medicalcondition:ebola

  • Ebola’s spread shows how science needs societies to succeed - Reuters
    https://www.reuters.com/article/us-health-ebola-society-analysis-idUSKCN1TI0H1

    Those seeking ways to end the Congo Ebola outbreak’s longevity and persistence say the issues it raises go to the heart of what public health means in the 21st century for countries across the world, rich and poor.

    The World Health Organization cites mistrust of authorities in Congo, with attacks on healthcare workers and patients avoiding treatment centers, as major factor in the failure so far to contain the Ebola outbreak. Similarly, it cites anti-vaccine misinformation campaigns in the United States, Ukraine and elsewhere as allowing measles to spread furiously among people who are fearful and confused.

    #santé #société

  • The Battle Against One of the Worst Ebola Epidemics Ever Is in Trouble
    https://www.nytimes.com/2019/03/07/health/ebola-epidemic-congo.html

    “Ebola responders are increasingly being seen as the enemy,” Dr. Joanne Liu, president of Doctors Without Borders, said at a news conference in Geneva on Thursday. “In the last month alone, there were more than 30 different incidents and attacks against elements of the response.”

    “The existing atmosphere can only be described as toxic,” she said.

    Some people in the region question why the vaccine is being given only to certain people — including health workers and contacts of patients — and not to everyone, she said. Many wonder why outside aid has flooded in for Ebola, but not for malaria, diarrhea or other common, debilitating diseases that afflict many more people. Some have asked aid workers where they were when militias were carrying out massacres of civilians.

  • #Angola : Les migrants africains en danger de mort

    Les autorités angolaises lancent « la chasse aux ressortissants sub-sahariens en situation irrégulière ». Une #opération dénommée « #expatriado » est en cours en ce moment. Elle vise à « expulser tous les immigrés en situation irrégulière en Angola ». Des ressortissants maliens témoignent des « cas d’#emprisonnement suivis de pires formes de #maltraitance et d’#humiliation ». Pour l’instant, difficile d’avoir des chiffres officiels sur le nombre de Maliens victimes. Mais ceux joints sur place appellent à l’aide des autorités maliennes.

    Selon certains Maliens, ces opérations d’expulsion ont débuté dans les zones minières. Elles se déroulent maintenant dans toutes les villes du pays, et concernent toutes les nationalités y compris les Maliens, qui sont parmi les plus nombreux. « Cela fait des jours que nous ne pouvons plus sortir pour aller au boulot par peur de nous faire arrêter », explique un ressortissant malien sur place. Selon lui, cette opération qui ne devrait concerner que les #sans-papiers, est aussi menée par les forces de l’ordre angolaises contre ceux qui sont en situation régulière. L’objectif, selon notre interlocuteur, est de soutirer de l’argent aux migrants.

    « Une fois entre les mains des autorités angolaises, il faut payer de l’argent ou partir en prison », témoignent certains migrants maliens, avant de confirmer que plusieurs d’entre eux sont actuellement en prison. En Angola certains Maliens ont l’impression d’être « laissés pour compte par les autorités maliennes ». Pour l’Association Malienne des Expulsés, « il est inacceptable qu’un pays membre de l’Union Africaine expulse d’autres africains de la sorte ». L’AME qui juge la situation « grave » en Angola, appelle les autorités maliennes à réagir.

    https://www.expulsesmaliens.info/Angola-Les-migrants-africains-en-danger-de-mort.html
    #migrations #asile #réfugiés #rafles #expulsions #renvois #chasse_aux_migrants #migrants_maliens

    • Briefing: Problems multiply in Congo’s Kasaï

      The Kasaï region in the Democratic Republic of Congo is struggling to recover from two years of intense conflict. The influx last month of more than 300,000 people from Angola, most of them long-standing migrant workers, has made a fragile humanitarian situation worse.

      Here’s our briefing on the risks for the region and the new challenges for the humanitarian response.
      What happened?

      In attempts to clamp down on what it called illegal diamond mining operations, Angola’s government ordered the expulsion of more than 360,000 Congolese nationals, forcing them to flee in October into the Kasaï region of neighbouring DRC.

      "This new shock is compounding an already dire situation in the same area that was the epicentre of the Kasaï crisis over the last couple of years,” explained Dan Schreiber, head of coordination in Congo for the UN’s emergency aid body, OCHA.

      Congolese migrants and officials said the crackdown was violent, telling Reuters that dozens of people were killed, with the worst attacks occurring in Lucapa in Angola’s diamond-rich Lunda Norte province. Angolan security forces denied the allegations.
      Where did they go?

      Most of those expelled crossed into Kamako in Kasaï province, where aid organisations are responding to the tail-end of the Kamuina Nsapu insurgency that first erupted in 2016. Some of the returnees include refugees who fled violence in Kasaï over the last two years, the Norwegian Refugee Council said.

      The NRC said conditions returnees face in Congo are “shocking”, including the risk of waterborne disease due to ineffective water and sanitation; thousands sleeping outdoors because of insufficient shelter; food prices tripling; and extortion of goods on both sides of the border.

      “Hundreds of thousands of people have been robbed of their right to a dignified existence,” said Ulrika Blom, NRC’s country director in DRC. “This is not a crisis that is about to begin, it is a full-blown emergency.”
      What has the reaction been?

      While local communities have generally been welcoming to the returnees, OCHA’s Schreiber said skirmishes erupted in certain villages, mainly over the strain on limited food resources.

      “Experience in the DRC does show that when you have a large influx of people arriving in an area it can generate tensions between host communities and the people who arrive,” he said.

      Schreiber said OCHA has seen most returnees wanting to move away from the border areas and toward other destinations inland, which could help ease the humanitarian strain in Kasaï, but he also warned that more returnees could arrive from Angola.

      “We don’t expect the first wave to be the last wave,” he said. “Expulsions from Angola are a cyclical phenomena that go all the way back to 2002-2003. It’s not a new phenomenon, but in this case we are seeing a major influx, and clearly the absorption capacity is not there.”
      Why is their arrival in Kasaï in particular such a problem?

      Kasaï was a relatively stable region in an unstable country – one currently dealing with multiple conflicts, an Ebola outbreak in North Kivu province, and one of the world’s most neglected displacement crises.

      The situation in Kasaï changed dramatically in 2016 when conflict erupted between the Kamuina Nsapu anti-government movement and Congolese security forces. The inter-communal clashes spread far and wide, soon engulfing the entire region.

      The conflict escalated in 2017, with massacres and mass graves, as well as general insecurity marked by banditry, and poor harvests that led to food insecurity and malnutrition.

      An estimated 5,000 people have since been killed and more than 1.4 million displaced.

      Toward the end of 2017 and into 2018, the crisis eased slightly, as national authorities regained control over large parts of the region. Despite isolated bouts of violence, aid groups say most militias have been formally disbanded and displaced communities are tentatively returning home.

      “But those returns are accompanied by many needs, because people are returning to burned villages, destroyed homes, and a lot of destruction,” said OCHA’s Schreiber.

      Two years of violence and displacement also mean locals have been unable to grow crops for three seasons, which has led to concerns over malnutrition. “We have really seen food insecurity skyrocket. So even in areas where returns have occurred, humanitarian needs have not come to an end,” Schreiber added.
      What are the risks?

      Although the current influx of people from Angola isn’t directly linked to the Kamuina Nsapu rebellion, aid groups are concerned about the implications of piling one problem on top of another in the same geographic area.

      For the most vulnerable groups, specifically women and children, the challenges that affect those displaced by the insurgency also pose risks for the new returnees from Angola.

