Friday, 3 February 2012

POVERTY: Pakistan:Violence, Death Stalk Child Domestic Help

KARACHI, Jan 26, 2012 (IPS) -Zofeen Ebrahim
A Pakistani child domestic worker. / Credit:Fahim Siddiqi /IPS Credit:Fahim Siddiqi /IPS

A Pakistani child domestic worker.

 "He was a happy child, my younger brother," Mohammad Ramzan, 18, reminisced, his voice steeped in sadness.
Eldest among six siblings, Ramzan is still coming to terms with the murder of his 11-year-old brother, Shan Ali, who worked as a child domestic worker in a posh locality in the national capital, Islamabad.
Ali was allegedly strangled by his employer, Atiya Al Hussain, on Jan. 5, for neglecting her child.
She and her husband, Mudassar Abbas, told police that Ali had committed suicide, though the autopsy suggested the boy had been strangled to death.
"The woman has since confessed that Ali neglected her seven-month-old son while she was trying to catch up on her sleep and had, in a fit of anger, strangled him," Ramzan told IPS over phone from Islamabad, where he works as a security guard in an office.
Many wealthy households employ children, some even as young as six, a practice not prohibited by law in Pakistan.
Because of the invisible nature of this issue and the difficulty in accessing domestic child workers, no recent nationwide study exists. In 2003, UNICEF reported that eight million children, under 14 years of age, were engaged as labourers in brick kilns, carpet weaving units, agriculture, small industries, and in homes.
An International Labour Organisation (ILO) report in 2004 estimated that around 264,000 children were engaged in domestic labour in Pakistan.
Child domestic workers can often been seen sitting meekly in the corner of expensive restaurants keeping an eye on a sleeping baby while the employer’s family enjoys a sumptuous dinner. They accompany rich kids to birthday parties, but do not take part in the celebrations.
"In Pakistani culture it was once considered an act of charity to employ poor children," explained Samar Minallah, an anthropologist and a documentary filmmaker.
"In the past, there was a culture of entire families of employees being looked after by feudal lords. With time we saw this disappearing and the child was separated from his parents and employed in a nuclear family setup," she said.
In many cases, said Minallah, the child is the only worker in the house. "I witnessed this in many posh urban areas," Minallah told IPS. Recently she made a film ‘I have a dream’, on the dark reality of what she calls the "worst form of exploitation of children."
"Many families prefer to employ young boys and girls because there are women and daughters in the house. They feel safer around them," explained Ramzan, who does not find children working in whatever capacity of any consequence or even hazardous.
Sending children off to work in homes could mean additional income, says Anees Jillani, an advocate at the Supreme Court of Pakistan. "And then there is the additional incentive of having to feed one less mouth and more space in the room that they call home," he explained.
Over the years, however, the Pakistani media have been consistently reporting on the abuse and violence that child domestic labour often suffer at the hands of their employers.
In the last two years, the Society for the Protection of the Rights of the Child (SPARC), a non-governmental organisation, has documented 18 cases of extreme violence inflicted by employers, resulting in the death of 13 children and serious injuries to five.
To date not one employer has been charged as guilty. "The perpetrators usually buy off the poor parents in out-of court settlements," said Jillani, who is also a child rights activist. Last year, a six-year-old Laiba’s body was found in a deserted place in the eastern city of Lahore, in Punjab. She was beaten to death by her employers for urinating on the kitchen floor.
Taqi Usman, 12, was clubbed to death by his employer for not feeding her dog. In most cases, domestic workers were penalised for being just who they were - mere children.
In 2010, when 12-year-old Shazia Masih, a maid in an advocate’s house died, the media coverage was intense. The paltry sum of 720 rupees (eight dollars) a month in return for washing dishes, mopping floors and cleaning toilets helped pay off her family's debts.
There were 17 blunt injuries on Shazia's forehead, cheeks and scalp and she died after the wounds inflicted on her by the employer became infected.
"Clearly the profiles of the employers suggest that this has nothing to do with literacy levels. It is a reflection of how far a society tolerates injustice and exploitation," said Zarina Jillani, who works for SPARC.
Reacting to such cruel deaths, SPARC urged the government to take immediate steps to ban child domestic labour in line with laws that already prohibit children from being employed in hazardous industries.
SPARC’s Jillani considers domestic labour even more hazardous than factory work because of its "hidden nature, slavery like conditions, the complete control of the employer and the absence of a protective parent or adult and the potential for all kinds of abuse."
While the country has ratified the United Nations Convention on the Rights of Child, advocate Jillani rues there is no legal validity for it in the country. "The ILO has lately introduced a domestic labour convention but Pakistan is yet to sign it," he told IPS.
SPARC believes that the answer lies in extending existing labour laws to domestic work and making education compulsory.
Ramzan, who is completely unlettered like the rest of his siblings, says: "We don’t have the choice or the luxury to attend school. We all work, and the more hands there are, the easier it is to feed the many mouths."
http://ipsnews.net/news.asp?idnews=106560

MALARIA: Bhutan declares malaria elimination


 February 2, 2012 by Ted Purlain

 Malaria
According to a Bhutanese government report, the small, landlocked kingdom has virtually eliminated the incidence of malaria within its borders over the past 17 years.
The report, published by Bhutan’s Vector-borne Disease Control Program, revealed that Bhutan had one death related to the mosquito-borne illness in 2011. In 1994, there were approximately 40,000 malaria cases reported. By 2011, there were less than 200 cases confirmed, according to SciDev.net.
The VDCP lauded its successes in the face of a number of challenges that included difficult terrain, mudslides, poor road access to a large portion of the population and a constant influx of labor from India, where malaria remains endemic.
“Given these and other challenges, the recent success in reducing malaria incidence may contain lessons for other countries,” the report said, SciDev.net reports.
Bhutan is now considered to have almost achieved a zero transmission rate for indigenous cases, a remarkable feat for any country where malaria is prevalent.
“We target to eliminate malaria by 2016,” Thinley Yangzom, the chief program officer of the VDCP, said, SciDev.net reports.
Health officials in Bhutan credit malaria’s decline to improved access to diagnosis and treatment facilities, as well as the continued use of vector control programs.
Yangzom said that Bhutan and VDCP will remain vigilant. In the coming years, he expects malaria to spread into colder regions due to global warming.
“Climate change will definitely have an impact on malaria incidence in the future,” Yangzom said, according to SciDev.net.
http://vaccinenewsdaily.com/medical_countermeasures/317811-bhutan-declares-malaria-elimination/

MALARIA: Rwanda: Malaria in Pregnancy & Elimination

 Bill Brieger : 25 Jan 2012
Malaria in Pregnancy in Rwanda as We Move Closer to Elimination
Malaria incidence and prevalence has been dropping quickly in Rwanda, below 2% in children under 5 years old. Malaria in Pregnancy (MIP) is still a risk some and may be more severe as the disease becomes rare and immunity reduces. The US President’s Malaria Initiative is supporting a prevalence study of MIP through its Maternal and Child Health Integrated Program (MCHIP) and the National Malaria Control Program (NMCP) so that appropriate data will become available to design appropriate MIP interventions as the country moves towards malaria elimination.
The study focuses on pregnant women during their first visit to focused antenatal care (FANC) for their current pregnancy. Four FANC visits promote maternal and newborn health through 1) Early detection and treatment, 2) Prevention of complications and disease, 3) Birth preparedness and 4) Health promotion.
The study of over 4000 women is at the half way mark. Supervisory visits determine if data such as RDT, Microscopy and PCR tests, are being gathered correctly.


dscn7279sm.jpg
Pictured here are Alice and Donatien who are nurses based at Gakoma Health center in Gisagara District and were trained for the the MIP prevalence study. They are seen here taking blood samples for the study. They have integrated the study procedures into the routine FANC they provide. This makes it easier for the client as well as the nurses who also extract study data on age, parity, hemoglobin, bednet ownership and fever history which is normally collected as part of FANC.

Since data collection began in late December, Alice and Donatien have enrolled about half of their target number of clients. When the results from all 38 health centers across the country are compiled in April, the National Malaria Control Program will have valuable information to plan how best to protect pregnant women as the country moves closer to malaria elimination.
http://www.malariafreefuture.org/blog/

MALARIAUAM Ghana launches campaign to win the Africa Cup of Nations 2012 and the Fight to Eliminate Malaria

 Bill Brieger : 25 Jan 2012
By Emmanuel Fiagby in Accra, January 23, 2012, Voices for a Malaria-Free Future

safe-playbook-sm.jpg
The United Against Malaria (UAM) Partnership in Ghana being led by the Johns Hopkins University Center for Communication Program Voices for a Malaria-free Future project, the National Malaria Control Program and the Ghana Football Association held a special media event in Accra as a prelude to Ghana’s attempt to win the Africa Cup of Nations (AFCON) 2012 tournament currently taking place in Gabon and Equatorial Guinea. In the photo to the right we see Ghana’s NMCP Manager launching the UAM Malaria-Safe Playbook.
Held under the theme, “Partnership for Malaria Elimination - Winning the Africa Cup of Nations - AFCON 2012 and the fight to eliminate malaria,” the event brought together about 70 personalities representing 15 News papers, 6 Television stations/channels, 6 Radio stations, the National Sports Authority, the Ghana Football Association, the NMCP, WHO, USAID/PMI/CDC, Ministry of Information, Private Sector companies, academia and the Ghana Coalition of NGOs in Malaria.
In introducing the event, the Country Director of the Johns Hopkins University Voices Project Emmanuel Fiagbey reminded participants of the significance of tapping in to the enthusiasm and support for the national team the Black Stars to win the AFCON 2012 to promote greater advocacy for eliminating malaria from Ghana. “While football is the most popular sports in Ghana, malaria is the most popular killer, we need to employ the positive popularity of football to defeat the negative popularity of malaria,” he remarked.

a-section-of-the-media-at-the-event-sm.jpgIn a statement to the event, Mr. Kwesi Nyantakyi, President of the Ghana Football Association reminded the audience and press members (seen in photo) that footballers are not immune to malaria. Malaria, he pointed out is a big threat to footballers and the practice of their profession. “Aside that we also think society has invested in us and we need to give back what society has invested in us. That is why we have decided to use the Ghana Football Association and football as a vehicle to disseminate information on malaria prevention and treatment,” he stated.

