POVERTY: UGANDA: Meningitis outbreak kills 16 in north

KAMPALA, 23 March 2012 (IRIN)

 Photo: Charles Akena/IRIN
Meningitis vaccination can significantly reduce mortality (file photo)

At least 16 people have died in a meningitis epidemic in two districts in northern Uganda over the past three weeks, say health officials.
Amuru District, where the epidemic is spreading fast, has recorded 33 cases with 14 deaths since 24 February, while Oyam District has reported 25 cases with two deaths.
The two districts are just recovering from two decades of Lord’s Resistance Army insurgency which displaced over 1.8 million people and left thousands dead.
“The deadly disease is spreading… The number could be higher as not all come to health facilities,” Charles Okwera, deputy district health officer in Amuru, told IRIN.
“We have stepped up surveillance and alertness following the outbreak. We are doing everything possible to contain the disease.”
The World Health Organization (WHO) in a 21 March statement said 18 suspected cases with three deaths were recorded in three parishes in Pabbo sub-county, Amuru District, while 25 cases including two deaths were recorded in Oyam.
“In Oyam the sample revealed that the causative organism was streptococcus pnuemonie which is a usual bacteria that causes meningitis of the sporadic nature,” said Emmanuel Tenywa, a WHO official in Gulu.
Meningitis is an inflammation of the meninges, the lining surrounding the brain and the spinal cord. It is caused by bacteria and transmitted through contact with respiratory or throat secretions. The most worrying type of meningitis is caused by a bacteria of the subtypes of meningococcal meningitides.

Dust helps meningitis spread
Medical experts say dust, which is common during the dry season, leads to an increase in respiratory infections and helps spread meningitis because the bacteria attach themselves to dust particles, but “the dry season is ending and there should not be much worry,” said Tenywa.
Rukia Nakamatte, a Ministry of Health spokesperson, said an Epidemic Response Team and health experts had been dispatched to the affected districts to contain the outbreak. “We have delivered the necessary drugs and supplies to contain the deadly disease,” Nakamate, told IRIN.
Uganda lies within the African meningitis belt, stretching from Senegal in the west to Ethiopia in the east, according to WHO. The region, experiences meningitis cycles whenever the dry season sets in. While vaccination can significantly reduce mortality, the exact strain of meningitis needs to be identified before vaccines are administered.
Typically, the disease has a mortality rate of 5 to 10 percent, with death occurring within 24 to 48 hours, while some survivors suffer brain damage, hearing loss or learning disabilities.
http://www.irinnews.org/Report/95139/UGANDA-Meningitis-outbreak-kills-16-in-north

POVERTY: Cracking open the LRA to better eliminate it

DUNGU, 21 March 2012 (IRIN)

 Photo: Guy Oliver/IRIN
Troops of the UN Stabilization Mission in the DRC (MONUSCO) providing an armed escort on the road from Dungu to Faradje

 After seven years held captive by the Lord’s Resistance Army (LRA), 16-year-old Apiyo Tabisa’s release five months ago in the Democratic Republic of Congo (DRC) along with a dozen or so others was as sudden as her abduction from Uganda.
Vincent Binany - deputy to senior LRA commander and International Criminal Court (ICC) war crimes indictee Dominic Ongwen - “gave us no reason. He left us by the side of the road and just told us to go to the soldiers [Armed Forces of the DRC (FARDC)],” she told IRIN.
She spent seven years wandering the frontier lands of the DRC, South Sudan and Uganda as a porter and cook and witnessed “too many [killings] to remember. There were just too many,” said Tabisa, who is awaiting repatriation from Dungu (northeastern DRC) once her relatives have been traced.
“Some were shot or beaten with pieces of wood. I don’t know why. If you make a mistake they kill you. If you have witchcraft, they kill you. There does not have to be a reason,” Tabisa said. “Seeing the killings and the beatings - that was always the worst. If you say something [to object to the killings] they kill you.”
Matthew Brubacher, political affairs officer working with the UN Stabilization Mission in the DRC (MONUSCO)’s Disarmament, Demobilization, Repatriation, Reintegration and Resettlement (DDRRR) unit, and an LRA specialist based in the eastern DRC city of Goma, told IRIN: “We still don’t know why they were released [by Binany],” but answering such questions is key to developing strategies to dismantling the armed group.

Why so durable?
Why has Joseph Kony’s LRA, which has raped, abducted and pillaged for the past 25 years survived so long?
From the early 1990s, the LRA conducted raids into northern Uganda from bases in eastern Equatoria in southern Sudan (now the independent state of South Sudan), where President Omar al-Bashir co-opted and supplied the group to fight the then-rebel Sudan People’s Liberation Army, which in turn enjoyed support from Ugandan President Yoweri Museveni.
From 2005, the LRA began moving into areas of the DRC close to the border with Sudan. More recently, the LRA has also been active in the Central African Republic.
The undeveloped frontier lands with scarce infrastructure, weak government and isolated communities enabled the LRA to forage for food, and kidnap - boys for child soldiers and girls as sex slaves.
At the core of the LRA’s ability to survive and outwit their numerically superior opponents was “maintaining secrecy in the LRA”, said a World Bank June 2011 report entitled Diagnostic Study of the LRA authored by Philip Lancaster, Guillaume Lacaille and Ledio Cakaj.
“Kony appears to understand that one cannot defeat the enemy one does not know, and consequently masks the LRA behind a curtain of mystery. The rituals performed in the LRA, some military in nature, others religious, are in part designed to maintain the secrecy and mystery of the LRA - much like a secret society or a cult,” the report said.

Runners and fliers
The LRA’s few hundred core fighters are dispersed across a region about half the size of France spanning three fragile countries. Modern methods of communication, such as satellite phones (there is little to no coverage for mobile phones in much of the region) are eschewed as they can be tracked by satellite and reconnaissance aircraft. Runners are used to carry messages, with this task often entrusted to the senior ranks.
Onen Unita - an officer serving under senior LRA commander Okot Odhiambo who, like Kony, is wanted for war crimes by the ICC - was used as a runner to convey decisions to other commanders in the DRC taken at a meeting in CAR in June 2011.
Lt-Col Golam Faruque, chief coordinator of MONUSCO’s Joint Intelligence Operating Cell based in Dungu, which collates information about the armed group, told IRIN: “We know about the meeting, but we don’t know anything of what decisions were taken,” but added that in the second half of 2011 the number of violent incidents in the DRC attributed to the LRA decreased substantially. He also noted that armed groups have high and low periods of activity.
Ian Rowe, DDRRR head of Orientale Province based in Dungu and working to eliminate the group, tries to gather intelligence based on snippets of information.
Unlike his counterparts in eastern DRC where mobile phone communication with potential defectors is a vital tool in convincing the officer class of the Democratic Forces for the Liberation of Rwanda (FDLR) to defect, no such avenue exists with the LRA.
Instead, there is a reliance on leaflet distribution guaranteeing amnesty, except for those indicted by the ICC, and a network of FM radios conveying a similar message to LRA combatants in a variety of languages, including Acholi and Lingala, in the three affected countries.
Rowe said the fliers are either air-dropped by MONUSCO, or distributed by FARDC in the DRC and by the Uganda People’s Defence Force (UPDF) in CAR and South Sudan, “and put on trees or along waterways, as historically the LRA follow waterways”.
MONUSCO’s DDRRR has produced 30,000 flyers for distribution, showing photographs of recent escapees in the past few years, which those still “remaining in the bush” were likely to recognize, Rowe said.
"We just had a Kony wife surrender in Djema. She saw the wife of Odhiambo on one of our leaflets disseminated by the UPDF in eastern CAR. That convinced her to leave, despite Kony telling her that the woman had been killed shortly after the picture was taken," Brubacher said.
“Our inability to communicate, deal or negotiate with the LRA directly and effectively… means that for the most part, we have very little idea as to the extent our messages are getting through,” Rowe said
It was difficult to put a precise number on the penetration of the messaging by DDRRR, but he said some estimates of 75 percent were probably an “overestimation of the number of escapees we're receiving in Dungu who state having seen or heard our messaging.”

