“Norway is concerned about the treatment of former Ukrainian Prime Minister Yulia Tymoshenko and the status of the rule of law in the country,” said Foreign Minister Jonas Gahr Støre.

The Ukrainian Ambassador to Norway was summoned to the Ministry of Foreign Affairs today to be informed of Norway’s concern about the situation in Ukraine. The Ambassador was received by State Secretary Torgeir Larsen. The situation of former Prime Minister Yulia Tymoshenko and other political prisoners was discussed at the meeting.

“The report on Ms Tymoshenko’s treatment is worrying. We have asked the Ukrainian authorities to give an account of the situation. Ukraine must fulfil its international obligations,” said Mr Støre.

Ukraine is due to take over the Chairmanship of the Organization for Security and Co-operation in Europe (OSCE) in 2013, and will be hosting the European Football Championship this summer. This means that the country will be playing a key European and international role. Therefore, it is particularly important for Ukraine to demonstrate a strong commitment to democracy, human rights and the rule of law.

During his meeting with the Ambassador, State Secretary Larsen also brought up a current bill submitted by a member of the Ukrainian parliament banning “homosexual propaganda”. The bill is in violation of fundamental human rights set out in international human rights conventions that Ukraine is a party to.

End

Source.mfa.norway

Photo: ttfnrob/Flickr

AIDS response in trouble

KINSHASA,  – Many national hospitals in the Democratic Republic of Congo (DRC) are not accepting new HIV-positive patients for antiretroviral (ARV) treatment. The only way to get onto a treatment list is to wait until a space opens up due to a death or drop-out, or seek the limited treatment options available outside the government’s programmes, but few people can afford the drugs.

“At least in the big cities like Kinshasa [the capital] and Lubumbashi there is some coverage, but in rural areas there is a big problem,” said Erick Ngoie, head of advocacy for Union Congolaise des Organisations des personnes vivant avec le VIH (UCOP-Plus), an umbrella network of organizations of people living with HIV in DRC.

Chief among the problems in the DRC’s fight against HIV is a severe funding deficit. A major World Bank project recently closed after six years, while UNITAID, an international health financing mechanism that provides funding for paediatric and second-line ARVs, will end its funding to the DRC in December 2012. The cancellation of Round 11 funding by the Global Fund to fight AIDS, Tuberculosis and Malaria is likely to worsen the situation.

“ARV coverage in Kinshasa is about 30 percent, and much lower in the rest of the country – close to half of the health zones are not covered by any HIV treatment programme,” said Anja De Weggheleire, medical coordinator for Médecins Sans Frontières in the DRC. “Many health zones may offer HIV services at only one site, and even then it may not be the whole package.”

Only 12.3 percent of people who need life-prolonging ARV treatment have access to it, according to government statistics. Poor information and low testing coverage – just 9 percent of adults know their HIV status – means people are often diagnosed in very advanced stages of illness, when treatment options are limited.

“There is an urgent need for more centres because people need access to testing earlier. Many patients come here very late, with multiple pathologies… some arrive here and only survive a few days, while others die on the way to the hospital,” said Dr Laura Rinchey, the manager of the MSF-run Centre Hospitalier de Kabinda (CHK) in Kinshasa.

MSF started 2012 with a campaign to highlight the huge funding gap in the DRC’s HIV treatment programme, and urged people to seek testing and treatment. Since then, demand for services at CHK has gone up significantly, straining the centre’s resources. “We are now treating about 3,200 patients, which is about 20 percent of people on ARVs in Kinshasa,” Rinchey said.

At Réseau National d’Organisations Assises Communautaire (RNOAC), a national network of community-based organizations, patients who are well enough to live at home come to collect drugs provided by MSF and receive support from other people living with HIV.

“We help them deal with stigma, teach them how to live a healthy life, with a balanced diet, and give them treatment education,” said Jean Lukela, coordinator of RNOAC. Stigma remains high, Lukela said, with many people being ostracized by their families after they test positive for HIV, and others turning to churches for ‘healing’, rather than seeking medical help.