Presenting the key note address, Prof Fred Binka, a renowned Malariologist and Dean of the School of Public Health of the University of Ghana called on all stakeholders especially communities, civil society leaders and groups, NGOs, the media, local government agencies and development partners to ensure strict adherence to the use of ACTs in treating malaria. “The support of these groups will equally be crucial in lifting our education programs up two or more notches to encourage the use of LLINs by all Ghanaians in particular our children and pregnant women,” he emphasized.
With regards to funding challenges, Prof. Binka lamented the suspension of Global Fund Round 11 grants and opined that this could lead to loss of the gains so far made and malaria could be back with a heavy toll on especially children and pregnant women. He called for new partnerships from oil producing countries (OPEC) such as Saudi Arabia and new economic giants such as China to increase their resource support for malaria control and elimination in endemic countries.
Prof. Binka further stressed that the control and elimination of malaria will involve the contribution of every sector – from local government, education, employment and social welfare as well as private companies to the Ministry of Finance. “No sector can be excluded. Indeed we need a strong partnership with global initiatives, privately financed public sector projects, industry partnerships, local, regional and national partnerships led by civil society,” he accentuated.
In conclusion, Prof Binka hoped that the opportunity of the AFCON 2012, contest will energize several potential partners to accelerate their efforts to fight malaria by creating workplace malaria control policies and programs such as provision of treated bed nets and treatment services to their employees and dependants and adopting villages and whole districts within their catchment areas, working with them to reduce mosquito density and providing them with treatment and prevention services.
uam.jpg
In launching a set of UAM branded malaria advocacy materials developed by the JHU/CCP/Voices project in partnership with the Ghana Football Association, Dr. Constance Bart-Plange, Manager of the National Malaria Control Program called on the Private Sector companies to ensure the application of the Malaria-Safe Pillars of increased and continuing education, adherence to improved protection practices, greater visibility of efforts in order to attract added resources and promote effective advocacy. She charged the private companies in particular to endeavour to apply the 13 Winning Moves prescribed in the Winning Moves Chart, one of the materials launched. Other materials outdoored at the event included the 2012 edition of the GOAL Malaria Newspaper and the Malaria Safe Play Book – a Resource Guide for private companies.
In her concluding remarks, the Ag. Director General of the Ghana Health Service, Dr. Gloria Quansah Asare who chaired the event called on all malaria program managers, specialists and activists to remain ever committed and creative in the presentation of malaria information to the public as demonstrated by the Voices UAM Partnership. “The more efforts we put in the development and presentation of our health messages to our audiences the more successful we would be in making such messages acceptable and easy to adopt by our clientele, she emphasized.
About United Against Malaria: Founded in the lead–up to the 2010 FIFA World Cup South Africa, United Against Malaria is an alliance of football teams and heroes, celebrities, health and advocacy organizations, governments and corporations who have united together to end malaria deaths by 2015. We have the tools and the momentum. United, we can beat malaria.
http://www.malariafreefuture.org/blog/

Wednesday, 1 February 2012

POVERTY: GUINEA: Evading the cholera epidemic*

CONAKRY, 12 December 2011 (IRIN)
 Photo: Anna Jefferys/IRIN
An actor, personifying cholera, tries to creep up on his victims

With just two cholera cases reported in 2011, Guinea escaped an epidemic in West and Central Africa that infected 85,000 people and killed 2,500 in the first 10 months of 2011. Luck, as well as targeted prevention efforts on the part of aid agencies and the government brought this about, specialists told IRIN, but a far deeper countrywide overhaul of the water and sanitation system is needed to diminish the likelihood of future outbreaks.
After widespread cholera infection in 2009, the government and aid agencies boosted prevention efforts in Guinea, making chlorine to sterilize water more readily available, spreading hand washing and clean water storage messages, and improving access to drinking water in schools and villages. These efforts have paid off: the absence of “cholera is one of the few highlights” this year, said Julien Harneis, head of the UN Children’s Fund (UNICEF) in Guinea.

Fish faeces and hand washing
Prevention is working better than in the past partly because aid agencies have developed a more sophisticated understanding of what drives the disease. In coastal areas of Guinea, including the capital, Conakry, fish proved to be an effective cholera host, passing it on through their faeces at markets across the city.
Cases dropped significantly once fish storage and transportation were cleaned up. “Approaches to cholera treatment and prevention are more sophisticated now, and are based on a more in-depth scientific understanding,” said Harneis, who recently returned from a regional workshop in the Senegalese capital, Dakar, on how the disease is spread in the region.
A cholera emergency contingency team - made up of representatives from the Ministry of Health, the International Committee of the Red Cross, administrators from the principal hospital, Donka, NGOs such as Action Contre la Faim (ACF) and UN agencies, including UNICEF - now meets regularly to discuss early warning and response.
Hygiene practices and access to clean water are the main problems in Guinea. One marker of poor hygiene practices is that diarrhoea prevalence is similar in areas with high or low access to clean water, and in Conakry it is double that in rural regions. “The vast majority of people use unsanitary shared latrines… and the seaside is used for defecation in large parts of the city,” said Lalit Patra, head of water, sanitation and hygiene (WASH) at UNICEF in Guinea.

 Photo: Anna Jefferys/IRIN
ACF pays Conakry residents to clear up rubbish to create a more sanitary environment

ACF tackles cholera by using street theatre to educate residents in at-risk neighbourhoods in cholera prevention, backed up by house-to-house visits where they distribute hygiene kits and give further advice.
In Matoto, northeast Conakry, an actor representing cholera infects all who approach him. In the question and answer session after the show, another actor asks the audience of mainly women and children, “How can someone be infected by cholera?” A woman grabs the microphone to answer: “With dirty hands, and when you don’t store your water well.”
Hand washing and other hygiene practices have improved. “People are doing better - they wash their hands, there are more toilets in schools, but there remains too much to do,” Hawa TourĂ©, Joint Director of Community Health at the Ministry of Health, told IRIN.

No water surveillance
Emergency prevention and response in Guinea are working well, but a more holistic water and sanitation strategy is needed to prevent future outbreaks, Patra told IRIN.
Cholera is unlikely to disappear anytime soon - the nature of the disease in the region has changed to become “hyper-endemic”, meaning it is ever-present, with regular peaks, say aid agencies.
There has been no systematic water quality surveillance in Guinea to date, but it is highly likely to be polluted, as sources are not protected and sewage can enter pipes.
The work of aid agencies such as ACF and UNICEF has had an impact. UNICEF has helped build water points and latrines in schools, and has worked with communities in 120 villages to discourage open defecation but Patra said more resources are needed to scale up such work throughout the country, and access to clean water should be made cheaper.
The government, private sector and large agencies have traditionally turned to drilling boreholes as the answer to a lack of water, but at $10,000-$12,000 per borehole this approach is very expensive. Cheaper solutions include using local equipment to manual drilling - successfully tried in Chad and Democratic Republic of Congo - installing hand-pumps, or building water pipe systems in mountainous regions. “I was shocked that nothing else had yet been tried here,” Patra told IRIN.
Trying alternatives will not be easy. Trainers will have to be imported from abroad and a monopoly of French and Germany manufacturers will need to be dismantled, said Patra, who suggests India as a cheaper alternative, based on his experience in promoting governance and community management of locally appropriate WASH technologies in Bangladesh, Indonesia and India.
Bold steps are needed to keep Guinea cholera-free in the long term. As Harneis put it: “We have been lucky… but whether or not we get cholera next year - that will be the real lesson.”
http://www.irinnews.org/report.aspx?reportID=94449

MALARIA: "Innovations in Health Care Financing and Service Delivery: Making Malaria Treatment Available".

The World Bank's Development Impact Evaluation Initiative (DIME), in collaboration with the Affordable Medicines Facility-malaria (AMFm) at the Global Fund, the Clinton Health Access Initiative (CHAI) and the Center for Disease Dynamics, Economics & Policy (CDDEP), is hosting a conference on "Innovations in Health Care Financing and Service Delivery: Making Malaria Treatment Available". This will showcase research implemented in conjunction with the World Bank and its partners, including studies carried out under the World Bank's Malaria Impact Evaluation Program (MIEP). The event will feature a keynote speech on December 8th by Nobel Laureate Kenneth Arrow titled "Seven years after 'Saving Lives, Buying Time' - New Challenges for Financing Malaria Diagnosis and Treatment." ... http://allafrica.com/stories/201112090837.html

POVERTY: ZIMBABWE: Typhoid stalks Harare

HARARE, 30 January 2012 (IRIN) -

 Photo: IRIN
Broken water and sanitation infrastructure is being blamed for the outbreak of typhoid in the Zimbabwean capital Harare. In this 2007 file photograph raw sewage flows into the street. In 2008 a year-long cholera epidemic began.