Assembly points
In September 2011, another LRA commander, Ocan Bunia, died, reportedly of malaria, in the DRC, and a number of captives were released. At their debriefing there were indications that fighters in the group had also wanted to defect, but had no way of safely doing so.
The last LRA commandant who surrendered jumped onto the road naked in front of a Caritas motorcycle. When the motorcycle driver agreed to help him surrender, the LRA fighter went back into the forest and got his gun and uniform. That is how hard it is to surrender
Ugandan LRA defectors are met with hostility by affected communities and MONUSCO’s DDRRR programme has embarked on an awareness-raising programme to try and convince people to hand them over to the authorities rather than mete out their own form of justice, which acts as another barrier to the LRA's disarmament and demobilization, Brubacher said, and has led to bizarre acts by LRA fighters.
“The last LRA commandant who surrendered jumped onto the road naked in front of a Caritas motorcycle. When the motorcycle driver agreed to help him surrender, the LRA fighter went back into the forest and got his gun and uniform. That is how hard it is to surrender,” he said.
The incident with Bunia acted as a catalyst to develop the concept of assembly points, which are at least 10-15km from the closest communities. Two sites have been identified northeast of Dungu, one north of Faradje, one in Garamba National Park, and one south of Bangadi.
Rowe said 30,000 fliers detailing the locations, funded by the San Diego-based NGO Invisible Children, would be distributed to make these sites known, and it was expected the concept would be rolled out regionally.
MONUSCO has agreed to send patrols to these sites twice a week to check-up on any LRA defectors. “It is the best we can do for these people [defectors]. Although they might have to hang around for a few days before being picked-up.”
http://www.irinnews.org/Report/95109/SECURITY-Cracking-open-the-LRA-to-better-eliminate-it

POVERTY: UGANDA: Charcoal boon a bust for forests

GULU, 7 February 2012 (IRIN)

 Photo: Charles Akena/IRIN
Uganda loses some 80,000 hectares of forest every year

Once a fortnight, Moses Sserwada travels from the capital, Kampala, to northern Uganda to pick up a truckload of charcoal destined for the popular Owino market in the city.
“I have been in this trade for three years; we get our supply from northern Uganda because the charcoal produced there is of a good quality and in high demand,” Sserwada told IRIN.
The charcoal trade, referred to as "black gold" by Kampala traders, has become more profitable than the forests where trees are being indiscriminately cut down for charcoal-burning. For the rural population, charcoal trade is an opportunity to earn an income.
According to the National Forest Authority (NFA), more than 73,000 hectares of private forest are cleared every year across the country and over 7,000ha of protected forest reserves are destroyed annually for timber and charcoal.
“People are cutting down trees indiscriminately without thinking of the future,” said Moses Watasa of the NFA.
Watasa said Uganda had no clear policy on charcoal production. "We must encourage planting fast-growing trees like eucalyptus now so that we can be in a position to get timber and charcoal in 10 years," he said.
Northern Uganda has thick forest cover, comprising both hard and soft wood. Forest growth in the area flourished during the two-decades-long Lord's Resistance Army (LRA) conflict as many locals were displaced from their villages.
Previously, Kampala charcoal traders relied on charcoal from Nakasongola, Hoima, Masindi, Kafu, Luwero areas of eastern Uganda. These have since been depleted of private and community forests.
For instance, Langele village, adjacent to the Murchison Falls National Park in Nwoya district in northern Uganda, known for its beautiful scenery and thick forests, is no more. Locals refer to Langele as a charcoal factory.
“The price of forest depends on its thickness but on average it costs 1.5 million shillings [US$600] for a hectare,” said Otto Oola, a resident of Langele. "Any patch of land here covered with trees is [worth] a fortune, it can earn you millions of shillings any time."

Poverty
Although aware of the environmental impact of indiscriminate cutting of trees, Oola said many people were doing it out of poverty. He said charcoal buyers not only provided cash upon purchase, they also helped villagers clear forested land for cultivation.
“I am trying to survive, I can’t sit hungry in that forest,” Oola said.
According to the State of the Environment report by the Uganda National Environment Management Authority, the rate of deforestation had, by 2005, increased from 1.76 percent per annum to 2.13 percent per annum.
The report says pressure on land, water, forest and biological resources has dramatically increased to meet the needs of a growing population, leading to a loss of 76 percent of the country's forest cover.
Geoffrey Oryema, the district leader of Nwoya, said poverty and lack of a meaningful livelihood source were the driving factors for environmental destruction.
“What do you expect somebody in the village without money to pay for his needs such as soap, salt, medicine and food to do?” Oryema said. "People are struggling to find alternatives to survive."
However, Samuel Abwola, a district environment officer in Gulu, said people in rural areas were being exploited to degrade their own environment.

 Photo: Charles Akena/IRIN
Charcoal production is seen as a way out of poverty

Depletion
Gulu initially had 371 sqkm of forest cover, but environmentalists now estimate the cover to be only 200 sqkm, a reduction they attribute to charcoal-burning, human settlement as well as the quest to open up cultivable lands.
Margaret Barihahi, a coordinator for the African Climate Change Resilience Alliance, said it was necessary to devise alternatives for sustainable livelihoods and to empower communities with information on the dangers of indiscriminate forest-cutting.
“Without a viable alternative source of energy, it is clear that charcoal and wood fuel will remain the dominant sources of energy,” Barihahi said.
An estimated 95 percent of Ugandans depend on charcoal and wood for cooking. Moreover, Uganda's rapid population growth, coupled with rapid urbanization, has increased the demand for energy, especially cooking fuel.
However, growth in energy demand has not been matched by corresponding growth in supply of alternative sources of fuel, such as hydro-electricity, which is the cheapest and most convenient alternative source of energy for cooking.
Because of its short supply, hydro-electricity is neither affordable nor reliable.
Uganda's National Development Plan estimates the country's electricity demand to reach 35,000MW by 2015 and the absence of cheap charcoal is likely to push demand for electricity even higher.
http://www.irinnews.org/report.aspx?reportID=94810

MALNUTRITION: Malnutrition diabetes worries experts.

Nov 24, 2011 Share3 Type 3 diabetes also called malnutrition diabetes is worrying health experts. The disease is predominant in sub-Saharan Africa, says Dr. Meredith Hawkins, a medicine professor and the global diabetes initiative director at Albert Einstein College of Medicine, New York.
“This is a paradox,” she says. “I thought only overweight people suffer from diabetes, but it is prevalent even in skinny poor Ugandans.”
It presents itself like Type 1. Its cause is still unclear, but stress and poverty have been pointed out as factors for its cause. Uganda, DR Congo and Niger hospitals are currently grappling with this new type.
Type 1 diabetes results from destruction of the pancreatic beta cells. Here, insulin is required for survival. Type 2, also called adult-onset that accounts for 90% of diabetes cases, results largely from too much sugars in the body that may accrue from eating fatty foods and less active lifestyles.
Type 3 has raised concern amongst local health gurus considering that 31% of Ugandans or 9.3 million live below the poverty line.This means many secretly suffer from malnutrition and the fact that the bigger percentage of Ugandans comprises young people.


A child being tested for diabetes in Adjumani.

Type 3 results from destruction of the pancreas due to drugs, cancer, HIV/AIDS and trauma. People who have high cassava diet and proteins deficiency are likely to suffer from it as well.
It is because of this emerging scare that Albert Einstein College of Medicine, New York, is conducting a research on Type 3 with Christian medical college, South India. The pathophysiology study is intended to understand why the disease develops. “We want to know- does Type 3 emerge because the pancreas isn’t well developed or has heavy fat content,” says Hawkins.
In Uganda, 100 doctors and nurses from 20 clinics converged in 2009 to deliberate on the growing diabetes cases, its social and economic impacts, treatment options as well as behavioral changes patients need to undertake.
The International Diabetes Federation (IDF) chief, Dr. Silver Bahendeka, says diabetes was growing by 93% in 15 years up to 2010.
Diabetes, in simple terms, means a person’s blood glucose, or blood sugar, is too high. It is associated with acute complications such as ketoacidosis and hypoglycemia. This vascular disease occurs when small blood vessels leak, affecting the eyes, kidneys, feet, nerves brains and blood vessels, says Uganda Diabetes Association (UDA) chief, Prof. Andrew Otim.
“Without insulin, too much glucose stays in your blood,” says Otim. “Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth.” It blocks or bursts the large blood vessels, affecting the normal functioning of the brain, heart and legs.
“Left untreated,” Otim says. “Diabetes can lead to loss of sight, amputations, impotence and eventual death.”

