Photo: AJC1/Flickr

A colour-enhanced electron micrograph of the Ebola virus

JUBA,  – South Sudan is worried about the spread of Ebola, an incurable disease which has killed 16 people in neighbouring Uganda over the past few days.

“The Ministry of Health of the Republic of South Sudan in collaboration with World Health Organization (WHO) would like to caution the general public to be vigilant following reports of an Ebola haemorrhagic fever outbreak in the Kibaale area of mid-western Uganda,” a government/WHO statement said this week.

A 2005 peace deal in Sudan opened up borders for aid and trade and Uganda has become South Sudan’s largest supplier. “South Sudan and Uganda share a lot in terms of population movements and trade. As a result people move from one place to other [and are] likely to cause importation of the disease into the two countries once the other is affected”, the joint statement said. 

Several buses ply the Juba-Kampala route daily, and there are also two flights a day from Entebbe to Juba,

“We suspect [Ebola would strike] first in the border areas, as that is where people are coming and going,” said Kajamsuk Moi, CEO of the country’s leading but run-down hospital in Juba.

“WHO are not worrying a lot but we’ve already taken some emergency measures where we’ve activated the national task force and enhanced surveillance of the border areas with Uganda”, said Abdinasir Mohamed Abubakar, WHO South Sudan’s head of communicable diseases.

It is also educating communities near the border on Ebola risks and signs of infection, as well as training health workers to be able to identify and treat it.

The Health Ministry has called for “more vigilance” from all health workers who are “requested to wear personal protective gear at all times of examining patients presenting at a health facility”.

However, the country faces severe socioeconomic, health, educational and infrastructural challenges: 98 percent of its revenue was lost after the shutdown of oil production in January; there are only 100km of paved roads in a country bigger than France; illiteracy is widespread; and ethnic tensions continue to simmer in Jonglei State – to mention just a few of the factors hampering effective implementation of anti-Ebola measures.

The UN Development Agency (UNDP) said in July, as South Sudan celebrated its first birthday, that hospitals outside the capital had started to run out of drugs. Other donors say the government has stopped buying basics, leading to chronic shortages of medicines nationwide.

Misplaced optimism?

Despite this, Moi said he was sure that if Ebola struck, the government would rush in supplies somehow.

“If it hits, we are already prepared. South Sudan’s health system is not as strong as Uganda’s but I think we have the tools and the means to prevent and contain an outbreak”, said Abubakar.

Moi said premises previously used for cholera cases existed for up to 30 people if Ebola strikes the capital.

“We in the hospital, we are ready. We have the quarantine so if there is any such disease we will admit them to isolation. We can take more than 20, maybe 30, into isolation”, he said.

Moi said Juba Hospital is not yet on high alert. “It is still early for us and it was only yesterday that the Ministry of Health talked about this [Ebola] so in the coming days people will be alert, but we never saw one patient with this yet,” he said.

No vaccine has been found for the highly infectious disease, which WHO says has a fatality ratio of 23-90 percent. Transmitted through touch, fluids and waste from a living or dead person, it causes fever which can lead to bleeding from orifices and death within days.

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source www.irinnews.org

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Photo: Dogs and music/flickr

The judgement reaffirms women’s rights over what is done to their bodies (file photo)

NAIROBI,  – The Namibian High Court has ruled that the human rights of three HIV-positive women were violated when they were coerced into being sterilized while they gave birth, but the judge dismissed claims that the sterilization amounted to discrimination based on their HIV status.

“This decision is a victory for HIV-positive women throughout Namibia, as it reaffirms their right over what is done to their body,” said Priti Patel, deputy director and HIV programme manager at the Southern Africa Litigation Centre (SALC), a legal aid group that supported the women. “This judgment makes clear that obtaining consent while a woman is in labour or in severe pain violates clear legal principles.”

The case – the first of its kind in southern Africa – was filed in 2009. The women chose to have caesarean sections at public hospitals to reduce their chances of passing the HI virus on to their children, but said the doctors told them they could only have the procedure if they agreed to be sterilized at the same time.

