and her friends would shoo us into the kitchen to drink jarma,” a hearty drink made of crushed grain and water or yogurt. After 1991, “there were about 10 years that were critical for the population - now we’re reaping those fruits.”

UNICEF and the Swiss Red Cross decided on a holistic approach to make up for families' poor access to wholesome food, accurate information and high-quality medical care. The programme began as an educational campaign about healthy eating for pregnant women, best practices for breast-feeding and a balanced diet for infants. The free micronutrient powder was added in 2009, followed by materials for boosting infants’ intellectual development with simple interactions like talking, reading, singing and playing.

“The Gulazyk project is unique in that it addresses both nutrition and early cognitive and social stimulation of young children,” said Farhad Imambakiyev, UNICEF’s communications officer in Kyrgyzstan. “The two are mutually reinforcing - like two wings that allow each child to reach full developmental potential.”

The programme trains local doctors and nurses and groups of volunteers, called village health committees, who spend a few days a month visiting neighbours with health-related information and advice, so as to reach families with small children. Even medical professionals say they have learned from the experience.

“When I was a student there was no emphasis on nutrition - it was more about illness,” said Uruzbayeva, the nurse-practitioner in Kok-Kashat, who likes the colourful charts and pamphlets illustrating the programme’s key points. “The materials make things easier; before, lessons were all oral.”

Obstacles and prospects

The Gulazyk project has not been trouble-free. In the provincial capital of Talas, a city of about 34,000, Dr Damira Baisabayeva, who coordinates distribution of the powder and is second-in-command of healthcare in the province, asked doctors to collect data on usage. They reported that from January to September 2010, 91 percent of eligible families received Gulazyk, but only 59 percent used it as directed.

“In the countryside communities are compact - medical professionals are viewed as authority figures,” Baisabayeva told IRIN. “In the city it’s harder - the population is bigger, there’s lots of migration. People have more doctors to choose from, but doctors have large caseloads and no support from civil society, so there’s less interaction with patients, less time to talk with them.”

Mistrust is as prevalent in the capital as in rural areas. A small number of families refused to participate, saying they were sceptical of the powder’s foreign origins. Others became afraid because Gulazyk, like any iron supplement, changed the colour of children’s stools, or because it was initially introduced in the summer, when children often fell ill with seasonal intestinal infections, and parents attributed these to the powder. Some feared they were being subjected to an experiment.

Gulazyk has proven effective in reducing infant anaemia and the Swiss Red Cross is funding the project for three years in Naryn, one of Kyrgyzstan’s poorest provinces. Charitable foundations backed by financier-philanthropist George Soros have committed US$1.3 million to distribute it in three more of the country’s seven provinces.

In the remaining two, Jalalabad and Osh, which were devastated by ethno-political violence in June, UNICEF and the Health Ministry are distributing the powder to hospitalized children as a part of an emergency response.

Gulazyk’s cost-benefit ratio makes it attractive to donors: one sachet costs less than 2.5 US cents, including shipping and customs clearance. The three-year programmes in Talas and Naryn have price tags of about $300,000 each and a nationwide scale-up would cost under $6 million – a fraction of the estimated $28 million lost by Kyrgyzstan each year “due to the problems of iron and iodine deficiency”, according to statistics cited by the Health Ministry.

The global economic crisis has intensified nutritional needs. Dr Nargiza Kanazarova, a general practitioner in rural Talas, told IRIN: “I’d like to see a programme like Gulazyk for pregnant women ... While they’re pregnant, they’re scared; they want healthy babies. When the babies start growing up, they run, they jump, they seem healthy and mothers get lax.” Many public-health experts and medical professionals would like to see Gulazyk, or comparable supplements, expanded to children older than two.

The World Food Programme concluded in 2008 that one-fifth of Kyrgyzstan’s households were at “high nutritional and health risk because of poor food consumption.”

In 2008 the Copenhagen Consensus, a group of prominent economists rated micronutrient supplements for children as the most cost-effective poverty-fighting measure available. Local production of micronutrient supplements is being considered in Kyrgyzstan.

Video: Rioting in Haiti

From Al Jazeera, more footage on the riots in Haiti.

UN warns that food prices could increase by 20%

The United Nations is warning of food price increases of 10 to 20 percent next year. The UN says that there were poor harvests this year for about every grain type except for rice. They also cite an unexpected drop in world stockpiles as another reason for the possible price increases.