Over the past few weeks some 900 residents of the Zimbabwean capital Harare have been diagnosed with typhoid, and about 60 have been admitted to hospital, say health authorities.
“Initially, we were focusing on Dzivarasekwa high density suburb as being the source of the disease outbreak but we are now receiving patients from different high density suburbs in Harare such as Kuwadzana and Warren Park,” Harare’s health director, Propser Chonzi, told IRIN.
There have been no confirmed fatalities from the disease, although senior health officials, who declined to be identified, told IRIN they were investigating the cause of some deaths at hospitals.
Chonzi said about 20 tuberculosis (TB) patients had been relocated from the 144-bed Beatrice Infectious Diseases Hospital on the outskirts of Harare to another infectious diseases institution, the Wilkins Hospital in central Harare, to make way for typhoid victims.
According to the UN World Health Organization (WHO), typhoid “usually occurs where water supplies serving large populations are contaminated by faecal matter.” The disease is “characterized by the sudden onset of sustained fever, severe headache, nausea, abdominal pains, loss of appetite, constipation or sometimes diarrhoea. The illness can last for several weeks and even months,” it says.
Recent heavy rain in Harare is expected to compound the problem: Broken drains and water pipes have forced people to dig shallow wells, which are easily contaminated by human faeces.
“I can bet my last dollar there is typhoid in Chitungwiza and Epworth [Harare commuter towns]. The hygienic levels there are not good,” said Chonzi in a recent interview with the daily The Herald newspaper.
Furthermore, Chonzi said street food had been tested and found to be contaminated with Salmonella typhi, the bacteria which causes typhoid.
“We all need to change our habits if this [typhoid] outbreak is to be contained. We need to work on improving on cleanliness such as washing hands and avoiding dirty open air vending sites,” he said.
However, fish vendors, threatened with arrest by municipal police, have changed tactics and are selling their wares at night.

Cholera fears
Conditions which allow typhoid to flourish also provide favourable conditions for the waterborne disease cholera. Zimbabwe’s year-long cholera epidemic in 2008-09 killed more than 4,000 people and infected nearly 100,000 others.
“We can have cholera any time. The environment is conducive for the outbreak. We need to be proactive and play our part,” Chonzi warned in the same newspaper interview.
The Harare Residents Trust (HRT), an NGO campaigning for better municipal service delivery, said the spread of waterborne disease was due to the authorities’ failure to collect refuse, the erratic provision of water services, and the practice of pumping raw sewage into one of the main reservoirs supplying “drinking” water to Harare.
“The city must guarantee adequate clean water supplies to avoid the 2008 cholera outbreak,” HRT’s Precious Shumba told IRIN.
http://www.irinnews.org/report.aspx?reportID=94758

MALARIA: Rwanda: Malaria On the Rise Among Workers At Nyagatare Rice Scheme

Nyagatare — Many workers at Kilimburi Rice Scheme in Nyagatare district have been hit by Malaria due to lack of mosquito nets.
The scheme in Tabagwe Sector, Nyagatare District, is run by Rural Sector Support Project (RSSP) and is set to produce 21,000 tonnes of rice annually with a projected annual income of Rwf 4.5 billion once complete.
When The Sunday Times visited over 170 workers camping in tents in Cyenjojo cell, most of them were suffering from severe malaria.
"I have slept in this tent for a week without going to work because of severe Malaria that hit me last week. We don't get access to mosquito nets yet this place is home to mosquitoes due to its terrain," narrated one Nzabamwita, a casual worker at the rice scheme...

http://allafrica.com/stories/201201300306.html




Nyagatare — Many workers at Kilimburi Rice Scheme in Nyagatare district have been hit by Malaria due to lack of mosquito nets.

The scheme in Tabagwe Sector, Nyagatare District, is run by Rural Sector Support Project (RSSP) and is set to produce 21,000 tonnes of rice annually with a projected annual income of Rwf 4.5 billion once complete.

When The Sunday Times visited over 170 workers camping in tents in Cyenjojo cell, most of them were suffering from severe malaria.

"I have slept in this tent for a week without going to work because of severe Malaria that hit me last week. We don't get access to mosquito nets yet this place is home to mosquitoes due to its terrain," narrated one Nzabamwita, a casual worker at the rice scheme...

http://allafrica.com/stories/201201300306.html

MALARIA: Rwanda wins award for fighting malaria

The New Times: January 31, 2012

President Paul Kagame, yesterday, received on behalf of Rwanda the prestigious 2012 African Leaders Malaria Alliance (ALMA) award. Rwanda was among the seven African countries to receive the Excellence Award for ‘exemplary leadership in accelerating and sustaining access to malaria control and treatment’.
The award was presented to President Kagame during a luncheon hosted by ALMA, held on the sidelines of 18th Ordinary Session of the African Union. In his acceptance speech, President Kagame noted that the reduction of malaria is a result of the numerous efforts geared towards improving the welfare of the Rwandan people. “Thank you for the award, which I receive on behalf of Rwandans who work so hard to make their lives better” Kagame said.“The efforts recognized today are proof of what can be done with the resources at our disposal, relevant policies, and a great deal of commitment.” Current figures indicate that deaths due to malaria in Rwanda dropped to only 7% from 60% following years of a rapid scale-up.
The battle against Malaria in the country was characterized by massive distribution of insecticide treated bed nets, indoor residual spraying and a combination of therapies.
Addressing the high profile gathering, that included Heads of State and governments, attending the AU summit, President Kagame called for collaboration among countries in the fight against malaria. “Shared information translates into shared and reduced costs thus helping countries to overcome the issue of insufficient funds,” “If we work together and direct more domestic resources to malaria control, I believe this challenge can be overcome, and we can make even greater strides towards a healthier African population.” Kagame said, adding that cross border anti-malaria efforts are needed in areas such early detection of drug resistance and harmonization of control interventions. Award recipients were grouped into two categories.
In the First category, Rwanda, Burundi and Mozambique were recognized for having banned the importation and use of oral artemisinin –based monotherapies and removal of tariffs on all essential commodities used in the fight against Malaria. The second category included Benin, Cameroon, Kenya and the United Republic of Tanzania.
The four countries were recognized for having made outstanding progress in malaria control over the last year. Liberia’s President Ellen Johnson Sirleaf was announced the new chair person of ALMA replacing Tanzanian President, Jakaya Kikwete.
info@newtimes.co.rw

MALARIA: The complexities of malaria disease manifestations with a focus on asymptomatic malaria

Dolie D Laishram, Patrick L Sutton, Nutan Nanda, Vijay L Sharma, Ranbir C Sobti, Jane M Carlton and Hema Joshi Malaria Journal 2012, 11:29 doi:10.1186/1475-2875-11-29: Published: 31 January 2012
Abstract (provisional)
Malaria is a serious parasitic disease in the developing world, causing high morbidity and mortality. The pathogenesis of malaria is complex, and the clinical presentation of disease ranges from severe and complicated, to mild and uncomplicated, to asymptomatic malaria. Despite a wealth of studies on the clinical severity of disease, asymptomatic malaria infections are still poorly understood. Asymptomatic malaria remains a challenge for malaria control programs as it significantly influences transmission dynamics. A thorough understanding of the interaction between hosts and parasites in the development of different clinical outcomes is required. In this review, the problems and obstacles to the study and control of asymptomatic malaria are discussed. The human and parasite factors associated with differential clinical outcomes are described and the management and treatment strategies for the control of the disease are outlined. Further, the crucial gaps in the knowledge of asymptomatic malaria that should be the focus of future research towards development of more effective malaria control strategies are highlighted.

http://www.malariajournal.com/content/11/1/29/abstract




POVERTY: YEMEN: Fighting in north leads to fresh displacements

HAJJAH, 31 January 2012 (IRIN)
 Photo: Adel Yahya/IRIN

IDPs receive food from villagers after reaching Khairan al-Muharaq District, Hajjah in northern Yemen
Ahmad Hussein Naji, 75, and his wife Taqwa, spent three days in the open after fleeing clashes in Kisher District in Yemen’s northern governorate of Hajjah before eventually finding shelter in a school in the neighbouring district of Khairan al-Muharaq.
“My husband coughs and coughs until he vomits blood… We have no medicine to give him,” Taqwa told IRIN. “It was the hardest trip in my life… We had neither food nor water nor even a blanket to protect ourselves from the cold.”
The elderly couple are among hundreds of families displaced by last week’s clashes between Houthi-led Shia fighters and Sunni Salafi members in Kisher.
Helene Kadi, an emergency coordinator with the UN Children’s Fund (UNICEF), told IRIN 580 families had been displaced by the fighting. “Over 30 percent of the IDPs [internally displaced persons] have taken shelter in five schools, a worrying trend we have seen with recent displacements in the country… Others have been hosted with families or have no shelter.”
According to Ali Meshaal, a social worker in Kisher, around 230 displaced families - mostly the elderly, women and children - fled to Hajjah Governorate’s Ahim District, while more than 250 families had made it to Khairan al-Muharaq. “The whereabouts of dozens of other displaced families is still unknown,” he told IRIN.
Hajjah Governorate is home to more than 100,000 IDPs displaced by fighting between government troops and Houthi rebels since June 2004, according to a December 2011 report by the UN Refugee Agency (UNHCR).

Kind hosts
People from the al-Khamisein area in Khairan al-Muharaq District warmly received several displaced families. “They are sharing their food and water with hundreds of displaced persons who reached their villages. They also freed up schools in the area so they could be used as shelters for the displaced,” he said.
Meshaal appealed to the government and aid organizations to intervene: “The condition of the IDPs is getting much worse due to lack of food and appropriate shelter,” he said.
Ali al-Dubai with local NGO al-Khair Social Charitable Society (ASCS) said more than 2,000 IDPs had been identified and registered for assistance in Hajjah Governorate.
UNICEF, according to Kadi, has distributed 316 hygiene kits and made efforts to raise awareness about hygiene issues among IDPs and the host community. The construction of 12 latrines has been completed and water trucking to IDPs is taking place in the al-Khamisein area. Seven more 1,000 litre tankers are to be deployed and eight emergency latrines will be constructed, and more hygiene kits distributed. Water, sanitation and hygiene assistance is being delivered by UNICEF's partner ASCS, Kadi told IRIN.

