IRIN Africa Reports: Aid to refugees "race against time"

Aid agencies working in northern South Sudan are worried about refugees from Sudan's war-torn Blue Nile State who are reaching under-resourced camps in increasingly poor health.

In recent weeks over 35,000 people have flocked to a site 50km from the border known as Kilometre 18 (KM18) by aid agencies - the distance to the nearest refugee camp (Jamam) holding over 30,000 people.

The war in Blue Nile between Sudan's government forces and rebels has raged since September 2011.

Several refugees from Bau County said they had joined an exodus of people fleeing recent shelling, bomber planes and soldiers attacking villages.

"We were running from the war," said 22-year-old Hawegu Oram Junjal, who arrived from Mugum village three days ago. "There was no one left in the village when we fled."

The UN Refugee Agency (UNHCR) last week said it expected up to 15,000 more people to cross from Blue Nile in the coming weeks to join over 100,000 refugees already in Maban County in South Sudan's Upper Nile State.

"I saw the army coming and the plane came and bombed so we ran away," said Anim Chapa, who, like many others, is now being treated at a Médecins Sans Frontières (MSF) clinic for dehydration at KM18.

After weeks and sometimes months of walking, aid agencies say refugees are arriving in places like KM18 (which have limited water and no sanitation) increasingly exhausted, malnourished, and in poor health.

KM18 under pressure

MSF doctor Erna Rijnierse said that last week, the clinic carried out 500 consultations, whereas half way through this week 900 people had already been seen.

Half of the consultations are for diarrhoea, with increasing cases of bloody diarrhoea from persistent dehydration and poor hygiene.

"There's not enough clean water, so people drink from pools of dirty water and get diarrhoea,” said an MSF worker as she handed out cup after cup of rehydrating fluid mostly to women, children and the elderly.

MSF said malnutrition was above emergency levels and particularly prevalent in children under five, for whom diarrhoea can prove fatal.

"Four out of eight children in the family have diarrhoea" from drinking dirty water, said Junjal.

"On the way, there was no food, no water", and some people died from bad water or a lack of it, claiming they could not walk any more, said Chapa.

"You are already vulnerable, you have very little to eat and you've been a refugee for four weeks, so if you suffer from diarrhoea, then it is quite easy to cross the line from being a normal kid to having severe malnutrition," said Rijnierse.

Aid agencies fear that if the lack of water, poor sanitation and rising diarrhoeal diseases cannot be solved, the possibility of disease outbreaks is very real. "You've got poor water, poor sanitation and poor hygiene… The risk of that turning into cholera is very high," said Pauline Ballaman, Oxfam's humanitarian coordinator in South Sudan.

MSF has vaccinated over half the child target group in KM18 for measles and hopes to achieve 90 percent coverage to avert an outbreak. It is also trying to deliver cholera kits and, in case of an outbreak, has earmarked sections of its tented hospital in Jamam.

Eating trees

"When we came from there to here, we brought a little bit of sorghum with us, but when we crossed over, the food ran out, and we were just eating the leaves of trees," said Chapa.

The sight of small children in rags eating the whitish flesh from a tree stump is apparently not rare. "We've seen children eating bark at the side of the road," said Rijnierse.

"People need very basic things like shelter when it rains and they need proper food. There is food distribution going on but some people need something extra," she added.

MSF said it only had the capacity to treat the worst cases of malnutrition, and expects to have a much bigger caseload during the six-month rains, due to a lack of shelter and mosquito nets.

"The rainy season has started, and we are seeing the first cases of malaria and respiratory diseases," said Rijnierse.

Poor road access

It is a race against time before rains cut off access to transit points like KM18 and places like El Foj, just inside South Sudan, where refugees often rest before moving on.

UNHCR is trying to move 2,000 people per day to permanent camps using buses and trucks, but five days after the last rain, buses from Jamam to KM18 are getting stuck in the sticky clay.