From the Guardian, writer John Vidal tells us more about the food price warning.

"Countries must remain vigilant against supply shocks," the report warned. "Consumers may have little choice but to pay higher prices for their food. The size of next year's harvest becomes increasingly critical. For stocks to be replenished and prices to return to more normal levels, large production expansions are needed in 2011."

Prices of wheat, maize and many other foods traded internationally have risen by up to 40% in just a few months. Sugar, butter and cassava prices are at 30-year highs, and meat and fish are both significantly more expensive than last year.

Food price inflation – fuelled by price speculation, the searing heatwave in Russia in the summer and heavy trading on futures markets – is now running at up to 15% a year in some countries. According to the UN, international food import bills could pass the $1tn mark, with prices in most commodities up sharply from 2009.

Extreme volatility in the world markets has taken the UN by surprise and forced it to reassess its forecasts for next year. "Rarely have markets exhibited this level of uncertainty and sudden turns in such a brief period of time. World cereal production this year, which is currently put at 2,216m tonnes, is 2% below 2009 levels, 63m tonnes less than the forecast reported in June," said the authors.

"Contrary to earlier predictions, world cereal production is now forecast to contract by 2% rather than to expand by 1.2%, as anticipated in June," they said.

Gates Foundation to give 500 million for micro-savings

The Bill and Melinda Gates Foundation is hosting a Global Savings Forum in Seattle, and took the occasion to make a big announcement. The Foundation will give a half a billion dollars in grants to expand savings to those in poverty. 500 million dollars will go to a host of different programs that help under-developed world accumulate savings.

From the Business of Giving blog at the Seattle Times, writer Kristi Heim tells us more about the new money. Heim's article also includes an itemized breakdown detailing which programs the money will go to.

At the Global Savings Forum hosted by the Gates Foundation today and tomorrow in Seattle, Melinda Gates said including the poor in financial services is a goal that has been elevated on the world's agenda. Financial inclusion was cited as one of the key development issues by the G20 countries in meetings last week.

"The stage is set for incredible breakthroughs," she told nearly 200 people gathered for the two-day event.

After the rapid growth of small loans for the poor as a development strategy, savings is now being recognized as an effective way for people "use their own energy, their own talents to lift themselves out of poverty," Gates said.

Princess Maxima of the Netherlands, the UN special advocate for inclusive finance, said over the last several years, the focus on savings has increased, along with financial literacy, consumer protection and strong infrastructure, for the two-fifths of the world living on less than $2 a day.

"People need an array of financial services," she said. "It is not only households that need financial services but enterprises, the ones that are the biggest job creators."

One project seen as a model is Kenya's M-PESA, a mobile banking program that is now used by more than 70 percent of the adult population. The program, which lets people send and receive money over mobile phones, is reaching 50 percent of the country's poor, Gates said.

Video: MSF struggles to keep up with the cholera cases in Haiti

From Medecins Sans Frontieres, a rather graphic video on the cholera situation in Haiti. MSF fears that medical facilities will not be able to keep up with the amount of cases.

Dengue fever vaccine begins human testing round

A vaccine for Dengue fever is closer to realty as human testing is about to begin. If testing goes well, the vaccine could win regulatory approval and begin to be used against the disease commonly found in the under-developed world. Dengue fever is caused by a certain type of mosquito and brings with it severe fevers, headaches and nausea.

From the Heath Blog at NPR, writer Eliza Barclay describes the new round of testing.

French pharmaceutical giant Sanofi-Aventis is putting its experimental vaccine into the kind of large clinical test that can produce the evidence needed to gain regulatory approval. This comes on the heels of what it claims were several successful smaller trials in Asia and Latin America. The latest study, being conducted in Australia, is expected to take two years to finish .

The World Health Organization estimates that 2.5 billion people worldwide are at risk of getting dengue, and most of them are in Asia and Latin America. But it's also on the rise in Florida and Texas; Key West has reported 57 cases in the last two years. And on Thursday, Miami-Dade County health officials had ominous news of their own: confirmation of the first "locally acquired" case there.

At this stage, the dengue vaccine race lacks some of the unexpected twists and bitter rivalries of the polio vaccine race, but it's gotten steadily more interesting as more heavy hitters take the field.