Clarrise Kambele, 30, frail and recovering from an HIV-related illness that nearly killed her, shelters at the RNOAC centre. Diagnosed with HIV in 2009, she didn’t start taking ARVs until she fell very ill in 2012. Her husband abandoned her and took their child to his parents’ home, leaving her to fend for herself. Too sick to work, Kambele was soon living on the streets, where an RNOAC volunteer found her and brought her to the NGO.

“I was very weak and my feet had swollen so much I couldn’t walk. Now I’m still weak but much better, but I don’t know what will happen to me when I leave here. My husband won’t take me back – he won’t even let me see our child – and my own family is dead,” she told IRIN/PlusNews.

“We need the government to take HIV as a priority, and take the lead in HIV information so people can know that someone living with HIV is just like anyone else – they should not be shunned,” Lukela said. “All support for HIV programmes comes from outside – we need the government to put its hands in its own pockets to pay for HIV treatment and care.”

UCOP-Plus’s Ngoie noted that unless donors and the government commit more resources to fighting HIV, the country’s programmes will probably fail. “Because of poor funding, NGOs have disappeared, community-based agencies have closed. Some of the centres that remain have no people trained to handle HIV,” he said.

“In this situation, we cannot achieve ‘zero new infections, zero deaths and zero stigma’,” Ngoie stressed. “We don’t want this to be just a slogan, we want it to be real.”

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source www.irinnews.org

Photo: Brahima Ouedraogo/IRIN

Malian refugees at Somgande refugee camp just outside of the Burkina Faso capital, Ouagadougou

DAKAR/OUAGADOUGOU,  – Sahelian governments and local and international aid groups are struggling to cope with both the continual arrivals of people fleeing the regions of Gao, Timbuktu and Kidal in northern Mali, and the mounting number of hungry people across the region as the lean season gets underway.
 
Altogether some 284,000 Malians have fled the north according to the UN Office for the Coordination of Humanitarian Affairs, 107,000 of them thought to be displaced within Mali; 177,000 in neighbouring countries. New arrivals have pushed refugee numbers to 56,664 in Burkina Faso and to 61,000 in Mauritania, and to 39,388 in Niger, according to UNHCR. These governments are already struggling to get aid to millions of their inhabitants, who are facing hunger due to drought. Fleeing Malians have told the UN Refugee Agency (UNHCR) they want to avoid getting caught up in possible conflict if government soldiers or foreign troops intervene in the north.

The UN estimates that 16 million people across the Sahel are facing hunger this year, and hunger levels are rising as the lean season gets fully underway. Families across the Sahel are also experiencing a significant loss of income as hundreds of thousands of Mauritanians, Burkinabes and Malians fled conflict in Libya, bringing a halt to the remittances they regularly sent.

New appeals

This complex mix of slow and fast-onset crises means the UN will be revising or launching new funding appeals from the current US$1 billion to $1.5 billion in coming weeks, said Noel Tsekouras, deputy head of office at the West Africa bureau of the UN Office for the Coordination of Humanitarian Affairs (OCHA) in Dakar.

Donors have given or pledged US$750 million in aid, most of it for food or nutrition needs, which many in the chronically underfunded region welcome as a strong response, but mounting demands will make this just half of the total necessary.

The World Food Programme (WFP) alone needs $360 million to bridge its immediate funding gap, having received just over half of the US$790 million it requires for the Sahel so far, said Claude Jibidar, deputy director of WFP in West Africa. The agency desperately needs cash so that it can start buying food in regional markets, he said.

In early May most food sectors remained severely underfunded. The Niger cluster appeal is only 7 percent funded for protection activities, 19 percent for water and sanitation, and has received no funding at all for education.

