The Daily Impact: Ebola Emergency Declared in Sierra Leone

June 13, 2014

Sierra Leone has declared a state of emergency in a district where an outbreak of Ebola virus is spreading. From VOA:

The government announced the closure of schools, movie theaters, nightclubs and trade fairs in the eastern district of Kailahun late Wednesday.

It also said all vehicles and their passengers entering the district are subject to screening at checkpoints.

The government said Ebola has now claimed 16 lives in Sierra Leone.

Earlier, the World Health Organization reported more than 30 confirmed cases of the disease  and seven deaths from it in Kailahun.

​The spread of Ebola has slowed in neighboring Guinea and and stopped in Liberia, after health officials isolated patients and warned the public to avoid direct contact with Ebola victims, including the deceased.

The WHO said this week that community resistance in Sierra Leone is hindering efforts to identify and contact those who might have been exposed to the Ebola virus.

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The Daily Impact: International sexual violence in conflict protocol launched

June 12, 2014

An international protocol for dealing with rape and sexual violence in conflict was launched on Wednesday at a historic London summit on the issue, providing guidelines on the investigation of sex crimes and the collection of evidence for future prosecutions. The Guardian reports:

“For decades – if not centuries – there has been a near-total absence of justice for survivors of rape and sexual violence in conflict. We hope this protocol will be part of a new global effort to shatter this culture of impunity, helping survivors and deterring people from committing these crimes in the first place,” the UK foreign secretary, William Hague – who is co-hosting the summit with film star Angelina Jolie – wrote in a foreword to the 140-page protocol.

The Global Summit to End Sexual Violence in Conflict opened on Wednesday with 117 countries formally represented, plus scores of UN and aid agencies, civil society organisations, survivors and nearly 2,000 delegates from around the world.

Zainab Bangura, the UN’s special representative on sexual violence in conflict, said conflict-related rape was no longer considered “a marginal issue, an inevitable by-product of war or mere collateral damage. It can no longer be amnestied or pardoned as the price of peace. It cannot be dismissed … as a private matter. And the countless women, girls, men and boys affected can no longer be deemed second-class victims of a second-class crime.”

Bangura had witnessed the enduring effects of sexual violence in the civil war of Sierra Leone. “The scars that remain beneath the surface of society make peace less possible. We’re here today to write the last chapter in the history of wartime rape and to close the book once and for all on humanity’s tolerance for such inhumanity.”

To survivors, she said: “Your voices are being heard. Wartime rape is now among the greatest global security priorities of our time.” To perpetrators: “We will pursue with every means at our disposal. There will no hiding place and no safe haven. Sooner or later, we will get you … This is not mission impossible.”

In a video message, Hillary Clinton paid tribute to Hague and Jolie as “formidable champions of this cause”. The summit was a historic opportunity to effect change, she added.

The protocol, funded by the UK government and the result of two years’ work, aims to provide best practice on the documentation of sexual violence. It includes practical advice, checklists and sample questions for fieldworkers.

For example, it provides a template for personal data to be collected from survivors and witnesses, tips on carrying out interviews and gathering testimonies, and guidance on photographing, filming and sketching crime scenes, and on the collection of physical evidence.

About 25 experts were involved in compiling the protocol, whose contents were “field tested” in countries such as Uganda and the Democratic Republic of the Congo before publication.

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Haitian healthcare community gearing up for mosquito-borne virus new to region

A municipal truck carries out fumigation in the Dominican Republic capital Santo Domingo against the mosquitoes that carry the painful Chikungunya virus. (Credit: REUTERS/Ricardo Rojas)

May marks the beginning of one of the two rainy seasons here in Haiti. With rain come mosquitoes. At PSI, as with other public health programs, this is a time when we put more emphasis on water-borne illnesses, hygiene, sanitation and diseases like malaria and dengue fever. Now, we add Chikungunya to that list.

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The Daily Impact: Gender-Based Violence in War Summit Kicks off in London

June 11, 2014

A four-day summit on sexual violence in war is taking place in London, the culmination of a two-year campaign to raise awareness. From the BBC:

Opening the summit, Mr Hague said: “From the abolition of slavery to the adoption of the Arms Trade Treaty, we have shown that the international community can tackle vast global problems in a way that was once considered to be impossible.

“There is power in numbers, and if we unite behind this cause, we can create an unstoppable momentum and consign this vile abuse to history.”

Ms Jolie said: “We need to shatter that culture of impunity and make justice the norm, not the exception, for these crimes.”

She said she wanted to dedicate the conference to a rape victim she recently interviewed in Bosnia, who felt so humiliated by what had happened to her that she could not even tell her own son.

“She felt that having had no justice for her particular crime, in her particular situation, and having seen the actual man who raped her on the streets free, she really felt abandoned by the world,” Ms Jolie said. “This day is for her.”

Angela Atim, one of the speakers at the conference, was kidnapped as a 14-year-old schoolgirl by Lord’s Resistance Army (LRA) rebels in Uganda.