Stranded
However, several families are stranded “either on their way to safer areas or inside their homes after many villages in Kisher District became inaccessible and roads unsafe,” said Sheikh Abdullah Dhahban, a member of a recently established tribal mediation committee which is trying to persuade the warring parties to lay down their arms.
“Several dead bodies are still lying in the mountains… None of their relatives have come to collect them for burial,” Dhahban told IRIN.
Local witnesses who preferred anonymity told IRIN on 28 January that Houthi fighters were attempting to tighten their control of a strategic mountain-top position called Abu Dowar, and fighting was also continuing for control of Mishabah hill, which overlooks Suq Ahim (a local market) in Kisher District.
“If Houthis take over this hill it will be easier for them to control the entire district,” one of the witnesses told IRIN.
Waning central government influence due to political turmoil since early last year, has allowed the Houthis to tighten their control of Sa’dah Governorate and push into eastern parts of neighbouring Hajjah Governorate.
“The whole governorate [Sa’dah] is controlled by Houthis. We only have to deal with one party,” said Beatrice Megevand-Roggo, head of operations for the Near and Middle East at the International Committee of the Red Cross.
The fresh displacements are taking place as Yemen prepares for presidential elections scheduled for 21 February.

http://www.irinnews.org/report.aspx?reportID=94763

POVERTY: CHAD: Why polio is so hard to eliminate

DAKAR, 31 January 2012 (IRIN)


 Photo: UNICEF
UNICEF supports polio immunization campaign in Chad 

Poor-quality emergency immunization campaigns and low routine polio immunization coverage are helping the polio virus to spread in Chad, with 132 cases reported in 2011 - five times the number in 2010. More commitment is needed across the board, especially from local health authorities, to try to get immunizations right, say aid agencies.
The current outbreak in Chad has been ongoing since 2007, classifying Chad as a “re-established transmission zone” according to the World Health Organization (WHO). Polio is endemic in Nigeria, Pakistan, India and Afghanistan - in other words, transmission of the disease in these places has never been broken.
While a dysfunctional health system is linked to poor routine immunization coverage, “the primary reason [for the upsurge] is operational,” said Oliver Rosenbauer, spokesperson for the Global Polio Eradication Initiative at WHO in Geneva. “It is not to do with insecurity or lack of infrastructure… The outbreak response has not been sufficient to stop it [the outbreak]… They continue to miss too many children.”

Why children missed
Immunizers have missed children for a variety of reasons: In some cases government and agency staff or volunteers inaccurately mapped out where they lived; or may have ordered too few vaccines or too few ice packs to cover each district, said WHO. Often communities are not well-sensitized in advance so families remain reluctant to bring their children forward, some resist on religious grounds, or they simply may not know that they can immunize a child even if he or she is sick, said WHO and UNICEF’s West Africa communication for development specialist Irina Dincu.
Human error also plays a role, added Dincu, explaining that an ill-trained vaccinator may rest en route, breaking the cold chain, or a team may miss a few houses in a village.
An outbreak of the polio virus would not spread so far if routine polio immunization coverage was better, said Rosenbauer. Polio immunizations are rigorous to administer: vaccinators must go house-to-house, and must give each child four doses over a 6-12 month period, reaching 90 percent of all children to eliminate polio, according to WHO.
Coverage rates are estimated to be 60 percent at most in Chad, partly due to a poor-quality health system: Just 30 percent of health clinics are operational across the country; access to health care is poor; and routine immunization strategies are poorly planned.

The godmother approach
To ensure fewer children are missed, immunizers need to make better use of “social data” to find out why and where a campaign is not working, says Dincu. Agencies used to take a purely medicalized approach to polio immunization but this has now changed. “Immunization campaigns are not just a medical intervention. You need to address campaigns from a medical, political and societal angle,” said Rosenbauer.
Social data has been used creatively in India and Nigeria to help vaccinators reach more children, according to UNICEF. In Nigeria’s Kebbi State households were assigned “godmothers” who came regularly pre-immunization day to discuss the disease and why vaccination was important. When poring over the data afterwards to find missed children, the “godmothers” could identify them by place, name and age, making them much easier to re-trace.
These are the kinds of approaches that could be adopted in Chad, say practitioners, where despite its weak health system, polio should not be too challenging to control, says Rosenbauer. “We don’t face the same high-population challenges that we do in Nigeria, or insecurity as is the case of Afghanistan and Sudan. Here it is more a question of political and societal will.”
In his view, polio could be eliminated in six months if the government committed to doing so at all levels.

Government commitment
International efforts to combat polio are mounting: the Centers for Disease Control (CDC) has established an Africa-based emergency operations centre which will tackle public health crises, including polio.
Meanwhile, the Polio Eradication Initiative - made up of WHO, UNICEF, CDC, the Bill and Melinda Gates Foundation and the Rotary Foundation - has designated polio a “programmatic public health emergency” until eradication is achieved.
The Chadian government appears to be taking polio seriously: President Idriss Déby has emphasized the importance of fighting it, and catalyzed the development of a six-month polio emergency action plan (which will then be renewed for a further six months). This includes targeting high-risk areas and analyzing what is and is not working.
But commitment at the district and sub-district level in some parts of the country is weak, say aid agency staff. National authorities need to hold “sub-national” staff accountable for their performance, said Rosenbauer. “The virus doesn’t respect district boundaries so we need high commitment in every single one,” he told IRIN.
IRIN could not reach anyone in the Health Ministry for an interview.
Without local-level government commitment, elimination efforts will fail, says Rosenbauer. The number of cases in Nigeria rose from 21 to 57 between 2010 and 2011 partly due to local authorities focusing on presidential elections; while election-related violence also distracted from efforts to quash 36 cases that broke out in CĂ´te d’Ivoire in 2011.
And until polio is eliminated in Nigeria and in Chad, all West African countries are at high-risk, according to WHO. “There are immunization gaps in many countries - it can strike in the most unexpected places… that is why it is such a dangerous disease.”
http://www.irinnews.org/report.aspx?reportID=94769

MALNUTRITION: MADAGASCAR: The “less is more” philosophy of rice production

TALATA, 31 January 2012 (IRIN)

 Photo: Guy Oliver/IRIN
A family prepares a rice field for planting in the Madagascan capital of Antananarivo

Ernest Rakotoarivony, 45, was teased by some members of the Talata community, a small town 30km north of Madagascar’s capital Antananarivo, after breaking with traditional rice cultivation methods and employing a technique taught to him by a Jesuit priest.
A decade ago the Dutch priest, Ed Mulderink, promised him that adopting the System of Rice Intensification (SRI) would substantially increase his rice yield, but warned it would also be more labour intensive.
“When you replant the rice, you have very small plants, and they need to be planted individually in rows [with SRI]. The others [traditional rice farmers] just take bunches of plants, beat the roots against their feet to get the soil off, and replant them. It takes them one hour to replant their field, while it takes me two days. People don’t want to use that much time,” Rakotoarivony told IRIN.
Other farmers were skeptical of the “less is more” approach to rice production. “They think that the more plants they put in the field, the more rice they’ll have. But the opposite is true. Even if they just used some parts of the method, like controlling the water, or not beating the plant roots, it would help,” he said.
“There were people who laughed at me, until they saw the harvest,” said Rakotoarivony, who was approached by the priest when he was earning his living as a bread vendor. “The priest asked me to work with him, using SRI. So we worked on my family land together, and we managed to double the yield, just as he had promised.”
During the lean season Rakotoarivony produces vegetables and now has enough cash to buy seed and fertilizer every three years. Although some of his family have adopted SRI, relatively few others in the area have, despite the best efforts of the priest preaching the benefits of the practice.
Rice is the staple for Madagascar’s 20 million people, and the average annual consumption is about 102kg per person; about 75 percent of the population lives below the poverty line.
Production has declined from 4.7 million tons in 2010 to 4.3 million in 2011 and prices have doubled in two years to about US$1 per kilogram. In the 1970s Madagascar was a rice exporter but has since become a rice importer, a consequence of outdated farming methods and poor infrastructure, but farmers still produce 80 percent of the country’s national rice requirement.