Aside from Sanofi, GlaxoSmithKline is conducting trials in Thailand, the United States, and Puerto Rico, while the U.S. government threw its hat into the ring with an announcement in August from the National Institutes of Health that it would start its own tests. And don't underestimate dark horse Brazil: its Instituto Butantan, best known for a snake farm where researchers milk snakes to make antivenoms, is now running its own trials with the NIH strains.

Every year there are 250,000 to 500,000 cases of severe cases of dengue and more than 20,000 deaths, typically from the worst permutation of the disease called dengue hemorrhagic fever, according to the World Health Organization. There is no treatment for any version of it.

Protests in Haiti over the cholera outbreak

A lot of the people in Haiti are blaming the United Nations peacekeepers from Nepal for starting the cholera epidemic. And you know what? The people may be right. A UN base dumped their sewage into the Artibonite river where the contamination began. Researchers have found that this strain of cholera is one commonly found in South Asia. Meanwhile, Haiti has not had cholera for over fifty years. The UN has admitted sanitation problems but will not investigate the cause of the contamination.

The Haitian people have began to turn to protests in order to be heard. Crowds in two northern cities threw stones, started fires, and blocked roads. The UN peacekeepers shot one demonstrator dead. From the Guardian, writer Rory Carroll recieves word from the UN on why they believe the riots began.

The UN peacekeeping force, known as Minustah, said the soldier had acted in self-defence, but an investigation had been launched.Cap-Haitien, the country's second city, was this morning cut off from the rest of Haiti after a day of rioting shut its roads and airport, and left more than a dozen people wounded. Clashes in the town of Hinche injured seven Nepalese peacekeepers, according to local radio.

Minustah officials said the protests were politically motivated, and linked them to the election later this month.

The mission said, in a statement: "The way events unfolded suggests these incidents were politically motivated, aimed at creating a climate of insecurity on the eve of elections. Minustah calls on the people to remain vigilant and not be manipulated by enemies of stability and democracy in the country." The flare-ups followed mounting anger and fear over a disease many blame on effluent from a base used by Nepalese troops in the Artibonite valley, where the outbreak began three weeks ago.

The US Centres for Disease Control and Prevention found that the strain, which has infected more than 15,000 people and reached all 10 departments, resembled one from south Asia. Haiti's first epidemic in living memory began in the valley a week after the Nepalese arrived.

UN officials have admitted problems with the base's sanitation but denied its soldiers brought the disease, which is spread by contaminated faeces. No official investigation into the epidemic's origin has been launched despite appeals from Haitian leaders and foreign epidemiologists.

"In Haiti, most of the population believes it came from the Nepalese and that the UN will do its best to hide it," said Prospery Raymond, country director of the UK-based charity Christian Aid. "If it is confirmed to be from them, this will be damaging for the UN and their peacekeeping all over the world."

The "Parallel State" of NGOs in Haiti

Haiti has more Non-Governmental Organizations than any other nation, as many as 100,000. The NGO aid groups and charities are as varied as the big names such as the Red Cross and World Vision to American churches who sponsor an orphanage.

Some observers of the Haiti situation say that the volume of NGOs in Haiti have created a "parallel state," meaning the NGOs provide basic services while the government does not. Another problem is that the NGOs continually provide for the immediate needs of the people while not having the time or money to create long term solutions for food, sanitation or jobs.

From the Wall Street Journal, Writer José De Córdoba looks into this issue.

Critics say the NGOs have put Haiti in a Catch-22: By building a parallel state that is more powerful than Haiti's own government, aid groups are ensuring Haiti never develops and remains dependent on charities. "The system as it is guarantees its failure," says Laura Zenotti, a political scientist at Virginia Tech who has studied NGOs in Haiti.

"A word for the NGOs," warned former President Bill Clinton, the U.N.'s special envoy to Haiti, at a ceremony here marking the six-month anniversary of the earthquake, "tell us what you are doing, and where."

Pope Benedict XVI appeals for international aid efforts for Haiti as cholera continues to ravage the earthquake-stricken population. Video courtesy of Reuters.

Even NGOs with a long history in Haiti sometimes show a cavalier attitude toward the authorities, Haitian officials say. For two months, the government refused to allow a new obstetrics hospital built by Médecins Sans Frontièrs to open, saying the group ignored its request to locate the hospital elsewhere to better cover the country's health needs. "They didn't even ask permission to build, and when we asked them to stop, they didn't stop," says Dr. Claude Surena, the coordinator of Haiti's national commission to reconstruct the health system.