“Normally it takes us about half an hour to get there [Jamam]. After one night of rain, it took about 4.5 hours,” Rijnierse said.

Water at KM18’s two `hafirs’ (man-made watering holes) is only expected to last another week, while rains could cut off aid agency access.

“The problem is that nothing is easy here. The roads are a nightmare. They turn into some kind of mud that sticks to everything,” said Rijnierse.

But even if refugees are moved in time, they will face similar water shortages in the camps that are already over their capacity.

“There is not enough space now in the camps. They are not ready and the rainy season is starting. It’s too late, we have to react right now,” warned MSF’s Maban County coordinator, Patrick Swartenbroek.

Air access

Maban County has an airstrip near Doro refugee camp, but the lack of other airstrips in the area has sparked concern among charities which believe Jamam, a new site called Yusuf Batil, and KM18 could be cut off.

On 16-17 June UNHCR gained access to government-and-oil-company-owned Paloich airport in Melut County 90km from Jamam and 150km from Doro.

"We needed a much swifter delivery system, as the number of refugees in Upper Nile rapidly surpassed our original planning assumptions," said UNHCR representative Mireille Girard. "Whereas we had planned for 75,000 refugees, we are already counting some 105,000 - with several thousand more reportedly about to cross the border from Blue Nile State."

Since 16 June, the agency has flown in thousands of plastic sheets, blankets, jerry cans, kitchen sets, mosquito nets, sleeping mats, in addition to more materials to construct wells, and piping. UNHCR said it is also planning to fly 5,000 tents from Nairobi to Paloich.

UNHCR recently appealed for an extra US$40 million to address the refugee crisis in Upper Nile and in neighbouring Unity State, where around 50,000 refugees have fled conflict in Sudan’s South Kordofan State since June.

Girard said only $34 million of UNHCR's initial appeal for $111 million had been secured, and that the agency had now exhausted its emergency reserves.

Boreholes

Meanwhile, Oxfam has been struggling to meet water and sanitation demands for months in an area with black-cotton soil and drill rigs which have dug boreholes that have simply collapsed.

In Jamam people are getting 5-7 litres of water a day, while the standard is 15 litres.

Oxfam's Ballaman said it had been impossible to get drill rigs big enough to match existing boreholes that are about 150m deep and were drilled by oil companies operating nearby. "It's an ongoing battle just to provide some of the basics… It's been a long time since we've had a positive borehole."

Oxfam hopes that some of the riverbeds they have found have water underneath, while MSF is setting up pipes to try and transport water from other 'hafirs' nearer Jamam.

"It's all terribly hit-or-miss, and there are no guarantees that this is going to be enough," said Ballaman.

Source:  

Dry Days In Africa!

Soaring temperatures and the severity of this year’s drought have taken some by surprise in southeastern and eastern Mauritania. When rains are normal people only dip into their cereal reserves from June/July in the following year, but in mid-2012 people have already been without food for more than three months, and many pastoralists in the region have lost the animals on which they depend for a living.

Livestock farming is the second biggest export earner so the loss extends to the national purse.

Mauritania is poor - among the bottom 30 in the UN Human Development index - and recently asked for US$95 million to help respond to the crisis. But if it had signed up for a pooled drought risk insurance facility, it could have had up to $30 million to help respond within weeks after the weak rainy season ended in October 2011, said the World Food Programme (WFP).

In any given year a thin rainy season in Mauritania is probable, but this cannot be predicted with certainty says WFP, which is helping the African Union (AU) set up the Africa Risk Capacity (ARC) insurance and early response facility. The objective is that the insurance will pay out when an extreme event occurs - in this case drought - rather than in the case of persistent or localized arid events that occur often or even every year.

By linking insurance payouts to effective response plans, ARC aims to help African governments reduce the negative impact of droughts on the lives and livelihoods of the vulnerable, while decreasing reliance on external aid. "We are still in the design phase, and if all goes well we hope to establish the ARC in mid-2013 or so," said Joanna Syroka, programme director of the project.

