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Archive for September 20th, 2011

Refugees crossing borders

Posted by African Press International on September 20, 2011

Of the 9,500 Congolese in Gabon, at least 692 had crossed the border to return to Congo by 1 September (file photo)

BRAZZAVILLE,  – The refugee status of 9,500 people from the Republic of Congo, who have been in neighbouring Gabon since the late 1990s, expired on 31 July, but many are still reluctant to return home.

“Many want to go home but are worried about conditions. We have no houses, no work. Soon it’s back to school and we worry about our children’s education,” said Philippe Vangou, head of a large family, a recent returnee to Brazzaville, the Congo capital.

As of 1 September, of the 9,500 refugees, at least 692 had crossed the border to return to Congo by land and air. The UN Refugee Agency (UNHCR) registered 553 returns in August.

“UNHCR is organizing repatriation, from registration formalities to departure,” said Philippe Bateza, a UNHCR protection officer in Brazzaville, noting that since the signing in 2001 of a tripartite agreement between Gabon, Congo and UNHCR on repatriation, only 2,609 have returned.

“The Congolese authorities… want to reinvigorate the process,” he said.

“So far, 1,700 applications for residence permits – for about 3,500 people – have been lodged with the Gabonese authorities,” UNHCR public information officer Daniela Livia Biciu told IRIN.

“When you count, you find that the number of undecided people is still very significant. What will most of these people decide to do? The next two months will allow us to identify the trend,” Gabriel Ontsira, director of humanitarian information at the Congolese Ministry of Humanitarian Action, told IRIN.

Almost all the Congolese refugees fled to Gabon after several civil wars, which rocked southern and southwestern Congo in 1997-2003. They were chased out of the Bouenza, Niari and Lékoumou areas where armed groups clashed with government forces.

“About 65 percent of returnee children were born during the exile of their parents,” said UNHCR.


Photo: OCHA/Reliefweb
Map of the ROC

To encourage the return of their citizens, the Congolese authorities have had an amnesty in place since 1999 for people who took an active part in the war.

Accommodation problem

“We came back home. We were received by our families but there is a big accommodation problem because in the intervening period our families have grown,” a 39-year-old refugee near Dolisie (Congo’s third-largest city), who wanted to be known only as Paul, told IRIN.

“Not everything is going as we would have wished. It’s a start. We are learning to live again. I think we will eventually adapt,” he added. 

“For many, the family has grown and become a great burden,” said Ontsira.

UNHCR is providing the equivalent of US$200 per adult and $100 per child “to help them make ends meet in the first few days”, said Bateza.

The Congolese government has set aside 300 million CFA francs ($600,000) to help the refugees.

With regard to reintegration, the government claims to have taken all the necessary measures.

“Officials are received by their former local authorities, and their salary arrears are paid; and the same goes for pensioners,” said Ontsira.

lmm/cb/mw source www.irinnews.org

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Thailand – Care for refugees by refugees

Posted by African Press International on September 20, 2011

A baby sleeps inside a homemade blue light incubator in Mae La

MAE SOT,  – Just as staff at the maternity clinic in the Mae La refugee camp began learning about special care for newborns, a baby was born six weeks premature, weighing 1.3kg.

The medics and nurses – all ethnic Karen refugees from Myanmar – were anxious about treating the tiny boy. Resigned to his fate, the family decided to take him home for his last hours or days. The staff agreed.

Then Claudia Turner, a British research paediatrician working in the camp, convinced them to let the clinic staff help the baby live. After a month-and-a-half in the special care baby unit (SCBU), he went home, healthy.

“The staff suddenly realized they could do it. It boosted confidence. That feels like a pivotal moment for us here,” Turner said in the office at the cluster of bamboo and thatch huts housing the Shoklo Malaria Research Unit (SMRU) maternity clinic. “Babies do die, but not all babies have to die, and we do our best.”

Turner has been training Karen refugee medics and nurses in neonatal care since 2007, when she set up the clinic’s SCBU in Mae La, the largest camp, housing 45,000 of the estimated 145,000 refugees living in nine camps along the Thai-Burmese border.

“Forty percent of neonatal deaths happen within the first 24 hours after delivery,” said Hervé Isambert, senior regional health coordinator with the UN Refugee Agency (UNHCR) in Bangkok. “This can be prevented by providing appropriate care within the first hours of life.”

The care can be as simple as cleaning the baby, providing skin to skin contact to prevent hypothermia and encouraging the mother to breastfeed within the first hour if possible, he said.

While UNHCR does not provide healthcare in the camps, NGOs working in maternal care mostly refer severe neonatal cases to nearby hospitals, but the SMRU unit in Mae La is staffed with 10 medics and 15 nurses trained to deal with difficult cases.

