Army Takes Over, Access to HIV Treatment Halted by Strikes in South Africa

As South Africa’s health system is crippled by strikes the Government warns health workers of contributing to murder. HIV/AIDS treatment access has also been halted as the health system ceases to function. Strikers are demanding increased pay due to their insubstantial compensation. Should they be paid more?

Army Medical Teams Move into Strike-Bound Hospitals

Health Minister Warns of Murder as Staff Strike at Hospitals

Strike Jeopardizes HIV Treatment

Government Threatens Action Against Health, Security Strikers

National Public Sector Strike Hits HIV Treatment

Nation Becomes a Victim of its ARV Treatment Success

Public Health Strained by Nurses Strike

Botswana: Acquiring a Taste for Recycled Water

The Water Utilities Corporation in Botswana is breaking ground on a facility to treat waste water in order to supply a water source for the country. Many citizens have expressed disgust at the thought of drinking waste water, but the program holds great potential as water scarcity increases across the continent and around the world.

Hillary’s “new approach” to Global Health

David Rieff takes on the US Secretary of State’s approach to global health and development calling it naive, contradictory and muddled.

Donor Fatigue New Threat to HIV/AIDS Fight

Doctors Without Borders has raised the alarm that this is, “No time to quit! The HIV crisis is far from over.” As economic recession hits, many countries around the world  are decreasing their aid funding for HIV/AIDS treatments. The Obama Administration has come under fire for their cuts to HIV/ AIDS and PEPFAR funding.

• Is Obama Failing on AIDS?
• Optimism as U.S.  HIV Program Lifts Funding Caps

Mozambique: Maputo Central Hospital Bans Use of U.S. Dollars

Patients in Mozambique will no longer be forced to use U.S. Dollars to pay for treatments. This is an important move to increase access to health care in the country.

Cholera Outbreak Grips Nigeria

The need for clean water is demonstrated as cholera rapidly spreads across Nigeria and neighboring countries. As a common disease and treatable disease, the recent cholera outbreak calls for greater access to clean water sources for impoverished communities.

Cholera claims 352 lives

Cholera Outbreak Highlights Vulnerability of Children, Mothers

Cholera Outbreak – FG Moves Drugs, Officials to Bauchi, Borno

Cholera, Measles claim more lives

Cholera Outbreak hits 3,000 in Three Nations

Nyala, Kalma camp, South Darfur - March 2007 (MSF Photo Blog)

The impact of conflict on the environment and then the subsequent, direct effect on human health cannot be overlooked. This internally displaced peoples (IDP) camp in Sudan shows the seriousness of that impact.

Your Old Cell Phone Can Make a Difference in Global Health

Everyone in the global health sector is writing about the incredible reach of SMS technologies working for health in developing countries, and rightly so. Hope Phones has partnered with FrontlineSMS to provide old cell phones to communities in need through SMSmedic partner organizations.
More:
Your Old Phone Can Change the World

TeleMed
A service that I just recently came across is one that is not being as widely talked about. TeleMed is different from FrontlineSMS: Medic because it connects local health care workers directly to patients in need via SMS technology. SMS: Medic is focused on health infrastructure. TeleMed does not have a website up yet, but is definitely one to watch:

Paul Farmer and the US Government?

The other big talk within global health is whether Paul Farmer will take a job within the US government. Some have expressed great hope for potential reform others voice their plea with him to continue his incredible community based work outside the bureaucracies. My opinion is that Partners in Health has developed into a strong organization and does not depend on Paul Farmer to further their work. If he wants to take on the inefficiencies and inadequacies of the US government and global health, then all the more power to him.