The ARC is modelled on the Caribbean Climate Risk Insurance Facility (CCRIF), a non- profit pooled insurance scheme created in 2007 for the 16 members of the Caribbean Community (CARICOM), which pay comparatively low premiums and get quick payouts when a member is hit by a hurricane or an earthquake.

However, the ARC will be modified to reflect the continent's weather and food security context, bringing together the concepts of insurance and contingency planning to help African countries hit by severe drought translate an ARC payout into effective and timely responses to assist those affected.

Waiting for money to buy aid, and then getting it to people who need it quickly, have always been challenges for the WFP. But drought is a slow-onset event and its impact on people takes time to become visible, so raising money to respond has been even more problematic.

The famine in Somalia in 2010/11 is an example. The agency had rung the alarm bells early but it took the declaration of famine and images of starving children to get money flowing in, and putting aid in place then was expensive because it had to be done quickly. 

"Early action can lead to direct cost savings on commodities and logistics, and prevent dislocation in markets," said Shadreck Mapfumo, Head of Risk Management and Capacity Building at ARC. "Evidence suggests the savings that result from early action could be significant," he told a recent workshop for African countries in Johannesburg. The ARC said they have done some evaluations and will be sharing these in due course.

How it works

WFP has developed software called Africa Risk View (ARV) to define the payout rules. The package takes the 10-day rainfall estimates from the US government's National Atmospheric Administration (NOAA) and uses them to plot a drought graph. "Measuring total rainfall at the end of a season has proven to be too crude an indicator for estimating the potential impact of rainfall deficits on production and livelihoods," said Syroka.

ARV then uses the Water Requirement Satisfaction Index (WRSI), which monitors water deficits throughout the growing season, and captures the impact of the timing, amount and distribution of rainfall on annual rain-fed staple crops and pasture. "Although a simple index, it is used by many national meteorological offices across Africa to monitor rainfall seasons and their impact on agriculture, and is the basis of many drought early warning tools for the continent," she noted.

The resulting drought index is applied to vulnerable populations - identified in household surveys - that depend on rainfall. The "ARV then uses this information to estimate how many people may be directly affected, or have been affected, by drought or deficit rainfall in a given season. Using cost-per-affected-person numbers as a final step, ARV estimates how much response costs to the observed drought event may be," Syroka said.

The software tool can be customized by each country to define drought events, as modelled by ARV, for which they would want a payout from ARC, and the size of the payout, which is made at the end of the season. Information from the software will calculate the size of the premium to be paid.

Sitting on the fence

Countries have yet to sign up to this African Union (AU) initiative. Some have valid concerns. Malawi deals with chronic drought in at least two of its regions nearly every year. "The question is, 'Should we put our money into hefty premiums when we know we will not get the money to respond to the crisis in these two regions every year, or rather spend that money on safety nets in the two regions?'" a Malawi representative said at the workshop in Johannesburg. 

Kenya says it needs an insurance scheme that can pay out for multiple natural disasters. Mary Mwale from Kenya's National Drought Management Authority noted that in any given year her country could be dealing with a chronic drought in the north and floods in other regions, or even drought and flood in the same region simultaneously.

Fatima Kassam, chief of government affairs and policy at the ARC and advisor to the AU Commissioner for Rural Economy and Agriculture, said they were talking to countries about developing a package that could suit them, and hoped to expand their coverage to other natural disasters in the future. She said 18 countries have expressed interest in signing up.

To the make the ARC effective, it needs a diverse portfolio to reduce risk, which will keep the premium down, Kassam explained. For example, if all the countries in the Sahel - who share exposure to similar climatic conditions - were to sign up, the premium would be high and payouts low. If other countries, with different risks, signed up, more money from premiums would be available to cover payouts.

