Photo: Micheal Porebiak/Flickr

Traffic accidents, the second leading cause of deaths of young people in Africa

ADDIS ABABA,  – Increasing traffic accident deaths are a likely consequence of economic and population growth in Africa unless leaders on the continent, already beset by the world’s worst road-safety record, implement a wide-ranging plan to address the second leading cause of deaths of young people, specialists at a major conference told IRIN.

“Africa has the worst road safety record in the world, despite the fact that it has fewer cars than other regions,” Robert Lisinge, an expert in transportation at the Economic Commission for Africa (ECA), told IRIN on the sidelines of the Second African Road Safety Conference held in Addis Ababa this month.

Between 10 and 20 people per 1,000 in Africa own a vehicle. In Western Europe and Canada, the figure is 600; in the United States, more than 800. Yet some 322,000 lives are lost in Africa every year in road traffic accidents, according to a report by the World Health Organization (WHO), [ ] which said the phenomenon was robbing the continent of its “breadwinners” and reducing national GDPs by between 1 and 5 percent, or US$10 billion a year.

“We are losing more human capital now and it’s affecting our economies. African governments, as well as others who have a say in this, need to do more to curb this,” Taye Birhanu, an economist with the Transportation and Development Forum, an NGO, told IRIN.

Worse to come?

Increasing populations and an average economic growth of 5 percent make the need for action all the more urgent, said Lisinge.

“If nothing is done, the poor accident record in Africa will even worsen as African countries develop economically and have more vehicles,” he said.

According to the World Bank/WHO report, if the status quo continues, road deaths will soar by 30 percent by 2020.

There is a “need to awaken people’s consciousness, to stop this silent war often forgotten by society but one of the biggest wars, one that has claimed 10 million lives [worldwide] over the last decade,” says Sandra Vitale, a road traffic accident prevention campaigner, who lost a son in Addis Ababa while he was driving without wearing a seatbelt.

“Africa has the fastest-growing population statistics and, therefore, we also have to be fast and work as soon as possible by finding an efficient synergy between African nations to work on this issue,” she said.

Under the Accra Declaration signed in the Ghanaian capital in 2007, African transport and health ministers pledged to work to halve road deaths by 2015.

“The problem is that there were no action plans and clear strategies on how to implement the recommendations,” said Lisinge.

Now a more detailed way forward has been set out, in the form of the draft African Plan of Action for the Decade, a continentally tailored version of the WHO’s Global Plan for the Decade of Action for Road Safety.

The African plan, which was reviewed at the Addis Ababa conference, envisages the creation of a continental body to  coordinate national strategies, especially with regard to ensuring safety is given more emphasis in the development of road construction. Safer vehicles, public education and post-crash response are other key elements of the African plan, which ministers are expected to endorse in Luanda, Angola, later in November.

“I think some countries have shown quite a lot of progress in terms of political will especially in establishing structures. One problem in Africa is that to prove you have improved your crash figures, you have to have a baseline,” said Elna van Niekerk, an adviser at the Global Road Safety Partnership (GRSP) , which groups government agencies, the private sector and civil society organizations.

“So it’s very difficult to say that we have really improved on our statistics because we really have to establish that baseline,” she said, adding that the African plan could help further mobilize political leaders across the continent.

The plan calls for mechanisms to monitor activities, indicators and accomplishments.

It also aims to bring down the continent’s average annual fatality rate from the current 32.2 per 100,000 people to 21.3.

“It’s generally accepted that if you put up some ambitious target, you will achieve a result. I am not saying we will exactly achieve halving this in time in each country but there will be significant results,” said Van Niekerk.

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source www.irinnews.org

ETHIOPIA: Cautionary migration tales are no deterrent

Photo: Kristy Siegfried/IRIN

Ibsa Mohamed, a student from Oromia, paid a smuggler to take him to Yemen but has been left stranded in Djibouti

JIJIGA,  – Ethiopians are on the move. Not only are more rural people relocating to towns and cities, but the number of Ethiopians leaving the country has also ballooned in the last few years.

Many are trying to reach Saudi Arabia via Yemen, while thousands of others head for South Africa, Israel and Europe, crossing deserts and seas and placing their lives in the hands of smugglers who often have little regard for their well-being.

Most of the migration from Ethiopia is undocumented, so accurate numbers are hard to come by, but the UN Refugee Agency (UNHCR) reported in 2010 that in Yemen alone nearly 35,000 of newly arrived migrants were Ethiopians, accounting for two-thirds of all new arrivals that year. Between January and October 2011, almost 52,000 Ethiopians made their way to Yemen.

Refugees from Somalia follow similar routes, often using the same smugglers, but their reasons for undertaking these dangerous journeys are more apparent: Somalia has been plagued by armed conflict for nearly two decades and is now in the midst of a famine.

Ethiopia is not engaged in a civil war, and although parts of the country have been hard hit by drought, it is one of the world’s largest recipients of development aid. However, it also has one of Africa’s largest populations – an estimated 75 million – with a growing rate of youth unemployment and a shortage of job opportunities.

