KENYA: The million man cut

Photo: Mercedes Sayagues/IRIN

KISUMU, 17 November 2009 (PlusNews) – The Kenyan government is expanding services to meet the growing demand for voluntary medical male circumcision after the launch of a national campaign a year ago.

“We believe the launch of a rapid results initiative to scale up what we are already offering will help meet the demand; our target is an ambitious one to see to it that at least 1.1 million of the uncircumcised men in this country get the cut by the end of five years,” said Jackson Kioko, director of medical services in western Nyanza Province.

Results of three random trials in South Africa, Kenya and Uganda in 2005 and 2006 demonstrated that medical male circumcision reduced the risk of HIV infection among men by up to 60 percent.

According to the Kenya AIDS Indicator Survey 2007, 85 percent of Kenyan men are circumcised; HIV prevalence is higher by three-to-five times in uncircumcised men. There are about 1.2 million uncircumcised men between the ages of 15 and 49 in Kenya, most of whom live in Nyanza Province, where fewer than 50 percent of men are circumcised.

Since the launch of the national campaign in November 2008, an estimated 40,000 men have been circumcised and 124 sites opened and equipped with facilities and personnel to offer the service. The government has trained 700 health workers in the province to offer the services in various health facilities.

“The trained health workers will ensure people who demand these services get them in a safe and timely manner and the training of others is ongoing across the various provinces within the country,” Kioko added.

The government also plans to roll out mobile medical circumcision. “We do not want people to opt out simply because the services are not near them and we are making arrangements that we go to them rather than them coming to us,” Kioko said. “We will, in the near future, offer infant medical circumcision; this has the potential to help people in time before their sexual debut.”

Experts remain emphatic, however, that male circumcision must not be viewed as a complete prevention tool. “It is refreshing to see that research is being put to use, but we should take precautions to ensure that we constantly give information that male circumcision must work along with other HIV infection prevention strategies to be effective,” said Kawango Agot, head of the Nyanza Reproductive Health Society.

“We have plans to launch a study to look into the sexual behaviours of men who have been circumcised to find out if they are engaging in risky behaviours due to the fact that they have been circumcised,” she added. “We hope this will ascertain if indeed people are engaging in [risky sex].”

A 2007 study in Kisumu, provincial capital of Nyanza, found that circumcision did not result in increased HIV risky behaviour. It found that as male circumcision became more widely promoted, there would be a need to monitor “risk compensation” associated with the procedure.

ko/kr/mw source.irinnews.org

AFRICA: Trying to give sex workers safer alternatives

Photo: Manoocher Deghati/IRIN

JOHANNESBURG,  – A plan by Malawi to offer prostitutes low-interest loans to start small businesses in return for abandoning sex work is generating controversy in a country where women are disproportionately affected by high rates of poverty and HIV.

“Most [sex workers] leave school at an early age, get pregnant, and then have to provide for a child, so they end up on the streets as a way to earn a bit of money,” said Ayam Maeresa, special assistant to the Minister of Gender, Children and Community Development, Patricia Kaliati, who proposed the plan after discussions with sex workers, most of whom said they had been driven into prostitution by poverty.

The plan aims to economically empower female sex workers and reduce the spread of HIV, but critics question whether it can achieve either of these goals when there are so few opportunities for Malawian women to earn more than they do from prostitution.

“If we help them to get out of this trade, we’ll also be helping to control the spread of HIV,” Maeresa told IRIN/PlusNews. He was vague about what type of businesses the women would be encouraged to set up, saying only that several NGOs had indicated they would provide business management training.

Rehabilitation approach flawed

Many initiatives in Africa have made attempts to help sex workers find alternative sources of income without much long-term success. None of the sex workers in Botswana, Namibia and South Africa interviewed in a recent study by the Open Society Institute (OSI) had found jobs after completing what the authors called “rehabilitation” programmes.

“They offer women an alternative job in another part of the informal economy that is equally if not more unpredictable, and often leads to the women earning much less money,” said Vivienne Mentor-Lalu of the Sex Worker Education and Advocacy Taskforce (SWEAT), a Cape Town-based NGO that lobbies for the rights of sex workers.