      In May for instance, UNICEF reported that 400,000 children were “at risk of death” in the Kasaïs, because of food shortages.

      Yves Willemot, a spokesman for UNICEF in Congo, said the rate of severe acute malnutrition among children living in the region has improved slightly since earlier this year but “remains challenging”.

      “The security situation has clearly improved, but the impact on children is not ending in the short term,” he said.

      Among those newly returned from Angola are 80,000 children. They now are also at risk, forced to walk long distances while exposed to inclement weather, hunger, and the threat of violence. Willemot said basic services are lacking for them, including access to drinking water, schooling, and treatment for diseases like malaria and measles.

      Médecins Sans Frontières is among the NGOs initiating primary healthcare services for the recent arrivals, while also continuing interventions to assist the local population.

      In a recent report, MSF documented alarming levels of rape in the Kasaï region, saying it treated 2,600 victims of sexual violence between May 2017 and September 2018; 80 percent of those interviewed said armed men raped them.

      “The sexual violence committed in Kasaï was perpetrated largely by armed groups against non-armed people,” Philippe Kadima, MSF’s humanitarian advisor for the Great Lakes region, told IRIN. “Although the main conflict is over, we still see some violence happening in Kasaï.”

      For the more than 300,000 returnees, he said there are clear humanitarian concerns, but also the risk of insecurity. “The question is, how do you keep people secure?”

      “Displaced people become vulnerable, so it’s not that different to what the existing IDPs in Kasaï are going through… Security concerns, humanitarian needs, and risks of sexual violence are all factors when people become vulnerable,” he said.
      What about the longer-term challenges?

      Humanitarian needs remain critically underfunded in the Kasai region, said OCHA’s Shreiber, emphasising that beyond the immediate concerns are much broader needs in the region and the DRC as a whole.

      He added that the humanitarian response must help minimise the long-term impact of the crisis on those affected.

      “The longer we remain in this critical phase, the more we can expect to see humanitarian needs spiral out of control,” he said. “The current trigger of new humanitarian needs (the returnees from Angola) may be time-bound, but I think the impact will be lasting.”

      Schreiber said the Kasaï region remains vulnerable because it faces particular challenges, including decades of underdevelopment and inaccessibility as a result of poor road infrastructure, and he urged more development actors to get involved.

      “People in the Kasaïs are eager to rebound, to be back on their feet, and move on. There is no expectation that humanitarian assistance should continue forever in the Kasaï region,” he said. “People want to be autonomous, but what they need is support to build up their resilience and be able to move towards a situation where their most basic needs are met and they are able to think about their futures again.”


      http://www.irinnews.org/news-feature/2018/11/08/briefing-congo-kasai-angola-aid-conflict

    • Les violations des droits humains des migrants africains en Angola

      Les violations des droits humains des migrants africains en Angola

      Depuis un certain moment, la communauté africaine vivant sur le territoire angolais est l’objet de toute sorte de violation de ses droits les plus fondamentaux par les autorités de ce pays. La Charte Africaines des Droits de l’Homme et des Peuples protège les droits des migrants dans tous ses aspects contre les violations des droits et l’Angola est justement membre de l’Union Africaine. Ainsi, ces violations se matérialisent par des arrestations musclées et arbitraires, des emprisonnements dans des conditions inhumaines et dégradantes (art.5 de la Déclaration Universelle des Droits de l’Homme et de la Charte Africaine des Droits de l’Homme et des Peuples) de même que les expulsions collectives pourtant interdites par la Charte Africaine dans son article 12.5.

      L’AME est vivement préoccupée par les récentes arrestations, détentions et expulsions des centaines de milliers de migrants africains dont des maliens. Selon des informations recueillies auprès de nos sources sur place, une centaine de maliens sont concernés par cette situation qui évolue et change de jour en jour.

      Nous attirons l’attention de l’Union Africaine et de ses pays membres sur la situation inacceptable que vivent les étrangers sur la terre africaine d’Angola et rappeler que les droits de l’homme sont des droits inaliénables de tous les êtres humains, quels que soient leur nationalité, leur lieu de résidence, leur sexe, leur origine ethnique ou nationale, leur couleur, leur religion…

      L’Angola comme la plupart des pays africains s’est engagé à protéger, respecter et réaliser les droits de l’homme, non seulement de ses nationaux, mais de toute personne sous sa juridiction. Dans ce contexte, tous les étrangers se trouvant sur le sol angolais auraient dû bénéficier de la protection des autorités angolaises quelque soient les raisons qu’elles mettent en avant pour justifier ces expulsions.

      L’Organisation des Nations Unies (ONU) n’est pas resté silencieuse comme la plupart des pays africains, le Haut-Commissaire des Nations Unies aux droits de l’homme a mis en garde sur les conséquences des expulsions massives de réfugiés depuis l’Angola, au cours des trois dernières semaines de ce mois d’octobre.

      Par ailleurs, le Secrétaire Général des Nations Unies a rappelé le 19 septembre 2017 que : « tout pays a le droit de contrôler ses frontières. Mais cela doit se faire de telle sorte que les droits des personnes ‘en mouvement’ soient protégés ».

      Au regard de tout ce qui vient d’être évoqué :
      1. L’Association Malienne des Expulsés (AME) pour sa part, exhorte le gouvernement Malien à tout mettre en œuvre pour la sécurisation de nos compatriotes et de leurs biens dans les pays d’accueil ;
      2. Appelle le gouvernement à communiquer davantage sur cette situation en donnant beaucoup plus d’informations aux familles des maliens vivants en Angola ;
      3. Encourage le gouvernement de continuer à œuvrer pour le respect des droits des migrants maliens et aussi pour le développement d’une relation franche entre les Etats africains en vue de la réalisation de l’unité africaine comme le prévoit l’article 117 de la Constitution ;
      4. Invite l’Union Africaine à dénoncer et prendre des mesures contre les violations des droits humains dans les pays membres ;
      5. Invite également les Etats membres de l’Union Africaine à renoncer aux expulsions massives des ressortissants d’autres pays africains et à mettre fin sans délais aux opérations actuelles en cour ;
      6. Exhorte l’U.A et les Etats à une plus grande implication des organisations de la société civile aux différents processus pour la gestion de la migration.

      http://www.expulsesmaliens.info/Les-violations-des-droits-humains-des-migrants-africains-en-Angola

  • Uganda’s refugee policies: the history, the politics, the way forward

    Uganda’s refugee policy urgently needs an honest discussion, if sustainable solutions for both refugees and host communities are to be found, a new policy paper by International Refugee Rights Initiative (IRRI) reveals.

    The paper, entitled Uganda’s refugee policies: the history, the politics, the way forward puts the “Ugandan model” in its historical and political context, shines a spotlight on its implementation gaps, and proposes recommendations for the way forward.

    Uganda has since 2013 opened its borders to hundreds of thousands of refugees from South Sudan, bringing the total number of refugees to more than one million. It has been praised for its positive steps on freedom of movement and access to work for refugees, going against the global grain. But generations of policy, this paper shows, have only entrenched the sole focus on refugee settlements and on repatriation as the only viable durable solution. Support to urban refugees and local integration have been largely overlooked.

