CONGO: “Simmering discontent” ahead of elections

Photo: Laudes Martial Mbon/IRIN

President Denis Sassou Nguesso is among the candidates running for election on 12 July

BRAZZAVILLE,� – Barely two weeks before presidential elections in the Republic of Congo, Marcel Kombo decided to send his wife and children away from Brazzaville.

“When you listen to the politicians talking, you�ve got to be prudent,” said Kombo, a secondary school teacher in the capital. The poll is due on 12 July.

“Their language is a bit violent and they don�t give one confidence. I have decided to send my family – my wife, three children and a nephew – to the village so they are safe if fighting breaks out,” he added.

With a past marred by army mutinies, rebellions, coups and attempted coups, Congo has been in the throes of a humanitarian crisis for more than a decade. Hundreds of thousands of people remain displaced, especially in the north of the country, where rebel activity is ongoing.

In the Pool region, for example, where government forces fought militias for years until 2003, the conflict destroyed livelihoods and set back years of progress, according to aid agencies.

Primary school enrolment, which used to be almost 100 percent, had by the end of the war dropped to less than 60 percent, according to the UN World Food Programme, which in May expanded its school-feeding programme in the Pool.

“People have not forgotten that elections have led to certain conflicts in the past,” Henri Okemba, a former minister, explained. However, he thought the political class had sufficiently matured to avoid a civil war.

Marguerite Kongo, a vendor at Bouemba market, said she had put some cash aside in case the situation deteriorated. “With our politicians anything can happen; they want power so much that they could unleash war on the country again,” she said. “When you hear people saying in the media that no one has a monopoly on violence, you get worried and take action.”

Service breakdowns

Maixent Hanimbat, chairman of the Forum for Governance and Human Rights (FGDH), said Congo�s socio-economic context was an important factor.

“Simmering discontent” was noticeable in the city, with frequent breakdowns in essential services such as water, healthcare and electricity, and discontent could lead to civil war when the election results are announced, he warned.

The socio-economic situation is precarious, with salaries unable to cover basic costs, he added. Education and health facilities are inadequate and unemployment is high – despite significant revenue from oil and timber.

Two supposedly “moderate” opposition candidates on 22 June threatened to withdraw from the elections in protest at the late publication of electoral lists.

They also claimed that the composition of the electorate and the number of polling stations was still not known by 26 June, and disputed the impartiality of the electoral commission.

Parliamentary elections in 2007 and local elections in 2008, organized by the same electoral commission, were marred by fraud, according to observers from the African Union observers and the Coordination d�appui au processus �lectoral, a Congolese civil society body comprising more than 20 NGOs.

On 22 June, Prime Minister Isidore Mvouba, who is also vice-president of the National Security Council (CNS), sought to reassure people that adequate security measures were in place.

The CNS was deploying 17,000 security staff to protect polling stations and election rallies, as well as the candidates, including incumbent President Dennis Sassou Nguesso, who has ruled twice, from 1979 to 1992 and from 1997 to date. In March 2002, he won elections with 89.41 percent of votes cast.

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Photo: Charles Akena/IRIN

Piya Ajuwa

JUBA, ) – Pia Ajuwa, 62, cannot recall when she fled Southern Sudan for Uganda. A mother of six, she returned in April to find that things had changed so much, she could not tell which house was hers in Nyakuro village. Ajuwa spoke to IRIN on 30 June:

“I left when I was young; I can�t remember the year and my age at that time, all I remember is that there was a lot of fighting between the [northerners] and SPLA [Sudan People's Liberation Army].

“We were living in Nyakuro. Our village was badly bombed. Many people died and my parents decided to flee to Pajeri village in Nimule [Southern Sudan]. I remember how we walked for many days, with little food and water.

“Some children died of hunger while others who couldn’t walk any more were left behind. We found so many people in Nimule who had fled from Juba.

“We camped in Pajeri for some years and in 1996 we left. Nimule was attacked several times and we decided to move further into Adjumani [District] in Uganda.

“We were later taken to a Sudanese refugee camp. The place was peaceful but life was hard. I stayed in the camp with my children but sometimes tong-tong [Lord's Resistance Army rebels] would raid the camp and abduct children.

“In 2005 we heard that the SPLA and the Khartoum government had signed the peace agreement; everyone was happy and anxious to go home. However, this was not possible until April this year when we were brought back by the UN Refugee Agency [UNHCR].

“I found Nyakuro a new place, completely different from the one I left. I can�t see the houses we left. We are starting everything afresh but it has been very difficult. Water is a problem here; we have to travel long distances to the [River] Nile to get water.

“People are struggling to build their homes but life has remained difficult. My two sons are working in Juba; I don�t know what their work is but they help the family. My husband died when he came back to Juba during the war.

