He will be in Norway to be paid for his intentions to bring peace to the world. That is impossible to be realised because Obama is now doubling his efforts in the war we all witness in Afghanistan.

Norway is in high gear to foot the bill when the messiah comes visiting the country on the 10th of december to get what he really does not deserve as yet, the Nobel Peace Prize. We think he was simply given the award in order to lure him to visit Norway. By visiting the tiny country in the north, the world media will be there and that is what Norway likes to see so that they are not forgotten by the International community. The Norwegian politicians love attention and will do everything possible to get it, even giving grants to countries around the world in their efforts to be recognised on the world stage. One wonders what Norway would do if they did not have oil to sell and using the proceeds to lure the world to recognise its existence.

In Oslo at the moment, people are being searched in order to eliminate any threat to the messiah – Obama. People who run businesses in central business district of Oslo , the city centre, will be screened and vetted before they are alllowed to open their businesses on the 10th, and the 11th of december – the two days the messiah is expected to technically own the streets of Oslo.

With his wife Michelle Obama, without their two children, the messiah will take over Oslo city. And for what? They say because he wants to bring peace to the world. What a mistake! Do you give a man or a woman a gift because he or she plans to bring peace?

Let us take an example of a woman who wants to get a baby. It is like giving an award to a woman who says I want to get pregnant next year. First, one must wait and see the woman pregnant and wait and see the baby then award the bearer.

The Nobel Peace Prize has lost value after this latest function where one is awarded the prize – using the award to encourage for results that may never come. The intention of the Prize by Mr Nobel was to award achievement not intention to achieve.

By Chief Editor Korir

African Press International.

According to Nigeria’s constitution, the President’s duties are carried out by the Vice President once the Head of State writes a declaration to the heads of the Senate and House of Representatives that he is going on leave or otherwise unable to carry out his official functions. (Reuters)

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Photo: IRIN

NAIROBI,  – A new Ugandan study adds to a growing body of evidence that providing home-based antiretroviral (ARV) care in low-income settings can be as effective as facility-based interventions.

The study, run by The AIDS Support Organisation (TASO), a national NGO, recorded the progress of 859 patients receiving home-based care in the district of Jinja in southeastern Uganda, and 594 receiving care at clinics in the town of Jinja, from Feb 2005 till Jan 2009.

“In terms of patient survival, patient retention and virological failure [an increase in viral load after taking ARVs], the patients in both arms of the study had very similar results,” lead author Dr Shabbar Jaffar, from the London School of Hygiene and Tropical Medicine’s department of epidemiology and population health, told IRIN/PlusNews.

In home-based care, 16 percent of patients had virological failure, compared with 17 percent in facility care; 11 percent of patients in both arms of the study died during the course of the research; one percent of patients receiving home care were lost to follow-up, and two percent of those receiving clinical care.

“We also found that for patients, the cost of home-based care was significantly lower because they did not have to make as many clinic visits. Costs incurred by the healthcare service were also slightly less for home-based care, but not by much,” Jaffar said. Overall, the median cost of a clinic visit was US$2·30, about 13 percent of the reported monthly cash income for men, and 20 percent for women.

Task-shifting

Trained field officers on motorcycles visited patients in the home-care group every month to deliver drugs and provide adherence support; patients in the facility-based group obtained drugs from the clinic each month and had routine reviews with a medical officer and counsellor every three months.

“The main significance of this study is that it shows that programmes can successfully roll out care, using non-clinical workers,” Jaffar said. “The need to rely on clinical staff is not as great as previously thought.”

According to the UN World Health Organization, Uganda has only one doctor for every 22,000 patients, and an overall health worker deficit of up to 80 percent. Other African countries are not much better off: Tanzania has just 2.3 doctors per 100,000 people, while Malawi has 1.1 doctors for a similar population.

“Systems like South Africa’s, where HIV service delivery is so highly medicalized, are not necessary, and can in fact inhibit wider access to these vital services,” Jaffar noted.

Several southern African countries – Malawi, Mozambique, Lesotho – have allowed nurses to initiate and manage ARVs, but South Africa, where the doctor-patient ratio is better than many African countries – 69.2 doctors for every 100,000 people – still largely relies on doctors to manage HIV treatment.

