KENYA: Slum fires highlight urban preparedness gap

Photo: Julius Mwelu/IRIN

Fires are common in Nairobi’s slums (file photo)

NAIROBI, 15 April 2011 (IRIN) – When fires swept through three Nairobi slums from January to March this year, leaving an estimated 25,000 people homeless, authorities and agencies were slow to respond.

Fires are common in Nairobi’s slums but urban disasters receive a “baffling” lack of response from aid agencies, indicating major gaps in urban crisis preparedness, says the UN Office for the Coordination of Humanitarian Affairs, OCHA.

According to the UN Human Settlements Programme (UN-Habitat), 60 percent of Nairobi’s population lives on 5 percent of the land. The city’s overcrowded slums and informal settlements, constructed from cheap materials like corrugated iron and connected to hazardous electricity lines, make them particularly vulnerable to fire. Access roads are few, making passage difficult for fire trucks.

Fires are not the only risk prevalent in low-income urban areas. OCHA highlights terrorism attacks, floods, social conflicts, disease outbreaks, insufficient access to water and sanitation, high risk of gender-based violence and food insecurity as some of the major issues facing urban communities.

Most of the world’s people now live in cities. As urban development accelerates, the proliferation of informal settlements, declining ecosystems and failing infrastructure increase the vulnerability of inhabitants to disasters. ISDR estimates that eight out of 10 of the most populous cities in the world can be severely affected by an earthquake, while six out of 10 are vulnerable to storm surges and tsunamis. A 2006 report by UN-Habitat said slum populations accounted for more than 70 percent of the urban population and are estimated to grow at a rate of 27 million per year between 2000 and 2020.

Finding the tools

While rural disasters have clear response plans in place, none is available for urban disasters. Choice Okoro, senior humanitarian affairs officer for OCHA, told IRIN it was important to develop appropriate information systems and tools for urban areas.

“In Nairobi for instance, if you want to do an assessment for a slum like Mathare, you see it’s a spatial issue. You have the most affluent and the poorest together in the same district and if data is aggregated, it looks good – the affluent side balances the poorest. So you don’t see the needs.

“I think also there is a general perception that urban areas are places of economic development. You can locate IDPs in rural areas, but [in] urban areas, how do you [know] who is an IDP? We need to find the appropriate tools. The challenge here is not a deliberate unwillingness to provide humanitarian support.”

A number of agencies, including UN-Habitat, frequently highlight the resilience and knowledge of communities as a factor to consider when planning urban disaster responses, rather than excluding their expertise from emergency planning. “Community leaders should be at the centre of relief, rehabilitation and reconstruction,” said Jean-Christophe Adrian, country programme manager for UN-Habitat in Haiti.

Photo: Julius Mwelu/IRIN

Urban disasters lack clear response plans (file photo)

While Haiti is facing a unique set of challenges in reconstructing Port-au-Prince after the 2010 earthquake, lessons learnt could be applied to disaster-prone urban areas in Africa, such as developing flood-mitigation measures and improving basic services for slum dwellers. In response to the fires in Nairobi, Amnesty International called on the Kenyan government to ensure essential services in informal settlements, including access roads, safe electricity and water and sanitation.

Long-term development measures are fundamental to building urban preparedness to disasters, says Okoro. “After two days, we didn’t even know where the displaced communities in the Nairobi fires went, because these are informal settlements. If you have thousands displaced, where do you house them after the fire? Then there are other longer-term concerns. We talk of resilient communities. But if you rebuild the same structure again, is that resilience?

“We have also food insecurity. In urban areas… the amount of money needed for food is very high compared to rural areas. Increases in food prices have a direct impact on communities in urban areas, especially informal settlements. This puts communities in a chronic and constant state of emergency.” OCHA is working to mainstream urban disaster preparedness into humanitarian response.

Corruption issues

But some see the lack of urban resilience in many cities as testimony to “poor planning, corruption and negative attitudes” . After a panel in March organized by the UN International Strategy for Disaster Reduction (ISDR), Addis Ababa, Nairobi, Kampala and Yaoundé joined the campaign, Making Cities Resilient. It seeks to raise awareness among politicians and the public and to incorporate 10 essential actions into city planning, including assigning a budget for disaster risk reduction, preparing risk assessments, maintaining critical infrastructure and creating public education programmes in schools and local communities.

Allen Kisige, a representative of Kampala City Council, said: “One of the biggest impediments in addressing urban sustainability is corruption and the general lack of political buy-in” – another issue the campaign hopes to address.