Development of SRI
The SRI method was developed in the 1980s by the French Jesuit priest Henri de Laulanié, who challenged accepted norms of rice production. Traditional farmers flood their rice fields and plant bunches of mature rice plants, while SRI farmers transplant young seedlings with greater spacing on soil that is moist but not flooded. Proponents of SRI claim this system uses 25-50 percent less water, requires 80-90 percent fewer seeds, and can sometimes double or even triple the yields.
SRI has been promoted locally by NGO Tefy Saina (Change you Mentality, established by De Laulanié) and internationally, through the Cornell International Institute for Food, Agriculture and Development (CIIFAD).
“The method has really taken off in Asia and is now practised in more than 30 countries. However, it has not been adopted on a wide scale in Africa or in Madagascar itself,” Winifred Fitzgerald, adviser to the Better U Foundation, told IRIN.
The Better U Foundation, funded by the Canadian actor Jim Carrey, has assisted in SRI’s implementation and dissemination at grassroots, institutional and policy levels.
However, there remains conjecture as to whether SRI methods are outpacing traditional methods. A 2005 report by Cornell University entitled Does the System of Rice Intensification Outperform Conventional Best Management? A Synopsis of the Empirical Record, says: “Aside from one set of experiments in Madagascar where SRI more than doubled rice productivity with respect to Best Management Practices, we found no evidence of a systematic or even occasional yield advantage of this magnitude elsewhere.”
In Asian countries, these researchers found, there could even be a negative impact when the system is used, the report said.
“This is a method that was discovered in the field, not in a laboratory. Some want to promote other systems. But I think that there is no competition. Some places are better for SRI than others,” said Better U adviser Rames Abhukara.
A recent progress report of the Better U Foundation cites the results of an evaluation with its partner, Catholic Relief Service (CRS) - an international faith-based NGO working in the Vakinankaratra highland region of Madagascar. In a sample of 120 households out of 600 beneficiary families, the average yields with SRI were 3.28 tons per hectare, compared to 2.87 tons per hectare prior to the project’s implementation. The regional average of rice production is two tons per hectare.
The study showed that families’ food stocks lasted on average 54 days longer as a result of their increased harvest, and helped to decrease vulnerability during the lean season.

Resistance to change
“For some farmers, they don’t see why they should change the way their fathers and grandfathers grew rice. To minimize risk, they may start practising SRI in one corner of the rice field,” Fitzgerald explained. “Others are interested in the method, but do not know how to start or have received insufficient training, so partners are working to address these gaps.”
For some farmers, they don’t see why they should change the way their fathers and grandfathers grew rice
“We don’t tell them to do this. We tell them: If you think it’s useful, we can help you with it,” Abhukara added.
At the institutional level, the Better U Foundation helped to create an association known as the Groupement SRI de Madagascar (GSRI).
GSRI has 267 members, including local and international NGOs, research institutes and private sector entities. In June 2011, the Ministry of Agriculture included SRI in its national strategy for rice development for the first time.
“We were also quite pleased that the UN Special Rapporteur on the Right to Food, Olivier De Schutter, in his preliminary conclusions cited SRI as an important agro-ecological method that could contribute to the country’s food security,” Fitzgerald said.
Apart from increased productivity for farmers, the method has environmental benefits, its proponents claim. With increased yields and improved incomes, there is less pressure for farmers to cut down forests for agriculture purposes. SRI also contributes to a reduction in greenhouse gases, especially methane, because the rice fields are not continuously flooded as in traditional rice cultivation.
“Just producing more rice is not enough. For an effective SRI dissemination strategy, you have to consider the whole rice chain, such as farmers’ access to micro-finance as well as the storage, transportation and marketing of rice,” Abhukara said.

http://www.irinnews.org/report.aspx?reportID=94764

TUBERCULOSIS: TANZANIA: Good results in programme to boost TB detection

ARUSHA, 1 February 2012 (PlusNews) -

 Photo: David Gough/IRIN
Better TB case detection would improve the country's treatment and prevention programmes (file photo)

A pilot community programme to improve TB detection in northern Tanzania has shown good results and could be replicated nationwide as the country seeks to improve its TB treatment and prevention systems.
Tanzania has been battling TB for years, a struggle intensified by the parallel HIV epidemic; approximately 47 percent of new adult cases in the country are HIV-positive. Without proper treatment, about nine in 10 people living with HIV who become ill with active TB will die within two to three months, according to UNAIDS.
The programme, which ran from April to September 2011, systemized the way suspected TB cases were reported and handled. It encouraged healthcare professionals to work closely with community leaders to raise awareness of symptoms at every opportunity, such as at village meetings. It also used posters and slogans to make sure high-risk groups were aware of symptoms. This produced more patient referrals to health centres for diagnosis, treatment and follow-up care.
Another crucial part of the TB pilot project was the creation of a "cough register" in each area, recording who was referred to a healthcare professional for further testing, by whom and the results of that referral.
Management Science for Health collaborated with the NGO, PATH, and the National Tuberculosis and Leprosy Programme, with financial support from the US Agency for International Development, at 12 health facilities in northern Tanzania's Arusha and Meru district councils. A crucial tenet of the programme was emphasising that TB and HIV treatment must be done "hand in hand".

Results
"In both districts the standard operating procedure intervention has improved TB case notification in children and women," said Zahra Mkome, director, TB/HIV projects at PATH in Tanzania. "[It] improved team work, commitment, motivation of healthcare workers, awareness and involvement of communities in TB control activities."
An evaluation comparing six months of TB case notification before and after the project showed a 54 percent increase in detection of TB in all forms in Meru, while in Arusha it increased by 117 percent.
The standard operating procedure “rules” were used to provide clear and simple instructions to the health workers on how to improve TB case detection at different units and sections within health facilities, both outpatient and inpatient departments. Each area was provided with a plan and goals to implement their strategy, plus additional equipment to aid diagnosis such as paediatric score charts. Each area appointed a task force for TB treatment and these groups were encouraged to hold regular feedback meetings.
Little data exists on the scale of the TB epidemic in Tanzania, and experts believe the records created by this system could prove a crucial tool in combating its spread and establishing where it is already most prevalent.
One doctor based in a rural practice was particularly encouraged by the increased reporting of paediatric cases. He said some children suffering severe respiratory distress had been saved, "who in normal circumstances would have died". A number of the clinicians involved attributed an increase in notification of cases in the under-16 age group specifically to the wider use of paediatric diagnostic score charts.
However, several challenges were flagged during the pilot: healthcare workers at Arusha's Selian Hospital said there was an urgent need to strengthen laboratory services to help confirm diagnoses; a lack of microscopes in labs and delays in issuing results were also highlighted.
Rolling out the rules on a national scale could also prove challenging as the majority of Tanzanians live in very rural areas and a poor road network means access to healthcare is limited.
Mobile diagnosis and training centres that offer new methods of testing - for example, with the use of fluorescence microscopes - could make diagnosis much faster and more accurate.
"Patients in Tanzania often have to travel very long distances as most live in rural areas, which costs them money to travel every day and some are essentially too week to go on their own as a very large number are already suffering from the weakness that comes with HIV," said Alex Schulzer of the Novartis Foundation for Sustainable Development, which runs patient-centred TB programmes with the government.
A shortage of medical professionals could also hinder the expansion of the programme; Schulzer recommended the use of lower cadre health workers and the community itself to fill gaps. The Novartis programme gives patients the choice to either take the daily treatment at a health facility under the supervision of a medical professional, or at home, supported by a family or community member. In the case of home-based treatment, the patient and treatment supporter are required to visit the health facility once a week during the two-month intensive phase to refill prescriptions and see a medical professional.
Schulzer said the programme had created a system that gave patients "the freedom not to have to walk miles to the clinic every day.
"We also needed to relieve some of the healthcare providers who cannot cope with such large patient numbers on a daily basis," he added.
http://www.plusnews.org/report.aspx?reportID=94771

POVERTY: THAILAND: Authorities boost flood-control measures

BANGKOK, 1 February 2012 (IRIN)

 Photo: Shermaine Ho/IRIN 
Millions were impacted by the 2011 floods

The Thai government is pressing ahead with efforts to mitigate the risk of flooding during the upcoming rainy season, but greater coordination is still needed, flood experts say.
The US$9.6 billion measure was announced on 20 January as a first step, ahead of the annual May-October rainy season, at a flood forum organized by the National Economic and Social Development Board and the Asian Development Bank.
"If the same amount of water comes to Bangkok this year [as in 2011], the situation will be improved," Chusit Apiramanekal, a water resource management specialist in the Climate Risk Management Department of the Asian Disaster Preparedness Centre (ADPC) in Bangkok, told IRIN.
While no specific timeline is yet in place, the government will soon produce a master plan for flood risk reduction activities, including canal drenching, cleaning drainage systems and excavation to prevent the recurrence of last year's damage, when "most of the waterways and drainages were not functioning properly", said Ti Le Huu, former chief of water security for the Environment and Development Division at the UN Economic and Social Commission for Asia and the Pacific (ESCAP).
The severity of the 2011 floods, brought on by unusually high rainfall after several storms and typhoons, has underscored the need for stronger prevention efforts.
More than 675 people died and millions were affected in what has since been described as the worst flooding to strike the Thai kingdom in 50 years.
The government's 2012 Action Plan includes a budget of $3.9 billion for the construction of flood ways and flood diversion channels, which will allow 1,500 million cubic metres to flow out per second, according to ADPC. Immediate work this year would include the improvement of dykes, sluice gates and canals.
In addition, almost $2 billion will go towards converting 324,000 hectares of Chao Phraya farmland north of Bangkok into land that can retain up to 10 billion cubic metres of water to prevent the flooding of areas downstream.

Preparedness key
The damage last year was exacerbated by the "lack of preparedness of people living in the affected areas, partly due to a lack of an effective communication system to share information, especially of flood forecasts", said Le Huu.
But Le Huu downplayed the risk of similar flooding in 2012. Similarly, ADPC says there is little chance that there will be a repeat of 2011's "extraordinary" precipitation, which was 40 percent above national averages at 70,000 million cubic metres of water, according to Chusit.
"When the dams tried to release the water, the provinces downstream were already flooded. When operators tried to control it, a tropical storm hit Thailand, forcing them to release it fully," he said.
The total volume of floodwater has been confirmed at 14,000 million cubic metres by the government's Strategic Committee for Flood Reconstruction and Development, according to Le Huu.