“The main reason people migrate from Ethiopia to Yemen is because of need – they go there [Saudi Arabia] to earn money,” said Daud Elmi, 28, who left his village of Lafaisa in eastern Ethiopia to find work in Saudi in 2006.

Instead, he spent a year in a refugee camp in Djibouti, and another three months in a camp in Yemen, avoiding arrest by claiming to be a refugee from Somalia. After failing to earn enough money to cross into Saudi Arabia, he finally returned home.

Elmi advises others in his town who are planning to migrate to Yemen or Saudi not to take the risk, but a number still do. “Everyone goes there to improve his life,” he told IRIN. “What we earn here is hand-to-mouth – we can’t save. If you go there and send money home, you can build a house, start a business or help your relatives.”

Tagel Solomon, coordinator of irregular migration programmes at the International Organization for Migration (IOM), confirmed that Ethiopians usually migrate in search of economic opportunities.

Most are young men like Kadar Mowlid Mahamoud, 23, who teaches English and computer skills. He set off from Lafaisa in 2008, “seeking a better life” in Europe, but was lucky to make it through Somaliland, a self-declared state on the Gulf of Aden, and Yemen. He ran out of water near the Saudi Arabian border and resorted to drinking his own urine, only to be robbed at knifepoint shortly after crossing.

“Even if I got a visa for Europe…I wouldn’t go”

Photo: Kristy Siegfried/IRIN

JIJIGA, Abdirizak Mohamed Mohamoud, 30, returned to his home village of Lafaisa, in the Jijiga zone of eastern Ethiopia, six months ago, after his attempt to reach Europe and a better life turned into an ordeal. He talked to IRIN, as well as a roomful of curious neighbours and friends, about his experiences as a migrant in Libya. Full report

He eventually found casual labour on construction sites in Riyadh, Saudi Arabia’s capital, and during the 18 months he spent there managed to save a little money. But after being severely injured in a car accident, his savings were wiped out by the hospital bill and he decided it was time to go home. He turned himself in to the authorities and was deported in October 2010.

Political factors

Most Ethiopians who leave the country are classified as economic migrants and do not qualify for the protection and assistance that refugees receive, but a 2011 study of migration from the Horn of Africa to Yemen by the Danish Refugee Council, notes that “a significant percentage fall in a grey zone that involves elements of economic migration brought on by political and economic oppression”.

Interviews with new arrivals in Yemen reveal that certain ethnic groups are harassed and suffer discrimination by local government officials in Ethiopia because of their perceived allegiance to rebel armed groups such as the Oromo Liberation Front (OLF), the Ogaden National Liberation Front (ONLF) and even established opposition parties like the Oromo People’s Congress.

Earlier this year, Human Rights Watch (HRW) reported that the authorities were carrying out mass arrests of ethnic Oromo Ethiopians, whom they alleged were members of the banned OLF. The Danish Refugee Council report said 47 percent of new Ethiopian arrivals registered in Yemen in 2010 were of Oromo ethnicity.

“You don’t even have to be an OLF sympathiser – any form of communication with someone who might have a link with the OLF could be enough to get you arrested, and this is what is very worrying,” Laetitia Bader, a researcher with HRW, told IRIN.

New Ethiopian arrivals interviewed in Yemen also confirmed the findings of a 2010 HRW report that ethnic groups such as the Oromos tend to have less access to international aid through donor-supported programmes, jobs and educational opportunities.

“Oromos are always linked to the Front,” said a 24-year-old woman quoted in the report. “As Oromos we can’t get work or an education. They [the government] will not allow us to develop.”

Root causes

Solomon of IOM said the activities of smugglers and their agents have driven up migration from Ethiopia. “Smugglers come to villages and tell people they’ll get jobs [in the Middle East] and it’s relatively easy,” he told IRIN. “There have been a number of arrests as part of a government effort to crack down on this network, but there is a lot of money involved.”

Local stories of success or failure can be even more persuasive than the smugglers. In Lafaisa, one man is rumoured to have made it to Malta and to be sending money home to his family, but more common are stories like that of Abdirizak Mohamed Mohamoud, who set off for Italy but spent seven months in various Libyan jails, and another 18 months trying to earn enough money simply to get home.

Failed attempts to migrate can be financially devastating for a household that has pooled its resources and even sold property to raise the cash for smugglers’ fees. Mohamoud said he would not try again and discouraged others from making the same mistake. “I’m an example for my village,” he told IRIN. “If I had succeeded, all the others would have gone.”

Yet cautionary tales are not enough to counter the root causes of Ethiopia’s exodus, and even a negative personal experience often does not deter people from trying again.

IOM is running a project in the Oromia Zone of Amhara in Ethiopia to reduce migration by not only raising awareness of the risks, but by supporting income-generating schemes, and providing youth training.

