Photo: Jason Gutierrez/IRIN

Sometimes cash is not enough

MANILA,  - A nationwide conditional cash transfer programme in the Philippines is slowly improving maternal health, but more is needed to reverse the climbing maternal mortality ratio, say women’s groups.

Known locally as “Pantawid Pamilyang Pilipino Program” (4Ps), five-year conditional cash transfers (CCTs) were first rolled out in 2007 as a pilot programme to cut poverty. Now, with a budget of US$227 million, the Department of Social Welfare and Development (DSWD) aims make CCTs available to 5.2 million eligible households by 2015.

The 4Ps identified 5.2 million of the poorest households with pregnant women and children aged 0-14, three million of which have been receiving cash grants since April 2012. In exchange, beneficiaries must meet certain health and education goals.

Participants receive a monthly grant of $12 for getting pre- and post-natal check-ups and delivering their babies in a health centre under the supervision of a skilled birth attendant, rather than with a traditional birth attendant as most women currently do, and must attend monthly parenting seminars offered by the DSWD.

National surveys indicate that prenatal check-ups average 4.4 visits per woman – the international recommendation is four – but only 44.2 percent of births occur in a health facility.

Beneficiaries also receive a monthly grant of $7 per child, for a maximum of three children, in exchange for proof of regular paediatric check-ups and school-aged children attending at least 85 percent of their classes.

Cash not enough

Perla Maribel Diotor, 36, a CCT beneficiary who lives in Baseco, one of the biggest slum communities in Manila, the capital, gave up paid employment when she became pregnant with her first child, now five children ago. She said the programme had helped her in the two years since she joined.

Her husband works “occasionally”, doing construction work, fishing or “whatever job is available”. On some days, he brings home the equivalent of $2. “I only wanted three kids, but I kept getting pregnant,” Diotor said.

The World Bank estimates that 22 percent of women of reproductive age in the Philippines (about six million) do not have access to contraception.

According to the 2008 National Demographic Health Survey (NDHS), women surveyed reported wanting 2.4 children, but had on average 3.3 each.

Until late 2011, the distribution of modern contraceptives was banned at public health clinics in Manila. The city government now allows it if the contraceptives are donated by development groups and NGOs, but has not used its own funds for contraception.

Diotor and others like her have had to find contraception on their own, usually going to NGOs, where the supply is often erratic and insufficient.

“Interventions made when a woman is already pregnant are already too late. We can save lives by preventing unwanted pregnancies,” said Junice Melgar, executive director of Likhaan Centre for Women’s Health, a local NGO working in some of Manila’s poorest communities.

A study published in 2010 by the Guttmacher Institute, a German reproductive health think-tank, estimated that up to 2,100 maternal deaths could be prevented each year by providing modern contraceptives to all women at risk of unintended pregnancy.

Government awareness

The maternal mortality ratio (MMR) in the Philippines has jumped by 35 percent, from 162 deaths per 100,000 live births in 2006 to 221 in 2011, according to the 2011 Family Planning Survey.

“We need a more serious approach to family planning. The family development sessions that beneficiaries are required to take are more of lectures that focus on natural family planning methods. Even then, were the women given beads or calendars to track their cycles? [No.] It’s more of a lip service to family planning,” said Melgar.

During the administration of previous President Gloria Macapagal Arroyo, from 2001 to 2010, the government supported only natural family planning methods, leaving NGOs and women’s groups to provide for the contraceptive needs of poor women. “We are really feeling the results of nine years under the Arroyo government,” Melgar noted.

The current government recently approved the purchase of $12 million in family planning commodities in an attempt to counter rising maternal deaths. “This administration [of President Benigno Aquino] has been very clear about its support for responsible parenthood, but admittedly, there is really a problem on the supply side,” said DSWD Secretary Corazon Soliman.

“We lack midwives to attend our pregnant mothers. We lack adequate healthcare facilities. We are doing what we can, given our limited resources. We have started nursing programmes to fill the manpower gap, but building healthcare infrastructures and equipping them takes time,” she said.

Enrique Ona, the Department of Health Secretary, told IRIN, “The latest family planning survey covers the period 2006 to 2010. We don’t have a survey that will reflect the effect of a fully implemented CCT programme yet.”

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source http://www.irinnews.org

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Photo: Meagan Weymes/IRIN

Local palm wine sold along roadside

DILI,  - National police and NGOs in Timor-Leste have noted an uptick in alcohol-fuelled violence, especially among unemployed youths.

Vidal Campos Magno, now 29, grew up surrounded by conflict, was a teenager during the final years of the Indonesian occupation of Timor-Leste, and then went through the turmoil that followed the 1999 referendum for independence.

“I was involved in the fighting. I remember hanging around with friends, then we’d plan to go and hurt this person or that person. We had to fight because of the political situation.”

It wasn’t until he was accepted into university that Magno decided to change what he calls his “bad behaviour”. Now a project coordinator at Ba Futuru, a local peace-building organization, he draws on his experiences to help young people, including former gang members and ex-prisoners.

One of the common problems, he said, is that unemployed youths are stuck in a cycle of alcohol and violence. In Timor-Leste,unemployment among young people is estimated at over 40 percent, and approximately 16,000 young people enter the labour market each year. The problem is expected to grow, with 41 percent of the population under 15 years old, according to government data.

“There’s a lot of youth unemployment and sometimes young people hang around and drink alcohol, then go to the main road to fight each other or throw rocks at cars. This is their reality,” said Magno.

An analysis of drug and alcohol issues in the Pacific by the Australian National Council on Drugs in 2008-2009 concluded that “alcohol is still a substance of concern” in Timor-Leste, but noted a lack of official data.