    The Ugandan refugee crisis unfolded at the same time as the UN adopted the New York Declaration for Refugees and Migrants, and states committed to implement a Comprehensive Refugee Response Framework (CRRF). Uganda immediately seized this opportunity and adopted its own strategy to implement these principles. As the world looks to Uganda for best practices in refugee policy, and rightly so, it is vital to understand the gaps between rhetoric and reality, and the pitfalls of Uganda’s policy. This paper identifies the following challenges:

    There is a danger that the promotion of progressive refugee policies becomes more rhetoric than reality, creating a smoke-screen that squeezes out meaningful discussion about robust alternatives. Policy-making has come at the expense of real qualitative change on the ground.
    Refugees in urban areas continue to be largely excluded from any support due to an ongoing focus on refugee settlements, including through aid provision
    Local integration and access to citizenship have been virtually abandoned, leaving voluntary repatriation as the only solution on the table. Given the protracted crises in South Sudan and Democratic Republic of Congo, this remains unrealistic.
    Host communities remain unheard, with policy conversations largely taking place in Kampala and Geneva. Many Ugandans and refugees have neither the economic resources nor sufficient political leverage to influence the policies that are meant to benefit them.

    The policy paper proposes a number of recommendations to improve the Ugandan refugee model:

    First, international donors need to deliver on their promise of significant financial support.
    Second, repatriation cannot remain the only serious option on the table. There has to be renewed discussion on local integration with Uganda communities and a dramatic increase in resettlement to wealthier states across the globe.
    Third, local communities hosting refugees must be consulted and their voices incorporated in a more meaningful and systematic way, if tensions within and between communities are to be avoided.
    Fourth, in order to genuinely enhance refugee self-reliance, the myth of the “local settlement” needs to be debunked and recognized for what it is: the ongoing isolation of refugees and the utilization of humanitarian assistance to keep them isolated and dependent on aid.


    http://refugee-rights.org/uganda-refugee-policies-the-history-the-politics-the-way-forward
    #modèle_ougandais #Ouganda #asile #migrations #réfugiés

    Pour télécharger le #rapport:
    http://refugee-rights.org/wp-content/uploads/2018/10/IRRI-Uganda-policy-paper-October-2018-Paper.pdf

    • A New Deal for Refugees

      Global policies that aim to resettle and integrate displaced populations into local societies is providing a way forward.

      For many years now, groups that work with refugees have fought to put an end to the refugee camp. It’s finally starting to happen.

      Camps are a reasonable solution to temporary dislocation. But refugee crises can go on for decades. Millions of refugees have lived in their country of shelter for more than 30 years. Two-thirds of humanitarian assistance — intended for emergencies — is spent on crises that are more than eight years old.

      Camps are stagnant places. Refugees have access to water and medical care and are fed and educated, but are largely idle. “You keep people for 20 years in camps — don’t expect the next generation to be problem-free,” said Xavier Devictor, who advises the World Bank on refugee issues. “Keeping people in those conditions is not a good idea.” It’s also hard to imagine a better breeding ground for terrorists.

      “As long as the system is ‘we feed you,’ it’s always going to be too expensive for the international community to pay for,” Mr. Devictor said. It’s gotten more and more difficult for the United Nations High Commissioner for Refugees to raise that money; in many crises, the refugee agency can barely keep people from starving. It’s even harder now as nations turn against foreigners — even as the number of people fleeing war and violence has reached a record high.

      At the end of last year, nearly 70 million people were either internally displaced in their own countries, or had crossed a border and become a refugee. That is the largest number of displaced in history — yes, more than at the end of World War II. The vast majority flee to neighboring countries — which can be just as badly off.

      Last year, the United States accepted about 30,000 refugees.

      Uganda, which is a global model for how it treats refugees, has one-seventh of America’s population and a tiny fraction of the wealth. Yet it took in 1,800 refugees per day between mid-2016 and mid-2017 from South Sudan alone. And that’s one of four neighbors whose people take refuge in Uganda.

      Bangladesh, already the world’s most crowded major nation, has accepted more than a million Rohingya fleeing ethnic cleansing in Myanmar. “If we can feed 160 million people, then (feeding) another 500,00-700,000 …. We can do it. We can share our food,” Shiekh Hasina, Bangladesh’s prime minister, said last year.

      Lebanon is host to approximately 1.5 million Syrian refugees, in addition to a half-million Palestinians, some of whom have been there for generations. One in three residents of Lebanon is a refugee.

      The refugee burden falls heavily on a few, poor countries, some of them at risk of destabilization, which can in turn produce more refugees. The rest of the world has been unwilling to share that burden.

      But something happened that could lead to real change: Beginning in 2015, hundreds of thousands of Syrian refugees crossed the Mediterranean in small boats and life rafts into Europe.

      Suddenly, wealthy European countries got interested in fixing a broken system: making it more financially viable, more dignified for refugees, and more palatable for host governments and communities.

      In September 2016, the United Nations General Assembly unanimously passed a resolution stating that all countries shared the responsibility of protecting refugees and supporting host countries. It also laid out a plan to move refugees out of camps into normal lives in their host nations.

      Donor countries agreed they would take more refugees and provide more long-term development aid to host countries: schools, hospitals, roads and job-creation measures that can help both refugees and the communities they settle in. “It looked at refugee crises as development opportunities, rather than a humanitarian risk to be managed,” said Marcus Skinner, a policy adviser at the International Rescue Committee.

      The General Assembly will vote on the specifics next month (whatever they come up with won’t be binding). The Trump administration pulled out of the United Nations’ Global Compact on Migration, but so far it has not opposed the refugee agreement.

      There’s a reason refugee camps exist: Host governments like them. Liberating refugees is a hard sell. In camps, refugees are the United Nations’ problem. Out of camps, refugees are the local governments’ problem. And they don’t want to do anything to make refugees comfortable or welcome.

      Bangladesh’s emergency response for the Rohingya has been staggeringly generous. But “emergency” is the key word. The government has resisted granting Rohingya schooling, work permits or free movement. It is telling Rohingya, in effect, “Don’t get any ideas about sticking around.”

      This attitude won’t deter the Rohingya from coming, and it won’t send them home more quickly. People flee across the closest border — often on foot — that allows them to keep their families alive. And they’ll stay until home becomes safe again. “It’s the simple practicality of finding the easiest way to refuge,” said Victor Odero, regional advocacy coordinator for East Africa and the Horn of Africa at the International Rescue Committee. “Any question of policies is a secondary matter.”

      So far, efforts to integrate refugees have had mixed success. The first experiment was a deal for Jordan, which was hosting 650,000 Syrian refugees, virtually none of whom were allowed to work. Jordan agreed to give them work permits. In exchange, it got grants, loans and trade concessions normally available only to the poorest countries.

      However, though the refugees have work permits, Jordan has put only a moderate number of them into jobs.

      Any agreement should include the views of refugees from the start — the Jordan Compact failed to do this. Aid should be conditioned upon the right things. The deal should have measured refugee jobs, instead of work permits. Analysts also said the benefits should have been targeted more precisely, to reach the areas with most refugees.

      To spread this kind of agreement to other nations, the World Bank established a $2 billion fund in July 2017. The money is available to very poor countries that host many refugees, such as Uganda and Bangladesh. In return, they must take steps to integrate refugees into society. The money will come as grants and zero interest loans with a 10-year grace period. Middle-income countries like Lebanon and Colombia would also be eligible for loans at favorable rates under a different fund.

      Over the last 50 years, only one developing country has granted refugees full rights. In Uganda, refugees can live normally. Instead of camps there are settlements, where refugees stay voluntarily because they get a plot of land. Refugees can work, live anywhere, send their children to school and use the local health services. The only thing they can’t do is become Ugandan citizens.