“There are no schools or hospitals. When you are sick you have to go to Juba. The children are not able to get an education here. As for food, we buy most of it from Uganda. The prices are high in Juba because the products are from Uganda.

“People here grow little food because there is not enough rain.

“I am happy that I am finally home. Even if life is harder here, home is good. It is a place you feel free and your mind is at peace.�

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Photo: Charles Akena/IRIN

The price of cow’s milk has recently gone up by more than fifty percent

GULU,� – The rising cost of food in northern Uganda is forcing HIV-positive new mothers to turn to risky alternatives to formula milk or exclusive breastfeeding, as recommended by health professionals.

Despite the insecurity caused by a two-decade-long war in the north, prevention of mother-to-child transmission (PMTCT) programmes in the region are reported as largely successful.

The Italian NGO, the Association of Volunteers in International Service (AVSI), says that in its programmes in the districts of Kitgum and Pader, HIV testing and counselling acceptance rate are above 90 percent; more women are also coming to health centres to deliver their babies.

However, health workers and local NGOs trying to provide post natal support are finding it increasingly difficult to ensure that the women continue with safe feeding methods.

Health Alert-Uganda, a local NGO that provides funds for HIV-positive mother’s to buy milk, is struggling to meet the demands on its services. The NGO usually provides women with enough money for a month’s supply, but the price of milk recently jumped by more than 50 percent, which has forced cuts to its programme.

Powdered milk, while available in local grocery stores, is unaffordable for the vast majority of mothers in the country.

Ignoring the guidelines

World Health Organization (WHO) guidelines recommend that HIV-positive mothers opt for replacement feeding if it is affordable, feasible, acceptable, sustainable and safe; if not, it recommends exclusive breastfeeding for the first six months of the infant’s life.

“The problem has been that some of the mothers breastfeed their children while giving replacement feeds,” said Walter Anywar, a project officer with Health Alert. “We can reduce transmission of HIV to babies if support towards baby feeding is provided to these mothers who can’t afford the costly replacement feeds.”

Grace Adong gave birth eight months ago and was lucky enough to find a local NGO to supply her with a daily litre of cows’ milk, but her baby now requires more than a litre a day. Adong can’t afford to buy more milk, so dilutes her ration with water.

“I add half a litre of water to the milk so that it can take the baby through the day,” she said.

Uganda’s PMTCT policy follows WHO guidelines, but acknowledges that the majority of Ugandan mothers cannot formula feed because of high levels of poverty, the low status of women, stigma and an almost universal breastfeeding culture.

“The fact is that most mothers in Uganda, and especially those in post-war northern Uganda, currently cannot afford infant formula,” said a recent report�on the failures of PMTCT, Missing the Target, by the International Treatment Preparedness Coalition. “There was a feeling among pregnant women that their breast milk was insufficient due to moderate malnourishment, and they were likely to try to supplement it with other feeding, a step that eliminates the risk-protective factor of exclusive breastfeeding.”

“The Ministry of Health and non-government service providers should mobilize resources for nutritional support for replacement feeding for babies born to HIV-positive mothers who have registered for prevention of vertical transmission services,” the report recommended.

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Photo: Manoocher Deghati/IRIN

Programmes that distribute condoms to sex workers are under-funded in Zambia

JOHANNESBURG,� – The United States President’s Emergency Plan for AIDS Relief (PEPFAR) has taken a damagingly narrow approach to HIV prevention in Zambia, ignoring realities on the ground and neglecting the most at-risk populations, says a new report.

Researchers from the Sexuality Information and Education Council of the United States (SIECUS), a non-governmental organization that advocates sexual and reproductive health education and services, travelled to Zambia to determine what nearly US$577 million in PEPFAR funding between 2004 and 2008 had achieved.

Their findings are based on interviews with HIV/AIDS organizations, activists, medical professionals, community leaders, policymakers and programme participants.

PEPFAR followed the “ABC” (“abstinence, be faithful, condomise”) approach to HIV prevention in Zambia, but according to the SIECUS report, in 2008 $20.5 million was channelled to programmes focused on abstinence and being faithful, compared to $12.4 million allocated to programmes promoting other approaches, including the use of condoms; only four organizations received funding to promote condom use.

“We noticed that social marketing of condoms was non-existent in the Zambian capital [Lusaka], where approximately 10 percent of the population lives,” commented William Smith, vice-president for public policy at SIECUS.

In the report, Making Prevention Work: Lessons from Zambia on Reshaping the US Response to the Global HIV/AIDS Epidemic, condoms are dubbed “the silent ‘C’”.