Steve Wiggins, research fellow at the Overseas Development Institute (ODI), a UK-based think-tank, said the ARC was "like governments running their own insurance scheme", with the advantage that they would not have to pay for the services of the insurance industry, and could be flexible in operation and use of the fund - although too much discretion would undermine the scheme.

"I guess one of the advantages of formal schemes such as ARC is that they take away the scope for local discretion, and introduce reliability in political contexts where public action is often highly discretionary and arbitrary."

Some officials, like Joseph Kanyanga, Zambia's chief meteorologist, are concerned about what influence regional politics might have if the ARC is housed in the AU. "We would like it to be totally independent of the AU, as it could perhaps influence the amount of payouts made when and to whom."

AU advisor Kassam says the ARC is based on hard, parametric triggers.

"There will be no discretion at the time of payout", which means that payouts will be made based on facts and not influenced by any other factors. ARC will be a specialized agency of the AU - a financial subsidiary independent of any political influence. The details of the relationship between the ARC and the national legislation of member countries are yet to be worked out.

Alternatives

"[The ARC] provides an alternate route to manage drought-related disasters besides the UN-mediated Consolidated Appeals Process," said Christopher Barrett, a food expert who teaches development economics at Cornell University in the US.

"But it is equally important to recognize the limitations of these sorts of products. They insure against low rainfall over a particular period and space - low rainfall is imperfectly correlated with crop yields, income shortfalls, loss of key productive assets, livelihoods crises and the magnitude of a humanitarian emergency, if any."

Both Barrett and the ODI's Wiggins said the ARC should not be seen as a "silver bullet", and countries should not lose sight of other options. Wiggins said one such option was to consider an offshore account earning interest, which would be used to import maize in poor rainfall years, and pay the difference between the landed cost of maize, usually US$100 a ton or more than the typical local wholesale price.

"The offshore fund would be built up by the country setting aside the funds in the good years," Wiggins said. He proposed this option for inland countries in Southern Africa in 2004, where crops failed at least twice in a decade.

Climate change

Drought events that occurred once in 10 years could soon become more frequent, said Koko Warner, head of environmental migration, social vulnerability and adaptation at the UN University in Bonn. Insurance schemes like the ARC, which at present provide answers for short-term climate variability, need to factor in the impact of long-term climate change.

"We need to start taking action now to design safety nets and risk reduction schemes that will be able to respond to extreme and intense events, which could perhaps be occurring almost every other year in the not too distant future." 

Source: irinnews.org
 

DRC (Congo) Cholera Outbreak Worsens

A growing cholera outbreak in the Democratic Republic of Congo has claimed nearly 400 lives and affected more than 19,100 people since January, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA).

"The total number of cholera cases in 2012 is around 90 percent of cases reported last year. Since January 2011, 983 people have died from the outbreak affecting eight of 11 provinces of the country," Yvon Edoumou, OCHA spokesman, told a news conference.

Since the outbreak started, more than 40,795 cases have been reported. Edoumou said the growing epidemic had put a strain on ongoing humanitarian interventions funded mainly by a US$9.1 million grant by the UN Central Emergency Response Fund, which provides rapid response grants for humanitarian emergencies.

Experts have blamed the continued spread of cholera in the DRC on poor hygiene, lack of awareness about transmission mechanisms, limited access to protected and monitored water sources and a general lack of sanitation infrastructure.

sw/kr/cb 

Source: irinnews.org

Looking For A Great Father's Day Present?

Looking for a great Father's Day gift?  Easyfundraising have 30% off Gap, 20% off Habitat and Debenhams, 25% off Wickes, 40% off Amazon and lots more... plus win £200 for The Simson Foundation and check out our great Father’s Day giveaway.  Please don't forget to name us as your cause!  http://www.easyfundraising.org.uk/causes/simsonfoundation

 Click Here to Visit Easyfundraising

Call to Reverse Soaring Adoption Rates

As the number of African children adopted by people outside the continent reaches record levels, experts, activists, government officials and academics have called for the practice to be stemmed, warning that adoption was too often motivated by financial gain rather than the best interests of the children involved.