      Given the global hostility to refugees, it is remarkable that Ugandans still approve of these policies. “There have been flashes of social tension or violence between refugees and their hosts, mostly because of a scarcity of resources,” Mr. Odero said. “But they have not become widespread or protracted.”

      This is the model the United Nations wants the world to adopt. But it is imperiled even in Uganda — because it requires money that isn’t there.

      The new residents are mainly staying near the South Sudan border in Uganda’s north — one of the least developed parts of the country. Hospitals, schools, wells and roads were crumbling or nonexistent before, and now they must serve a million more people.

      Joël Boutroue, the head of the United Nations refugee agency in Uganda, said current humanitarian funding covered a quarter of what the crisis required. “At the moment, not even half of refugees go to primary school,” he said. “There are around 100 children per classroom.”

      Refugees are going without food, medical care and water. The plots of land they get have grown smaller and smaller.

      Uganda is doing everything right — except for a corruption scandal. It could really take advantage of the new plan to develop the refugee zone. That would not only help refugees, it would help their host communities. And it would alleviate growing opposition to rights for refugees. “The Ugandan government is under pressure from politicians who see the government giving favored treatment to refugees,” Mr. Boutroue said. “If we want to change the perception of refugees from recipients of aid to economic assets, we have to showcase that refugees bring development.”

      The World Bank has so far approved two projects — one for water and sanitation and one for city services such as roads and trash collection. But they haven’t gotten started yet.

      Mr. Devictor said that tackling long-term development issues was much slower than providing emergency aid. “The reality is that it will be confusing and confused for a little while,” he said. Water, for example, is trucked in to Uganda’s refugee settlements, as part of humanitarian aid. “That’s a huge cost,” he said. “But if we think this crisis is going to last for six more months, it makes sense. If it’s going to last longer, we should think about upgrading the water system.”

      Most refugee crises are not surprises, Mr. Devictor said. “If you look at a map, you can predict five or six crises that are going to produce refugees over the next few years.” It’s often the same places, over and over. That means developmental help could come in advance, minimizing the burden on the host. “Do we have to wait until people cross the border to realize we’re going to have an emergency?” he said.

      Well, we might. If politicians won’t respond to a crisis, it’s hard to imagine them deciding to plan ahead to avert one. Political commitment, or lack of it, always rules. The world’s new approach to refugees was born out of Europe’s panic about the Syrians on their doorstep. But no European politician is panicking about South Sudanese or Rohingya refugees — or most crises. They’re too far away. The danger is that the new approach will fall victim to the same political neglect that has crippled the old one.

      https://www.nytimes.com/2018/08/21/opinion/refugee-camps-integration.html

      #Ouganda #modèle_ougandais #réinstallation #intégration

      avec ce commentaire de #Jeff_Crisp sur twitter :

      “Camps are stagnant places. Refugees have access to water and medical care and are fed and educated, but are largely idle.”
      Has this prizewinning author actually been to a refugee camp?

      https://twitter.com/JFCrisp/status/1031892657117831168

    • Appreciating Uganda’s ‘open door’ policy for refugees

      While the rest of the world is nervous and choosing to take an emotional position on matters of forced migration and refugees, sometimes closing their doors in the face of people who are running from persecution, Uganda’s refugee policy and practice continues to be liberal, with an open door to all asylum seekers, writes Arthur Matsiko

      http://thisisafrica.me/appreciating-ugandas-open-door-policy-refugees

    • Ouganda. La générosité intéressée du pays le plus ouvert du monde aux réfugiés

      L’Ouganda est le pays qui accueille le plus de réfugiés. Un million de Sud-Soudanais fuyant la guerre s’y sont installés. Mais cette noble intention des autorités cache aussi des calculs moins avouables : l’arrivée massive de l’aide internationale encourage l’inaction et la #corruption.

      https://www.courrierinternational.com/article/ouganda-la-generosite-interessee-du-pays-le-plus-ouvert-du-mo

    • Refugees in Uganda to benefit from Dubai-funded schools but issues remain at crowded settlement

      Dubai Cares is building three classrooms in a primary school at Ayilo II but the refugee settlement lacks a steady water supply, food and secondary schools, Roberta Pennington writes from Adjumani


      https://www.thenational.ae/uae/refugees-in-uganda-to-benefit-from-dubai-funded-schools-but-issues-remai

    • FUGA DAL SUD SUDAN. LUIS, L’UGANDA E QUEL PEZZO DI TERRA DONATA AI PROFUGHI

      Luis zappa, prepara dei fori per tirare su una casa in attesa di ritrovare la sua famiglia. Il terreno è una certezza, glielo ha consegnato il Governo ugandese. Il poterci vivere con i suoi cari non ancora. L’ultima volta li ha visti in Sud Sudan. Nel ritornare a casa sua moglie e i suoi otto figli non c’erano più. É sicuro si siano messi in cammino verso l’Uganda, così da quel giorno è iniziata la sua rincorsa. É certo che li ritroverà nella terra che ora lo ha accolto. Quella di Luis è una delle tante storie raccolte nei campi profughi del nord dell’Uganda, in una delle ultime missioni di Amref, in cui era presente anche Giusi Nicolini, già Sindaco di Lampedusa e Premio Unesco per la pace. 



      Modello Uganda? Dell’Uganda il mondo dice «campione di accoglienza». Accoglienza che sta sperimentando da mesi nei confronti dei profughi sud sudanesi, che scappano da uno dei Paesi più drammaticamente in crisi al mondo. Sono 4 milioni le persone che in Sud Sudan hanno dovuto lasciare le proprie case. Chi muovendosi verso altri Paesi e chi in altre regioni sud sudanesi. In questi ultimi tempi arrivano in Uganda anche persone che fuggono dalla Rep. Democratica del Congo.

      https://www.amref.it/2018_02_23_Fuga_dal_Sud_Sudan_Luis_lUganda_e_quel_pezzo_di_terra_donata_ai_pro

    • As Rich Nations Close the Door on Refugees, Uganda Welcomes Them

      President Trump is vowing to send the military to stop migrants trudging from Central America. Europe’s leaders are paying African nations to block migrants from crossing the Mediterranean — and detaining the ones who make it in filthy, overcrowded camps.

      But Solomon Osakan has a very different approach in this era of rising xenophobia. From his uncluttered desk in northwest Uganda, he manages one of the largest concentrations of refugees anywhere in the world: more than 400,000 people scattered across his rural district.

      He explained what he does with them: Refugees are allotted some land — enough to build a little house, do a little farming and “be self-sufficient,” said Mr. Osakan, a Ugandan civil servant. Here, he added, the refugees live in settlements, not camps — with no barbed wire, and no guards in sight.

      “You are free, and you can come and go as you want,” Mr. Osakan added.

      As many nations are securing their borders and turning refugees away, Uganda keeps welcoming them. And they keep coming, fleeing catastrophes from across this part of Africa.

      In all, Uganda has as many as 1.25 million refugees on its soil, perhaps more, making it one of the most welcoming countries in the world, according to the United Nations.

      And while Uganda’s government has made hosting refugees a core national policy, it works only because of the willingness of rural Ugandans to accept an influx of foreigners on their land and shoulder a big part of the burden.

      Uganda is not doing this without help. About $200 million in humanitarian aid to the country this year will largely pay to feed and care for the refugees. But they need places to live and small plots to farm, so villages across the nation’s north have agreed to carve up their communally owned land and share it with the refugees, often for many years at a time.

      “Our population was very few and our community agreed to loan the land,” said Charles Azamuke, 27, of his village’s decision in 2016 to accept refugees from South Sudan, which has been torn apart by civil war. “We are happy to have these people. We call them our brothers.”