Paul McPhun, who oversees MSF in Haiti, says the group did inform the government about its new hospital, which replaced one destroyed in the quake, and only as the hospital neared completion did the location become an issue. Mr. McPhun says MSF could have done a better job of "giving updates" to the ministry of health, but the urgency of saving lives after the quake was too acute. "To continue in Haiti, we need to be partners and have to be a part of the reconstruction plan, but I don't think anybody knows what those plans are," he says.
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Aid groups provide four-fifths of social services here, according to a 2006 analysis by Washington's National Academy of Public Administration, a congressionally chartered, nonpartisan group of management experts. Jean Palerme Mathurin, economic adviser to Prime Minister Jean-Max Bellerive, says NGOs may account for as much as a quarter of Haiti's gross domestic product. He says the NGO presence has permanently "infantilized" the country, creating a vicious cycle: The government lacks the money—and historically, the inclination—to provide social services. Those services, therefore, are provided by NGOs, which means the government, in turn, has no incentive to improve.

Paul Farmer, founder of Partners in Health, an NGO which, in conjunction with the ministry of health, is the country's largest health provider, believes that NGOs and foreign governments should channel some of their funds directly to the Haitian state. "NGOs have flourished in number and size as the public sector has withered in Haiti," says Dr. Farmer.

How soap could help to stop the spread of cholera

In combating the spread of cholera in Haiti, a simple bar of soap could help to stop an infection. Yet many people who live in poverty cannot afford to purchase the soap, as they opt for food instead. The Washington Post says that UNICEF has brought in over 100,000 bars of soap to the 500 orphanages in Haiti.

Post Writer William Booth tells us how one simple household item is going underused in the country.

A cake of yellow Haitian soap costs about 50 cents. But many Haitians do not have soap, because they cannot it afford it. More than half of the population lives on less than $1.25 a day.

"They buy food instead," said Gaelle Fohr, a coordinator for hygiene programs in Haiti for the U.N. Children's Fund.

"We borrow, we buy, but right now, we don't have any soap in the house, I am sorry to say," said Joceline Jeune, living with three children in a hillside shanty at the edge of a displaced persons camp, as a gutter filled with greasy gray water flowed inches from her front door.

When confronted by dubious toilets or flyspecked markets, people here daily use the expression, "mikwob pa touye ayisyen," which translates "germs don't kill Haitians."

"As hard as it is to believe, Haiti still needs soap. They have many needs, but soap - and access to clean water - is absolutely essential to fight cholera," said Nigel Fisher, the top U.N. humanitarian coordinator, in an interview.

There are plans for more water trucks, and more chlorine in water tanks, wells, and distribution points. But building a modern water and sanitation system will take years. By contrast, experts say, soap is fast and doable, allowing people to clean their hands and food that has been exposed to dirty cholera-tainted water.

Report calls for end of US and European cotton subsidies

The FairTrade Federation issued a new report that calls for the removal of subsides that the US and European governments pay to their cotton farmers. FairTrade says that cotton farmers in West Africa could earn ten percent more if subsidies in the US were removed. The report says that 1 billion dollars in subsidies are payed out every year.

From the BBC, writer Mark Doyle details the report for us. The entire study can be viewed at this link.

Trade negotiators for the so-called "Cotton 4" West African states - Chad, Mali, Benin and Burkina Faso - believe that removing US cotton subsidies alone could boost West African cotton farmers' income by up to 10%.

A report published by the Fairtrade group - which pays premium prices for organically-produced agricultural goods to stabilise incomes in poor countries - says an increase of this magnitude can make a huge difference.

Working with co-operatives in Mali, Fairtrade says the extra money generated by the premium prices it pays has boosted school enrolment for farmers' children and allowed them to build a basic health clinic.

In parts of southern Mali, the report says, the extra money generated by organic cotton farming has boosted school enrolment to 95%, compared with a national average of 43%.
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Cotton producers in the United States, represented by the National Cotton Council, counter that subsidies have helped them to establish a stable income for more than 340,000 people employed in some of the poorer southern states of the country.

They add that many more jobs have been created in ancillary industries, such as those producing crop-protection chemicals and machinery.

European Commission officials make similar points - saying the subsidies help farmers in Greece and Spain, some of who are relatively poor by European standards.
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In 2001, a new series of multilateral trade negotiations began, known as the Doha Round.