Southern Africa: Global Financial Crisis Leads to HIV Budget Cuts

Broken promises abound as the economic crisis deepens and the right to health falters, but activists are coming together to ensure that funding for health and HIV are not cut. International donors are expected to slash budgets for health due to the economic crisis and health experts fear that this will lead to, “less food security and quality of nutrition, which will in turn put more stress on already weak health systems.” Paula Akugizibwe, regional treatment literacy and advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia demanded, “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.” Tanzania was the first sub-Saharan country to announce a 25 percent cut of its annual HIV/AIDS budget.
Other budget cut impacts:
Guinea: Medicines Running Out

Zambian High Court to Hear Groundbreaking HIV Case

On Wednesday, the Livingstone High Court was supposed to hear a ground breaking case about whether mandatory testing for HIV and discrimination solely on the basis of HIV status is constitutional in Zambia. Unfortunately two days later news came that the trial was postponed until mid-July. Be sure to keep watching this story.
More:
Trial postponed until 15 July

HIV Prevention and Behavior Change

Mara Gordon writes on Change.org’s Global Health Blog about a direct campaign in Tanzania discussing behavior change. “This campaign is partially paid for by the President’s Emergency Plan for AIDS Relief, U.S. government money to fight HIV that’s notoriously had lots of conservative strings attached. Had I seen this ad a year ago, I probably would have dismissed it as unrealistic abstinence-only propaganda. But behavior change works. Behavior change – in combination with access to condoms, comprehensive sexual education, open discussion about HIV and sexually transmitted infections in general, all that good liberal stuff.”
More:
Changing Human Behaviors: Sexual and Social
During a course on Africa’s environmental history I wrote about the need for changing human behavior in both the sexual and social arena to make a real impact in HIV prevalence. The major social change is the response from Western institutions and organizations in how they talk about HIV/AIDS and Africa while seeking to change sexual behavior.
Lesotho: Cultural Beliefs Threaten Prevention of Mother-Child HIV Transmission
Health workers note an encouraging response to the PMTCT program. The number of facilities providing PMTCT has risen from nine in 2004 to 166 by the end of 2008. The number of women who received PMTCT and subsequent antiretroviral (ARV) treatment increased from 421 in 2004 to about 5,000 by end of last year, according to 2009 National AIDS Council statistics. “The primary health care coordinator at St. James Mantsonyane Mission Hospital, Khanyane Mabitso, says stigma and cultural beliefs make it difficult for medical personnel to follow up on HIV-positive mothers and their babies.”

Progress on health-related MDGs mixed

Many advances have been made in health. Some argue that these advances have been dwarfed by the HIV/AIDS epidemic, the economic crisis, or the failures of African governments. The WHO report shows that the only statistic with concrete results was the number of children dying before the age of five. Is this a solid example of the failure of big plans and blanket goals for development?

Sierra Leone: ACC Recommends Reform At Health Ministry

The Anti-Corruption Committee report provides a number of recommendations for reform all focused on improving the health care delivery services in Sierra Leone and eliminating the risk of corrupt practices in the health services across the country.
More on health service scale-up:
Chad: Paving the Way for Better Obstetric Care
Government meetings with UNICEF to help scale-up of health services for better obstetric care across the country.

Ten Things You Can Do to Fight World Hunger

The Nation provides an interesting set of things you can do in your everyday life to fight world hunger. They properly focus on how food, a basic human need, has been commodified in our global capitalist structure. “Our planet produces enough food to feed its more than 960 million undernourished people. The basic cause of global hunger is not underproduction; it is a production and distribution system that treats food as a commodity rather than a human right.” When in February I wrote that agricultural experts had said the food crisis of the last year was over evidence from this past week point to the contrary.
More:
Tanzania: Food Shortage Unnecessary
“Tanzania has since independence sang the song of ‘Agriculture is the backbone of the economy’, but little has gone into strategizing and implementing viable actions towards surplus food production.”
Kenya: UN Agency Makes First Local Food Purchase from Small Scale Farmers
The United Nations World Food Programme (WFP) has for the first time bought food from small-scale farmers in Kenya under a new initiative aimed at boosting agriculture by connecting farmers to markets.
Zimbabwe: Another Year Without Much Food
Rwanda: Nearly Half the Country’s Children Are Malnourished
Kenya: Over Three Million Face Food Shortages

Africa: High Level Engagement with Continent Has Started

Speaking at a gala reception in Washington marking the beginning of “Africa Week,” Carson said: “Most of the Obama administration’s Africa team is in place, and we are gearing up. We will continue to build on and strengthen the strong bipartisan consensus in Congress and among the people of America that has motivated U.S. policy towards Africa. Over the next four years, we will be focusing our efforts on strengthening democracy, promoting sustainable development, resolving or mitigating conflict, and dealing with transnational issues such as climate change and agriculture,” he pledged. While Obama has built a great team, the White House has yet to announce any Africa Policy, greater control and influence for the Bureau of African Affairs, or take any serious (or effective) action for the continent.
More:
Tanzania: Obama, Kikwete Meet in Oval Office on Africa’s Conflicts