Statistics
Diabetes has taken a sky rise over the years. In 1972, only 254 people were diagnosed. They sought treatment and counselling from the only diabetes clinic at the time at Mulago Hospital.
By 2000, about 80, 000 diabetic people were living in Uganda, according to World Health Organisation (WHO) figures. This figure rose to 560, 000 by 2006, while an additional 560 000 patients were unaware that they were diabetic.
In 2009, about 1.5 million of Uganda’s 30 million were diabetic. This has seen the number of centres handling diabetic cases countrywide rise from one in 1972 to over 10 presently.
A total of 18 million people, suffer from the disease in Africa, according to WHO. Dr Hawkins, says over 170 million people suffer from it globally.
http://www.newvision.co.ug/news/30267-malnutrition-diabetes-worries-experts-world-diabetes-day-supplement.html

MALNUTRITION: Two million Ugandan children malnourished

Nov 16, 2011 By Prossy Nandudu


Mothers hold their children as they await malnutrition treatment in Karamoja

OVER two million children in Uganda under the age of five are chronically malnourished, the Minister of State for Agriculture Professor Zerubaberi Nyiira has revealed.
Nyiira made these remarks while officiating at a consultative workshop on Nutrient Rich Food Crops at the Golf Course Hotel recently.
“Malnutrition is the underlying cause of death in nearly 60 per cent of infants and 25 per cent of mothers especially in rural areas which have high incidences of poverty and malnutrition as compared to their urban counterparts," he observed.
The minister also revealed that the children under five years affected by malnutrition account for 38 per cent, of which 16 per cent are underweight while six per cent are said to be wasted.
“Promotion of nutrient-rich food crops is part of our endeavor to integrate nutrition into agricultural development programs to reduce malnutrition."
The workshop was organized by BRAC Uganda, an NGO offering different services, and is aimed at creating awareness on availability of nutrient-rich food crops in Uganda.
BRAC Executive Director Dr. Mahabub Hossain attributed the increasing rate of malnutrition cases in Uganda to inadequate nutrients like Vitamin A, zinc andiron in food intake particularly for the rural poor.
Dr.Mahabub suggested that citizens should breed locally grown food to increase their nutrition content in order to address challenges related to malnutrition in Uganda.
Such crops include staple foods that include beans, cassava, sweet potatoes, and maize.
The breeders assist in screening plants of staple food crops that contribute to high amounts of minerals or vitamins.
Nyiira assured the stakeholders that the challenge related to malnutrition would be addressed in Uganda’s Nutrition Action Plan (UNAP), a plan recently launched by the president with an objective of ensuring that all citizens are well nourished.
"The plan calls for the scaling up of interventions, placing emphasis on community-based initiatives that have been proved to yield cost effective results, as well as targeting areas and groups with the highest level of malnutrition," Nyiira noted.
http://www.newvision.co.ug/news/30038-two-million-ugandan-children-malnourished.html

MALNUTRITION: UGANDA: Farmers battle uncertain weather patterns

ALERO, 20 July 2011 (IRIN)

 Photo: Charles Akena/IRIN

A farmer winnows her beans harvest in Nwoya district

 Having spent years uprooted by conflict, farmers in northern Uganda are again facing tough times – this time caused by the weather.

In late June, Joel Lacung and Margaret Ataro of Got-Ngur village in northern Uganda’s Nwoya district, laboured under the scorching sun as they drove two pairs of oxen to prepare their land for the approaching second rice-planting season.
They were among many rural farmers in Uganda whose livelihoods have been affected by increasingly erratic rainfall and high temperatures. Most were displaced by the years of conflict with the rebel Lord's Resistance Army (LRA) and remain poor and unable to acquire farm inputs.
Jackson Odong, a research assistant with the Uganda Refugee Law Project, said helping these farmers was critical to restoring some normality in that part of the country.
"We no longer have enough food harvested compared to 30 years ago; these days when it rains, it sometimes falls too much, making the crops over-grow... [and not] germinate, and when the sun shines, sometimes it goes on for a long time, withering the crops."
Growing crops such as beans, groundnuts, sweet potatoes, sesame and millet had become difficult, he added.
For the past 20 years, the population in northern Uganda has depended on food aid because of the LRA conflict that forced about 1.2 million people into camps. The region, comprising savannah grass land and forests, is potentially very productive.
However, between May and June 2010, several farmers in the Acholi and Teso region in the north lost land to torrential rains that left fields water-logged, causing crops to rot.
In 2009, heavy rains in the first quarter and prolonged sunshine also left several farmers counting losses, undermining food reserves.

Uncertainty
"In the past, our grandfather could predict rain through cloud formations, direction of the wind and when certain trees begin to grow leaves," Lacung said.
Faced with the effects of the unpredictable weather, a group of 600 rural farmers in the districts of Amuru, Gulu, Nwoya, Pader, Kitgum and Lamwo are adapting to alternative farming methods.

The farmers, supported by the Catholic Relief Agency (CARITAS) in the Acholi sub-region through a community managed disaster risk reduction programme (CMDRR), are adapting by planting early and using quick maturing seeds.

 Photo: Charles Akena/IRIN : Growing crops such as beans, groundnuts, sweet potatoes, sesame and millet has become difficult in northern Uganda

Lacung said they also practised crop rotation, irrigation, inter-cropping and use of manure to help the soil regenerate.
Patrick Otto, a farmer from Kitgum, said the knowledge and support they had received had helped them improve their yields.
Jackson Lakor, an agricultural officer in Gulu, said farmers needed information on climate change to guide them in their daily farming activities.
He said the only way to minimize losses was to engage in activities that would help restore the environment, such as re-forestation and inter-cropping with perennial crops.
Longinous Olong Ogwang, CMDRR project officer, said the 300 million shilling (US$125,000) project would help farmers adapt to better methods through training and input provision.

Lessons learnt
Ogwang added that CMDRR hoped to replicate the project in more areas to help farmers become self-reliant.
"Here the farmers identify risks and we support them on how they can address these risks.
"If they identify delays in rain as a risk, we support them with knowledge on alternatives so that they are in a position to use seeds suitable for a given condition, and how to plant, when to plant," he said.
"The farmers identified inadequate capacity to till larger portions of farm land and we provided them with oxen and ploughs," he added.
Paul Isabirye, coordinator of the climate change unit in the Water and Environment Ministry, said the only way to help farmers cope with unreliable weather was to have a comprehensive programme that catered for all the sectors to address the different challenges.
"All government ministries have a role to play," he said, referring to roads, health, education and disaster preparedness, among others. "Climate change is the main cause of the intense rainfall we are receiving, its poor distribution and erratic [patterns]."
He said addressing the effects of climate change varied according to the farming practice.
"There are different levels of adaptation depending on the availability of resources and geographical set-up of a place," Isabirye added.
http://www.irinnews.org/report.aspx?reportID=93274

MALNUTRITION: EGYPT: Desertification threat to local food production

CAIRO, 11 July 2011 (IRIN)

 Photo: Amr Emam/IRIN
Water shortages sparked off protests in Minya Governorate last year, as farmers demanded water for their crops. (file photo)

 Only about 3 percent of Egypt’s land area is cultivated but desertification, and construction work fuelled by economic activity and a rapidly growing population, are eating into this resource, posing a significant threat to domestic food production, according to experts.
“Desertification is the real danger everybody should pay attention to,” Abdel Rahman Attia, a professor of agriculture at Cairo University, told IRIN. “This problem is manifesting itself in a huge food gap [which] will widen even more in the future as we lose more agricultural land to desertification.”
Egypt loses an estimated 11,736 hectares of agricultural land every year, making the nation’s 3.1 million hectares of agricultural land prone "to total destruction in the foreseeable future", he said.
The country imports more than 60 percent of its food, and about 768,903 hectares of agricultural land in the north Delta region has been lost to rising ground water, poor drainage practices and encroaching sand dunes over the decades, he added.
Rising sea levels also pose a threat to agricultural land, causing intrusion of seawater into groundwater, and reducing agricultural productivity.
Thousands of acres of agricultural land have also been lost to construction. According to the Ministry of Agriculture, 165,000 cases of building on agricultural land were recorded between February and June 2011.
“This is disastrous,” said Salah Youssef, head of agricultural services at the ministry.
Ismail Abdel Galil, the former chairman of Egypt’s Desert Research Centre, said studies showed that just over a hectare of fertile land in the Nile Valley is lost every hour because of construction on agricultural land.
In a paper he warned that this trend would continue as long as there was a “business as usual” attitude.

UN convention
Egypt signed the UN Convention to Combat Desertification in 1994, subsequently banning the use of top soil as a raw material for red bricks, taking measures to restrict urban development on arable land, and regulating irrigation systems.
But despite this, the combination of dwindling farmland and a rapidly increasing population - expected to reach 123 million in 2029, from 85 million at present - will make it harder for Egypt to meet its food needs, Attia said.
Increasing desertification has also affected water availability. Egypt’s 55.5 billion cubic metre share of Nile water is already insufficient to satisfy the country’s growing needs, according to Egyptian officials.
For example, to irrigate all its 3.1 million hectares of agricultural land, Egypt needs 10-15 billion cubic metres more Nile water, said Maghawri Shehata, a leading water expert.
“Water has already stopped reaching some fields in the northern and middle parts of the Nile Delta. This makes our country lose even more land to desertification.”
Agriculture is responsible for 85 percent of water consumption in Egypt, according to the country’s state of the environment report. Egypt’s water problems are expected to get worse as upstream countries like Ethiopia and Uganda, which also have rapidly growing populations, push for a greater share of the water to satisfy their own needs.
In 2010, six upstream Nile countries met in Uganda and signed a new water-sharing agreement. Egypt and Sudan did not sign, and have called instead for fresh talks involving all riparian states.