One of the aims of the Doha round was to set new global trading rules which would stimulate growth and wealth in underdeveloped countries. One way of doing this would be to reduce tariffs and subsidies, so creating a "level playing field".

Food prices rise in Afghanistan

From IRIN, a story on a food price hike in Afghanistan that is forcing families to make tough choices as winter draws near.

Ali Ahmad, the sole breadwinner of an extended family in Kabul, has to decide whether to buy firewood to keep his children warm in winter or food to save them from hunger.

“Everything is expensive… wheat flour, ghee, sugar, fuel and wood and I cannot afford them,” he complained.

A steady rise in food prices this year is posing serious risks for millions of Afghans who earn less than US$30 a month, aid agencies say.

The average wheat price in September was 7.3 percent higher than in August, and wheat prices in Afghanistan were “the highest in the region”, according to a UN World Food Programme (WFP) market price bulletin.

On 15 November in Kabul a 50kg sack of wheat flour was 1,190 Afghanis (US$26.50), and 16 litres of cooking oil 1,200 Afghanis (almost $27) - prices which, according to vendors, were higher than in September.

“Prices are going up steadily,” said Mohammad Zahir, a vendor in Kabul, adding that they would increase further in winter.

Food prices are, however, markedly lower than during the global crisis in 2008, which pushed 4.5 million Afghans into high-risk food insecurity.

Afghanistan is expecting a good harvest this year but there is likely to be a deficit of at least 700,000 tons of wheat in 2010 which is expected to be met in part by wheat imports from Kazakhstan.

Protracted crisis

Afghanistan is among 22 protracted emergencies in the world “which are facing enormous challenges like repeated food crises and an extremely high prevalence of hunger due to a combination of natural disasters, conflict and weak institutions,” the UN Food and Agriculture Organization (FAO) said in its October report entitled State of Food Insecurity in the World.

A protracted food insecurity crisis can become a self-perpetuating vicious circle and pose serious threats to both lives and livelihoods, from which recovery may become more difficult over time, FAO said.

Over half of Afghanistan will face moderate or high-level food insecurity in the next three months, the US Famine Early Warning System Network, said.

At least nine million Afghans (36 percent of the population) live in absolute poverty, and five million “non-poor” live on 2,100 Afghanis (US$43) a month, according to a 2008 National Risk and Vulnerability Assessment.

The government, backed by foreign aid agencies, said it would assist vulnerable households with free food rations, and imports of wheat flour from India and Kazakhstan to stabilize market prices.

Pakistan flood impact

This year’s catastrophic floods in Pakistan have seriously damaged agriculture, causing food prices to rise sharply and the government to impose a ban on most food exports. Traditionally Afghanistan has relied on food imports from Pakistan. This year the government plans to import about 250,000 tons of wheat from India.

“Over 50,000 tons of Afghan food imports have been stopped in Pakistan’s Karachi city and we have been unable to meet market needs,” Khan Jan Alkozai, an official from the traders’ union, told IRIN, pointing out that imports from Central Asia and Iran were both more difficult and expensive than Pakistan.

Under US auspices, Afghanistan and Pakistan signed a new trade and transit agreement in October (after 44 years of negotiations) which promises free transit facilities for traders from both countries.

But convoys on the Afghanistan-Pakistan highway have frequently been torched, and the new agreement faces numerous bureaucratic hurdles in both countries, according to Alkozai - all of which bodes ill for families like Ali Ahmad’s who will struggle to survive this winter.

Haiti's cholera death toll nears 1000 people

From the Associated Press, the cholera death toll in Haiti nears 1000 people.

Guest Voices: Winning Back the Water in Ethiopia

We continue our series of quest posts from Concern Worldwide, with a piece from Communications Officer Joan Bolger. The story mentions a saying in Ethiopia about winning back the water that can apply to education as well.

There’s a saying in southwestern Ethiopia and not surprisingly—in an area ravaged by drought for three months of the year—it relates to water. Loosely translated it goes: it’s impossible to win back your water after the bucket has fallen over.

Abebech Tito, a mother of five, told me this through the school fence near her children’s classroom as she considered how her life might have been different had she not dropped out of school at Grade 8. She delivered the proverb with a smile and a shrug. “It was my own foolishness,” she added.

Her village of Fango Bijo is located in the Rift Valley in the Southern Nations, Nationalities, and People’s Region (SNNPR) region of Ethiopia, where recurrent drought and the prevalence of malaria is notoriously high. “A child died of malaria last year here,” she says, tipping her head towards the Concern-supported Alternative Basic Education (ABE) center that her children now attend.