Between 2003 and 2011, for example, at least 41,000 African children were sent abroad for adoption from Africa, according to a study entitled Africa: The New Frontier for Inter-country Adoption by the African Child Policy Forum (ACPF).

“Commercial interests have superseded altruism, turning children into commodities in the graying and increasingly amoral world of inter-country adoption,” the ACPF study said.

In 2010 alone, it said, some 6,000 African children were involved in inter-country adoption, representing an almost threefold increase in just seven years. Global rates are at a 15-year low, the report said.

Participants at the fifth International Policy Conference on the African Child, held in Addis Ababa at the end of May, called for “a reversal of the current trend of resorting to inter-country adoption as an easy and convenient option for alternative care in Africa, and for giving absolute priority to enabling all children in Africa to remain with their families and their communities”.

Inter-country adoption should only take place when “an alternative family environment cannot be found in the home country, and, in line with the African Charter on the Rights and Welfare of the Child, is used as a last resort”, the participants said in a joint declaration.

They also expressed concern that “sometimes children are being procured for adoption abroad through manipulation, falsification and other illicit means of securing financial gains” and that “in some instances there are both internal and external pressures put on families and governments to make their children available for inter-country adoption.”

According to the ACPF study, the number of adoption cases from Africa has risen by almost 300 percent in the last eight years because of the suspension or limitation of international adoptions from traditional source countries. This has made host countries turn en masse to Africa to fill the need for adoptive children. The USA is the leading host country.

Money matters

“Money determines not only the way these adoptions are carried out, but also the reasons for which many are initiated. Money does not just matter - it is a key factor that must be tackled if the human rights of African children are to be effectively protected vis-à-vis inter-country adoption,” said another ACPF report, entitled Inter-country Adoption: An African Perspective.

The report noted that many orphanages in Africa have been set up to generate profit, receiving up to $30,000 per adopted child from prospective parents.

While the 1993 Hague Convention on the Protection of Children and Co-operation in Respect of Inter-country Adoption also says inter-country adoption should be a last resort, only 13 African states are party to the convention, and, aside from South Africa, they include none of the continent’s five leading sources of adopted children (Ethiopia, Nigeria, Democratic Republic of Congo, South Africa and Mali).

Experts at the Addis Ababa conference called on more African countries to harmonize existing national legislation with applicable international human rights instruments alongside a comprehensive child protection system.

“We have a lot of homework to do despite our recent progress in ensuring children’s rights. But the problem is not an issue left to government alone and requires a collaborative effort of concerned bodies,” said Bizunesh Taddesse, the Ethiopian minister of women, children and youth affairs.

Ethiopia was in 2010 ranked the second top origin country for inter-country adoptions after China. Other top 10 African countries in 2009 and 2010 were Burkina Faso, Côte d’Ivoire, the Democratic Republic of Congo, Ghana, Mali, Morocco, Nigeria, South Africa and Uganda

Source: irinnews.org

Brendan Reports from Sikkim

We join Brendan this week on his continuing travels.  He is on the go all the time, so barely has time to talk to me.  This week he told me, “The only access here are Jeeps.  We are travelling up steep hills, driving into clouds and then down into valleys with stunning rivers running through, before driving up another steep mountain.  Sikkim is a world of beauty”.

After travelling a day by jeep Brendan and his party finally arrive at their destination Khecheopalri Wishing Lake, which is a place of worship for both Hindus and Buddhists.  At the lake there are no tourist traps, shops, Internet or televisions, just nature at its best.  After a 45 min hike they finally reached their home stay, which was a world up in the clouds.  There were breath taking views, a range of small wooden houses with vegetable gardens, a small school and, most importantly, really amazing people!