Climate change
Environmentalists warn that climate change will further complicate the situation.
“It is difficult to assess the full destruction [that] climate changes cause to agriculture in this country,” said Emad Farid, a leading environmentalist. “Increased temperatures and the severity of heat and cold waves cause rainfall fluctuations. These fluctuations lead to desertification at the end of the day…
“Some action must be taken to compensate for the loss of agricultural space by reclaiming the desert hinterland of villages in the Delta and the other areas. We should not stand passively by and watch our agricultural land destroyed acre by acre.”
http://www.irinnews.org/report.aspx?reportID=93193

MALARIA: Uganda: DDT Spraying Costly for Country

Raymond Baguma and Gerald Kawemba : 5 July 2011
Indoor residual spraying as a strategy to control malaria in Uganda is too costly and has affected the programme countrywide.
According to Dr. Seraphine Adibaku, the head of the Malaria Control Programme, this is why other malaria control strategies such as use of insecticide-treated nets and Artemisinin-based combination therapy are considered to be ahead of indoor residual spraying.
The Government is implementing the indoor residual spraying using pyrethrum-based and carbon-based insecticides in 10 malaria-endemic districts in the northern and eastern regions.
They include Amolatar, Apac, Kitgum, Kumi and Bukedea.
"About three million people in the 10 districts have been covered. We have reached over 90% of the population," Adibaku said.
She added that under the Presidential Malaria Initiative, the budget for indoor residual spraying is sh4.5b per district each year.
Adibaku said it would be much cheaper if the ministry distributed insecticide-treated mosquito nets.
She, however, said indoor spraying has an advantage of delivering immediate impact compared to treated nets.
Adibaku disclosed that the health ministry is re-evaluating the effectiveness of using DDT for malaria control.
Dr. Joaquim Saweka, the World Health Organisation (WHO) resident representative in Uganda, said indoor residual spraying is highly effective and has been successful in Zanzibar and Rwanda.
He, however, added that it is capital intensive and needs a lot of money for each application done twice a year.
Saweka cited his previous posting in Ghana during which a town of 300,000 inhabitants required $3m for spraying each year.
He said with the high cost of spraying and low financial resources available, Uganda needs to prioritise usage of insecticide-treated mosquito nets.
Saweka added that Uganda is on the right path to eradicating malaria with efforts in prevention, diagnosis and treatment as well as universal coverage of insecticide-treated nets.
Health minister Dr. Richard Nduhura yesterday kicked off a nationwide programme to distribute 11,000 bicycles to health volunteers who will diagnose and treat malaria in homes. The programme is supported by the Global Fund.
It is part of the Government's home-based management of malaria, which is part of a larger national strategy to deliver treatment to children within 24 hours after diagnosis

http://allafrica.com/stories/201107061302.html

POVERTY: Weaning countries off aidAid dependency

Jonathan Glennie  28 June 2011


Weaning countries off aidAid dependency can only be reduced if financial resources are found elsewhere. Uganda, for example, is using aid to improve tax collection so it will rely less on funding from outside donors



 A truck offloads freshly picked coffee berries at a processing factory in Mbarara, western Uganda. Tax revenue in the country has increased as a proportion of government expenditure from 55.2% in 2005 to 67.9% in 2010. Photograph: Trevor Snapp/Getty Images

It is a positive sign that major western NGOs are beginning to talk about the problem of aid dependence and the need for exit strategies from aid. They are doing no more than responding to the concerns expressed for some years by their developing world partners and diaspora in the west.
But as they seek to engage the public at a slightly deeper level than just "aid is good", they need to be careful that their message is not commandeered by a simplistic, often rightwing, but now fairly populist agenda that seeks only to reduce the amount of money rich countries spend on global issues.
Reducing aid dependence is not the same thing as reducing aid. Aid dependence can be reduced without reducing aid (if other sources of money increase). And reducing aid doesn't mean reducing aid dependence – it might well mean the opposite. It is the dependence not the aid that is the problem.
Dependency on aid can only be reduced if the equivalent financial resources (and more) are found elsewhere. That requires action at the international level on issues such as trade policy, illegal capital flight and commodity pricing. And at the national level it requires a coherent set of policies to gradually increase resource mobilisation from untapped areas of the economy.
Allen Kagina, commissioner general at the Uganda Revenue Authority, came to the Overseas Development Institute (ODI) this month to give a presentation on the need to transform tax collection to, in her words, "wean Uganda off aid". Her message was clear: we need to use aid to support processes of improved tax collection, rather than allow it to substitute for the mobilising of domestic resources.
As an economy grows, as Uganda's is, a country will gradually rely less on aid as a proportion of gross national income. But that doesn't necessarily mean the government sector will reduce its dependency on aid. Some countries receive little aid as a proportion of GNI, but maintain heavy reliance on aid inputs in social and other sectors because tough political decisions on tax are not made.
The challenges in Uganda (and elsewhere) are many, and include, in Kagina's analysis: the difficulty of taxing the informal sector; the limited capacity of fiscal administrations; the slow pace of adoption of better IT; a low tax base coupled with tax evasion and fraud; the disproportional representation of some stakeholders in the tax base through the use of incentives; and a low savings ratio relative to investment requirements. So there are no easy answers.
Nevertheless, according to Kagina (who says she would welcome independent research to verify this, if anyone is interested), tax revenue has increased as a proportion of government expenditure from 55.2% in 2005 to 67.9% in 2010. Some successful reforms have included the introduction of one-stop border posts that harmonise immigration procedures, reduce transaction costs and duplication of efforts, enhance border security and increase revenue.
Kagina argues that domestic resource mobilisation is "potentially the biggest source of long-term financing for sustainable development and it is the lifeblood of all state governance, such as the provision of public goods and services". Aid still fills a gap, so rather than calling for an abrupt end to it, she asks: Is foreign aid to Africa promoting the strengthening of tax administration or simply having a substitution effect?
Crucially, she notes that there has been limited support from donors on tax matters, but where it has existed, it has helped. Since 1990, 15 African countries have formed revenue authorities with support from the IMF and the World Bank, including Uganda, which set up its revenue authority with the UK's Department for International Development (DfID) support in 1991.
Kagina wants to persuade donors to reorient their efforts towards always having an endgame in mind. In her view, this means spending aid on revenue reform and the productive sectors of the economy. While there is always a place for trying to influence donor decisions, we have learned the hard way how difficult that can be – domestic considerations weigh heavier in donor minds than developmental priorities.
Ultimately, Kagina's success will depend on how well she is able to manage the complex political maze she is navigating in Uganda, distinguishing the possible from the optimal, and managing change in a difficult environment. The slogan she has given her department is: "One team, one dream".
Regardless of specific countries reducing their dependence on aid, which is the objective all countries should be striving for, spending on global public goods by rich countries – and eventually by all countries – should continue to rise as a proportion of our national income, as an evolving world order needs money to run effectively, safely, and sustainably. So this is no appeasement of the rightwing critics of foreign spending. It is progressive development theory fit for the 21st century.
http://www.guardian.co.uk/global-development/poverty-matters/2011/jun/28/weaning-countries-off-aid

POVERTY: EGYPT: Sewage-fed vegetable plots pose health risk

23 June 2011 (IRIN)

 Photo: Sarah Kamshoshy/IRIN
Because of water scarcity, many farmers in Egypt are now siphoning untreated sewage onto their farms to keep their crops growing (file photo)SHARQIA,

 Faced with a shortage of water for irrigation, Ahmed Osman, a farmer in his late thirties, opted to divert local sewage water to irrigate his two-hectare vegetable plot in the heart of Egypt’s Nile Delta governorate of Sharkia.
“Without water, any water, our plants will die, and we will go begging,” he said. “There can be no agriculture without water.”
He is not alone. Other farmers in his village, Kafr Saqr, are doing the same.
“Villagers around this country have to use untreated sewage to irrigate their land because Nile water is becoming so scarce; the nation’s sewage treatment plants do not function properly, and irrigation canals are not dug everywhere,” said Maghawri Shehata, a leading water expert and former president of Monofiya University. “Egypt needs to take action to stop this or it will be in for major catastrophes in the future.”
Given its rapidly rising population, Egypt is fast becoming water poor, and this is taking its toll on agriculture. As a result more and more farmers are now using pumps to siphon thousands of cubic metres of untreated sewage onto their farms to keep the crops growing.
The sewage-dependent vegetables and fruits end up in markets as far away as Cairo and as near as Kafr Saqr. Health experts say the practice is dangerous.