Dam fears
While fears about the dams bursting are rampant in local media, Deltares, a Dutch think-tank assisting the Thai government in an advisory role to the Flood Relief Operation Center (FROC), says dams are now operating at a lower level to mitigate flood risks.
"During 2011 the dams were full, up to the operational limit, and dam operators had to release water at the wrong time. Latest news is that they decided to operate at a lower level, give less priority to agricultural and energy use, in favour of downstream flood protection. Hence a lower risk for dam breaks," Tjitte Nauta, Deltares' integrated water management specialist for Southeast Asia, said.
According to local media reports, dam waters have dropped from 91 percent of capacity to about 84 percent in two weeks.
Of the more than two dozen dams in the Chao Phraya River basin constructed since the 1950s, the two largest - Bhumipol and Sirikit - are located on Ping and Nang river in the northern Tak and Uttaradit provinces, and control 22 percent of all water runoff from the Chao Phraya river basin.
But policymakers need to coordinate better to improve planning and flood response, said Nauta.
"The recent floods made very clear that the governance structure for water management is too complicated and during such a national crisis one single command authority would be strongly recommended," he said.
"The challenge is to maintain the momentum of work, interest, and commitment in flood management at the top level of government," added Le Huu.
http://www.irinnews.org/report.aspx?reportID=94770

MALARIA: Deeper understanding of acquisition of antibodies against #malaria vaccine target antigens in infancy is crucial

Plasmodium falciparum blood-stage antigens such as merozoite surface protein 1 (MSP-1), apical membrane antigen 1 (AMA-1), and the 175-kDa erythrocyte binding antigen (EBA-175) are considered important targets of naturally acquired immunity to malaria. However, it is not clear whether antibodies to these antigens are effectors in protection against clinical disease or mere markers of exposure. In the context of a randomized, placebo-controlled trial of intermittent preventive treatment in infants conducted between 2002 and 2004, antibody responses to Plasmodium falciparum blood-stage antigens in a cohort of 302 Mozambican children were evaluated by immunofluorescence antibody test and enzyme-linked immunosorbent assay at 5, 9, 12, and 24 months of age. We found that IgG subclass responses to EBA-175 were differentially associated with the incidence of malaria in the follow-up period. A double amount of cytophilic IgG1 or IgG3 was associated with a significant decrease in the incidence of malaria (incidence rate ratio [IRR] = 0.49, 95% confidence interval [CI] = 0.25 to 0.97, and P = 0.026 and IRR = 0.44, CI = 0.19 to 0.98, and P = 0.037, respectively), while a double amount of noncytophilic IgG4 was significantly correlated with an increased incidence of malaria (IRR = 3.07, CI = 1.08 to 8.78, P = 0.020). No significant associations between antibodies to the 19-kDa fragment of MSP-1 (MSP-119) or AMA-1 and incidence of malaria were found. Age, previous episodes of malaria, present infection, and neighborhood of residence were the main factors influencing levels of antibodies to all merozoite antigens. Deeper understanding of the acquisition of antibodies against vaccine target antigens in early infancy is crucial for the rational development and deployment of malaria control tools in this vulnerable population.
http://cvi.asm.org/content/19/2/157.abstract

MALARIA: Anti-malarial treatment available to millions of poor Nigerians at a fraction of its normal cost

 January 31, 2012   2 Millions of poor Nigerians will gain access to the most effective combination treatment for malaria at a fraction of its current cost, following the successful conclusion of negotiations between the United Kingdom Department for International Development (DFID) funded Partnership for Transforming Health Systems (PATHS2) and a variety of international and national stakeholders in Nigeria this week.
PATHS2, in collaboration with the Clinton Health Access Initiative (CHAI), will provide life-saving anti-malaria treatments to health facilities based largely in rural communities in the five Nigerian states of Lagos, Kaduna, Jigawa, Enugu and Kano, the latter state recently driven by terrorist bomb attacks.
A course of treatment will be provided for as little as 60 Naira (approximately 25 pence in Sterling), in comparison to previous costs of nearly 20 times as much, making the drugs affordable to even the poorest Nigerians, many of whom still subsist on less than US$1 a day.
The Affordable Medicines Facility for malaria (AMFm) is an innovative financing mechanism to expand access to affordable ACTs—Artemisinin-based Combination Therapies. ACTs are the medicines recommended by the World Health Organisation (WHO) as the most effective malaria treatment.
The AMFm is hosted and managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), with key financial support provided by UNITAID, DFID and the Bill & Melinda Gates Foundation, and with technical support provided by the Clinton Health Access Initiative (CHAI).
International manufacturers of ACTs receive a subsidy directly through the AMFm initiative almost to the tune of 95% which in turn is passed on by Nigerian pharmaceutical manufacturers, the First Line Buyers of ACTs. Acting as second line buyers, PATHS2 will distribute ACTs through primary health centres in the five Nigerian states in which it currently works, which have a total population of approximately 37 million, representing around 22% of the population of Nigeria as a whole.
Artemisinin-based Combination Therapies were introduced in Nigeria in 2005 for the treatment of uncomplicated malaria due to the increased resistance to chloroquine and sulphadoxine-pyrimethamine – also known as mono-therapies - which were older malaria medicines grown less effective due to the development of resistant strains .
PATHS2 has supported the significant reduction in prices of ACTs by bringing First Line Buyers and PATHS2 states together to discuss their requirement and support the signing of annual contracts between the states and First Line Buyers. The First Line Buyers are pharmaceutical companies in Nigeria who buy directly from WHO certified manufacturers outside the country. In Nigeria, there is currently no domestic manufacturer of AMFm drugs.
The First Line Buyer supported under AMFm will sell Artemisinin/ Lumefantrin (Pack of 24) for just 50 Naira to PATHS2 States health facilities and patients will get it for about 60 Naira, compared to its previous cost, which was as much as 2,000 Naira (£8-00). This pricing makes it the cheapest price available anywhere in the country.
It is estimated that 70% of all disease incidence in Nigeria is related to malaria. The World Malaria Report of 2008 recorded 57,506,430 cases of malaria across Nigeria, causing 225,424 fatalities.
http://www.news-medical.net/news/20120131/Anti-malarial-treatment-available-to-millions-of-poor-Nigerians-at-a-fraction-of-its-normal-cost.aspx

MALARIA: Spatial targeting of #Malaria hotspots

Heterogeneity is a common facet of infectious diseases, whereby infection and disease are concentrated in a small proportion of individuals.
In malaria, heterogeneity is manifested as small groups of households, or hotspots, that are at a substantially increased risk of malaria transmission.
These hotspots exist in all transmission settings but are less easily detected at high transmission intensity.
Hotspots maintain transmission in low transmission seasons and fuel transmission in the high transmission seasons.
Targeting hotspots is a highly efficient way to reduce malaria transmission at all levels of transmission intensity.

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001165

Tuesday, 24 January 2012

POVERTY: Analysis: Agriculture in a changing environment

JOHANNESBURG, 24 January 2012 (IRIN)


 Photo: Jaspreet Kindra/IRIN

Cows release huge amounts of warming methane every year- Agriculture has been seen either as a cause or victim of global warming at the UN climate change talks over the past few years - something that has thwarted efforts to attract the investment it needs, say scientists.
Some at the talks see a more dominant role for agriculture - an emitter of major greenhouses gases such as nitrous oxide and methane - in reducing global warming. The Intergovernmental Panel on Climate Change estimates agricultural emissions account for 13.5 percent of all man-made greenhouse gas emissions.
At the same time, poor countries want more money and better technology to help farmers adapt to the impact of climate change such as frequent droughts, flooding and increased salinity.
“It is really a bad split for agriculture,” said John Beddington, the UK’s chief scientific adviser, and one of the authors of a paper calling for a more integrated approach, combining mitigation and adaptation efforts.
The paper, published in the current edition of Science with contributions from several scientists, calls for a better understanding of agricultural practices with the aim of delivering multiple benefits - reducing emissions, helping agriculture to adapt, and using limited resources (like water) efficiently.
One model to emulate could be Denmark, where one of the world’s strictest agriculture control systems is in place - including, for example, the use of environmentally friendly practices such as substituting pig slurry (pig waste and water) for artificial fertilizers. The country has managed not only to reduce emissions from agriculture by 28 percent but also increase productivity.
This kind of win-win agriculture would attract more funding from a wider range of sources, said Beddington.
Climate change’s impact is likely to be greatest in low and middle-income tropical regions, where pressure will mount to produce more food because of population and income growth, says agricultural economist Christopher Barrett, who teaches at Cornell University. The global focus, therefore, has to be on helping agriculture in those regions adapt, and not just produce more or reduce emissions. “And that agenda needs to encompass post-harvest storage, distribution and transformation.”
Despite growing support for an integrated approach to agriculture encompassing adaptation and mitigation efforts, policy actions have been slow to materialize in most countries and at the UN climate change talks, the paper says.
A first step, say the scientists, is to get commonly agreed definitions of concepts like “climate-smart agriculture” and “sustainable intensification”, which integrate the two approaches.
The authors of the paper include ecologist Bob Scholes of South Africa’s Council for Scientific and Industrial Research; Mohammad Asaduzzaman, research director of the Bangladesh Institute of Development Studies; and Judi Wakhungu, executive director of the African Centre for Technology Studies in Kenya.