When I ask if she worries about her own children becoming infected, her undaunted air departs and she draws a sharp breath, “I worry,” she says in a way that suggests she’ll confront it head-on, if she has to. Like the millions of mothers in rural Ethiopia tasked with providing for their children on meager means, Abedech isn’t the type to bellyache.

Had she stayed in school, she likes to think she would have become a nurse or a health worker. She thinks she would have enjoyed tending to the sick. The nearest clinic is 6 kilometers away, a one hour distance by foot—and health workers in this remote area a positively rare phenomenon.

For the early learners of this hot and dusty village, some 50 kilometers from the nearest town—which can be reached after a two-hour truck journey through dried river beds, steep inclines and sporadic herds of cows and goats—the ABE center offers the only tuition around. The nearest primary school is a two-hour journey by foot and parents are loath to send their children across terrain where the water is scarce, wild animals prevalent and abductions rife.

Two of Abebech’s boys attend the center here run by WRDA, Concern’s local partner. They are in Level 1 and Level 2, and she is thankful that their future looks bright. Here in this drought-prone, food-insecure region of Ethiopia an overwhelming percentage of the population are pastoralists. Without the center, her children would almost certainly be helping her in the fields, she says.

ABE centers are part of the Government strategy to achieve education for all and are designed to streamline out-of-school children into formal schools through accelerated programs. After completion of level 3, they are equipped to enter primary schools at Grade 5 and continue in the government-run formal schools.

Brimming with pride, Abebech tells Concern that her eldest boy completed the ABE curriculum a couple of years back and now attends Grade 9 at a secondary school two hours from here. “He rents a house with a group of boys his age so that he doesn’t have to walk the long distance in the heat,” his mother says. “I left school to marry and start a family,” she recalls. “My children, they will finish.”

Her husband, like the majority of the people in this tiny, remote village, is a farmer. Abebech is still happily married, she says, but after four boys and a girl, will have no more children. She and her husband grow teff (a grain used to grow Ethiopia’s bread Injera); false banana; sweet potato; and other staples like sorghum and beans. Most people must endure a three-month “hunger gap”—the period when food stocks from the last crops have run out and the new harvest is not ready. Frequent flooding from June through August also threatens crops, and deepens cracked land fissures from the dry season into yawning seasonal rivers.

Life is tough for Abebech, undoubtedly so, but the dreams of her children’s future make her life of labor tolerable. She tells me that she is thankful she and her husband earn enough farming to provide a good life for her five children. With their earnings she can cover the family’s expenses: their food and clothes. And she brightens at the mention of their education: “I can put my older child in school and save for the younger ones,” she says.

Ethiopia has seen unprecedented expansion of its education system. In 1992, around four of five primary school-age children were out of school. In 1999, this figure stood at over 60 percent. Now, it is one in five. Forty-four percent of the population in Ethiopia is under 14 years of age—a segment that represents 37 million children. According to the World Bank, this is the largest youth population in sub-Saharan Africa. Speaking to Abebech, I catch a glimpse of how the figures are being slowly vanquished across Ethiopia—it’s in the steadiness of the conviction held by the millions of mothers just like her: “I will struggle to win the life of all of my children,” she says.

New meningitis vaccine hopes to stop epidemic

Meningitis is one of the diseases that the under-developed world has little prevention against. The disease causes an annual epidemic across north-central Africa. A new low cost vaccine hopes to prevent the meningitis illnesses when it begins distribution next year.

From Nature News, writer Declan Butler describes the new vaccine and how it was brought from idea to reality.

This year will be different. Millions will receive a new vaccine, MenAfriVac, that promises protection against the meningococcal bacterium Neisseria meningitidis. It is the culmination of ten years' work by an international consortium to develop a vaccine at a price low enough for massive use in Africa: just US$0.40 a dose. "MenAfriVac is a fantastic initiative," says Andrew Riordan, a meningitis expert at Alder Hey Children's NHS Foundation Trust, in Liverpool, UK. "For the first time, we may be able to prevent these huge epidemics."