World Bank Resumes Zimbabwe Aid

Zimbabwe owes the World Bank and the African Development Bank more than $1bn, how much potential does renewed aid really hold for the country. If the debt is not forgiven there will be no way the country will be able to rebuild necessary infrastructures for health, water, etc. There are countless case studies to show this historical fact. It must also be noted that Western sanctions were a huge detriment to a country in need, maybe this marks a turnaround?

“No weapons” MSF in Nasir, Upper Nile State, South Sudan

More:
A Tale of Two Refrigerators
Fighting has renewed in southern Sudan, but its not just between militant groups – aid groups fall victim to needless fighting as well. Diane Bennet writes on William Easterly’s Aid Watch blog about the 2001 peace in Sudan and how it was a ripe time to treat disease and build health infrastructure. Unfortunately internal bureaucracy and politics became the largest hurdle.

Sudan: Darfur – Thousands Flee to African Union Safety
More recently, South Darfur has become the seen of violent clashes between government forces and militants. It is important to never forget the impacts that conflict has on health services.

Africa: Public Health Care Must Lead

Oxfam International has released a report [access here] “challenging the myths about private health care in developing countries.” The report emphasizes the role that private health care can play in developing countries, but reminds us that there is no way a scale-up of private health services will reach poor people in need. Key recommendations are to increase funding for free universal health care infrastructure, rejecting ineffective practices of the past, and combining efforts to fuel effective initiatives – sounds a lot like SCOUT BANANA

Global Health: Mobile Phones to Boost Healthcare

Revolutionizing access to health knowledge, the efforts of the Mobile Health Alliance (mHealth), supported by the Rockefeller Foundation, the UN Foundation, and Vodafone Foundation are making a mark across the African continent boasting 51 existing or to-be-implemented programs in 26 countries around the world. Harnessing the potential of growing technology in ‘developing’ countries for the purpose of health can only signal a major shift in access to health care across Africa.

Getting the Continent on Obama’s Agenda

It appears that Obama’s administration is stacked in the favor of Africa and in favor of better international development practices all around. With Susan Rice serving as Ambassador to the UN action against genocide may be bolstered, Gayle Smith more likely than not will be tapped as USAID Director, she was a major proponent of the HELP Commission creating a cabinet level position for foreign aid, and a well known name among insiders and outsiders in African affairs, Johnnie Carson, is expected to be named head of the Bureau of African Affairs of the State Department. The future of US relations in Africa has incredible potential and hope to change.

Zimbabwe: Staff Return to Hospitals, But Not to Work

As a massive cholera outbreak tears across the country, medical staff have returned to their posts, but the nature of their strike, that began in 2008 over poor working conditions and wages, is now “more like a sit-in.” In a country so crippled by Western exploitation and resulting politics, a strike of the health workers in the face of a rampant disease outbreak does not bode well for a vulnerable population.
More:
Too Much Cholera, Too Little Food
Over 80,000 Zimbabweans Infected with Cholera

Africa: U.S. Naval Engagement Offers Health Dividends

Imagine the potential of the US’ military might if it was dedicated to coordinating naval and health care workers from 13 countries to bring aid and health services to communities in need. This becomes a reality with the African Partnership Station Initiative and Project Handclasp. I can only dream of a day where initiatives like this are more a norm than a surprising gesture of good will.

Mali: Raising Money and Hygiene Standards

One of the most innovative programs that I have read most recently is the work the Dutch based Gender and Water Alliance which is employing women to make soap as well educate and use it to increase hygiene and combat preventable diseases. Health benefits, a source of income and empowering women!