“Climate-smart”
The “climate-smart” concept as developed by the UN’s Food and Agriculture Organization (FAO) advocates practices which generate both adaptation and mitigation benefits such as the efficient use of organic fertilizers; the development of efficient seed systems which produce crops naturally resilient to climatic shifts; the harvesting of water for irrigation; the production of biogas from livestock manure; and greater reliance on forage from maize crops to feed animals.
Such initiatives would not only improve food production but also reduce harmful gas emissions, says FAO.
About 70 percent of agriculture-related emissions are associated with the manufacture and use of nitrogen-based fertilizers -in large part through the emission of nitrous oxide - according to a 2011 review by the UK Biotechnology and Biological Sciences Research Council (BBSRC).
The livestock sector generates 65 percent of human-related nitrous oxide, which has 296 times the Global Warming Potential (GWP) of carbon dioxide. Most of this comes from manure.
Belching cows, goats and sheep emit 80 million tons of methane into the atmosphere every year. Though methane remains in the atmosphere for a short time (9-15 years), it has 23 times the GWP of carbon dioxide. Irrigated rice farming is another major source of methane emissions.
Soil carbon sequestration
But the “climate-smart” concept was given another interpretation at the Durban climate change talks in December: The World Bank announced it had launched a “climate-smart agriculture” pilot project in Kenya. The project (which is still running) aims to get small farmers to adopt agricultural practices such as low-tillage, which trap carbon in the soil in such a way that it is not re-emitted into the atmosphere (soil carbon sequestration). The carbon is then sold as credits in carbon markets.
Think-tanks like the Institute for Agriculture and Trade Policy (IATP), and scientists at BBSRC, point out that sustainable agriculture can increase the sequestration of carbon in the soil but it is difficult and costly to measure.
IATP’s senior policy analyst, Steve Suppan, said the very high transaction costs of converting Kenyan farmers’ work into carbon credits would be better spent on more rapidly adapting Kenya’s agriculture to climate change.
“Because the project's transaction costs are nearly half of the project budget, the main project co-benefit is not for the farmers but for the carbon accounting methodology that the Bank wishes to sell globally.”
Tosi Mpanu-Mpanu, Africa’s chief negotiator at the climate talks, who had been lobbying for a stronger presence for agriculture in the adaptation track, said they wanted predictable funds for agriculture, and not from shaky carbon markets, which in this case - for credits based on soil carbon sequestration - did not exist. “Our farmers will also be told to grow certain crops which sequester more carbon rather than what the farmers need, compromising their security.”
NGOs like ActionAid warn of the possibility of “soil grabs” in developing countries by big business to offset their emissions. Mitigation cannot be the predominant objective of any project aimed at benefiting agriculture, said ActionAid’s Harjeet Singh.
“Mitigation projects in agriculture need to begin in industrialized agriculture and land-clearing for agribusiness. The agro-ecological techniques of climate-smart agriculture should be deployed for adaptation, not in the service of carbon derivatives markets,” said Suppan.
Beddington said linking “climate smart agricultural practices” with carbon markets was “unfortunate”. The Science paper he co-authored calls for unpacking the term in such a way that addresses concerns that it might be giving more weight to agriculture’s role in reducing emissions, rather than focusing on improving production and ways to adapt.
Leslie Lipper, a senior environmental economist with FAO, said soil carbon sequestration is one example of an integrated approach but she was not against sourcing finance from carbon markets. “Identifying, crediting and financing mitigation co-benefits that can be generated from improving agricultural systems offers the potential to open a new and additional source of finance to help meet the investment gap” in agriculture.

“Sustainable intensification”
In agriculture, the term “sustainable intensification” as defined by FAO, refers to an increase in production either by using more inputs such as labour, land, time , fertilizer, feed or cash; or the maintenance of production at a certain level with the effective use of smaller amounts of fertilizer, or mixed cropping in smaller fields.

“Sustainable intensification”, said Scholes, focused more on increasing production not by physical expansion but the efficient use of inputs.
The UN Framework Convention on Climate Change has called for views on agriculture within the climate change context to be submitted to its Subsidiary Body for Science and Technological Advice by 5 March 2012.
http://www.irinnews.org/report.aspx?reportid=94711

MALNUTRITION: NIGER: Thousands of villages hit by severe food shortages

NIAMEY, 24 January 2012 (IRIN)

 Photo: Boureima Balima/IRIN
Pounding millet in the village of Boukanda, 50km west of Niamey, capital of Niger

 Nearly half Niger’s population does not have enough to eat and the government says it is facing a grain shortfall of 692,501 tons, following another severe drought across the Sahel.
The government says it needs 3.8 million tons of cereals to feed six million people spread across 6,981 villages, equating to 49.4 percent of the affected zones.
In a survey conducted in November 2011, the government’s Early Warning System projected the 2011-2012 “winter” gross cereal production for millet, sorghum, rice, wheat and fonio (one of West Africa’s most ancient cereals) at 3.8 million tons - 27 percent down on 2010-2011. Grain production last season was about 3.2 million tons.
The Early Warning System, which monitors and forecasts food security needs, has identified three major areas as reporting deficits: Tillabéry in the west; Agadez in the north; and Diffa in the east; with respective shortfalls of 164,146 tons, 123,576 tons, and 68,115 tons.
Boukanda, a village with a population of 1,000 about 50km west of the capital Niamey, is typical of many food insecure villages which have been largely abandoned by their younger residents.
"The able-bodied and young people of the village preferred to leave for big cities or abroad. They have little to do here,” Adamou Talba, the marabout (religions teacher) of Boukanda, said.
Only a few “wealthier” families pound sorghum instead of millet, the main staple of the village. These people still have small supplies but they will not last long.
"There's just a little bit in the granary," said Balkissa Adamou, a villager.
Boukanda village chief Seyni Seydou said the rains ended just when the plants needed water, and grasshoppers and other insects finished off the crops.
"In our village, some people have been left with just seven bundles [of grain], whereas previously nearly 700 could be harvested," he added. The Early Warning System puts Boukanda’s food deficit at 90 percent.

Appeals for help
Concerned by the current situation, Cheick Boureima Abdou Daoud, a citizen of Niger, donated 3,000 tons of cereal to the relief effort. "I want to kick-start action so that other citizens of Niger, who can afford it, can also help those in need,” he said.
While previous governments tended to avoid admitting to food crises, the current government is different: In August 2011, it asked for 100 billion francs CFA (about US$198 million) in donor aid.
President Mahamadou Issoufou, addressing the UN General Assembly in September 2011, said: “Knowing that we would have a very large deficit this harvest crop, we decided... to alert the international community. I would like, at this highest level of this forum, to renew once more our appeal to help Niger.”
Donors have pledged help, and the UN has launched a Consolidated Appeals Process (CAP) for $229 million.
"The CAP aims to provide humanitarian aid and to strengthen the resilience of millions of men, women and vulnerable children," said Guido Cornale, the UN Children’s Fund (UNICEF) representative in Niger who is also acting humanitarian coordinator in the country.
http://www.irinnews.org/report.aspx?reportID=94713

POVERTY: New Zealand: Poverty trap set at birth - study


Simon Collins Jan 18, 2012

Wealth-gap problems are growing.
Photo / Thinkstock Wealth-gap problems are growing. Photo / Thinkstock

New Zealand researchers have put hard numbers to the adage that success breeds success - and failure breeds failure.
A long-term study of 1265 children born in Christchurch in 1977 has found that those whose families were poor in their first 10 years of life earned about $20,000 a year less by the age of 30 than those who grew up in rich families.
Those from poor families were more likely to leave school without qualifications, have babies before they were 20, commit crimes, go on welfare and have addiction and other mental health problems in adulthood.
Most of these effects were explained by factors which tended to vary in line with family incomes, such as parents' education, addictions, criminality and marital conflict and breakup, and the children's own intelligence.
But study director Professor David Fergusson said the effects of childhood income on later educational and career achievement persisted even after allowing for all other factors.
"So in a sense success or failure drives educational and economic success or failure, but the things that drive behavioural outcomes are not so much income and are more familial and personal," he said.
"It could be that competent, bright families transmit their skills to their children and also earn higher incomes.
"It could also be that being bred in a high-income family provides children with role models and resources for both educational achievement and career success."
Deputy Prime Minister Bill English and Maori Party co-leader Tariana Turia are setting up a ministerial committee on poverty under the Maori Party's post-election agreement with the National Party.
The study results are reported in a newsletter published by Children's Commissioner Dr Russell Wills, who has said that attacking child poverty should be the first of seven goals in an "action plan" arising out of a Government paper on vulnerable children.
The newsletter also reports a Social Development Ministry finding that in 2010, 26 per cent of children lived in "poor" families earning under 60 per cent of the net median income after housing costs - down from a peak of 30 per cent of children in 2001, but still roughly double the proportion in poverty during the 1980s when the children in the Christchurch study were growing up.
Professor Fergusson said children being born in poor families today might face even worse outcomes than their parents born in the 1970s and 80s because of the greater disparity in earnings.
The study asked detailed questions about people's lives which also enabled the researchers to diagnose whether they had depression, anxiety disorder, drug or alcohol addictions or anti-social behaviour.
On average, those from poor families had slightly more of these disorders than those from rich families.
Professor Fergusson said the study showed that income inequality and behavioural issues, such as parents' addictions, both had to be tackled to fix social problems.
"For example, increasing the income of substance-using parents may be counter-productive since it will give them more access to purchasing alcohol or drugs," he said.
A spokesman for Mr English said the poverty committee would focus on "providing opportunity through things like education and jobs and ensuring we are getting the best results from the hundreds of millions of dollars already being spent on social service delivery".
Schooling
Almost 40 per cent of those in the poorest fifth of families left school without qualifications, compared with fewer than 10 per cent of those in the richest fifth.
Pregnancy
A third of those from the poor families but fewer than a tenth of those from rich families fell pregnant, or got someone pregnant, before they were 20.
Crime
A third of those from poor families, but only a sixth from rich families, committed a violent or property crime between the ages of 18 and 30.
Welfare
20 per cent of those from poor families, but only 4 per cent from rich families, spent some time on welfare before they were 30.
Income
Those from poor families earned an average of just under $40,000 a year by age 30, while those from rich families averaged $60,000.
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10779433

Friday, 6 January 2012

MALNUTRITION: MYANMAR: Rice harvests lost in Kachin conflict zones

KACHIN STATE, 6 January 2012 (IRIN) -
 Photo: Contributor/IRIN
Kot Nan worries about feeding her family

The annual harvest season in Myanmar's northern Kachin State has come and gone but much of the rice crop has not been harvested or was never planted after fighting between government forces and the Kachin Independence Army (KIA) erupted on 9 June 2011 after a 17-year ceasefire was broken.
Traditionally, farmers transfer their rice seedlings in June with harvests in November and December before the winter sets in.
"This year's harvest was next year's investment, but now we have nothing for the future. We will have to cross the mountains and scavenge for wild vegetables so that we will have something to eat," says Kot Nan, 35.
"When the conflict started we were planting rice but the soldiers came into our village so we couldn't plant," the mother-of-two told IRIN at the main camp for internally displaced people (IDPs) outside Laiza, a border town between Myanmar and China.
There are more than 40,000 IDPs in Kachin State, local aid groups say, including an estimated 20,000 in camps around Laiza, controlled by the political wing of the KIA, the Kachin Independence Organization.
For many Kachin families, farming is the primary source of livelihood, with rice being the main crop, along with sugar cane and corn.