UNHCR will also be upping its Sahel refugee appeal beyond the $35.6 million requested, of which just 41 percent has been received. UNHCR spokesperson Fatoumata Lejeune-Kaba said refugee camps in Burkina Faso and Mauritania will need to be expanded to keep up with the growing numbers.

Mounting demands make this [current funding] just half of the total necessary

IRIN looked briefly at the refugee and IDP situation in each affected country.

Mali displaced – unknown numbers

It is difficult to know the exact number of internally displaced persons (IDPs) in Mali – the UN estimates 107,000, with 75,000 staying in the north, though some observers in the area say as many as half of the population in some regions has left. Several aid agencies, including Catholic Relief Services (CRS), are diverting part of their aid response intended for the north to help displaced people who have fled south to Mopti in central Mali, or Bamako, the capital.

WFP plans to support 200,000 IDPs and host families with food aid, but there are fears for the estimated 75,000 in the north. Some NGOs have good access across northern regions, but UNHCR says the situation is still considered too insecure. “We have a real problem accessing IDPs in northern Mali,” said Lejeune-Kaba. David Gressly, Regional Humanitarian Coordinator for the Sahel, says agencies have reached 40,000 of the northern displaced, but 35,000 are without any aid.

In Mopti, just south of the area declared as Azawad by National Movement for the Liberation of Azawad (MNLA), CRS is leading the IDP response and says they are seeing approximately 2,500 people pass through each week, most of them moving on to villages and urban centres such as Ségou and Bamako further south. CRS gives hot meals to those in transit and has recently started distributing food and other goods, much of it diverted from the agency’s planned food aid response for the north.

The Mali Red Cross, UNHCR, and other groups are also trying to provide aid to IDPs sheltering in Bamako.

Mauritania – scale-up needed

Malians in Mauritania tell UNHCR that the two main reasons they have left are fear of more violence, or difficulty getting by with minimal aid and breaks in basic services.

Most of the 61,000 Malians sheltering in Mbéra camp, near the town of Fassala in southeastern Mauritania, come from Timbuktu, over which Ansar Dine, a jihadist Muslim group, claims control. Others come from the towns of Niaki, Guargandou, Tenekou and Goundam in the Timbuktu region, according to UNHCR, which says it needs $18 million to help the refugees for six months, as long as numbers do not rise significantly.

Photo: Jaspreet Kindra/IRIN

Niger is in a “very critical” state – these children in Ouallam have survived on wild foods since last year

With hundreds of new arrivals every day, mostly women and children, agencies working in the camps – UNICEF, WFP and NGO Médecins sans Frontières - are having to scale up their activities far beyond the anticipated needs. MSF says camp conditions need to be urgently improved – by mid-April there was just one toilet for every 610 people. The nearest hospital to Mbéra is in Nema, a six-hour drive, so MSF is trying to provide basic services, including maternal health care and nutrition for children. An MSF communiqué notes that many Tuaregs are arriving with respiratory tract infections and diarrhoea.

Niger- the most critical

There have been no recent arrivals of refugees in Niger, leaving the population at 39,000, most of whom are staying in Ouallam camp, 100km from the Niger-Mali border.

However, Niger as a whole is in a very critical situation, with the same number of people facing hunger as in all the neighbouring countries combined. When it comes to getting enough cereals and other basic foods into the country to stem hunger, “Niger is the biggest problem at the moment,” WFP’s Jibidar stressed.

Mariatou Adamou, a nurse at the nutrition treatment centre in Goudel, northern Niger, where many Malians originally arrived, said they were receiving higher numbers of malnourished children than in 2011, and adults were also suffering severely. “The grain banks are empty… so even the parents are malnourished and have nothing at home.” After an initial screening of newly arrived Malian children aged under five, 100 percent were considered malnourished.

UNHCR and WFP are supporting refugee families in Ouallam camp, while NGOs are also trying to include refugee needs in their ongoing responses. NGO Plan International is distributing food, conducting malnutrition screening and setting up drinking water distribution points and latrines for refugees staying outside of camps. They are also making available psychosocial support for people who witnessed violence or experienced devastating losses.