Health risks
“Untreated sewage is full of harmful matter,” said Mahmud Amr, a toxicology expert. “Using it in irrigating vegetables and fruits could result in serious health hazards.”
A 2009 study of the waterways and canals in the Nile Delta, conducted by the State Ministry for Environmental Affairs, found concentrations of harmful materials in these waterways and canals exceeded permissible limits.
“Organic matter concentration (biochemical oxygen demand) exceeded the permissible limit (6mg/l) at all canals,” said the report, which was included in Egypt’s 2009 State of the Environment Report.
The study found that average ammonia concentrations at most monitoring points in Delta canals exceeded permissible limits. It also found an E. coli bacterial count exceeding safe limits (1,000 cells per 100 ml) as prescribed by the World Health Organization.
According to medical experts, there could be a link between the rise in the number of kidney failure, liver cancer and respiratory disease cases in Egypt and the use of unclean water for irrigating vegetable and fruit farms.
In 2009, a report presented to the Egyptian parliament warned against irrigating plants with untreated sewage.
Sewage can be adapted for agricultural use if properly treated, said Khalid Al Qadi, an environmental expert and professor at Helwan University . “The problem is that sewage treatment in this regard is very costly.”
Osman, meanwhile, dismisses talk of the danger of using untreated sewage: “Some people like to talk only. What else can people like me do while clean water is a dream?”

Sharing the Nile
The River Nile is the world’s longest river and serves nine African countries.
Over the years, Egypt’s allotted share of 55.5 billion cubic metres has proven insufficient to meet the needs of a growing population now numbering about 85 million - three times more than it was when Egypt and Sudan signed an agreement on sharing the Nile’s water in 1959. Currently, agriculture is responsible for 70 percent of water consumption in the country.
“There is a clear water deficit of between 10 and 15 billion cubic metres here,” said water expert Shehata. “This shortage is expected to grow even more in line with population growth.”
A symptom of water’s political significance was seen with the July 2010 protest by 600 people from the southern governorate of Minya, who came to the Irrigation Ministry in Cairo to display their anger at the lack of it.
The problem is likely to get worse because upstream Nile Basin countries like Ethiopia and Uganda, which also have rapidly growing populations are pushing for a greater share of the water to satisfy their own needs.
In 2010, six upstream countries met in Uganda and signed a new water-sharing agreement. Egypt and Sudan did not sign, and called instead for fresh talks involving all riparian states. In the last few months, the new Egyptian government has sent emissaries to various Nile Basin countries to pursue the issue.

http://www.irinnews.org/report.aspx?reportID=93045

MALNUTRITION: 'Super wheat' resists devastating rust

Naomi Antony : 17 June 2011
 Stem rust can destroy wheat crops : Flickr/CIMMYT

'Super varieties' of wheat resistant to the deadly stem rust fungus Ug99 could replace wheat in affected areas in as little as two years — if farmers can be persuaded to adopt them, according to a wheat rust expert.
First discovered in Uganda some 13 years ago, Ug99 is increasingly virulent. It is spreading throughout East and Southern Africa, and spores have also reached as far afield as Iran and Yemen. Wheat breeders had been working on promising resistant varieties in Njoro, Kenya, in the hopes that one of them could combat the fungus.
Now they have bred new varieties with good resistance and with up to 15 per cent better yields than today's varieties, said Ronnie Coffman, head of the Durable Rust Resistance in Wheat Project at Cornell University, United States.
Stem rust, also known as black rust, is even more damaging than stripe (or yellow) rust which has wiped out about 40 per cent of harvests in Central Asia, the Middle East and North Africa.
The new varieties, developed by wheat breeding expert Ravi Singh and colleagues at the International Maize and Wheat Improvement Center (CIMMYT) in Mexico, are resistant to both rusts. They were unveiled at the 2011 Borlaug Global Rust Initiative's Technical Workshop in Minneapolis, United States, this week (13–16 June).
The varieties were developed by combining several plant resistance genes, which individually give low levels of resistance but when found together in the same plant make it more difficult for the Ug99 pathogen to unravel their combined defences, providing better resistance.
"We're trying to raise awareness of these materials and convince farmers that they should adopt them before [wheat rust] grows endemic — especially in countries such as Ethiopia," said Coffman.
Coffman said that the two most critical countries to tackle are Ethiopia and Yemen. However, as Yemen's political unrest has impeded anti-wheat rust efforts — material recently sent to the country by CIMMYT perished in customs — breeders are initially focusing their efforts on Ethiopia.
"We believe that farmers in Ethiopia will accept the new varieties," he said. "There is a major outbreak of yellow rust (stripe rust) there. It is not nearly as devastating as stem rust, but it's significant and farmers want something resistant to it.
"These new varieties are resistant to both rusts so we're hopeful that the incidence of yellow rust will cause them to accept the new varieties. Unless farmers have an incentive that they can see, they don't tend to accept new varieties."
He said that if the incentive works, the whole of Ethiopia could be growing resistant strains in just two years — and this same timetable could apply to the entire East African region. "But it's a big if," he added.
Singh said: "We need to see national governments making the investments in seed systems development, including seed production and distribution. In many areas there will need to be support and leadership from wealthy countries and international institutions to carry these innovations into farmers' fields."
http://www.scidev.net/en/news/-super-wheat-resists-devastating-rust.html

MALNUTRITION: Kenya: food insecurity and malnutrition

GILBERT arap BOR: May 22 2011


One of the paradoxes of food security is that an obese person also can be malnourished.
We often associate food insecurity with a lack of calories. This is its classic and most obvious form. In extreme cases, a lack of calories can mean severe hunger or even starvation.
Yet sometimes people get plenty of calories but not enough nutrients. This is a less obvious form of food insecurity.
Some call it “hidden hunger” and it poses incredible challenges. Malnutrition stunts growth, hurts cognitive development in children, and darkens futures. Fortunately, technological advances in agriculture provide a solution.
The fundamental challenge of malnutrition is that people do not always want to buy and eat the food that is best for them.
Their first and last impulse is to want food that is cheap, tasty, and easily available. Nutrition has little or nothing to do with the choices people make when they shop.
This is especially true in developing countries, where money and access to food are limited. Here in Kenya, I see the problem of malnutrition regularly.
Fruit should be a part of everyone’s diet. But people skip it all the time, especially when it is out of season and perceived as being expensive.
The problem is most severe in urban slums and many rural districts of the country, such as Samburu and Turkana, and the North Eastern districts.
Around the world, malnutrition may affect as many as two billion people. It has almost certainly grown worse because of the global spike in food prices.
The Economist recently described the bad diet of the poor as “one of the world’s neglected scourges.” Everybody needs a wide variety of vitamins and minerals, but several types are commonly in short supply.
Iron is necessary for a functional immune system, but more than half the women in India and 40 per cent of those in Indonesia do not consume enough of the mineral.

Zinc contributes to the proper functioning of the brain and an estimated 400,000 people die each year because they do not take in the minimal amount required.
Vitamin A helps the body to protect its organs, but half-a-million children go blind each year because they lack this simple ingredient in their diets.
In sub-Saharan Africa, 43 million children under the age of five are at constant risk. The world must grow more food simply to feed itself. It also must grow better food so that people can thrive.
Farmers in Kenya and Uganda have responded by raising orange-fleshed sweet potatoes, whose rich nutrients rapidly improve the health of women and children.
Farmers would like to have access to the best technologies to fight malnutrition. Widespread approval of golden rice, a biotech crop, would combat vitamin A deficiencies.
So would the advent of biofortified cassava, turning a staple food crop for 250 million sub-Saharan Africans into an arsenal of carotenoids that boost vitamin A intake.
If researchers can find a way to change the colour of vitamin A-enriched maize from yellow to white, farmers would find a strong market for it.
Professors at Iowa State University recently used biotechnology to increase the protein content of soybeans. These are the sort of advances we hope can be achieved in Kenya.

http://www.nation.co.ke/oped/Opinion/We+all+need+to+play+our+role+in+fight+against+food+insecurity/-/440808/1167422/-/3it47h/-/

MALARIA: Roadmaps are a good tool - but we must stay on the road

Bill Brieger : 16 May 2011

Off-Road in Uganda
Uganda’s 2010 Roll Back Malaria Roadmap seemed reassuring. Apparently 2.7m nets were already in place by late 2009, and supposedly a supply of another 18m long lasting nets (or at least the funding) was ready for achieving universal coverage by December 2010.
Assessment of Uganda’s Roadmap progress credited the country with achieving procurement of these nets. It seems odd therefore that the 2011 Roadmap indicates that 6.4m nets are in place and 10.4m need to be distributed in 2011. What’s going on?
A new study by Carla Proietti and colleagues provides some answers. Not only do they document continued high transmission in the northern part of Uganda (polymerase chain reaction rate of 72% in children below five year of age), a situation that threatens control efforts by neighbors, but they also identify plausible reasons for the lag.
The researchers politely suggest that, “The failure to reduce the burden of malaria could reflect sub-optimal implementation of malaria control measures.” They also explained that, “Malaria control efforts in Apac (sub-county) were not reliably monitored in the last decade and affected by political unrest in preceding years.”
Stockouts of anti-malarial ACTs was also listed as a problem. It should be recalled a few years ago that, “The Global Fund has decided to suspend its five grants to Uganda because there is evidence of serious mismanagement by the Project Management Unit (PMU) for Global Fund grants in Uganda.” Although the programs have resumed, satisfactory settlement of the problem was not achieved.
In light of this study Childsurvival.net warns us not to let successes in recent years blind us to reality. “Those who believe that Africa is within shooting distance of malaria elimination may wish to reconsider their position after reading this article (Proietti et al.). One should qualify this Ugandan article in several ways: 1) Local insurgency in the area under consideration, 2) Hiccoughs with the GF over misappropriation of resources, 3) Autocratic gerontocracy at the national level. Unfortunately, these three factors are not peculiar to Uganda.”
 Roadmaps are a good tool to help us plan for malaria control and elimination - but we must stay on the road for them to work.

http://www.malariafreefuture.org/blog/?p=1203

MALARIA: As DDT Makes a Comeback, Uganda Must Weigh Its Costs

JOSH KRON : May 18, 2011
 Marc Hofer for The New York Times
Bosco Acope and his family tend their farm in Atek, Uganda, where the government's use of DDT has threatened their livelihood.