The judgment allows the women to seek damages from the government. “All medical personnel must obtain informed consent from HIV-positive women prior to any medical procedure,” Patel told IRIN/PlusNews. “This includes, but is not limited to, informing them of the nature of the procedure, the impact of the procedure, and gives the women enough time to consider the information before making a decision.”

The ruling that the women failed to show they were discriminated against based on their HIV status, made the win somewhat bittersweet.

“We were not very happy with the judge’s decision on discrimination – maybe it’s the way we presented the case, focusing more on informed consent than on discrimination – we will talk to our lawyers and strategize on whether to appeal or accept the judgment,” said Jennifer Gatsi-Mallet, executive director of the Namibian Women’s Health Network, which assisted in bringing the case to court.

We hope the Ministry of Health will now review its policies… so that we don’t see such cases brought up again

Gatsi-Mallet told IRIN/PlusNews that her organization had 16 similar cases pending, and had recorded dozens more while conducting research. “We hope the Ministry of Health will now review its policies, providing information circulars on sexual and reproductive health to women in public hospitals so that we don’t see such cases brought up again,” she said.

SALC’s Patel noted that the judgment would have an impact beyond Namibia. She said there were anecdotal reports of similar practices in Swaziland, and documented cases in South Africa, in which SALC was involved.

“This case does have implications in other countries,” Patel said. “It brings the issue to the attention of countries in southern Africa, allowing them to take the necessary steps to ensure the practice isn’t happening in their country, and if it is, that the practice is stopped.”

kr/hesource www.irinnews.org

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NAIROBI,  – An estimated six million HIV-positive Africans are receiving life-prolonging antiretroviral treatment – a critical component in the management and control of HIV infection – but new studies show that resistance to the drugs is growing, especially in sub-Saharan Africa.

Resistance to first-line regimens means switching to much more expensive second- and third-line therapy, with patients progressively running out of treatment options at each stage. The authors of the study noted the need for enhanced surveillance and drug-resistance prevention efforts by national HIV treatment programmes.

Leah*, 45, a mother of four who was diagnosed with HIV 15 years ago, has since become resistant to first-line drugs. She shared her story with IRIN/PlusNews.

“At the time [I was diagnosed], it was common to hear people describe you as a walking corpse. I started taking antiretroviral [ARV] drugs when they were not very easy to come by, and when most people didn’t really understand what they were or didn’t believe they could help.

“When I realized I was HIV-positive, I lived in Nyanza [province in western Kenya] – not many health facilities had antiretroviral drugs in their stores, nor could they even handle HIV patients. I used to take a matatu [minibus-taxi] and travel 45 kilometres to get the drugs. My health started being robust again – I looked like a healthy person.

“I took the drugs for ten years. When my condition improved and I started feeling well, I decided to go slow on my treatment. I thought I had regained full life. I was now taking my drugs when I liked, and not as I had been advised at the hospital.

“When my employer, the Teachers’ Service Commission, realized I was HV-positive, I was transferred to Nairobi. It was a tactical move to get me away from pupils.

“When I got here [Nairobi], I stopped taking the drugs completely. My condition started to deteriorate just seven months after I stopped. I was bedridden again and I knew I would die. I didn’t realize my condition was worsening because I was not taking the drugs.

“When I was taken to the hospital, I was put on ARVs again after my condition stabilized, but I was not responding well. I was later diagnosed with drug resistance and I was started on second-line treatment, but it was not easy because the bureaucracy then of switching a patient to another line of treatment was slow. The drugs were not easily available and only certain people at the Ministry [of Health] could authorize [them].

“I was lucky because my employer was more proactive in ensuring that I get back on treatment again. Not many people are as lucky, and resistance leads to many people dying. Monitoring people more often will ensure they do not develop resistance.

“If you pass a drug-resistant strain of HIV to another person and the cycle continues, we will have many deaths. We must always guard against resistance because the success of treatment programmes relies on the positive outcomes of first-line treatment.

“Many health professionals, I can tell you, still do not have the knowledge to diagnose resistance to HIV.

“Now, I take my drugs more religiously… I don’t want to get to third-line ARVs because I am not even sure they are found here.”

*Name changed

ko/kr/he
source www.irinnews.org

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