      United Nations officials have pointed to Uganda for its “open border” policy. While the United States, a much more populous nation, has admitted more than three million refugees since 1975, the American government settles them in the country after they have first been thoroughly screened overseas.

      By contrast, Uganda has essentially opened its borders to refugees, rarely turning anyone away.

      Some older Ugandans explain that they, too, had been refugees once, forced from their homes during dictatorship and war. And because the government ensures that spending on refugees benefits Ugandans as well, younger residents spoke of how refugees offered them some unexpected opportunities.

      “I was a farmer. I used to dig,” Mr. Azamuke said. But after learning Arabic from refugees from South Sudan, he got a better job — as a translator at a new health clinic that serves the newcomers.

      His town, Ofua, is bisected by a dirt road, with the Ugandans living on the uphill side and the South Sudanese on the downhill side. The grass-thatched homes of the Ugandans look a bit larger and sturdier, but not much.

      As the sun began to set one recent afternoon, a group of men on the Ugandan side began to pass around a large plastic bottle of waragi, a home brew. On the South Sudanese side, the men were sober, gathered around a card game.

      On both sides, the men had nothing but tolerant words for one another. “Actually, we don’t have any problems with these people,” said Martin Okuonzi, a Ugandan farmer cleaning his fingernails with a razor blade.

      As the men lounged, the women and girls were still at work, preparing dinner, tending children, fetching water and gathering firewood. They explained that disputes did arise, especially as the two groups competed for limited resources like firewood.

      “We’ve been chased away,” said Agnes Ajonye, a 27-year-old refugee from South Sudan. “They say we are destroying their forests.”

      And disputes broke out at the well, where Ugandan women insist they should be allowed to skip ahead of refugees.

      “If we hadn’t given you the land you live on, wouldn’t you be dying in Sudan?” said Adili Chandia, a 62-year-old refugee, recounting the lecture she and others got from a frustrated Ugandan woman waiting in line.

      Ugandan officials often talk about the spirit of Pan-Africanism that motivates their approach to refugees. President Yoweri Museveni, an autocratic leader who has been in power for 32 years, says Uganda’s generosity can be traced to the precolonial days of warring kingdoms and succession disputes, when losing factions often fled to a new land.

      This history of flight and resettlement is embedded in some of the names of local groups around western Uganda, like Batagwenda, which means “the ones that could not continue traveling.”

      The government encourages the nation to go along with its policy by directing that 30 percent of foreign aid destined for refugees be spent in ways that benefit Ugandans nearby. So when money for refugees results in new schools, clinics and wells, Ugandans are more likely to welcome than resent them.

      For Mr. Museveni, hosting refugees has given him relevance and political capital abroad at a time when he would otherwise have little.

      A former guerrilla fighter who quickly stabilized much of his country, Mr. Museveni was once hailed as an example of new African leadership. He was relatively quick to confront the AIDS epidemic, and he invited back Ugandans of Indian and Pakistani descent who had been expelled during the brutal reign of Idi Amin in the 1970s.

      But his star has fallen considerably. He has clung to power for decades. His security forces have beaten political opponents. Freedom of assembly and expression are severely curtailed.

      Even so, Uganda’s openness toward refugees makes Mr. Museveni important to European nations, which are uneasy at the prospect of more than a million refugees heading for Europe.

      Other African nations also host a significant number of refugees, but recent polls show that Ugandans are more likely than their neighbors in Kenya or Tanzania to support land assistance or the right to work for refugees.

      Part of the reason is that Ugandans have fled their homes as well, first during the murderous reign of Mr. Amin, then during the period of retribution after his overthrow, and again during the 1990s and 2000s, when Joseph Kony, the guerrilla leader who terrorized northern Uganda, left a trail of kidnapped children and mutilated victims.

      Many Ugandans found refuge in what is today South Sudan. Mark Idraku, 57, was a teenager when he fled with his mother to the area. They received two acres of farmland, which helped support them until they returned home six years later.

      “When we were in exile in Sudan, they also helped us,” Mr. Idraku said. “Nobody ever asked for a single coin.”

      Mr. Idraku has since returned the favor, loaning three acres to a South Sudanese refugee named Queen Chandia, 37. Ms. Chandia said the land — along with additional plots other Ugandans allow her to farm — has made all the difference.

      Her homestead of thatched-roof huts teemed with children tending their chores, grinding nuts into paste and maize into meal. Ms. Chandia is the mother of a girl and two boys. But over the years, as violence hollowed out her home country, Ms. Chandia started taking in the orphaned children of relatives and friends. Now 22 children call her “mom.”

      A refugee for nearly her entire life, Ms. Chandia arrived in Uganda as a young girl nearly 30 years ago. For years, she worried about being expelled.
      Image

      “Maybe these Ugandans will change their minds on us,” she said, describing the thought that plagued her. Then one day the worry stopped.

      But Mr. Osakan, the administrator who oversees refugee affairs in the country’s extreme northwest, is anxious. There is an Ebola outbreak over the border in the Democratic Republic of Congo. Mr. Osakan fears what might happen if — or when — a refugee turns up in Uganda with the dreaded illness.

      “It would destroy all the harmony between refugees and host communities,” he said, explaining that it would probably lead to calls to seal the border.

      For now, the border is very much open, although the number of refugees arriving has fallen significantly. In one of the newer settlements, many of the refugees came last year, fleeing an attack in a South Sudanese city. But some complained about receiving too little land, about a quarter acre per family, which is less than previous refugees had received.

      “Even if you have skills — in carpentry — you are not given a chance,” said one refugee, Simon Ludoru. He looked over his shoulder, to where a construction crew was building a nursery school. The schoolhouse would teach both local Ugandan and South Sudanese children together, but the workers were almost entirely Ugandan, he said.

      At the construction site, the general contractor, Sam Omongo, 50, said he had hired refugees for the job. “Oh, yes,” he exclaimed.

      How many?

      “Not a lot, actually,” he acknowledged. “I have about three.” Mr. Omongo called one over.

      “Are you a refugee?” Mr. Omongo asked the slight man.

      “No, I’m from Uganda,” he said softly. His name was Amos Chandiga, 28. He lived nearby and owned six acres of land, though he worked only four of them. He had lent the other two to a pair of refugees.

      “They asked me, and I gave it to them,” Mr. Chandiga explained. He patted his chest. “It comes from here, in my heart.”


      https://www.nytimes.com/2018/10/28/world/africa/uganda-refugees.html?smtyp=cur&smid=tw-nytimes

    • Uganda: a role model for refugee integration?

      Uganda hosts the largest refugee population in Africa and is, after Turkey and Pakistan, the third-largest refugee recipient country worldwide. Political and humanitarian actors have widely praised Ugandan refugee policies because of their progressive nature: In Uganda, in contrast to many other refugee-receiving countries, these are de jure allowed to work, to establish businesses, to access public services such as education, to move freely and have access to a plot of land. Moreover, Uganda is a pilot country of the Comprehensive Refugee Response Framework (CRRF). In this Working Paper the authors ascertain whether Uganda indeed can be taken as a role model for refugee integration, as largely portrayed in the media and the political discourse. They identify the challenges to livelihoods and integration to assess Uganda’s self-reliance and settlement approach and its aspiration towards providing refugees and Ugandan communities receiving refugees with opportunities for becoming self-reliant. Drawing on three months of field research in northern and southern Uganda from July to September of 2017 with a particular focus on South Sudanese refugees, the authors concentrate on three aspects: Access to land, employment and education, intra- and inter-group relations. The findings show that refugees in Uganda are far from self-reliant and socially integrated. Although in Uganda refugees are provided with land, the quality and size of the allocated plots is so poor that they cannot earn a living from agricultural production, which thus, rather impedes self-reliance. Inadequate infrastructure also hinders access to markets and employment opportunities. Even though most local communities have been welcoming to refugees, the sentiment has shifted recently in some areas, particularly where local communities that are often not better off than refugees feel that they have not benefitted from the presence of refugees....

      https://www.ssoar.info/ssoar/handle/document/62871

    • Uganda has a remarkable history of hosting refugees, but its efforts are underfunded

      Uganda has agreed to a request from the United States to temporarily accommodate 2,000 refugees from Afghanistan while Washington processes their applications to live in the US. The move underscores the reputation Uganda has of being progressive on refugee issues. Refugee expert Dr Evan Easton-Calabria provides insights into why.
      When did Uganda start hosting refugees?