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source http://www.irinnews.org

NIGERIA: Blemishes and blessings in the elections

Photo: Aminu Abubakar/IRIN

Campaign billboards in Kano

JOS/KANO, 15 April 2011 (IRIN) – Analysts say the initial round of parliamentary elections, which began on 9 April, have been more transparent than the country’s past three elections, which were marred by violence and irregularities, but nonetheless, evidence of candidates in some towns employing desperate measures, including vote-buying, has emerged.

According to Shehu Dalhatu, director of the Centre for Democratic Research and Training (CDRT) in the northern city of Kano, candidates for the 9 April legislative elections recruited agents who hung around a few metres from polling stations offering money for votes. In some cases candidates demanded Muslim voters swear on the Koran that they would not change their mind once in the polling booth.

Akibu Dalhatu of Transition Monitoring Group (TMG), a local group in Jigawa state that has been involved in election monitoring in Nigeria since 1999, told IRIN that when monitoring the polls: “I witnessed politicians [in villages in Jigawa] openly offering money to voters at polling stations to cast their votes in favour of their candidates and many voters took the money with the promise to vote for the politicians’ candidates.”

“Most of the voters approached were women who are mostly illiterate with no voter education and therefore more gullible to such offers,” he told IRIN.

Politicians also went door-to-door offering food, soap, clothes and money to potential voters, residents of the northern city of Kano told IRIN. “I was offered a wax fabric and 500 naira [US$3.3] which I collected, but I voted for the candidate of my choice,” Fatima Musa, a 35-year-old voter in Kano, told IRIN.

In previous elections, voters in northern Nigeria would often wear leaves on their heads to advertise that their vote was for sale, and would openly haggle with candidates’ representatives over the price.

The practice is evidence of disillusionment with the elections’ process. “After voting several times, and their electoral wishes have been flaunted through election rigging, many voters feel their votes do not count and will take money to vote,” TMG director Festus Okoye told IRIN. “Coupled with excruciating poverty and illiteracy, these voters would readily part with their votes for some paltry financial gain.”

Yahaya Badda, a 65-year-old farmer in the northern city of Sokoto, declared his vote was for sale.

“I have been voting since the 1960s during the first republic, but good leaders have deserted Nigeria since then, and now my vote is for sale… I’m ready to give my vote for 2,000 naira [$13] which is better than wasting my time in casting a vote that will not count.”

Nick Dazen, spokesman for Nigeria’s Independent National Electoral Commission, told IRIN: “We are aware that some people do sell their votes, but the electoral law doesn’t empower us to sanction [punish] such people. The best we can do is to appeal to their patriotic instinct not to exchange their votes for money and ensure they vote for the right candidate.”

More transparency

Despite irregularities in some cases, Nigerians are more engaged in this elections’ process than they have been in previous years, said Nasir Abbas, a civil society activist with the Civil Rights Congress in the northern city of Kaduna.

“Procedurally, [elections in Nigeria] used to be an affair of thuggery. Street vagabonds were put in charge of this [rigging and intimidation] and a lot of upper class citizens didn’t go out to vote… [But] the ruling People’s Democratic Party (PDP) has been unpopular [in recent years] so now a lot of people are voting… Elites, the downtrodden… people are determined to have an upright process,” said Abbas.

Civil society watchdog groups including the Abuja-based coalition known as the Elections Situation Room, say electoral reforms initiated under the leadership of respected elections commission chief Attahiru Jega have enabled greater transparency in the 2011 polls. International observer groups also praised the polls as the most credible since 1999.

One of the new regulations allows voters to remain at the polls after casting their ballots in order to observe the counting procedure, making it more difficult for fraudsters to manipulate the results. In other cases, observers have used SMS technology to report real-time on irregularities.

Presidential race

However, Oladayo Olaide of the Open Society Institute in the capital, Abuja, said victories of opposition candidates in the country’s commercial capital Lagos and in some areas of the “core North” could push the ruling PDP to “become more desperate, which could mean [the party] could come out with new tricks” on 16 April when the presidential elections take place.

It is not beyond the ruling party to employ “all manner of tricks” if politicians feel their power could be taken by voters casting ballots against them in the upcoming polls, said Olaide.

Given the simmering Muslim-Christian tensions in many Nigerian cities – including Kaduna in 2002, and more recently, Jos – a spike in conflict related to the outcome of the presidential vote is not out of the question, especially given that many citizens blame their own political leaders for prolonging the crisis in the Middle Belt region.