PEPFAR policy emphasized condom promotion and distribution only for specific populations, such as discordant couples – in which one partner is HIV positive and the other negative – sex workers, and men who have sex with men. “The disproportionate emphasis on abstinence-until-marriage … has created a distinctly anti-condom atmosphere,” the authors noted.

President Barack Obama has overturned a policy banning funds for organizations performing or promoting abortion, like the Planned Parenthood Association of Zambia, which had also run successful condom promotion campaigns until their funding dried up. However, the anti-prostitution loyalty oath that requires all recipients of PEPFAR funds to denounce commercial sex work is still in place.

Researchers visited one of Zambia’s major trucking routes, where high rates of poverty have caused the commercial sex trade to flourish, and found that only one of three organizations distributing condoms to sex workers received PEPFAR funding, and that the supply of condoms constantly ran out. PEPFAR has also failed to prioritize comprehensive sex education as a foundation for effective HIV prevention.

Many organizations receiving funding were confused by PEPFAR requirements, such as that 33 percent of prevention funds be spent on abstinence-until-marriage programmes. Although this stipulation was removed in 2008, the researchers worried that communicating this change to implementers on the ground would take time.

Most PEPFAR funding goes to international or US-based NGOs, and the failure to adequately involve and capacitate local NGOs is viewed as another shortcoming. “Therelatively tiny investment in the efforts of Zambian NGOs on the prevention side raises concerns about sustainability and the further development of Zambian professionals to lead this work in the future,” wrote the authors.

Among other recommendations, the report called on PEPFAR to develop the capacity of local NGOs to make more substantial contributions to HIV prevention in their country, provide greater transparency about how PEPFAR funds were spent, shift away from the ideological emphasis on abstinence-until-marriage, and invest more in comprehensive sex education.

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Photo: Les Neuhaus/IRIN

Internally displaced persons in North Kivu Province: Hundreds of IDPs demonstrated last week near the town of Sake to protest continuing clashes between armed groups in the region – file photo

KINSHASA,� – Continuing clashes between armed groups in eastern Democratic Republic of Congo (DRC) have forced civilians to abandon their homes in North Kivu and affected aid operations, a UN official said.

“These incidents are causing a significant movement of IDPs [internally displaced people] from the area adjacent to Nyabiondo Masisi,” Lt-Col Jean-Paul Dietrich, spokesman for the UN Mission in DRC (MONUC), said.

The national army, FARDC, recently clashed with the Mayi-Mayi group known as the Alliance of People for a Free and Sovereign Congo (APCLS � Alliance du peuple pour un Congo libre et souverain).

Last week, hundreds of IDPs demonstrated near the town of Sake, 30km south of Goma, North Kivu’s capital, blocking a main road.

“The IDPs blocked the Sake-Kitchanga [at Kilolriwe] road, asking humanitarian officials for food,” the UN Office for the Coordination of Humanitarian Affairs (OCHA) said in a brief.

IDPs, it added, had continued to arrive in the region west of Kitchanga, in Masisi territory of North Kivu. Access to the displaced was, however, a problem because of ongoing military operations.

Aid workers could also not access South Lubero (north of Goma) following recurrent incursions by the FDLR (Forces d�mocratiques pour la lib�ration du Rwanda) in the region.

The situation is almost the same in the neighbouring province of South Kivu where, according to OCHA, three people were killed and a woman was raped on the night of 9-10 June in Kabare region.

“On the night of June 20-21, several houses were burned and a health centre looted in the counties of Mianda in the territory of Kalehe,” OCHA said, adding that the attack was attributed to the FDLR.

“According to an initial assessment, 118 houses were burned,” it added. “There is no information on civilian casualties, but there are reports of people drowning as they crossed a river during their escape.”

Local authorities in Nindja, in the territory of Kabare, said most of the civilian population had fled to areas controlled by the DRC army.

Photo: Eddy Isango/IRIN

Former rebels and Mayi-Mayi militiamen integrated into the FARDC: The army recently clashed with the Mayi-Mayi group known as the Alliance of People for a Free and Sovereign Congo – file photo

Fields looted

According to the UN-supported Radio Okapi, hundreds of families have also fled their homes because of insecurity in the North Kivu villages of Kashuga, Kalembe, Malemo, Minjenje, Mpet and Mera.

Callers to the radio station said they no longer had access to their fields for fear of being attacked by rebels and their villages were no longer safe from armed men who also looted their fields.

There were reports from the town of Pinga, about 250km west of Goma, that army troops had looted, erected barriers and were holding civilians at ransom. They were also creating fear and panic in nearby villages.

MONUC said some of the atrocities were attributed to the fact that soldiers have not received their salaries for some time.

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Some ODM leaders led by Prime Minister Raila Odinga (centre) after a previous meeting. Photo/HEZRON NJOROGE