      Uganda has a long history of hosting refugees. This started in the early 1940s with Polish refugees who fled from Nazi-occupied Europe. The Nakivale refugee settlement – formed in 1959 – in southwest Uganda is the oldest refugee camp in Africa.

      Uganda also hosts huge numbers of refugees. In the mid-1950s almost 80,000 Sudanese refugees, fleeing the first civil war, sought refuge in the country. They were only the first of many waves of refugees from different neighbouring countries to arrive. Uganda has hosted significant numbers of refugees ever since.

      Today, almost 1.5 million refugees live in Uganda, making it the top refugee-hosting country in Africa and one of the top five hosting countries in the world.

      Its longstanding ‘open-door’ policy has benefited it both politically and financially, with hundreds of millions of donor funds provided each year for humanitarian and development projects. These target both refugees and locals. While Kenya, for example, has received Euros 200 million in humanitarian aid from the European Union since 2012, Uganda has received this much from the EU in just over four years.
      Is the country more progressive towards refugees than its neighbours?

      Uganda’s policies towards refugees have been hailed as progressive. It has even been called “the world’s best place for refugees”.

      Refugees have the right to work and freedom of movement, thanks to Uganda’s 2006 Refugee Act and 2010 Refugee Regulations, which provide a strong legal and regulatory framework for refugee rights.

      Refugees have the right to the same social services as Ugandans, including health care and free primary education. They are not confined to camps but can also live in urban areas. The country has, therefore, received a lot of positive attention for ‘fostering’ the self-reliance of refugees.

      However, despite rights on paper in Uganda, refugees still struggle.

      They are not legally recognised as refugees if they live in cities besides the capital, Kampala. As ‘self-settled’ urban refugees, they risk being misclassified as economic migrants. Lacking official refugee status (unless they have been registered in a settlement), urban refugees also often lack assistance.

      Although refugees in Uganda are economically diverse – one study even identified over 70 different types of livelihoods activities by refugees in Uganda – for many in settlements, subsistence farming is their primary livelihood. But, despite plots of land being provided in settlements, many don’t have enough land to farm on and soil quality is often low. This means that, for many, farming is no longer a viable livelihood. This shows that liberal refugee policies, like those promoting self-reliance in Uganda, must be backed with adequate resources if they are to be more than just words on paper.

      Comparatively, Uganda’s neighbours – such as Kenya and Ethiopia – have traditionally been more restrictive. Kenya relies on a system of encampment, where most refugees live in camps, and Ethiopia has only recently expanded its out-of-camp policy to all refugees and aslyum-seekers, although regulatory gaps remain. Nevertheless, it’s important to note that both are major refugee-hosting countries. They host far more refugees than many western (and wealthier) countries. Kenya hosts over half a million refugees, mainly from Somalia and South Sudan. Ethiopia hosts over 788,000 and is the third largest refugee-hosting country in Africa.
      How effectively does Uganda manage its refugee community?

      ‘Effectiveness’ is an interesting word in this context. On one hand, Uganda provides an important foundation in terms of providing the legal infrastructure to allow many refugees to lead independent lives. But refugees also enter a challenging context: Uganda struggles to provide adequate services for its own citizens and unemployment is high. It has one of the world’s lowest rankings in the Human Capital Index.

      In addition, the 2021 presidential election saw increased political and social unrest which has led to the violation of rights such as the freedom of assembly and expression for citizens and other residents, including refugees. While many Ugandans have welcomed refugees, there are increasing accounts of overburdened cities and strains on resources, like firewood, in some parts of the country.

      The corruption of humanitarian aid is also a problem, with UNHCR Uganda accused of mismanaging tens of millions of dollars in 2016-2017. This illustrates the clear need for effective financial management so that refugees can actually be helped.

      There is also another important question of responsibility. Despite the positive attention the international community has given the country, donor funds have not often matched the praise. If schools and health facilities are crowded, in part because of refugees, the responsibility to provide additional support should not fall on a refugee-hosting country such as Uganda alone. Limited resources mean limited management. As of June, the 2020-2021 Uganda Refugee Response Plan was only 22% funded, leaving a shortfall of US$596 million to cover all sectors ranging from protection to food security to sanitation.
      Does it look likely that Uganda will continue in its role as a leading refugee destination?

      Uganda has had a strong commitment to hosting refugees for over 70 years –- about the same length that the 1951 Refugee Convention has existed. A spirit of pan-Africanism and first-hand understanding of displacement by many Ugandans have all contributed to its willingness to host refugees. Its recent temporary accommodation of Afghan refugees indicates that it is interested in continuing this role.

      That said, no country should host refugees without significant international support. Many refugee response plans, such as Uganda’s, remain significantly underfunded even as displacement rises and challenges – such as the COVID-19 pandemic – remain. Even though Uganda receives a significant amount of money, it’s not enough to support the number of people arriving as evidenced by a funding appeal by refugee response actors in June this year.

      Mechanisms such as the Comprehensive Refugee Response Framework offer a means to channel resources and increase collaboration on refugee hosting. But it is important to consider what displacement in Central, Eastern, and the Horn of Africa would look like if Uganda closed its borders. Uganda is making an effort in a neighbourhood where few other countries have the same enthusiasm.

      https://theconversation.com/uganda-has-a-remarkable-history-of-hosting-refugees-but-its-efforts

  • Study Confirms That Security Line In Airport Is A Hotbed For Viruses : Goats and Soda : NPR
    https://www.npr.org/sections/goatsandsoda/2018/09/08/645255357/where-are-the-most-viruses-in-an-airport-hint-its-probably-not-the-toilet

    When you go through airport security, you might wish you had a pair of gloves on like the TSA agents do.

    Researchers have evidence that the plastic trays in security lines are a haven for respiratory viruses. The trays likely harbor more of these pathogens than the flushing button on the airport toilets, researchers reported last week in BMC Infectious Diseases.

    [...]

    The study was teeny-weenie. Virologists looked for viruses on 90 surfaces at the Helsinki Airport. And they took only eight samples from the plastic security trays over the course of three weeks. Half of those samples showed signs of at least one respiratory virus, such as influenza A or a coronavirus that can cause severe respiratory infections. (In contrast, none of the 42 samples taken from surfaces around the toilets showed traces of these viruses.)

    [...]

    Gendreau recommends using sanitizers that contain at least 60 percent alcohol or washing your hands with soap and water. “Just make sure you do if for 25 seconds,” he says.

    And be careful about where you put your hands before you get a chance to clean them, Gendreau adds.