The most recent national data reported to the World Health Organization (WHO) was in 2006, before a political crisis displaced more than 100,000 people, a tense and violent presidential poll in 2007, and a presidential assassination attempt in February 2008.

There are no government-funded rehabilitation facilities for people addicted to drugs or alcohol, but Pradet, a national mental health NGO, was one of the first groups to provide treatment. It has offered community awareness workshops to prisoners, police and community leaders since 2009, funded by AusAID.

Pradet director Manuel dos Santos told IRIN drug use was still a relatively small problem, but there are fears that it could increase. “Our border does not have a secure system for controlling drugs, so people are consuming more and more, but there’s no specific research to find out how much.”

The regional office of the UN Office on Drugs and Crime (UNODC) in Bangkok, Thailand, which oversees Timor-Leste, has no record of drug use or seizure trends in the country.

A December 2010 policy brief by a national conflict-monitoring NGO, Belun, found a “worrying degree of drug use”, including the consumption of sabu-sabu, an illegally manufactured amphetamine, and korneta, a plant that creates a feeling of euphoria.

Dangers unknown

Dos Santos said most people in Timor-Leste are unaware that over-consumption of alcohol is harmful. “Many who participate in the training are surprised when they find out about the negative impacts of alcohol. Before they receive the information, they say they used to keep drinking until they fell asleep.”

He said workshop participants had recommended creating defined places to sell alcohol, introducing a law restricting children from buying alcoholic drinks, and increasing the tax to make such drinks more expensive.

There are no regulations for the alcohol content in drinks, and no age restrictions on purchasing them. The popular local palm wine (tua mutin) and palm brandy (tua sabu) are both sold in recycled plastic bottles along the roadsides.

In Timor-Leste, drinking alcohol is part of  tradition so if you sit down with two or three people, they feel they must drink.

“In Timor-Leste, drinking alcohol is part of our tradition, so if you sit down with two or three people, they feel they must drink. But sometimes it causes accidents and sometimes it causes fights,” said Domingos Maia, the drug and alcohol trainer of the National Police of Timor-Leste (PNTL).

Domestic violence

The police link alcohol to domestic violence. “Often we see fathers and husbands fighting with their families after drinking too much alcohol,” Maia said.

The most recent demographic survey by the Ministry of Health, in 2010, did not track alcohol or drug consumption, but found alcohol was a significant factor in domestic violence. Of the women who experienced domestic violence, 60 percent said their husbands “get drunk very often”, compared to 26 percent who said their husbands did not drink alcohol at all.

In 2009, Belun started tracking alcohol-related violence through an Early Warning Early Response Monitoring System, set up with the assistance of Columbia University, New York,  after noting a rise in alcohol-fuelled violence.

Constantino Escollano Brandao, a research and policy specialist at Belun, said alcohol is often a catalyst for violence caused by underlying problems. “For young people [this] could be the stress of finding a job, social jealousy, or not being able to afford to stay in school.”

In the eastern district of Ermera, known for its celebration of the annual coffee harvest in July, drunkenness and causing trouble while drunk have been banned since February 2012, under a traditional form of law and order known as Tara-bandu.

Fines start at US$25. “Since the Tara-bandu there has been a positive change because the number of parties has been limited, and the sanctions discourage drunken people from causing problems,” Brandao told IRIN.

In the capital, Dili, where alcohol and drugs are readily accessible, youth coordinator Magno said the answer is not prohibition or punishment, but education.

“Many young people are stuck in a very negative mindset and it’s not easy to change their bad behaviour… but to reduce the violence we also have to reduce the alcohol.”

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source http://www.irinnews.org

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The Police officials in Nairobi have been conducting a thorough investigation at the residence of the late Olga Fonseca, Ambassador to Kenya.

The body of Fonseca was discovered in her bedroom on Saturday morning. Police received information about her death from Embassy officials who had gone to her house to pick her up and drop her at her office in Gigiri. The Police also collected a bottle of Johnnie Walker whiskey, which the diplomat and the suspected killer or killers could have shared moments before Fonseca was found dead at her residence in Runda.

When Fonseca had not emerged from her bedroom by 10 am, security guards and diplomatic police officers who guard the ambassador’s residence went to check on her, they discovered she was dead with a noose around her neck and visible bruises on her wrists. Investigators also noted that her mobile phone was used to send a text message to a staff member at her office informing them she would would not be going to the office, because she was feeling tired.

Investigators also suspect the SMS, which was not delivered to the intended recipient, was aimed at concealing the murder. Informed sources said that the ambassador could have been killed in her sitting room and dragged to the bedroom, where the noose was tied around her neck.

Sources also believe that her killers may have raped her before killing her. Four domestic workers are in police custody.

Nairobi police boss Anthony Kibuchi said the postmortem will be carried out to find out the cause of death. Some Ministry of Foreign Affairs officials also visited her home.

Ambassador Fonseca’s death comes less then a week after local staff at the Venezuelan embassy, filed a complaint with the Diplomatic Police Unit after being threatened with sacking if they did not withdraw sexual harassment reports filed against the former ambassador Gerardo Carillo Silva. Two male employees working at Mr.Silva’s home in Runda complained that the diplomat had exposed himself, grabbed their genitals and chased them around the house while naked. The embassy residence is just opposite the Diplomatic Police Unit in Gigiri and close to the main Gigiri Police Station. According to reports by the Star, a Kenyan newspaper, the Venezuelan government suspended Silva and appointed Fonseca to replace him.

The former ambassador has already left the country despite the serious charges he faces. Fonseca had also clashed with some of her domestic workers after she sacked them over what she had described as "insubordination".

By Elizabeth Koikai