She told the BBC: “These people who are accountable for the sexual violence in armed conflict, they have to be brought to justice.”

“It’s part of our healing because it’s really painful to see that they are still walking around, they are still doing the same thing.”

Nations taking part in the summit include Bosnia, the Democratic Republic of Congo and Somalia – countries where sexual violence has happened “on a vast scale”, Mr Hague told the BBC.

Sexual violence was systematically being used as a weapon of war in the 20th and 21st Centuries, he noted.

Mr Hague cited the estimated 50,000 women who were raped in Bosnia two decades ago, virtually none of whom have received justice.

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A partnership that’s working: Celebrating nine years of results and counting from UNICEF and Pampers’ One-For-One

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UNICEF and Pampers recently celebrated a ground-breaking partnership to eliminate maternal and newborn tetanus (MNT), which still claims the lives of 58,000 newborns every year—down from 200,000 newborn deaths a year in 2000.

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The Daily Impact: Ebola death toll doubles in Sierra Leone to 12

June 10, 2014

The death toll from Ebola in Sierra Leone has doubled to at least 12 in a week, local health authorities said on Monday. It is the continuance of an oubreak that has killed over 200 people in Guinea and Liberia. From Reuters:

The mounting deaths in Sierra Leone, which had been spared cases for months after Ebola was confirmed in the region in March, underscore the challenges weak health systems face tackling one of the deadliest diseases on the planet.

Amara Jambai, Sierra Leone’s Director of Disease Prevention and Control, said all the confirmed deaths in Sierra Leone were in the east, mainly in the Kailahun district on the border with Guinea.

“It is very difficult for us to ascertain community deaths at this moment, but the 12 deaths are the ones the hospital can definitely confirm to have died of Ebola,” Jambai said.

Jambai added that there were now 42 confirmed cases of Ebola from 113 people tested and new cases had been recorded in the northern district of Kambia.

Ebola was confirmed in a remote corner of Guinea in March and then later spread to Guinea’s distant capital, Conakry, and over the border into Liberia.

All suspected cases in Sierra Leone tested negative until last month and Jambai said that the disease was spreading as authorities are struggling to control the movement of people.

International medical experts have been dispatched to Sierra Leone but they face a combination of poor existing health systems and tensions among locals fuelled by the lack of understanding over the disease.

Two weeks ago, relatives removed an Ebola patient from a treatment centre in Koindu as they doubted the disease existed.

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The Daily Impact: Floods kill more than 80 in Afghanistan

June 9, 2014

More than 80 bodies have been found two days after a devastating flash flood in Afghanistan’s mountainous and remote north, a provincial official said Sunday. From the AP:

Lt. Fazel Rahman, the police chief in the Guzirga i-Nur district of Baghlan province, said the death toll from Friday’s flash flooding had climbed to 81 from 54. Some 850 houses across several villages were completely destroyed and more than 1,000 were damaged by the heavy rain and flooding, leaving thousands of people in need of shelter, food, water and medicine, Rahman said.

Defense Ministry spokesman Gen. Mohammad Zahir Azimi said Army helicopters were assisting in relief efforts in the remote district, which is just 140 kilometers (85 miles) north of the provincial capital Puli Khumri, but is an eight to nine hour journey by land because of the rugged terrain.

Rahman said local authorities had received around 100 tents, several hundred blankets and some food, but that more supplies were needed.

Afghan President Hamid Karzai has appointed a high-ranking government commission to accelerate emergency aid to the affected villages and expressed his “deep condolences” to those who lost loved ones, the palace said in a statement Sunday.

Afghans living in the northern mountains have largely been spared from the country’s decades of war, but are no strangers to natural disasters.

Last month, a landslide triggered by heavy rain buried large sections of a remote village in the northeastern Badakhshan province bordering China, displacing some 700 families. Authorities have yet to provide an exact figure on the number of dead from the May 2 landslide, and estimates have ranged from 250 to 2,700. Officials said it was impossible to dig up all the bodies.

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The Daily Impact: Boko Haram kill more than 200 civilians in Nigeria

June 6, 2014

Witnesses report that Islamist militants dressed up as soldiers slaughtered more than 200 people in northeastern Nigeria. From the AP:

A community leader who witnessed the killings on Monday said residents of the Gwoza local government district in Borno state had pleaded for the military to send soldiers to protect the area after they heard that militants were about to attack, but help didn’t arrive. The killings occurred in Danjara, Agapalwa, and Antagara.

“We all thought they were the soldiers that we earlier reported to that the insurgents might attack us,” said a community leader who escaped the massacre and fled to Maiduguri, Borno state capital.

The militants arrived in Toyota Hilux pickup trucks — commonly used by the military — and told the civilians they were soldiers “and we are here to protect you all,” the same tactic used by the group when they kidnapped more than 300 girls from a school in the town of Chibok on April 15.