Food Crisis Over, Say Experts

Supposedly the global food crisis of last year is over! Agricultural experts from Africa and Asia are saying that we are no longer in a food crisis and that there needs to be an increased production of rice in Africa in order to keep the food crisis at bay. In my opinion, as long as we continue our unsustainable and capitalist practices that commodify a basic human need, we will remain in a global food crisis affecting both the US and Africa.
More:
Rwanda: Food Production Up, Thanks to Green Revolution
Thankfully the increase is not due to the ‘Green Revolution,’ but instead to increase in practices that are focused on protecting the environment.

South Africa: Treasury Blamed for Shortage in Aids Drugs

Years of controversy seem to have brought the blame down on the South African Treasury. With an extensive bureaucracy, it is no wonder that the ARV roll-out program has taken much longer than it should – as many die without the proper medications. While the numbers of people enrolled in the ARV program has increased significantly there still exists a problematic policy of access. Access hinges on wealth, CD4 count, and location. To access the government’s ARV program your CD4 count has to be less than 300, which is at a point where you are already very vulnerable. This creates an issue of sustained treatment because it forces an irregular regimen. If your CD4 count is above 300, you will have to pay. Many cannot pay and if you live far from a government hospital access is just that much more difficult because of taxi fare and time sacrificed for travel. It seems the health and wellbeing of its citizens is not a high budget priority of the South African government.
More:
Rapid HIV evolution avoids attacks
Much like the flu virus, HIV mutates and evolves in response to treatments. This really exposes the South African ARV program as highly ineffective.
Duncan discusses HIV/AIDS in Morocco
Little known to the world, the HIV/AIDS crisis grows in Morocco.

"Ethiopia" a scene of over-grazing and desertification, making it difficult for both people and animals to survive. (From the MSF Photo Blog)

• ’There’s no reason only poor people should get malaria’

In an action that surprised many audience guests, Bill Gates, released a small number of mosquitoes into the crowd at the TED conference. Gates quit Microsoft last year to focus more on his philanthropic work. He spoke of the need, and his commitment, to put more funding towards developing drugs to combat malaria, one of the highest killers in the ‘developing’ world.
Watch the video:
More:
Mosquito Genes Linked To Insecticide Resistance May Be New Target in Fight Against Malaria,
Insecticide malaria impact clue

• When there is no village doctor

It is estimated that every fourth medical doctor and every twentieth nurse trained in Africa leaves the continent for better job prospects and better pay in wealthier countries. The UN Global Health Workforce Alliance warns that the economic crisis could further increase the medical workforce crisis across Africa.

For David Werner, who wrote the widely-translated 1970s village health care manual, “Where There is No Doctor,” medical specialization is not the best answer. “Experts come in and think they have all the answers, and end up drowning out solutions villagers could devise themselves.”

• Need to Focus on Maternal, Child Health – Top AU Official

As the African Union meets in Addis Ababa, Commissioner for Social Affairs Biencé Gawana said in regards to the AU’s proposed launch of a continent-wide program,

“We will launch a movement to promote maternal and child health in the continent,” she told reporters. “It will be an advocacy campaign… together with partners like UNFPA [the UN Population Fund] and UNICEF [the UN Children's Fund].

With 500,000 women dying in childbirth each year, Africa has some of the highest rates of maternal, infant, and child mortality. As part of the solution the AU report noted: “One of the main challenges in the promotion of maternal, infant and child health and development is access to health care facilities and services, especially at primary health delivery level and [in] rural areas.”

• Zimbabwe: Cholera Infection Rate Climbs As UN Cleared to Assess Crisis

On Monday the WHO reported an increase of 2000 cholera deaths in Zimbabwe. The report was released just as President Mugabe agreed to allow a top level UN assessment team to tour the country to find solutions to curb the cholera pandemic as well as the current hunger crisis. Food security continues to plummet in may areas of Zimbabwe as many worry they will not receive aid in time.
More: Zimbabwe Cholera Statistics Rise Again As New Malaria Fears Grow,
Zimbabwe Diary: fighting cholera

• South Africa: The Quiet Water Crisis

There is great concern with the cholera outbreak in Zimbabwe, but what the South African government may be missing is its very own growing water crisis. With an aging infrastructure and rising demand, the potential for deadly bacteria to be released into its water systems is high. When Mandela’s government took power in 1994, an estimated 14 million South Africans lacked access to clean water supply and 21 million people lacked proper sanitation. Although the numbers have changed drastically, the Department of Water Affairs and Forestry (DWAF) reported in 2008 that 5 million people still lacked access.