The Meningitis Vaccine Project (MVP), led by the World Health Organization (WHO) and PATH, a non-profit body based in Seattle, Washington, was born in 2001 after a particularly bad epidemic in 1996–97 caused 250,000 cases and 25,000 deaths (see 'Epidemic cycle'). Commercial manufacturers in developed countries could not produce the vaccine at such a low target price, according to Marc LaForce, director of the MVP. So the consortium did the research itself, and contracted the Serum Institute of India in Pune to make the vaccine. The entire research and development cost of the project was just $70 million — five to ten times less than typical vaccines. LaForce hopes that the MenAfriVac model can be applied successfully to other vaccines.

During next month's campaign, backed by the WHO and the United Nations Children's Fund (UNICEF), the government of Burkina Faso will vaccinate everyone aged 1–29 — the group hit hardest by the disease, numbering 12.5 million people. Mali and Niger will each vaccinate 4 million people in the same age bracket.

Meningitis A epidemics cause fewer cases and deaths in Africa than AIDS or malaria, but this masks its huge social and economic toll in those countries. "When the epidemic arrives, the entire community shuts down," says LaForce. The disease — which infects the meninges, the membranes surrounding the brain and spinal cord — begins with mild symptoms of stiff neck, high fever, confusion and headache, but can kill within 48 hours. Of those infected with meningococcal meningitis A, 5–10% die and 10–20% of survivors are left with severe disabilities.

UN asks for money for the Haiti cholera outbreak

The United Nations is asking the world to contribute 164 million dollars to stop the cholera outbreak in Haiti. Since the October discovery in northern Haiti, the outbreak has spread to the capital of Port-au-Prince. The numbers of cholera victims keep rising as well, with now 724 people dead from the disease, while another 11,000 have been hospitalized.

From the CBC, we find out more about the UN's appeal.

Doctors Without Borders (MSF), an emergency medical relief organization, said the outbreak has "taken grip" in Port-au-Prince.
...

"In the slum of Cité Soleil, located in the north of the city, yesterday we recorded 216 separate cases of cholera arriving at the hospital, while the total number recorded just five days ago was 30."
...

The government is working with relief organizations to increase the number of beds available to cholera patients by setting up 10 new cholera treatment centres to treat people with severe cases.

Funds will be used by the UN and non-governmental organizations to bring in additional doctors, medicine and water-purification equipment to treat up to 200,000 people who could show cholera symptoms ranging from mild diarrhea to severe dehydration, the global body said.

"We absolutely need this money as soon as possible," said Elisabeth Byrs, a spokeswoman for the UN humanitarian office.

She told reporters in Geneva that the funds need to be provided quickly "otherwise all our efforts can be outrun by the epidemic."

Read more: http://www.cbc.ca/world/story/2010/11/12/haiti-cholera-un.html#ixzz154oufA92

Restoring function to amputees of Sudan's civil war

From Al Jazeera, giving hope to amputees of the long civil war in Sudan.

G-20 to announce change in poverty fighting strategy

The G-20 plans on releasing a statement that says they will change their approach to combating poverty. The G-20 will announce that they will begin to focus on creating private sector jobs. From now on, aid to governments will focus on building infrastructure.

South Korea did invite business executives to be guests to this years meeting, and perhaps this is what helped to spur the change. Meanwhile, NGO's were hoping for pledges of more money from the G-20.

From the Globe and Mail, writer Bill Curry and Kevin Carmichael received a leak of the G-20 statement.

The Globe and Mail has learned that South Korea has secured G20 support for a standalone communiqué dedicated to this business-focused approach to development. (While G20 officials have worked on the aid plan as a standalone package, it is not yet certain that it will remain a separate statement, or be wrapped in to the final communiqué.)

“An enduring and meaningful reduction in poverty cannot be achieved without inclusion, sustainability and resilient growth,” states a draft communiqué, dated Nov. 3 and obtained by The Globe. “We recognize the unique role of the private sector to create jobs and growth.”

The Seoul Consensus includes an opening statement of principles and then a larger, multi-year action plan. The plan envisions a larger role for development banks to encourage more investment for small businesses and more infrastructure spending by governments.

Aid groups welcomed South Korea’s efforts to make development a priority for the G20, yet noted there are no indications the G20 will announce new funds when the final communiqué is released Friday.

“It’s important that this meeting doesn’t get totally distracted completely by the currency question,” said Jeremy Hobbs, a spokesman for Oxfam International. Mr. Hobbs welcomed the focus that the South Koreans are putting on development, but that he expressed concern that there is little talk of concrete financial commitments.

“We need to see money,” he said.