“Bandits came with guns and stole many of our things… in my village they were taking animals [representing the main family assets] away right in front of us… when I left I couldn’t bring anything because I had to bring my children. I didn’t bring any food,” Azahara Naziou, a Malian in Goudel, told Plan International.

Niger is the biggest problem at the moment

Another refugee, Adaoula Harouzen, said more than 20 animals were taken from him. “They have not stolen them… they would tell me, ‘You have to choose your animals or your life.’ You stand there looking at them, helpless. You prefer saving your life, so they take the animals and go.”

Burkina Faso – water critical

More Malians are arriving in Burkina Faso every day, leaving the government’s National Commission for Refugees (CONAREF) overwhelmed, said its coordinator Denis Ouédraogo. The agency has only 13 staff members. “We were expecting refugees, but not to that extent in this context of food deficit in Burkina,” he told IRIN. ‘’The problem is how to respect our commitments towards our populations, who are faced with a food shortage, and to assist refugees at the same time.”

The government is mapping out a response plan for the 60,000 refugees, but Ouedraogo fears it will be “quickly outdated”.

Only half of the government’s $170 million appeal to fund food security and refugee response has been met, said Roger Ebanda, head of the UNHCR in Burkina Faso, and the UN Refugee Agency’s funding is also low, making the response “difficult”. Ebanda and Jean Hereu, head of MSF in Burkina Faso, say water is the urgent need in the camps.

Refugees in camps in Burkina and Mauritania are receiving a maximum of 10 litres of water per day, but agreed minimum standards for disaster response puts rations at double that.

Mohamed Ag Mohamed Maloud, 60, a trader from Timbuktu who is now acting as a refugee representative at Somgande camp on the outskirts of Ouagadougou, the Burkina capital, told IRIN he had been forced from his country during the fighting in the 1990s, but this experience is worse. ‘’The problem is that we do not have enough food… these are difficult days, but we try to cope.”

Each refugee is given a ration of 7kg of food for two weeks. “It is just not enough,” he said. The refugees have a money-lending system for those who arrived with none, prioritizing families who are 100 percent dependent on WFP for food. Other agencies are also helping – the Burkina Faso Red Cross is distributing 400 million CFA worth of food vouchers, as well as tents and water.

Health facilities are weak but improving. MSF has set up mobile clinics in Dibisi and Goutoure in the north, where 10,000 refugees are sheltering – before, they had to walk 17km to the nearest health clinic. The World Health Organization’s Burkina Faso representative, Djamila Cabral, said children have been vaccinated against meningitis, measles and polio.

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source www.irinnews.org

ANTSOHIHY,  – Daughters as young as 12 in the villages surrounding Antsohihy, the capital of Sofia Region, in Madagascar’s remote, traditional north, often suffer the harmful consequences of falling pregnant and giving birth too young when parents accept zebus (cattle) or cash as a dowry.

Noeline Razafindradera, 16, wishes she had listened to the warnings of her mother and her teachers. Instead, she went out with one of the boys she met at school and became pregnant. After going into labour, she waited two days before leaving her village of Ambongabe and then travelled two more days by ox-cart to reach the Baptist Good Hope Hospital in the town of Mandritsara. By then, the baby was dead and it had to be removed.

Three months later, Razafindradera is back at the hospital for a procedure to repair an obstetric fistula – a severe medical condition in which a hole (fistula) develops between the bladder and the vagina, or between the rectum and the vagina – caused by difficult delivery. The surgeon performs the operation for a subsidized price of 10,000 ariary (US$5 dollars).

“Many young girls have this problem,” said hospital director and surgeon Adrien Ralimiarison. “Girls as young as 13 become pregnant. The pelvis of the girl is too small, so during delivery the head of the baby gets stuck. As it takes a long time to reach a hospital, the bladder can then erupt. After the delivery, these girls are often rejected because of the smell of leaking urine and the additional expense of soap and pads. In some villages, people even believe that these women are evil. Depression often follows.”