Men stand on the side of the road selling their labour, and women stand on the side of the road selling sex

Research by SWEAT found that a South African woman with primary school education could earn up to four times more doing sex work than any other job she would be eligible for, if she could find a job in a country with around 25 percent unemployment.

“In South Africa we have this phenomenon where men stand on the side of the road selling their labour, and women stand on the side of the road selling sex,” said Mentor-Lalu, who was worried that programmes steering women away from sex work were often less concerned with economic empowerment and reducing HIV risk than promoting a conservative moral agenda.

The OSI report suggested that the popularity of such interventions was linked to restrictions on foreign funding that undermined rights-based approaches favoured by the sex workers. Organisations that receive funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR), for example, are required to sign an “anti-prostitution pledge” that they will not support or promote sex work.

Marlise Richter, a South Africa-based researcher, said the requirement had “a chilling effect” on efforts to support sex workers’ rights. “Sex workers don’t need to be rehabilitated, they need to be given skills and a safe working environment. I can see there’s a place for exit programmes and microloans, but you’re not dealing with the underlying system.”

Rights not rescue

In most of Africa, as in the rest of the world, the underlying system is one that criminalises sex work, making it difficult for sex workers to access health services or to report abuse at the hands of clients, pimps and even police.

As host of the 2010 FIFA World Cup, South Africa is ahead of much of the rest of continent in starting to debate the merits of decriminalising sex work, a move supported by the National AIDS Council. “Increasingly, there’s recognition that you can’t begin to look at sex work and HIV if you don’t look at sex workers’ rights,” said Mentor-Lalu.

Explaining how the abuse of those rights could contribute to HIV infections, she cited the practice of police confiscating condoms from sex workers; of having to pay fines, when arrested, which made the women more likely to agree to unprotected sex for a higher fee; the marginalisation of prostitutes that prevented them from accessing health services.

Rather than addressing any of these issues, the Malawian plan would penalise women who returned to prostitution after accepting a loan from the government. “If it becomes a law, that will be one of the conditions,” the gender ministry’s Maeresa confirmed. “If you return to the streets, it [sex work] becomes a criminal offence.”

The Reproductive Health & HIV Research Unit (RHRU) of the University of Witwatersrand, in Johannesburg, South Africa, have adopted a more flexible approach with their “Beauty Shack” project for sex workers from the inner-city neighbourhood of Hillbrow.

After completing training in beauty therapy at a local health spa, the women are encouraged to give up sex work and start businesses or seek jobs, but if they choose not to they can still participate in the programme as peer educators, earning a monthly stipend of US$134.

Nonhlanhla Motlokoa of RHRU, who coordinates the “Beauty Shack” project, is optimistic that it will be more successful than previous initiatives offering training in cooking and sewing. Although some of the women “are scared to take that leap”, two have already secured full-time jobs at the spa where they were trained, while others are enthusiastic about the possibility of starting small businesses.

RHRU also operates a mobile clinic that provides condoms, HIV counselling and testing, and treatment of sexually transmitted infections at hotels where the women live and work.

Researcher Richter applauded RHRU’s public-health approach, but insisted that “The bottom line is the criminalisation of sex work that results in stigma and abuse,” and that only legal reform could address the gender-based violence and lack of legal recourse that put sex workers at most risk of HIV.

ks/he source.irinnews.org

by Philip Mwakio

The bad-boy of American film Nicholas Cage is in the country on a mercy mission targeting inmates in a Kenyan prison.

The award-winning actor best known for his flamboyant and eccentric roles in films such as National Treasure, Con Air, Lord of War and Adaptation, among others, arrived under the cover of darkness on Monday night. Few passengers accompanying him on a flight from Nairobi to Mombasa could recognise him.