Growing up as a child here along the muggy, isolated plains of northern Uganda, life was not easy. His parents were poor. He did not attend secondary school. Many of his friends died from bouts of malaria, a scourge that has plagued this agrarian society.
Mr. Acope, 49, survived. At 19, he became a small-time farmer, with one acre of land. He married. He sowed. “I have been a farmer in this life,” he said.
When the American government, a generous and close friend to Uganda, began an organic-farming program to help rural economies here, Mr. Acope expanded, selling a wide variety of commodities at good rates.
His one acre became seven. Mr. Acope fathered 11 children. Uganda was developing, and Mr. Acope was one of many who were riding high, he said.
But the very next year came winds of change. Faced with unrelenting malaria, which threatened both lives and livelihoods, Uganda’s government teamed up with the United States to use chemical insecticide sprays — including DDT — to try to eliminate the disease. Mr. Acope’s home district, Apac, which has some of the highest malaria rates in the world was chosen for spraying in early 2008.
Mr. Acope said an official from the organic-farming company he sold to, which was also supported by the United States, warned that the sprays were dangerous. Mr. Acope’s produce would no longer be guaranteed to be organic — especially since many crops were stored indoors, where the spraying occurred — nor would it be bought at a lucrative price.
“I was told to protect my market, to try to stop the spraying,” Mr. Acope said. “But the whole village was sprayed.”
One morning, he recalled, he watched a group of men in gas masks who were carrying metal canisters pass through the village, and just like that, Mr. Acope’s organic-food market was gone. He said he had to pull three of his children out of school. Furthermore, the chemicals in the insecticide lasted so long that the organic-farming companies said they would not be back for 15 years.
So Mr. Acope is helping to take his government to court.
Once condemned as poisonous and inhumane, DDT has staged a recent comeback. In 2006, the World Health Organization strongly endorsed the chemical’s use on indoor walls as a cheap and long-lasting weapon in the fight against malaria. The United States also sanctioned DDT to combat the disease in African countries with “a high burden of malaria,” including Uganda.
The United States sprayed DDT to eliminate the last remnants of malaria across North America. The disease’s eradication was a milestone in public health and development. Malaria almost thwarted construction of the Panama Canal and “influenced to a great extent human populations and human history,” the Centers for Disease Control and Prevention says.
But the United States banned the use of DDT in 1972 over the chemical’s hazardous environmental impact. Studies have also linked DDT to diabetes and breast cancer. One examination of the consequences of using DDT to fight malaria in sub-Saharan Africa, conducted by the National Institute of Environmental Health Sciences, said the chemical might have increased infant deaths.
Still, the risks of not spraying are clear as well. In Africa, malaria kills 2,000 children each day, according to Unicef, and costs approximately $12.5 billion in lost incomes each year, the Malaria Consortium says.
“It really affects the whole fabric of the economic system in Africa,” said Dr. Patrick Lukulay, a consultant to a United States Agency for International Development initiative to treat malaria. “It prevents people from being productive citizens.”
In the Apac region of Uganda, the United States focused on two conflicting agendas: developing organic farming and eradicating malaria, ultimately affecting the livelihoods of tens of thousands of farmers.
U.S.A.I.D. “has supported agricultural development in Uganda for many years, including the promotion of organic farming in Northern Uganda,” said Michael Brander of BioVision, a Swiss organization focused on eco-friendly economic development. “Organic farming provided a good price at low production costs for farmers; however, it was exactly in those areas they also supported spraying of DDT.”
Now Uganda’s constitutional court is expected to hear a case brought by a Ugandan environmental organization against the government that asserts that officials failed to meet W.H.O. standards for using DDT, including failure to properly prepare the local population.
But given the prevalence of the disease, “chemical spraying with strict monitoring and supervision is one of the most effective measures to control malaria in high-risk areas,” said a United States Embassy official, who was not authorized to speak publicly.
The village of Atek is a place where mangoes can be eaten directly from trees and children walk to school shoeless. Farming is a way of life, and the American aid agency’s organic-farming program gave the village a competitive edge.
When the DDT was sprayed, organic-farming companies say they lost the bulk of their supply immediately. An American-owned company, Dunavant, had 50,000 certified organic farmers in areas affected by the spraying, according to the Uganda Network on Toxic Free Malaria Control, the organization taking the government to court. Shares, another farming company, said at least 16,000 of its suppliers were affected.
“All that got lost,” said Jan-Alex Fokkens, the director of Shares. “It was game over.”
The organic-farming companies sued the Ugandan government after the first rounds of spraying, and a high court issued a temporary injunction on the use of DDT in 2008, but the case was later dismissed.
The American government says it has not returned to using DDT in Uganda since the court ruling, even though the Ugandan government has made numerous references to reinstituting the chemical. Now, the main chemical being used in the insecticide-spraying program, bendiocarb, has also been discontinued in the United States, and it is considered to be more expensive and less efficient than DDT.
“At a certain point bendiocarb will fail,” said Richard Onen, a field coordinator for Abt Associates, a business contracted by U.S.A.I.D. to carry out its indoor spraying program. “I cannot rule out the possibility of using DDT. It is cheap.”
But there are questions as to how well DDT worked in Uganda in the first place. “Mosquitoes had become resistant to the DDT,” said Kale Dickinson, a nursing officer at a local health center. “DDT was not effective.”
For Lillian Etime, Mr. Acope’s neighbor and a mother of six, the death of her chickens during the first round of spraying set off alarm bells. “We feared that the children could touch the wall,” where spray was administered, “and they could die,” said Ms. Etime, 32. Ultimately, it was business that suffered the most, she said, with her revenue reduced by more than half. “The problem I experience is the problem of money,” she said.
Underneath a mango tree nearby, Mr. Acope lamented his own reversal of fortune, but remained stoic. “I am now working on my own,” he said. “Still growing.”
http://www.nytimes.com/2011/05/19/world/africa/19uganda.html?_r=1&pagewanted=all

POVERTY: Fight against wheat rust needs sustained investment

5 May 2011
Mahmoud Solh, Shivaji Pandey, Thomas Lumpkin, Ronnie Coffman [Mahmoud Solh is director general of the International Center for Agricultural Research in the Dry Areas (ICARDA). Shivaji Pandey is director of the UN Food and Agriculture Organization. Thomas Lumpkin is director general of the International Maize and Wheat Improvement Center (CIMMYT). Ronnie Coffman is vice-chair of the Borlaug Global Rust Initiative (BGRI).]


 Flickr/CIMMYT

A strain of stem rust threatens to reach India after spreading from Sub-Saharan Africa to Iran

Developing countries need help with crop surveillance and the development of strains resistant to wheat rust, say agricultural research leaders.
Today's food security situation is being worsened by strains of wheat rust disease that are emerging more frequently and spreading much faster and to new areas — changes fuelled by climate change and conducive environments in increasingly fragile ecosystems.
Perhaps the most problematic wheat diseases are the two kinds of wheat rust: stripe rust (also called yellow rust) and stem rust (black rust).
To protect their crops from the fungus that causes wheat rust, countries need to take pre-emptive action with sustained investment in research, surveillance, a strategy to boost crop diversity, and policies to encourage farmers to adopt disease-resistant crop varieties.