After people gathered in the center on the orders of the militants, “they begin to shout ‘Allahu Akbar, Allahu Akbar’ on top of their voices, then they begin to fire at the people continuously for a very long time until all that gathered were all dead,” said the witness who didn’t want to be named for fear for his safety.

The slaughter was confirmed by both Mohammed Ali Ndume, a senator representing Borno and whose hometown is Gwoza, and by a top security official in Maiduguri who insisted on anonymity because he isn’t allowed to speak to the media.

It took a few days for survivors to get word of the massacres to Maiduguri, the provincial capital, because travel on the roads is extremely dangerous and phone connections are poor or nonexistent.

The community leader wasn’t shot because “I was going round to inform people that the soldiers had come and they wanted to address us,” he said. As people were fleeing, other gunmen lurked outside the villages on motorcycles and mowed them down, he said.

Militants of Boko Haram, which wants to establish Islamic state in Nigeria, have been taking over villages in the northeast, killing and terrorizing civilians and political leaders as the Islamic fighters make a comeback from a year-long military offensive aimed at crushing them. The death toll from Monday’s attacks is among the highest. Thousands of people have been killed in the 5-year-old insurgency, more than 2,000 so far just this year, and an estimated 750,000 Nigerians have been driven from their homes.

Nigeria’s military has insisted that the big influx of troops and a year-old state of emergency in three states which gives them the power to detain suspects, take over buildings and lock down any area has the extremists on the run.

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The Daily Impact: Liberia’s president sets her sights on reducing maternal mortality

June 5, 2014

Liberia’s Ellen Johnson Sirleaf said she would take on the nation’s high maternal mortality when assuming the presidency in 2006. The government is now taking that pledge more seriously. From VOA:

Liberia’s maternal death rate remains among the highest in sub-Saharan Africa, but the government is trying to change that. This year, President Sirleaf announced that reducing maternal deaths was among her government’s top priorities.

“The ministry of health developed the essential package of health services which describes maternal health interventions at both community level and health facilities level,” says Tolbert Nyenswah, deputy minister of health for preventive services. The deputy minister says he is “hearing some positive news about maternal mortality reduction in our country.”

Nyenswah names some of the practical steps being taken to protect the lives of pregnant women. He encourages women to seek at least four medical visits before the delivery date to receive needed services such as immunizations.

“Institutional delivery is improving in Liberia, as compared to from 1990. Right now our institutional delivery has increased.” Tolbert also urges medical services after the birth for the mother, the new infant and other children in the family for preventive treatment for malaria visits.

Women are also given vaccinations for tetanus and for malaria, he says, which can lead to still births, under-weight babies and even the death of the mother.  The government has also expanded access to family planning services to 20 percent of all couples, nearly twice the prior rate.

It is also taking measures to curb complications that can endanger the lives of the mother and baby.

“We have increased services to EMOC – that is, emergency obstetric care and centers – that can provide Cesarean section and other services to mothers. But this cannot be done alone by the Ministry of Health and Social Welfare in Liberia.

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The Daily Impact: UN calls for more midwives, to prevent maternal and newborn deaths

June 4, 2014

A new UN-backed report shows that as many as two-thirds of maternal and newborn deaths can be averted by increasing the training and number of midwives in 73 key countries. From Humanosphere:

Midwives are capable of providing as much as 87% of the essential care for women and newborns, says State of the World’s Midwifery 2014: A Universal Pathway – A Woman’s Right to Health. The ability to save lives is why Pakistani midwife Farida Shah decided to become one. As a child she saw how a trained midwife saved the life of an unconscious pregnant woman. The look of relief and joy that cam over the woman’s family inspired her to join the profession.

On December 16, 1996, a similar situation presented itself to Shah. A woman, also named Farida, was unconscious due to excessive bleeding. The region where Shah was working is cut off from the majority of the country during the winter due to snow. Travel to a hospital would take too long if Farida was to survive. An examination by candlelight revealed a tear in the girl that Shah was able to repair.

The date is memorable for Shah because it is an example of why she decided to be a midwife. It is also because the family offers her thanks on that day each year. Sixteen years later, Shah received a letter from Farida’s son to personally thank her for saving his mother’s life. The experience has led her to campaign for midwives and support their training by working with the Baltimore-based NGO Jpheigo.

“I enjoy working with the midwives because they are saving lives. It gives me so much satisfaction when a midwife saves a mother and her newborn. Midwives contribute to making strong families,” said Shah.

Presently, less than half of the 73 low and middle-income countries analyzed in the report have taken action to promote the deployment of midwives in remote areas. It underscores the key needs recommended by the report authors and its supporters: more midwives are needed. Doing so requires support for training, government-level policies and licencing and better data collection.

“Investing in midwives means in investing in midwifery education, so more midwives can be educated and more lives can be saved,” said Frances Day-Stirk, President of the International Confederation of Midwives, in a press call. “Education is an absolutely crucial pillar to midwives.”

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