No such programme exists in Lafaisa and Mahamoud still wants to go to Europe. “I will wait until the demonstrations [in Yemen] are over, then I’ll go back,” he told IRIN, adding that he advises his students to do the same.

“I have no future in Ethiopia,” he said. “I’ve seen Europe on TV, and it’s better.”

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source www.irinnews.org

HIV-positive women still confused about infant-feeding choices

Photo: Allan Gichigi/IRIN

For most HIV-positive mothers in Africa, exclusive breastfeeding may be the most practical option

The latest guidelines on infant-feeding options for HIV-positive mothers in Africa have not been disseminated in many countries, leaving women dangerously confused about the best nutritional path to protect their children from contracting the virus, a new report shows.

The UN World Health Organization’s (WHO) 2010 guidelines recommend exclusive breastfeeding with an antiretroviral (ARV) treatment intervention for the first six months of a child’s life to reduce transmission, and continued breastfeeding – with complementary feeding – until the child is at least a year old. Alternatively – where it is acceptable, feasible, affordable, sustainable and safe – WHO recommends complete avoidance of all breastfeeding.

For HIV-positive mothers in most sub-Saharan African nations, exclusive breastfeeding is the most practical option. According to a large African study, Kesho Bora, giving HIV-positive mothers a combination of three ARVs during pregnancy, delivery and breastfeeding cuts HIV infections in infants by 43 percent by the age of 12 months and reduces transmissions during breastfeeding by 54 percent compared with WHO’s 2006 recommendations, where ARV drug regimens ended at delivery.

“The six months of exclusive breastfeeding is what is crucial for mothers to understand – that not doing it is what raises the child’s HIV risk; but we are finding that while many countries have officially adopted the WHO guidelines, they have not trickled down, and health centres, policy-makers and communities are still unclear on what advice to give mothers,” said Aditi Sharma, of the International Treatment Preparedness Coalition (ITPC), and coordinator of a report, The Long Walk: Ensuring comprehensive care for women and families to end vertical transmission.

Based on new research by community health workers from Cameroon, Cote d’Ivoire, Ethiopia and Nigeria, the report – launched at the 16th International Conference on AIDS and STIs in Africa (ICASA) in Addis Ababa, Ethiopia – found that prevention of mother-to-child transmission programmes were focused too narrowly on the provision of ARVs to HIV-positive pregnant women, rather than more comprehensive approaches that involved family planning, maternal healthcare and exclusive breastfeeding.

Confusion

“Nutritional counselling doesn’t exist in rural areas,” the report quoted one Cameroonian woman as saying. “Health personnel are not trained and women do not know how to care for their children.”

In Cote d’Ivoire, the report found that national guidelines did not meet the most recent WHO recommendations on infant feeding.

Although the Nigerian government had revised guidelines to comply with the WHO, consensus did not exist in support of the recommendations, and some clinicians and researchers continued to oppose breastfeeding because they believed it deliberately exposed babies to possible HIV infection. Several focus group participants indicated they assumed that replacement feeding was preferable to breastfeeding, and that it had been recommended by health practitioners.

“The guidance on infant-feeding options needs to urgently get into the curriculum and training of health workers and other people who support community healthcare, such as traditional birth attendants,” said Sharma, adding that efforts needed to be made to support mothers to exclusively breastfeed their children.

“It is not enough to issue guidelines – in places where women may complain of insufficient breast milk or inadequate nutrition, they need nutritional support to ensure they can continue to exclusively breastfeed,” she added.

Conference speakers said community health systems were crucial to the success of prevention of mother-to-child HIV transmission services, as community health workers and traditional birth attendants were often the first port of call for a confused mother. Community health systems can also be used to engage men – frequently absent from ante-natal visits – in their wives’ experiences.

Supporting partners

Beatrice Ochieng, author of a study on infant feeding choices in poor settings in the Kenyan capital, Nairobi, noted that just 23 percent of 357 women in the study discussed their chosen feeding option with their partners. “There is a need to support partner involvement through partner counselling and testing, during antenatal and postnatal care,” she said.

According to Ncumisa Vika, who works with the Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) in South Africa, male involvement in reproductive health services, including PMTCT, remains low, creating challenges and barriers around disclosure of HIV-positive status to a partner, psychosocial support, adherence to treatment, and infant-feeding decisions. In 2010, in collaboration with community health organizations in South Africa’s Tshwane District, EGPAF was able to send invitation letters to the partners of all HIV-positive women who attended antenatal clinics, which boosted male participation in reproductive and family health matters.

Overall, ITPC’s Sharma said, there was a need for more comprehensive delivery prevention of mother-to-child services in Africa. “Countries must ensure that policy filters down to the women in all aspects of PMTCT – from HIV prevention for women to family planning, to the best ARV prophylaxis option to proper infant feeding to proper healthcare for the mother, child and family,” she said. “It is the only way we can achieve the 2015 targets of reducing vertical transmission by 90 percent.”

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source www.irinnews.org