Rust epidemics
A new form of stem rust known as Ug99 took several growing seasons to spread from the highlands of Uganda and Kenya in 1999, via Ethiopia and Yemen, to reach Iran by 2007. The disease could spread even farther — from Iran to the vast wheat fields in Turkey, Afghanistan, Pakistan and India, which are largely sown with varieties not resistant to Ug99.
Stripe rust is also prevalent in most of the world's major wheat-growing areas. In the past 30 years, it has caused severe economic losses to crops in North America, Europe, Australia, Central Asia, West Asia, South Asia and North Africa. The losses ranged from 30 to 50 per cent of the expected grain yield of a country's wheat production. And last season, an epidemic of a virulent new kind of stripe rust caused wheat losses of up to 40% in Western Asia.
Epidemics of stripe rust in the 1980s — caused by a strain that overcomes resistance in many wheat varieties — spread from East Africa to the Middle East, Turkey, Iran, Afghanistan, Pakistan and India. They affected major wheat-growing regions and hit the livelihoods of millions of farmers.
In the following years, researchers released varieties of wheat that were resistant to this strain in most of these areas. But many of these varieties are susceptible to the new strain of stripe rust that began to spread last season and continues to spread rapidly. This aggressive new strain, called YR27, is tolerant of higher temperatures and adapts rapidly to new environmental conditions.

Growing threat
The threat of a repeat of the 1980s epidemic is growing, and scientists who track wheat rust pathogens are warning countries to be prepared.
An epidemic in these wheat-dependent countries could cost billions of dollars, creating a further spike in food prices, reducing food security and causing political tensions. Developing countries are stepping up their efforts in surveillance and research on breeding wheat for rust resistance.
For example, networks of scientists and agriculture specialists are exchanging information for an early warning of rust incidence in their area; scientists are using 'slow-rusting' genes to extend the time that varieties can resist the disease in a bid to slow down the progression of epidemics; and farmers are avoiding covering large areas with wheat varieties with similar genetic backgrounds and degrees of resistance.
Although researchers can build disease resistance into wheat, this typically involves a ten-year cycle from development to the release of new varieties.
And while breeding programmes continuously develop resistant varieties, fungicides can be used to control wheat rust in cases of emergency. But this option is not generally affordable for resource-poor farmers, and fungicides are not environmentally friendly.

Sustained investment
Can wheat rust be eradicated? Norman Borlaug, the father of wheat improvement in the 1960s, noted that "rust never sleeps". Rust strains will continue to mutate and overcome crop resistance.
Rather than reacting to food crises, sustained investment is needed to support agricultural research and preparedness to help countries better manage rust problems in the long term.
Donor governments, development agencies and the international research community must increase their attention and support to low-income countries striving to develop strategies to prevent wheat rust. And those countries need robust food-security strategies that include sharing information on crop breeding across regions.
Increased surveillance — both national and regional — involves testing and tracking rust types using geospatial tools, monitoring the wheat varieties they attack and determining which are resistant. Susceptible varieties can then be replaced by resistant ones.
In Iran, for example, a monitoring network of agricultural extension specialists and researchers gathered reports of new strains that prompted the country's plant protection authorities to stock up on fungicide, and establish a nursery testing rust samples sent in by wheat breeders. This helped scientists identify 10 varieties resistant to a strain of stripe rust over the past three years, which were then prepared and distributed to farmers.
Wheat-producing countries must also be encouraged to design agricultural systems that enable new seed varieties to be released and multiplied faster. In Egypt, for example, such a system has led to the production of new resistant varieties that can cover 30% of the country's wheat-growing area in just three years. These varieties often offer better quality and higher yields — a powerful incentive for farmers to adopt them.
Faced with the threat of wheat rust epidemics, the solution for low-income countries and the development partners that support them is to adopt a combined strategy of continued disease surveillance, development and dissemination of new resistant varieties, strengthening research capacity, and ensuring that farmers adopt and multiply new seeds.
http://www.scidev.net/en/opinions/fight-against-wheat-rust-needs-sustained-investment-1.html

POVERTY: UGANDA: Government "won't budge on food prices"

KAMPALA, 3 May 2011 (IRIN)

 Photo: Charles Akena/IRIN
Rising food prices have led to protests (file photo)

The government of Uganda will not reduce taxes or consider food subsidies, despite an increase in violence that has led to a “national crisis”, according to the UN.
Minister of Information Kabakumba Masiko said the consistent government line since the "walk-to-work" protests began on 8 April still stood, though she maintained other measures were in place to address stability in the East African country.
“On the supply side, we are ensuring there will be enough food for our people,” she said. “The Bank of Uganda is also mopping up the excess currency that is contributing to the inflation.”
Opposition politicians and critics have blamed the lack of food and fuel reserves for contributing to skyrocketing prices.
According to the Uganda Bureau of Statistics, inflation jumped another 3 percent last month, reaching an annual 14.1 percent in April from 13.1 percent in March, while crop inflation rose from 29.1 percent in March to 39.3 percent.
The demonstrations against the rising cost of living have been led by opposition leader Kizza Besigye, who has vowed protests will continue.
On 29 April, riots broke out across the capital, Kampala, and five other centres across the country, killing at least five people and injuring hundreds more.
“We just woke up angry,” said George Lubwama, 27, a barber in Kasubi, where one person was confirmed by Red Cross officials to have been shot dead after live rounds and tear gas were used by security forces trying to dispel angry rioters.
The epicentre of violence in the city, Kisekka market, was taken over early in the morning by an elite military group led by President Yoweri Museveni’s son – journalists were reportedly barred from entering the area and threatened.
The height of the violence was widely seen as a protest against the violent arrest of Besigye the day before. Security forces smashed the former presidential candidate’s car window and sprayed him directly in the eyes with tear gas after an hours-long standoff, after which Besigye was thrown into a police vehicle.
The footage of the brutal arrest on 28 April was widely circulated and has brought criticism from domestic and international human rights bodies alike.
On 1 May, the UN High Commissioner for Human Rights, Navi Pillay, called the manner in which Besigye was arrested “shocking”.
“The excessive use of force by security officers was plain to see in the television footage of the event. While I do not condone the violent rioting that followed, the Ugandan authorities must realize that their own actions have been the major factor in turning what were originally peaceful protests about escalating food and fuel prices into a national crisis," Pillay said.
Meanwhile, Ugandans continue to feel the impact of increased food prices following a sharp increase in fuel prices in the past few months.
A Kasubi taxi driver, Robert Kawuki, says the rising costs have severely affected his livelihood. “It’s hurting me to the extremes,” he said.
Lubwama added that the politicization of "walk-to-work" protests was hurting those most affected. “He [Museveni] is fighting Besigye, but the greatest rebel is the economy now,” he said.

http://www.irinnews.org/report.aspx?reportID=92632

POVERTY: UGANDA: “Finding food for the whole family is becoming a nightmare”

GULU, 21 April 2011 (IRIN)


 Photo: Charles Akena/IRIN
Christine Amony hawks bananas in Gulu town

The sudden rise in food and fuel prices in the past four months in Uganda is raising concerns, with residents agitating for the government to intervene and curb the increases.
In Gulu town, a 42-year-old slum dweller, Christine Amony, ekes out a living by selling bananas in Gulu Town Street. She spoke to IRIN about living on one meal a day as she copes with the high cost of living.
“What we are experiencing is a difficult moment. Finding food to put on the table for the whole family is becoming a nightmare. Commodities are unaffordable as prices increase day by day. People in Kony Paco [a slum] are cutting their meals and staying hungry because the money can’t buy adequate food.
“I have four children and we live in Kony Paco. We have one meal of cassava and beans every day in the evening and even then the food isn’t enough.
“There is no breakfast and lunch for my children because I cannot afford to buy food for three meals.
“The prices have increased so much. In October last year, 1kg of sugar cost USh2,300 [US$1] but now it costs USh3,000 [$1.25]; rice is now USh3,000 [$1.25] up from USh1,600 [$0.60], maize USh1,000 [$0.41] from USh300 [$0.12]; flour USh1,700 [$0.70] from USh800 [$0.30], peas USh3,000 [$1.25] from USh1,000 [$0.41], groundnuts USh3,500 [$1.45] from USh2,500 [$1.04], millet USh1,000 [$0.41] from USh800 [$0.30], sorghum USh600 [$0.25], beans USh3,000 [$1.25] from USh1,800 [$0.75], tomatoes USH2,500 [$1.04] from USh1,200 [$0.50], meat USh6,000 [$2.50] from USh5,000 [$2.08].
“Last season the crop harvest was poor because the rain was excessive, causing crops to rot in gardens. Now, fuel prices have gone up. A litre of petrol, which last June cost USh2,800 [$1.16], now costs USh3,800 [$1.58]. Transport fares have also shot up, forcing food vendors to hike up the prices as they recover the costs of transportation.
“I don’t know where we are heading with all this. People are protesting because they are not eating enough. I pray that the first season harvest [April-June] yields enough food so that we have enough to eat. So far the weather is frightening because the rain has been erratic.
“Even house rents have shot up. I don’t know if I will raise the rent of USh20,000 [$8.30] for next month. There is no money even to pay my children’s fees next term.”
http://www.irinnews.org/report.aspx?reportID=92541