Neonatal deaths – within the first 28 days of life – have been halved in two years in Mae La. According to data, this is a model camp in terms of maternal health.


Photo: David Longstreath/IRIN
Claudia Turner examines a newborn baby

“Before that, there was no specific care or training for staff to look after very small babies,” Turner said, noting that to reduce infant mortality, a key focus must be on newborns.

“These are quite complicated cases. They [the medics] are operating on a level equivalent to doctor in the UK. It amazes me what they do,” Turner said. “They’re running it… they do all the work.”

Of the 10 million children who die each year globally, four million succumb in the first 28 days mostly to prematurity, infections and birth complication-related asphyxia. The first week is the hardest: three million die in those first seven days.

SMRU handles about 1,500 births each year. The neonatal unit cared for 279 babies in 2010.

In 2007-2008, the early years of SCBU, the neonatal mortality rate was 26 per 1,000 live births, according to SMRU statistics. By 2009-2010, that figure had dropped to 12 per 1,000 live births.

According to the UN Children’s Fund, neonatal mortality nationwide in Myanmar in 2009 was 33 deaths per 1,000; in Thailand, it was eight per 1,000. 

Caring for newborns in western countries is expensive – costing upwards of US$1,000 a day, and for premature babies in a refugee camp many believed it would be too difficult and too expensive. But a month of SMRU care totals about $165. Other NGOs afford local hospital bills through health programming grants and negotiating costs.

“People don’t believe it is possible – that’s what I hope to disprove. I’ve disproved it here, but I haven’t proved that it can be used in any setting,” Turner said. “Even without spending all that money, you can make an impact.”

Waves of ethnic Karen refugees and labour migrants have poured into Thailand since the 1980s. Many came to escape fighting between the Burmese government and ethnic minority groups, while others are in Thailand because of greater economic opportunities.

at/nb/mw source www.irinnews.org

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Congo’s health authorities introduced free Caesarean sections in May

Posted by African Press International on September 20, 2011

Congo’s health authorities introduced free Caesarean sections in May

BRAZZAVILLE, 15 September 2011 (IRIN) – A health policy shift that saw the introduction in May of free Caesarean section operations in 35 hospitals across the Republic of Congo – to curb the growing rate of maternal and infant mortality – seems to have prompted a proliferation of such operations, according to health officials.

“We are virtually living in the hospital because there are so many consultations,” said Jean-Claude Kala, head of gynaecology at Makélékélé Hospital, south of Brazzaville. “The free service has helped many people because until very recently many women were dying because their husbands or their parents had no money to pay for a Caesarean.”

Congo’s health authorities introduced the free Caesarean sections to reduce a maternal mortality rate considered high. Officially it is 781 deaths per 100,000 live births. One in 28 women dies in childbirth.

In 2010, Kala said, 5 percent of the 10,000 births in the hospital were by Caesarian; “so far this year we have had fewer than 6,000 births, but 10 percent of them were by Caesarean. This shows that the rate is increasing in our hospital.”

Makélékélé Hospital is one of the designated centres in Brazzaville where the free operations are available.

Between May and August, some 220 Caesarean sections and 29 obstetric operations were carried out, according to Kala, even though the hospital has only 150 beds and three gynaecologists.

Before the new policy, the cost of a Caesarean was 50,000-150,000 CFA francs (US$100-$300) in a country where it is estimated 70 percent of the population lives below the poverty line.

“We reckon there are more cases than before. But we should also note the decline in mortality of both women and children,” Jean Louis Lengouango, director of Talangaï Hospital in the sixth district of Brazzaville, told IRIN.

''Congo is a poor country. People are interested in anything offered for free''

“We have not seen any break in supplies of medical equipment since the scheme was introduced because we are regularly replenished by the Director of Studies and Planning of the Ministry of Health,” said Lengouango, adding that all the doctors involved were state-funded.

A commission set up to evaluate the scheme estimates it will cost more than 2.8 billion CFA francs ($5.9 million) in 2011. Between May and August, the commission recorded 1,779 Caesarean deliveries out of 15,211 births, with 14 maternal deaths and 83 neonatal deaths.

“Congo is a poor country. People are interested in anything offered for free. For the moment it is difficult to assess the value of the measure. I think that after a few years it will show its limits,” Paul Ngangoue, 71, told IRIN.

The UN Population Fund (UNFPA) is one of the partners supporting the initiative.

“We believe that free Caesarean sections and the promotion of family planning are among the elements that contribute to reducing deaths by 60 percent,” said Jean René Kule, head of advocacy at UNFPA in Brazzaville. “It’s an initiative that we want to see continued.”

lmm/cb/js/mw source www.irinnews.org

Posted in AA > News and News analysis | Leave a Comment »

 
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