Brendan’s bedroom was no more than a garden shed, with 2 basic wooden beds and blankets, apart from that it was totally bare.  The toilet was outside and the shower was literally a bucket, for which you collect water from the large container, which was replenished by rainfall.  “It really is back to basics”, Brendan told me.

Brendan explained the drastic contrast between this work and the world he knows so well.  He told me, “Obviously it is a bit of a shock and a world far apart from the world we know.  After a short time and quite a bit of adjustment, you realise that we could learn so much from these people and the way they live.  There are not shops, advertising, or television, just a life of survival making do with what they have. In my eyes this is the real world”.

Brendan went on to explain that the people of Sikkim grow their own vegetables.                   They have cows and goats, which are kept for milk, plus a horse used to transport heavier items from the low land.  He said, “All our meals were fresh and very healthy”. 

Brendan told me that life for children in Sikkim is very different to the life our children know.  They carry large baskets of wood and other materials often in a large basket on their back held by a strap that would be positioned on their head.  When work is done, they play like other children.  Brendan said, “It was so nice to see children playing in the mud, no distractions of TV and the Internet, watching them run to school in the morning with huge smiles was so refreshing”.

Brendan finished by telling me, “This was such a unique experience, a world that could be looked upon as poor compared to our way of life - but after spending 4 days there watching the special bond in the community and the family bonds, plus the team work, maybe we are not so rich after all!

Clinical Study Report - Zinc Improves Infant Infectious Treatment

In a newly released clinical study conducted in India, hundreds of seriously ill infants who received zinc - an essential micronutrient for the immune system and human growth - as well as antibiotics, responded better and more quickly to treatment than those who did not. This finding is the first proof that zinc supplements may boost infant survival from infections.

“It does not need to be serious zinc deficiency. Even mild deficiency can compromise a child’s immunity,” the study’s lead investigator, Shinjini Bhatnagar, of the Translational Health Science and Technology Institute and All India Institute of Medical Sciences, told IRIN. The infants’ weak immune systems, among other reasons, can lead to first-line treatments not working.

More than 300 infants no older than 120 days (4 months), hospitalized in New Delhi, the capital, for suspected meningitis (an infection of the brain or spinal cord lining), pneumonia (a lung infection) or sepsis (blood poisoning), were given zinc in addition to antibiotics. They were found to be 40 percent less likely to experience “treatment failure” - needing a second antibiotic within one week of the first treatment, or intensive care or death within 21 days - than those given a placebo.

Multiple medical studies have identified widespread zinc deficiency in low- and middle-income countries, and how this increases the risk of infection, but the research has thus far focused on children at least six months old.

In 2010, infections like pneumonia and meningitis accounted for 47 percent of all deaths in children aged under five worldwide, and almost a quarter died during the first 28 days of life, according to recent research by the Child Health Epidemiology Group, a global advisory body on interventions.

Rolling out zinc

The World Health Organization (WHO) recommended zinc and oral rehydration salts (ORS) to treat diarrhoea, a symptom of infections and a leading child killer, in 2004. Many low and middle-income countries have since changed their diarrhoea treatment policies to include zinc, according to a map by the US-based Zinc Task Force.

Yet only a “very small proportion” of children who need zinc have access to it, according to a 2009 WHO bulletin.

Policy changes are just one part of rolling out zinc supplements, Kenneth Brown, a professor of nutrition and child health at the University of California-Davis, told IRIN. “The distribution system - from central stores to peripheral facilities - must be functioning efficiently, and clinicians must be trained in when and how to use the [zinc] supplements if the programmes are actually going to be effective."

Ideally, a child’s immunity should be bolstered with zinc supplements (available in syrup and tablets) to help prevent infections, he added. “However, therapeutic intervention programmes have the advantage of being less costly, and allowing targeting of those infants/children at greatest short-term risk of mortality.”

Bhatnagar has applied to expand the study to include more children in different parts of India as well as elsewhere in South Asia. 

Source: irinnews.org