(Right) Hollywood actor Nicolas Cage and Executive Director United Nations office on drugs and crime, Antonio Costa (Second right) with inmates and officials at Shimo la Tewa Prison. Photos: Omondi Onyango /Standard

The 45-year-old actor arrived in Mombasa after flying in from Kampala in Uganda, where he spent two days raising awareness on war victims, such as those in Uganda’s Gulu region in the northern part of the country that has been devastated by child abduction and rape orchestrated by the Lords Resistance Army.

Cage, who is also an ardent human rights activist, is reported to have been moved by the grim images from Gulu that he saw while attending a funds drive in New York in the US.

Flanked by his aides and spotting a moustache, Cage appeared in a hurry as he tried to evade cameramen at the Moi International Airport arrival lounge at around midnight on Monday.

Cage is touring under the auspices of the United Nations Office on Drugs and Crime, and on Tuesday visited Shimo la Tewa Maximum Security Prison where he inaugurated a modern energy-saving kitchen funded by the UN office.

Pirates

UNODC executive director Antonio Maria Costa and programmes coordinator Allan Cole, as well as Shimo la Tewa officer in charge Wanini Keriri, conducted Cage on an extensive tour of the facility.

The UN body is also undertaking several infrastructure upgrade projects at the correctional facility. Apart from the new kitchen, UNODC is also involved in constructing staff houses and recreational facilities at Shimo la Tewa.

During his tour, Cage chatted with prisoners including the Somali pirates being held at the facility. “We have seen the prison facility and are amazed at the reforms and skills being imparted on them as they serve their jail terms,” Cage was reported to have said as he left the facility.

He and his entourage were entertained by prisoners before presenting certificates to prison warders who have been supportive of UNODC projects at the prisons.

60 films

The son of a comparative literature professor from Long Beach, California made a debut in television in 1981 and has never looked back since.

The Hollywood actor has appeared in over 60 films, picking an Oscar for National Treasure, among other awards, in a career spanning more than two decades.

In the movie, Cage plays an eccentric historian who goes on a dangerous adventure to find treasure hidden by the founding fathers of the United States.

Cage is staying at the Mombasa Serena Hotel, and the management of the four-star hotel, a member of the Club Best Resorts of the World, said they were not sparing any effort in pampering their famous guest. An exclusive breakfast on the beach designed for Cage and three others was laid out on the white sandy beach yesterday.

Last evening, a dinner was set at sunset at the popular hotel’s Jahazi Grill, which specialises in seafood.

Sources told The Standard that Cage had ordered drinks that had never been asked for since the hotel was built in 1975. The menu consisted of a 24-course meal and Cage was said to be keen on devouring his favourite dish – lobster thermidor.

The lobsters are first removed from the shells and fried with spices then cream and cheese added before being put back in the shells. The actor is expected to fly back to the US Wednesday morning.

source.standard.ke

by Biketi Kikechi and Jibril Adan

The first liberation was Independence in 1963, the second was tumultuous clamour for return of multipartism, which peaked in 1990, and the third could have begun on Tuesday.

In the three phases the war has been empowerment of the voter, respect for universal suffrage, clipping of presidential powers, and making every citizen count.

On Tuesday, the nation was put on track, through public release of the harmonised draft constitution that could lead to the ‘third liberation’.

This road is paved with the hard lessons, the bitter memories of the sad moments the constitution has failed us, and acceptance by the majority of Kenyans that comprehensive reforms are not only inevitable but also vital for national survival.

Kenyans’ wishes

The draft released by the Committee of Experts at the KICC, seeks to coalesce the wishes of Kenyans through the years in the way they want to be ruled. It builds on the aspirations of freedom fighters before Independence, the remonstrations of citizens, the reformist leaders, the civil society, and international standards of democratic practice and space. If accepted, it would symbolically be the ‘third liberation’ from competing interests.

The draft, which Kenyans will debate and present their views on after 30 days, attacks the powers of the presidency, seeks to introduce a powerful premiership, and to keep the President and the PM who share Executive power in check. It drastically seeks to embolden and empower Parliament and the Cabinet.

President Kibaki’s Party of National Unity pushed for retention of an all-powerful presidency, while Prime Minister Raila Odinga’s Orange Democratic Movement pitched for a powerful premiership and a ceremonial President.