Experts estimate that if this country is to reach its target of providing ARV coverage to 80 percent of people in urgent need of the drugs, it would have to more than double the number of people currently starting treatment annually.

Uganda’s home-based care research programme also allowed health workers to provide HIV counselling and testing to other family members, which would not have been possible in the clinical setting, where a patient is usually seen alone. Jaffar said the additional services were very well received.

“Another thing we thought we might find was stigma; we had been warned that we would find that homes that were visited by these workers would be stigmatized by the community, but this is not what happened at all,” he said. “In the Ugandan case, TASO had a good relationship with the community prior to our arrival; in a different setting, stigma could be an issue.”

A need for training

The field officers used in the study had degree qualifications or college diplomas, and received four weeks of intensive training at the start of the study, with subsequent yearly refresher courses in the principles of ARV therapy and adherence support.

A recent Ugandan study found that many clinical officers, nurses and midwives were prescribing ARVs without sufficient training.

“Rolling out home-based care would mean providing staff with training and support mechanisms; effectively you are creating a new cadre of health worker, one that is easy to get hold of, easy to train and easy to retain,” Jaffar said.

The researchers are exploring the possibility of expanding the same model of home-based care to other chronic health conditions such as tuberculosis and cardiovascular disease.

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Photo: Noorullah Stanikzai/IRIN

Shah Bibi says at nights her children cry from cold

KABUL,  – The onset of winter means freezing nights, cold-related diseases and more problems for the children at an informal settlement of internally displaced people (IDPs) in the western outskirts of Kabul city.

“They lack access to adequate food, shelter, healthcare, safe drinking water and sanitation, education, and are vulnerable to forced labour, sexual exploitation and many other problems,” Paola Retaggi, the coordinator of a Child Rights Consortium (CRC) led by Switzerland’s Terre des Hommes in Kabul, told IRIN.

Many IDP children either beg or work on the streets while some fall prey to the insurgents who have been accused by the UN of using children for military purposes.

“Afghanistan today is without a doubt the most dangerous place to be born,” Daniel Toole, regional director of the UN Children’s Fund (UNICEF) for South Asia, was quoted in the media as saying on 19 November.

About a quarter of Afghan children die before their fifth birthday (257 per 1,000) mostly from preventable diseases such as pneumonia and diarrhoea, according to UNICEF. The country also has some of the worst child malnourishment, stunting, underweight and vitamin deficiency figures in the world.

Half the country’s estimated 25 million population is below 15 but millions of Afghan children are deprived of their basic rights and are vulnerable to different forms of violence, aid agencies say.

“Internally displaced children suffer the most among all other children,” said Retaggi of the CRC.

More than 262,000 people are displaced in different parts of Afghanistan, according to the UN Refugee Agency (UNHCR). Conflict, natural disasters, poverty and communal tensions are among the major factors.

Little help

Between 2002 and 2005 more than one million people were internally displaced in Afghanistan, according to aid agencies. Most IDPs were accommodated in camps in Kandahar, Helmand and Herat provinces where UN agencies delivered essential aid.

Photo: Noorullah Stanikzai/IRIN

Aid agencies say IDP children lack access to adequate food, healthcare, education and protection

The UN-backed assistance programme ended in March 2006 and the IDPs were encouraged to return home in a bid to prevent a protracted emergency.

Many IDPs resettled in their original areas mostly in the northern provinces but tens of thousands have remained in camps, saying it is still unsafe for them to move back.

The ongoing conflict and recurrent natural disasters have added to the number of displaced families in the country over the past few years.

However, the UN and government have opposed the establishment of new IDP camps, particularly for conflict-affected families, and little sustainable aid has been provided to them.

“Refugees are assisted and protected by UNHCR but no agency has a clear mandate to assist IDPs,” said CRC’s Retaggi, adding that IDP children were particularly deprived of protection and assistance.

“What we fail to do [for] these children now will with no doubt reflect on the future of the entire country in a couple of years,” Hansjorg Kretschmer, head of the European Commission Delegation to Afghanistan, told a press conference on 22 November in Kabul.

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Photo: Nicholas Reader/IRIN

A woman pounds millet in a Niger village (file photo)

DAKAR, 27 November 2009 (IRIN) – Some communities in the Sahel region could face “extreme food insecurity” after erratic rains this year deeply cut cereal production particularly of the staple millet, food security experts say.