Impact
Bill Davies, a researcher with Physicians for Human Rights (PHR), says the food security issue is of major concern.
"The fighting starting when they were preparing the seedlings so some of them put the seeds right into the paddy in the hope that they would grow and others planted a lot later, which decreases the yield."
Davies led a fact-finding mission for PHR in the border areas of Kachin state last September, visiting six camps and four shelters for IDPs.
The group's findings were released in a report on 30 November.
"Not being able to plant 100 percent of their fields, planting it late, and also not transplanting it at the right time were the three main problems. A lot of people are worried that they were going to have a smaller crop yield than normal," Davies said.
Sporadic fighting has also restricted travel for civilians, including those farmers who were able to plant but could not return to their fields to tend their crops.
And while there are no official figures yet on the area's overall harvest shortfall for 2011, the impact on the population is already evident.
At a relief line in one of the main refugee camps near Laiza, 24-year-old Moo Pan breastfeeds her baby girl as she waits for food rations - almost seven months after fighting first erupted.
"We were forced to leave our village and we can't go back because government forces have taken over our houses and land," she said.
Compounding matters are reports that the Burmese army is regularly pillaging food and supplies from civilians in the area, a key finding of the PHR study.
With local supplies diminishing and the ability of local aid groups to provide assistance on the decline, the situation on the ground underscores the importance of further outside aid.
According to Human Rights Watch (HRW) at the end of December, the tens of thousands now displaced are in "great need of humanitarian assistance".


 Photo: Contributor/IRIN 
Workers tend a field near an IDP camp in central Kachin to supply food for the displaced

Access
But getting into the most-affected areas will only be the first step, Marcus Prior, spokesman for World Food Programme (WFP) Asia, told IRIN on 5 January.
"Even with improved access, WFP will need funding to provide the kind of assistance we think may be necessary in Kachin," he explained.
"Our operations across the country are facing significant shortfalls - right now WFP only has funds to guarantee food deliveries into February."
The UN food agency is able to reach about 15,000 of the displaced in Kachin State, but hopes that following a recent humanitarian convoy across the conflict line, the next convoy will include WFP food, Marcus said.
http://www.irinnews.org/report.aspx?reportID=94595

POVERTY: SOUTHERN AFRICA: Floods leave Angolan returnees stranded

JOHANNESBURG, 6 January 2012 (IRIN) -

 Photo: Tomas de Mul/IRIN
The Zambezi is prone to flooding annually
Several thousand Angolan returnees from the neighbouring Democratic Republic of Congo (DRC) are stranded by floods in northeastern Angola. They are among the first casualties of what promises to be a very wet rainy season in parts of southern Africa.
“At least 50,000 people - 24,000 of them returnees - in 10 villages in Uige Province [northeastern Angola near border with DRC] have been affected by the flooding, rains and hailstorms in the past four months,” said Antonio Maiandi, head of the Evangelical Reformed Church of Angola, which has been trying to help those affected. The rainy season here tends to be longer than elsewhere in Angola.
“It is still pouring hard. At least 1,142 houses have been destroyed by the rains. Each family with shelter is now hosting other families,” said Maiandi, adding that the returnees, who had sought refuge from the civil war in Angola which ended in 2002, were putting enormous pressure on locals, and organizations such as his.
“The local population who are mostly farmers have been severely affected. Their cassava [staple food in Angola] and groundnut crops have been destroyed, so there is not enough food to go round.”
The UN Refugee Agency (UNHCR) restarted formal repatriation of Angolans in November 2011 after logistical and other problems forced the process to stop in 2007. DRC is home to some 80,000 Angolans refugees, according to UNHCR.
The new return initiative comes after a UNHCR survey in 2010 found that 43,000 wanted to return home, and following a tripartite agreement between Angola, DRC and UNHCR (signed in June 2011), around 20,000 people signed up for help to return. The agreement came about after years of tense relations between the two countries: Angolan and Congolese nationals have been expelled from the two countries regularly.
Each family with shelter is now hosting other families
“The local population is extremely poor and unable to support the returnees,” and “people are still coming in every day,” said Maiandi.
UNHCR in Angola told IRIN they took a break in December 2011 and would resume formal repatriation on 17 January, but did not have an update on the number of people who had already arrived.
According to aid workers, increasing instability in the DRC following the recent disputed elections could be prompting more people to leave.
Maiandi said the returnees had not received adequate support from the authorities and church organizations had limited resources.
Meteorologists for the Southern African Development Community (SADC) have predicted normal to above normal rains for most of the region from January to March 2012 largely because of the continuing effects of the 2011 La Niña event. Thousands of people in the region were displaced and scores killed in early 2011 as a result of heavy rains and flooding associated with La Niña.

Zimbabwe
As the rainy season begins here, aid workers and disaster prevention teams are closely monitoring water levels in the all-important Zambezi river, the continent's fourth largest.
The authorities have issued a flood alert after being forced to release water from the swollen Kariba Dam on the Zambezi earlier than usual in the rainy season.
The Zambezi River Authority (ZRA) which usually opens the spillway gates of Lake Kariba in the last two weeks of January was forced to open one of the gates on 3 January. It has advised people living downstream to evacuate their homes.

Zambia
Zambia is in for a mixed season. Dominicano Mulenga, national coordinator of Zambia's Disaster Management and Mitigation Unit, said a plan had been drawn up to help 368,953 people likely to be affected by rain and dry spells. While northwestern and western parts of the country had seen heavy rain, southern, eastern and parts of central Zambia were likely to receive little or no rain, he said.
The water level in the Zambezi was higher than at the same time in 2011, he added. “We have had three seasons of heavy rainfall and the ground is saturated with water, making it more prone to flooding.”

Namibia
Namibians, currently experiencing a heat wave, are eager for rain, said Guido van Langehove, chief of the Namibia Hydrological Services. Southern African Development Community (SADC) meteorologists have forecast normal to above normal rains for Namibia over the next three months. “It was the same forecast last year and we recorded three times the normal rain,” van Langehove pointed out.
The Caprivi Region, Namibia’s poorest area, is prone to annual flooding.
Japhet Itenge, director of Disaster Risk Management in the Office of the Prime Minister, said they were prepositioning essential commodities and relief tools as part of their contingency plans.

Lesotho
Lesotho has not received adequate rainfall in the past few months, a spokesman for the country’s meteorological services told IRIN. “SADC has forecast heavy rains for Lesotho in the coming weeks. We are worried it can cause early frost and destroy crops that have already been planted,” he said.
Lesotho and Namibia have food insecurity levels greater than their five-year averages due to the severe flooding experienced during the last growing season, according to FEWSNET.

Mozambique
The Mozambican authorities have begun to release water from the Cahora Bassa Dam on the Zambezi. People living mainly along the lower Zambezi basin and in Buzi, Save, and Pungue basins, including Beira city, are on alert.
Sofala Province in central Mozambique is currently distributing items such as bicycles, stretchers, masks, gloves, megaphones and boats, according to the Mozambique Red Cross; and members of seven local disaster risk management committees established in Beira City are cleaning the drainage system.
The National Institute of Disaster Management (INGC) is monitoring the rivers Montepuez, Licungo, Mutamba, Pungué, Buzi, Save, and Maputo, said FEWSNET. In the Zambezi and Limpopo river basins, FEWSNET warned of a near-average-to-high probability of flooding.
JoĂ£o Bobotela, CARE’s emergency response coordinator in Mozambique, said INGC and local authorities had been running flood simulation exercises since November 2011 to prepare communities for sudden evacuations.

Botswana
Arid Botswana has not received good rains in the past few months. “We are expecting average rains which might help crops,” said a spokesman for the Botswana Meteorological Services.

Malawi
More rains have been forecast for southern Malawi, where land adjacent to the River Shire, one of the most food-insecure parts of the country, is prone to flooding. Parts of the region, which has seen an outbreak of foot and mouth disease and a hike in food prices, are in crisis mode, warned FEWSNET.

South Africa
Much-needed rain has fallen in South Africa’s major maize-producing northern Free State area in the past few weeks. The government and USAID’s Famine Early Warning Systems Network (FEWSNET) say the country has adequate supplies, but global maize stocks are low, putting considerable upward price pressure on South African white maize.

http://www.irinnews.org/report.aspx?reportID=94598