Option given

The CoE draft seeks to unite Kenyans on this potentially divisive issue by giving them the option of a hybrid system — that distributes Executive authority between the two offices.

It also proposes the President, once every year, reports, in an address to the nation, progress in national duty. It proposes that presidential election be held on the Tuesday, immediately preceding the 21 days before the expiry of the term of the President. The format of National Oaths will also change, as ministers will swear allegiance to the PM.

If passed the massive powers vested in the presidency will no longer be applied at the whim of the incumbent as checks and balances have been proposed. For example, Parliament shall vet executive appointments.

The draft proposes that persons seeking presidential office should not be MPs when they are sworn- into office. Today, the President enjoys immense and unchecked powers, allowing him to make executive decisions without reference to any other institution.

According to draft, the Cabinet will be chaired by the PM and does not include the president. In addition it seeks to move the office of the Secretary to the Cabinet from President to PM’s office.

The draft introduces bold proposals on the appointments of all constitutional office holders. For instance, it recommends Attorney General hold office for one term of 10 years. The same will also apply to the Chief Justice.

Also to be established will be a Supreme Court that would be the highest court in the land.

The President’s powers of appointments such as of Chief Justice are watered down by requirement that after recommendation by the Judicial Service Commission, Parliament has to be approved it.

In the harmonised draft, the State President can only dismiss the Deputy Prime Minister, a minister or a deputy minister, “on the advice of the Prime Minister”.

The PM can be sacked by Parliament, through a vote of no confidence, which the President ratifies within a week.

Removal of PM

It proposes that removal of the PM — who should be the leader of the majority party or coalition in the House — by Parliament be based on simple majority vote while President can be impeached by a minimum of a two-thirds majority vote.

But to check against the abuse of the provision, it proposes the entire Cabinet resigns if a no confidence Motion in Parliament falls the PM.

Holders of constitutional offices would still be appointed by the President, but on the advice of the PM and with Parliament’s approval.

The Standard analysed the harmonised draft constitution released by the Committee of Experts (CoE) on Friday and Saturday last week, and there were no contradictions between the report and the draft released on Tuesday.

Its highlights include proposal that the deputy president must have been the winning candidate’s running mate in the presidential election.

He or she will also execute the powers of the President when the incumbent is indisposed or abroad. If the office of the President falls vacant half way through term, there would be no election and the deputy president shall take over. “We have struck a balance and there will be no conflict between the President and the Prime Minister,” said chairman Nzamba Kitonga during the launch.

The proposed constitution also recommends the dissolution of the Provincial Administration because the national government will restructure itself into devolved units.

Devolved government

Civil servants serving as PCs and DCs will report to the Public Service Commission for redeployment. It also provides for a devolved government, with eight regions, down from the initial 14 in last week’s draft.

The Prime Minister shall be the head of government and shall direct and co-ordinate the work of ministries and legislation. The PM shall preside over Cabinet meetings consisting of himself or herself, Deputy Prime Minister, and not fewer than 15 and not more than 20 ministers.

The PM, it proposes, can also appoint not more than 10 people, who are not MPs to the Cabinet.

“Before anybody claims that the president will be ceremonial he should read the draft we have released,” Nzamba said, adding the presidency proposed in the draft would enjoy executive powers.

“He will be the Commander-in-Chief of the Armed Forces and will have powers to dissolve Parliament if it failed,” he said.

He made it clear the president and PM shall work in harmony. “The President will not be involved in the small issues of the running the day-to-day activities of the Government,” he said.

Major appointments

All major appointments by the President shall have to be approved by Parliament according to the draft constitution.

Mr Kitonga explained the role of Parliament in approving senior appointments was expanded to curtail the abuse of State power by the President. “These powers have always been open to abuse and we introduced these checks to limit them,” he said.

Overall, the draft introduces many checks on all public offices to limit abuse of power. Even in the case of MPs, a clause allowing voters to recall legislators, if they failed in their duties, has been included.

source.standard.ke