MALARIA: Using Artesunate Instead Of Quinine

Geneva, April 19, 2011 – New MSF report calls on African governments, WHO and donors to urgently make the switch
Revolutionary Advance in Severe Malaria Treatment: Using Artesunate Instead Of Quinine Could Save 200,000 Lives Annually

After the revision of World Health Organization (WHO) guidelines yesterday, international medical humanitarian organization Médecins Sans Frontières/Doctors Without Borders (MSF) calls for a drug proven to reduce deaths in children suffering from severe malaria to be immediately rolled out in African countries. In its new report Making the Switch.MSF calls on African governments to follow new World Health Organization (WHO) guidelines, and switch from the far less effective quinine to artesunate treatment, which could avert nearly 200,000 deaths each year. MSF also calls on WHO and donors to support governments so this urgent treatment change can happen quickly.
“When children arrive at the clinic with severe malaria, they often are having convulsions, vomiting or at risk of going into shock, and you just want to be able to give them effective treatment quickly,” said Veronique De Clerck, Medical Coordinator for MSF in Uganda. “For decades, quinine has been used in severe malaria, but it can be both difficult to use and dangerous, so it’s time to bid it farewell. With artesunate, we now have a drug that saves more lives from severe malaria, and is safer, easier and more effective than quinine.”
Quinine has to be given three times a day in a slow intravenous drip that takes four hours, a treatment that is burdensome for both patients and health staff. Artesunate, in contrast, can be given in just four minutes, by giving a patient an intravenous or intramuscular injection.
A landmark clinical trial in late 2010 concluded that the use of artesunate to treat children with severe malaria reduces the risk of death by nearly a quarter. The study, carried out in nine African countries, found that for every 41 children given artesunate over quinine, one extra life was saved. Because of the complexities of administering quinine, children in the trial who were assigned to receive quinine were almost four times more likely to die before even receiving treatment.
MSF participated in the trial through its research affiliate Epicentre, with a research site in Uganda. MSF has since changed its own treatment protocols and now plans to work with national health authorities to roll out artesunate in its projects over the coming months.
The evidence is overwhelming, but MSF’s report stresses that change will not happen on its own. While WHO has now issued new guidelines recommending artesunate for treating severe malaria in children in Africa, it needs to also develop a plan to help countries make this switch. African governments must urgently change their treatment protocols and donors must send a clear signal to countries that they will support the additional cost where needed. Artesunate is three times more expensive, but the difference in cost of US$31 million each year for a global switch is very little for the nearly 200,000 lives that researchers say could be saved.
“We’ve been here before – when WHO changed its treatment recommendations for simple malaria in 2001 it took years for countries to actually make the switch, and shockingly, in some countries the far inferior drugs are still being used ten years on,” said Dr. Martin De Smet, who coordinates MSF’s malaria work. “With severe malaria, WHO needs to make sure that the change is much less sluggish, so lives can be saved immediately. There’s simply no excuse not to make the switch now.”
MSF provided malaria treatment to around one million people in 2010. Severe malaria kills over 600,000 African children under the age of five annually. Each year, around eight million simple malaria cases progress to severe malaria, where patients show clinical signs of organ damage, which may involve the brain, lungs, kidneys or blood vessels. ‘Making the Switch’, MSF’s new report calling for a change in protocol for the treatment of severe malaria in children can be downloaded from www.msfaccess.org

MALARIA: Case Management of Severe Malaria - A Forgotten Practice: Experiences from Health Facilities in Uganda

Introduction:
Severe malaria is a life-threatening medical emergency and requires prompt and effective treatment to
prevent death. There is paucity of published information on current practices of severe malaria case management in sub-Saharan Africa; we evaluated the management practices for severe malaria in Ugandan health facilities

Methods and Findings:
We did a cross sectional survey, using multi-stage sampling methods, of health facilities in 11 districts in the eastern and mid-western parts of Uganda. The study instruments were adapted from the WHO hospital care
assessment tools. Between June and August 2009, 105 health facilities were surveyed and 181 health workers and 868 patients/caretakers interviewed. None of the inpatient facilities had all seven components of a basic care package for the management of severe malaria consistently available during the 3 months prior to the survey. Referral practices were appropriate for ,10% (18/196) of the patients. Prompt care at any health facility was reported by 29% (247/868) of patients.
Severe malaria was correctly diagnosed in 27% of patients (233).Though the quinine dose and regimen was correct in the majority (611/868, 70.4%) of patients, it was administered in the correct volumes of 5% dextrose in only 18% (147/815). Most patients (80.1%) had several doses of quinine administered in one single 500 ml bottle of 5% dextrose. Medications were purchased by 385 (44%) patients and medical supplies by 478 patients (70.6%).

Conclusions:
Management of severe malaria in Ugandan health facilities was sub-optimal. These findings highlight the challenges of correctly managing severe malaria in resource limited settings. Priority areas for improvement include triage and emergency care, referral practises, quality of diagnosis and treatment, availability of medicines and supplies, training and support supervision.
http://www.malariaconsortium.org/userfiles/file/Uganda/case%20management_uganda.pdf

MALNUTRITION: Uganda: matooke is insufficient diet

13th March, 2011  By Agnes Kyotalengerire


A child recovering from severe kwashiorkor




WHEN Ritah Namara turned one year, her mother put her under the care of her 70-year-old grandmother. While at her grandmother’s, Namara ate matooke daily.
A few months down the road, Namara’s hair became silky and her stomach and face started to swell. She was also weak and dull.
Pauline Apolot, a nutritionist at Mwana Mugimu Nutritional Unit, Mulago Hospital, describes Namara’s condition as acute malnutrition. She says malnutrition results from eating an unbalanced diet — in which certain nutrients are either lacking, in excess or are in the wrong proportions.
Dr. Elizabeth Kiboneka, the head of Mwana Mugimu Nutrition Unit, says 42% of Ugandan children are stunted, an indicator of acute malnutrition. Stunting means a child has not acquired the right height for his age. This can begin as early as four months.
According to statistics from the Uganda Demographic Health Survey 2006, 6.1% of the children are acutely malnourished, an equivalent of 360,000 children. The statistics also reveal that 52% of the children with severe malnutrition are HIV-positive.
“People suffering from malnutrition have an extremely compromised immune system and are 10 times more likely to die of treatable illnesses like colds or diarrhoea, depending on which nutrients are inadequate or abundant in their diet,” she affirms.

Forms of acute malnutrition
Edematous malnutrition (kwashiorkor)
Masitula Nangobi, a nutritionist at Mwana Mugimu Nutrition Unit, says edematous malnutrition, popularly known as kwashiorkor, occurs when there is not enough protein in one’s diet.
She says edematous malnutrition presents with swelling of the face and feet, silky hair and peeling of the skin that appear like burns. Others are a pot belly, dry cracked eye cornea (in later stages), sores at the corners of the mouth, oral thrush and dehydrated tongue.
Besides, the child’s immunity slows down, making one prone to infection such as diarrhoea, TB and skin infections. In addition, the child becomes dull, unhappy and loses interest in their surrounding.
Nangobi says kwashiorkor is common in areas with famine and people with low level of education, leading to inadequate knowledge of proper diet.

Non-edematous malnutrition
This is a form of primary malnutrition commonly known as marasmus.
Kiboneka says marasmus results from a diet low in both protein and calories. It is characterised by energy deficiency, a child becoming skinny and weight reducing to less than 80% of the normal weight for one’s height.
In addition, though a child with marasmus may have dark hair, the child develops a creepy and baggy appearance, prominent cheek bones and no flesh on the buttocks and shoulder blades. The child also becomes irritable, cries a lot and is hyper alert.
Kiboneka says HIV/AIDS has been associated with marasmus because of loss of substantial amounts of the much needed fat and muscle tissue. Sometimes such children develop marasmic kwashiorkor.
She says marasmus increases before a child turns one year, whereas kwashiorkor occurrence increases after 18 months.

Predisposing factors
Apolot says severe acute malnutrition is a result of many factors with the immediate ones being inadequate dietary intake and insufficient access to food.
Apolot says though Uganda is referred to as a food basket, some households do not have food.
Inadequate maternal and child care practices can also spark off malnutrition, Nangobi says. She says proper nutrition starts before conception, continues during pregnancy and after birth.
She says the chances of a malnourished mother giving birth to a malnourished baby are very high. The same applies if the children are not breastfed enough and given enough supplements.
Nangobi adds that some young mothers lack the knowledge while others are inexperienced.
She says many Ugandans in rural areas lack safe drinking water or suitable sanitation. These conditions lead to infectious diseases that can cause diarrhoea, resulting in severe malnutrition.
Other factors include congenital abnormalities for example cleft palate, wher a child cannot eat properly. Cerebral palsy, congenital infections and muscular skeletal disorders are the other causes.
Apolot encourages exclusive breastfeeding. After six months, solid foods can be introduced alongside breast milk.
http://www.newvision.co.ug/D/9/34/749035