At least 70 people were killed in political violence in the run-up to the current elections, according to Human Rights Watch, while more than 14,800 have allegedly been killed in inter-communal, political and sectarian violence in the past 12 years.

On 16 April voters will choose between President Goodluck Jonathan from the southern Niger delta region, and his two main rivals, both from the Muslim north – Muhammadu Buhari and Nuhu Ribadu.

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source http://www.irinnews.org

ETHIOPIA: Bid to boost ART adherence

Photo: Casey Johnson/IRIN

Patients taking their ARVs irregularly risk developing drug-resistant strains of the virus

ADDIS ABABA, 13 April 2011 (PlusNews) – A three-month campaign by Addis Ababa’s health bureau hopes to boost adherence to antiretroviral (ARVs) drugs in the Ethiopian capital by improving communication between patients and health service providers.

A 2009 study by the HIV/AIDS Prevention and Control Office found that on average, 72.3 percent of patients on ARVs were still on first-line medication one year after starting treatment.

“The remaining are lost… it could be due to any number of reasons such as death or an unannounced change of location but it is a cause for concern,” said Addis Akalu, head of the disease prevention and control department at the Addis Ababa Health Bureau.

According to Esmael Wabela, HIV prevention and treatment adviser at the city’s heath bureau, insufficient food, high transport costs to drug collection points and stigma-related issues such as fear of disclosure are some of the main reasons HIV-positive Ethiopians fail to stick to ARVs.

Such failure can hasten progress from HIV to AIDS; patients taking their drugs irregularly also run the risk of developing drug resistant strains of the virus, requiring significantly more costly second- and third-line ARVs.

Addis Ababa’s health bureau is partnering with the national AIDS Resource Centre (ARC) on the three-month campaign, launched in March and funded by the US President’s Emergency Plan for AIDS Relief. Through a mass-media campaign and the use of toll-free telephone HIV/AIDS information services, it seeks to promote “astewai” (responsible patients), and “tagash” (tolerant service providers) as part of its efforts to improve adherence.

“There are findings to suggest that if there is good communication between clients and service providers, better services are provided,” said Anthoula Assimacopoulou, ART communication programme officer at the ARC.

Some 26 state-run health centre, five state-run hospitals and 13 private facilities that provide ART in Addis Ababa will participate in the campaign, with a plan to roll it out to the rest of the country should it prove successful.

Improving communication

“For our communication campaign, we took best practices from Indonesia. The [2006] campaign they did there was called ‘Smart’; it aimed to improve the effective use of family planning services targeting clients,” Anthoula added. “What we did here in Addis is we targeted both clients and service providers because we found that both need help in their work.”

According to Anthoula, most clients visiting health centres in Ethiopia are timid. “They are typically non-assertive as when they go to health providers they don’t ask questions and they are shy to express themselves and talk about their health status.”

A 10-minute campaign video encourages patients to keep a note book and jot down issues to discuss during consultations with health workers; the video also encourages patients to lead healthy lifestyles and protect others from the virus.

“I am sure this [campaign] will help but some of the challenges we face are more to do with the health facility,” said one client, who requested anonymity. “As you see here, there is only one room and three clients are in with their service providers at the same time… this obviously makes things a bit harder for one-to-one conversation and that ideal environment to have an in-depth discussion about one’s health and feelings.”

Burnout

Thomas Ayele, a city health worker, says he and his colleagues often see as many as 30 patients every day; assessments done by the campaign found health workers to be overburdened.

“We don’t have a burnout management system that helps professionals cope with a tense working environment they could face. This was a major problem for our doctors in the pre-ART period as more than 40 percent of the hospital beds were occupied by people living with HIV and the doctors felt helpless to do anything for them and most left the service subsequently,” said Esmael.

When [patients] go to health providers, they don’t ask questions and they are shy to express themselves and talk about their health status

However, officials say the weaknesses in the health system are being addressed and improved.

“When the ART service was first launched, it was only in hospitals but the demand was so huge that health centres soon followed and now even in private hospitals ART is given for free; soon, with the completion of health centres under construction and commencement of the service by NGO clinics that are applying to provide the service, it will improve significantly,” said Addis.

According to Esmael, the campaign could serve as the basis for the creation of a burnout management system.

Some of the skills being imparted to health professionals include time management, better interpersonal communication skills and body language, the importance of working with clients and the use of appropriate language.

Health workers like Thomas, who say clients get upset when health workers are unable to help with requests for food assistance, will also now have information to provide clients with referrals to non-medical HIV services.

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source http://www.irinnews.org