    “The trick is to be mindful about not touching your face,” he says. “Eighty percent of all infections are transmitted by your hands: You touch a surface that’s contaminated with a virus and then introduce it into your body by touching your face. Humans touch their eyes, nose or mouth about 200 times a day.”

  • Opinion | We Know How to Conquer Tuberculosis - The New York Times
    https://www.nytimes.com/2018/09/26/opinion/we-know-how-to-conquer-tuberculosis.html

    And so, tuberculosis remains the world’s leading infectious disease killer, by far. It infects some 10 million people around the world every year, killing roughly 1.5 million. That’s some 4,000 deaths per day. By comparison, Ebola killed four people in 2017. America’s opioid epidemic kills about 115 people a day.

    Still, tuberculosis is rarely the stuff of headlines. It’s ancient. It normally affects only the poorest people in the poorest countries. And when it does spread through wealthier areas, it’s generally curable with antibiotics. But a contingent of doctors, scientists and public health officials have spent the past two decades battling a global epidemic of the disease. And on Wednesday, they got their first hearing at the United Nations General Assembly. In a high-level meeting exclusively about tuberculosis control, those experts called on world leaders to devote more attention and far more resources to the disease. Both are urgently needed. Tuberculosis receives significantly less funding than H.I.V. or malaria, even though TB kills more people each year than both of those diseases combined. The World Health Organization estimates a $3.5 billion funding shortfall for TB control efforts, and says that gap could double in five years.

    But policymakers, industry leaders and doctors on the front lines might also consider a change in strategy: Treat tuberculosis outbreaks in poor countries the same way they are treated in rich ones. That is, don’t just treat those who are sick; find and test their household members, neighbors, classmates and colleagues — and then treat the ones who test positive. Give them medications to kill the bacteria before they develop symptoms and before they pass the bacteria on, through their own coughing, to the next victim.

    #Tuberculose #Maladie_des_pauvres

  • African military partnerships in the age of the enemy disease
    http://africasacountry.com/2017/07/african-military-partnerships-in-the-age-of-the-enemy-disease

    One of the most disturbing developments in the 2013-2015 Ebola outbreak in West Africa was the decision, in late summer 2014, to place armed Liberian security forces around Monrovia’s West Point neighborhood. In an effort to contain the disease, the Liberian government deployed an urban warfare tactic against its own citizens. The cordon sanitaire was short lived and tragic: at least one person was killed (Shakie Kamara, shot by officers manning the…

  • Evidence for sexual transmission of the #Ebola Virus.

    In December 2013 cases of Ebola, a viral haemorrhagic fever with an extremely high mortality rate, began to emerge in Guinea, West Africa, marking the beginning of the most severe outbreak of the disease ever recorded. The epidemic rapidly spread to several neighbouring countries, including Sierra Leone and Liberia where if became established and killed large numbers of people before being eradicated. Liberia was officially declared free of Ebola on 3 September 2015, though cases were still being reported in Guinea and Sierra Leone, albeit at a much lower rate than during the peak of the epidemic.

    http://sciencythoughts.blogspot.it/2015/11/evidence-for-sexual-transmission-of.html

  • The Ebola endgame, and what comes after - The Lancet Infectious Diseases
    http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00032-8/fulltext

    It can be argued that the weak health systems that were in place when the #Ebola outbreak started helped spread the epidemic because of their lack of capacity to detect and diagnose the disease or to manage severely ill patients. The strategic plan notes that government health expenditure was low and that “external funding was skewed towards #millennium_development goals with limited investments in core health systems functions”.

    Management of endemic diseases such as malaria has suffered because of the focus on Ebola over the past year: a modelling paper by Patrick Walker and colleagues in this journal estimates an additional 10 900 #malaria-attributable deaths during the Ebola outbreak.

    #santé #développement

  • Bill Gates: The Ebola Crisis Was Terrible. But Next Time Could Be Much Worse. - NYTimes.com
    http://www.nytimes.com/2015/03/18/opinion/bill-gates-the-ebola-crisis-was-terrible-but-next-time-could-be-much-worse.

    The Ebola epidemic might have been a lot worse if the United States, Britain and other governments had not used military resources to fly people and equipment into and out of affected areas. But we should not assume that the next epidemic will limit itself to countries that welcome Western troops.

    #Data is another crucial problem. During the #Ebola epidemic, the database that tracks cases has not always been accurate. (...)

    Then there’s our failure to invest in effective medical tools like diagnostic tests, drugs and vaccines. (...)

    Compare all this to the preparation that nations put into defense. Armies have systems for recruiting, training and equipping soldiers. NATO has a mobile unit that is ready to deploy quickly. Although the system isn’t perfect, NATO members do joint exercises where they work out logistics like how troops will get food and what language they will use to communicate.

    #santé_sécuritaire

  • How Slow Responses Made the Ebola Outbreak So Deadly - Facts So Romantic
    http://nautil.us/blog/how-slow-responses-made-the-ebola-outbreak-so-deadly

    As a rule, huge organizations move sluggishly, bogged down in democratic decision-making processes and bureaucratic policies. Ebola, on the other hand, moves fast. People become desperately sick and contagious within a few weeks of infection. By the time international agencies effectively responded to the ongoing Ebola outbreak, it had spiraled out of control in West Africa. Although the rate of infection has now slowed in Sierra Leone and Guinea—and appears to have halted in Liberia—the Ebola virus has claimed the lives of more than 10,000 people to date. Had the international response been more responsive to the shifting situation, more organized, more trusting of infectious-disease experts, and braver and bolder early on, the death toll might not have been so high, the operation so (...)

  • Still Fighting Ebola: A View from Liberia’s Front Line | WIRED

    http://www.wired.com/2015/02/ebola-liberia/?mbid=social_twitter

    We’ve pretty much signed off on Ebola in the United States — last week, President Obama withdrew the US troops sent to fight the disease — but in Africa, the news on the epidemic has seemed pretty good. The overall number of known cases stands at 22,894, with 9,177 deaths, far below the dire predictions made last fall that the epidemic could sicken millions.

    Progress at beating the disease is stalling, though. According to the World Health Organization, the number of new cases has gone back up for two weeks in a row. Sierra Leone, now the outbreak’s epicenter, still has what the WHO calls “widespread transmission,” and on Saturday its government quarantined part of the capital. Guinea has had a spike in cases, and in several areas, mobs have attacked clinics.

    #ebola toujours

  • How a national food policy could save millions of American lives - The Washington Post
    http://www.washingtonpost.com/opinions/how-a-national-food-policy-could-save-millions-of-american-lives/2014/11/07/89c55e16-637f-11e4-836c-83bc4f26eb67_story.html

    The food system and the diet it’s created have caused incalculable damage to the health of our people and our land, water and air. If a foreign power were to do such harm, we’d regard it as a threat to national security, if not an act of war, and the government would formulate a comprehensive plan and marshal resources to combat it. (The administration even named an Ebola czar to respond to a disease that threatens few Americans.) So when hundreds of thousands of annual deaths are preventable — as the deaths from the chronic diseases linked to the modern American way of eating surely are — preventing those needless deaths is a national priority.

    (...)

    Only those with a vested interest in the status quo would argue against creating public policies with these goals. Now weigh them against the reality that our current policies and public investments have given us:

    Because of unhealthy diets, 100 years of progress in improving public health and extending lifespan has been reversed. Today’s children are expected to live shorter lives than their parents. In large part, this is because a third of these children will develop Type 2 diabetes, formerly rare in children and a preventable disease that reduces life expectancy by several years. At the same time, our fossil-fuel-dependent food and agriculture system is responsible for more greenhouse gas emissions than any other sector of the economy but energy. And the exploitative labor practices of the farming and fast-food industries are responsible for much of the rise in income inequality in America.