The Famine Early Warning Systems Network, FEWSNET, in a 25 November alert says 2009 millet production in Burkina Faso, central Chad, northeastern Mali, Niger and northern Nigeria is likely to be 30 percent below average.

Total production for the region should be near average given surpluses in some areas, but how cereals flow through grain markets will be critical. Experts say rain is just one of many factors affecting whether Sahelian families find enough to eat; local markets play a pivotal role.

“If food flows relatively freely from surplus to deficit areas, availability in affected areas will be sufficient to meet needs,” FEWSNET says. “Access to food markets, however, will be constrained by high prices and reduced incomes.”

If governments restrict cereal flows, poor farmers in Niger, Chad and northeastern Mali could face reduced availability, high prices and locally extreme food insecurity, the alert says. “Every effort should be made to encourage the free movement of cereals across borders.”

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Photo: Jefri Aries/IRIN

The remains of a mosque following the 30 September earthquake in West Sumatra (file photo)

JAKARTA, – Predicting earthquakes is an inexact science – which is why disaster preparedness remains key to saving lives, scientists say.

Experts have forecast that a long undersea faultline along Indonesia’s Sumatra Island is due to produce a powerful and devastating earthquake in the next few decades.

Sections of the fault, called the Sunda megathrust, have ruptured a number of times over the past decade, causing several earthquakes in the region.

A major earthquake could trigger a tsunami that could result in casualties and damage equal to the 2004 Indian Ocean tsunami, writes Kerry Sieh, a scientist at the Earth Observatory of Singapore, in an article made available to IRIN.

“To those living in harm’s way [on] the coasts of western Sumatra, it should be useful to know that the next great earthquake and tsunami are likely to occur within the next few decades, well within the lifetimes of children and young adults living there now,” the article states.

A magnitude 7.9 earthquake that devastated West Sumatra province and killed more than 1,100 people on 30 September originated near that faultline, according to experts.

“We don’t know when such a great earthquake will happen. It could be tomorrow, next year or the next five years,” said Fauzi, head of the Earthquake Center at the Meteorology and Geophysics Agency in Jakarta, who like many Indonesians only uses one name.

“It will be much more beneficial if we focus on preparedness. Earthquakes don’t kill, but collapsed buildings do,” he told IRIN.

Fauzi said between 1991 and 2009, Indonesia was hit by 43 major earthquakes, 15 of which generated tsunamis. The 30 September quake in West Sumatra resulted in a tsunami, though it was very small, he said.

Predicting earthquakes is also a sensitive issue in Indonesia and false rumours could create panic, Fauzi warned. “When scientists say an earthquake with a magnitude of 8.8 is likely to occur based on scientific findings, people refuse to go to school or work and SMS relatives,” he said. “The public talks about tomorrow, while scientists talk about years.”

Forecasting

Wahyu Triyoso, a geologist with the Bandung Institute of Technology, said the magnitude of an earthquake correlates with the size of the fault.

“If we could measure the amount of slip precisely, probably we could make rough estimates and we can make necessary preparations,” he told IRIN. “Forecasting means little if we don’t know the fault size, the dimension, length and width.”

Triyoso said even though knowledge of a potential earthquake was useful for scientists, it would be hard to communicate to the general public.

Photo: Jefri Aries/IRIN

Earthquake preparedness is key, say experts (file photo)

“If we say a certain place is dangerous and the public panic, it could become a social disaster,” he said. “So at the moment, preparedness is the best course of action,” he said.

In West Sumatra, an NGO called the Tsunami Alert Community (Kogami) has been working to instil a culture of preparedness among the population since 2005.

Kogami has been providing training on disaster preparedness in schools and communities in the provincial capital Padang, teaching them what to do should an earthquake and a tsunami hit.

The group has mapped out evacuation routes, with high-risk areas zoned red, while low-risk areas are zoned yellow.

It is introducing similar programmes in other districts in cooperation with other NGOs.

“Many people [live] in fear because they have received little information about earthquakes and what to do when a disaster happens,” said Patra Rina Dewi, Kogami’s executive director.

“We know we live in an earthquake zone and our job is to equip people with necessary knowledge,” she said.

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