• Twestival and Charity: Water

Last year SCOUT BANANA conducted a ‘Year of Water’ Project to benefit the work of Charity: Water. The organization is now utilizing the social media tool, Twitter, to raise a large amount of money to build wells across the world. Charity: Water began its work by supporting well projects across the African continent.

• South Africa: ‘Development Must Adapt to Water Resources We Have’

98% of water resources are being used in South Africa. Water security is becoming an issue as pollution from mining has been difficult to clean up and no other water resources remain unused.

• Obama Lifts “Global Gag Rule”

Also known as the Mexico City Policy, this move is being applauded by women’s and productive rights groups across the globe.
More: Obama Reverses U.S. Ban on Abortion-Linked Aid

• University Partnership Aims to Fight HIV/AIDS More Effectively

Backed by an almost $5 million grant from the Bill & Melinda Gates Foundation, John Hopkins University is growing a partnership with Makerere University in Uganda in an attempt to combat the growing HIV/AIDS epidemic. The partnership is only in its initial steps.

This is part of a series we hope to maintain on the Watchdog blogs, specifically alerting individuals to issues affecting young men in development. We will certainly be writing extensively on gender affecting both men, women, and those in between in other blogs, but hopefully others will find these entries valuable to explore concerns affecting men that have otherwise remained invisible in international development work.

As the world has broadcast overwhelming attention to the recent US election and win of Sen. Barack Obama, little notice has been paid to status of terrorist groups that provoked the current intervention in Iraq and War on Terror. Indeed, CIA director Michael Hayden reported this week that while Osama bin-Laden may be cut off from the daily operations al-Qaeda, the organization still poses a significant threat against the United States. Furthermore, he notes that al-Qaeda’s influence has grown in the Middle East and Africa, with special attention to the surge of support in Somalia and Algeria, where extremist groups in both areas have joined with al-Qaeda.

Although gendered perspectives are often applied exclusively to women and girls (sometimes by feminists themselves), I am perplexed as I consider the possibilities facing young men around the globe today. In the aftermath of 9/11, some writers, such as Lionel Tiger, have focused on the specific role of young, Muslim males in recruitment of terrorist organizations, such as the Taliban and al-Qaeda. Yet questions about young men have dissipated over the past seven years, despite the fact that recruitment has increased within ‘Islamist’ terrorist organizations and that young remain important, though invisible, in all parts of the world. In his article from 2001, Tiger, a professor of anthropology, writes,

One of the most difficult tasks for any social system is figuring out what to do with its young males. These are invariably the most impressionable, energetic, socially exigent, and politically inept members of any group. They cause trouble for their elders and ruthlessly hassle each other. They pose chronic danger to public order when they drive, drink and take drugs.

Though Tiger’s article highlights the dilemmas young Muslim men face (granted, in a problematic way that seems to generalize young men while ignoring that men of many cultures also face difference challenges and influences), he is correct to recognize that young males are vital as well as vulnerable in populations.

But then why do we (as students, academics and practitioners) continuously forget young men? In development work, the focus remains on providing services and assistance to vulnerable populations such as ‘women’ and ‘children’. Don’t we see that highlight ‘women’ and ‘children’ as vulnerable creates distinctions that girls and women are forever victims while ‘men’, rather than boys, can never be victimized? While this type of thinking is problematic for too many reasons to count, at its fundamental roots, conceptualizing male identity without vulnerability is simply an inaccurate depiction. It is essential that international development projects directly incorporate the potential of young men, especially in African countries where militancy and violence can be attractive and overbearing influences. Arguably, focusing specific and directed attention on young men and boys may even be ways to stop and prevent conflicts, depending on what techniques are used.

Focusing on young men is certainly not to suggest that women and girls are not important or vulnerable populations. It is crucial, however, that academics and practitioners alike recognize that young men face their own challenges that also need targeted solutions and assistance. And as more organizations that recruit civilians into militias creep into the African continent (on top of the ones that were already there), it is truly important that international development practices create safe, sustainable spaces for young men to participate in their communities outside of violence.