This is confirmed by his next patient, Rasoanirina, 21, who also developed the condition after a protracted labour and a three-day journey to the hospital from her village. “People reject you, they don’t want to stay near you because of the smell,” she said.

At the Good Hope Hospital, a relative haven in the midst of a neglected and inadequate health sector, Yolande Zafindraivo is the only gynaecologist in this region of over 1 million inhabitants. “There are no doctors or trained midwives in the villages, so people deliver with the help of the village matron, the elder woman of the village who has knowledge of traditional medicine,” she told IRIN. “It’s dangerous – the matrons give the girls traditional herbs to induce the baby, [but] these are very strong and can cause a shock reaction in the body.”

Zafindraivo concentrates on saving the mothers, and says she succeeds most of the time. Nonetheless, figures from the UN Population Fund (UNFPA) reveal that the Sofia region has one of the highest maternal death rates in the country, with 1 in every 10 mothers dying during childbirth.

Nationwide, 3,750 mothers and 16,500 babies die each year during or soon after delivery. Another 75,000 women experience medical problems as a result of childbirth, and an estimated 40 percent of these women receive insufficient care.

“These are the official hospital and health clinic figures. We don’t know how many die at home with the matrons,” said Zafindraivo. “Often people prefer the matrons, as they think hospitals are expensive and they know these women.”

Hospitals in the region, as well as UNFPA, are training community health workers and matrons to avoid delays in getting women in need of care during childbirth to a hospital. Dr Jean Francois Xavier of UNFPA said the goal was to reduce the three kinds of delay: leaving home, reaching a hospital, and finding care once they arrive.

Community training

“We try to shorten all this lost time by building capacity in the community,” he said. “This includes training for the matrons, who are taught that a woman in labour should not see the sun rise twice. After 24 hours, she needs to be sent on to a health clinic or hospital. We also support the network of clinics and maternity wards, where women can deliver for free. There we train community health workers and provide kits for delivery and for caesarean sections.”

This system worked in the case of Volasaina Ratongarizafy, 19, who is recovering from a caesarean section after coming by car from Port Berger, 122km to the south of Antsohihy. The midwife sent Ratongarizafy to the hospital after she had been in labour for two days, and she waited only an hour to be operated on.

UNFPA is trying to reach more young people with birth control. Madeleine Razanajafy, a health worker at the maternity clinic in Antsohihy said girls rarely used birth control once they marry. “Often, the husbands don’t want their wives to use birth control… [they think] it opens the way to promiscuity [for the wives],” she said.

I can say many things, and I regularly do, but these girls are my ambassadors. They can tell their peers to be careful, to make sure that they don’t fall pregnant

Reaching girls before they become sexually active is also not easy because many leave school early, said Xavier. “After they have a baby, they give the child to the grandparents to raise – this problem puts pressure on society everywhere.”

In an effort to overcome some of the obstacles, UNFPA has built a special clinic for young people on the premises of the maternity clinic in Antsohihy, where it supplies birth control options that last several months, such as hormone patches, injections or intra-uterine devices (IUDs).

Local NGOs, like Vilavila, are also training young volunteers to talk to their peers about HIV, sexually transmitted infections (STIs), and birth control, while village elders lead group discussions with parents to try to counter the custom of trading young girls for cows or money.

“These parents are poor, so it’s hard for them to refuse – sometimes they are offered as much as 2 million ariary ($1,000),” said Vilavila director Piantoni Rabarison. “We show movies and have discussions with them. Often, they admit they hadn’t thought about the effect their actions could have on the young girls.”

At the New Hope Hospital, surgeon Ralimiarison asks his patients to reach out to other girls through a radio programme. “I can say many things, and I regularly do, but these girls are my ambassadors. They can tell their peers to be careful, to make sure that they don’t fall pregnant.”

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source www.irinnews.org