    We find ourselves in this situation because government policy in these areas is made piecemeal. Diet-related chronic disease, food safety, marketing to children, labor conditions, wages for farm and food-chain workers, immigration, water and air quality, greenhouse gas emissions, and support for farmers: These issues are all connected to the food system. Yet they are overseen by eight federal agencies. Amid this incoherence, special interests thrive and the public good suffers.

    (...)

    The contradictions of our government’s policies around food become clear as soon as you compare the federal recommendations for the American diet, known as MyPlate, with the administration’s agricultural policies. While MyPlate recommends a diet of 50 percent vegetables and fruits, the administration devotes less than 1 percent of farm subsidies to support the research, production and marketing of those foods. More than 60 percent of that funding subsidizes the production of corn and other grains — food that is mostly fed to animals, converted to fuel for cars or processed into precisely the sort of junk the first lady is urging us to avoid.

    How could one government be advancing two such diametrically opposed goals? By failing to recognize that an agricultural policy is not the same as a food policy — and that the former does not necessarily contribute to public health.

    Our food system is largely a product of agricultural policies that made sense when the most important public health problem concerning food was the lack of it and when the United States saw “feeding the world” as its mission. These policies succeeded in boosting the productivity of American farmers, yet today they are obsolete and counterproductive, providing billions in public support to an industry that churns out a surfeit of unhealthy calories — while at the same time undermining the ability of the world’s farmers to make a living from their land.

    These farm policies have nourished an agricultural-industrial complex before which the president and the first lady seem powerless. The administration’s early efforts to use antitrust laws to protect farmers and consumers from agribusiness oligopolies were quietly dropped. Promises to regulate the use of antibiotics in animal agriculture — widely acknowledged as a threat to public health — resulted in toothless voluntary guidelines from the Food and Drug Administration.

    When it came to regulating #methane, one of the most potent greenhouse gases, the Environmental Protection Agency proposed stringent rules for the energy industry — and another voluntary program for agriculture, the single biggest emitter of the gas. And in February the president signed yet another business-as-usual farm bill, which continues to encourage the dumping of cheap but unhealthy calories in the supermarket.

    These policies and the diet they sponsor threaten to undermine President Obama’s Affordable Care Act. The government now finds itself in the absurd position of financing both sides in the war on Type 2 diabetes, a disease that, along with its associated effects, now costs $245 billion, or 23 percent of the national deficit in 2012, to treat each year. The government subsidizes soda with one hand, while the other writes checks to pay for insulin pumps. This is not policy; this is insanity.

    The good news is that solutions are within reach — precisely because the problems are largely a result of government policies. We know that the government has the power to reshape the food system because it has already done so at least once — when President Richard Nixon rejiggered farm policy to boost production of corn and soy to drive down food prices.

    Of course, reforming the food system will ultimately depend on a Congress that has for decades been beholden to #agribusiness, one of the most powerful lobbies on Capitol Hill. As long as food-related issues are treated as discrete rather than systemic problems, congressional committees in thrall to special interests will be able to block change.

    (...)

    Brazil has had a national food policy since 2004. In the city of Belo Horizonte that policy — coupled with an investment of 2 percent of the local budget in food-access and farmer-support programs — has reduced poverty by 25 percent and child mortality by 60 percent, and provided access to credit for 2 million farmers, all within a decade.

    #alimentation #lobbies #lobbying #corruption #santé #obésité #diabète_sucré #Etats-Unis

  • #Ebola raises profile of blood-based therapy | Nature News & Comment
    http://www.nature.com/news/ebola-raises-profile-of-blood-based-therapy-1.16625

    Many scientists have long argued that [convalescent plasma therapy] CPT has been wrongly neglected, both as a therapy for emerging diseases and in preparation for future unknown threats. (...)

    Convalescent plasma was found to effectively treat diphtheria and tetanus at the end of the nineteenth century, and was widely used in the first half of the twentieth century to treat diseases such as measles, mumps and pneumonia. But it fell off the radar after the development of antibiotics, antiviral drugs and vaccines.

    #recherche (ou absence de) #santé #sang

  • Daily chart: Ebola’s spread | The Economist

    http://www.economist.com/blogs/graphicdetail/2014/07/daily-chart-22

    Ebola’s spread

    Jul 29th 2014, 16:01 by R.L.W., A.C.M. and L.P.

    The current Ebola outbreak is the worst on record

    LIBERIA has closed most of its borders, banned public gatherings and announced quarantines of some communities in an effort to contain an outbreak of the Ebola virus. So far this year there have been 1,201 confirmed, suspected or probable cases of the disease in west Africa. Over 670 people have died. Ebola has no vaccine or cure, and kills up to 90% of those infected. It is transmitted to people by wild animals or by other infected patients. Fruit bats, often eaten by people living in West Africa, are thought to be a host for the virus, which starts with flu-like symptoms but can impair kidney and liver function, and in severe cases damages blood cells, leading to external and internal bleeding.

    The current outbreak started in south-eastern Guinea in February and spread to Liberia in March and Sierra Leone in May. Last week Nigeria reported its first probable case, and was put on high alert after a Liberian man died in its most populous city, Lagos. Outbreaks are only considered to be over after 42 days (twice the maximum incubation period) without any new confirmed cases, meaning the current outbreak will continue until at least September.

    #eoola

  • UN Ambassador Warns Against Intervention Fatigue - Defense One
    http://www.defenseone.com/threats/2014/11/un-ambassador-warns-against-intervention-fatigue/99485

    #Samantha_Power, the U.S. Ambassador to the United Nations, warned the American public against a kind of intervention fatigue, emphasizing that U.S. #leadership is needed now more than ever amid global threats from Ebola to the Islamic State.

  • I’m a Hazmat-Trained Hospital Worker: Here’s What No One Is Telling You About #Ebola
    http://www.huffingtonpost.com/abby-norman/im-a-hazmat-trained-hospi_b_5998486.html

    ... you can’t just expect any nurse or any doctor or any health care worker or layperson to understand the deconning procedures by way of some kind of pamphlet or 10-minute training video. Not only is it mentally rigorous, but it’s physically exhausting.

    (...)

    The truth is, in terms of virology, Ebola should not be a threat to American citizens. We have clean water. We have information. We have the means to educate ourselves, practice proper hand-washing procedures, protect ourselves with hazmat suits. The CDC Disease Detectives were dispatched to Dallas almost immediately to work on the front lines to identify those who might be at risk, who could have been exposed. We have the technology, and we certainly have the money to keep Ebola at bay.

    What we don’t have is communication. What we don’t have is a health care system that values preventative care. What we don’t have is an equal playing field between nurses and physicians and allied health professionals and patients. What we don’t have is a culture of health where we work symbiotically with one another and with the technology that was created specifically to bridge communication gaps, but has in so many ways failed. What we don’t have is the social culture of transparency, what we don’t have is a stopgap against mounting hysteria and hypochondria, what we don’t have is nation of health literate individuals. We don’t even have health-literate professionals. Most doctors are specialists and are well versed only in their field. Ask your orthopedist a general question about your health — see if they can comfortably answer it.

    Health care operates in silos — we can’t properly isolate our patients, but we sure as hell can isolate ourselves as health care workers.

    As we slide now into flu season, into a time of year when we are normally braced for winter diseases, colds, flus, sick days and cancelled plans, the American people have also now been truly exposed to another disease entirely: the excruciating truth about our health care system’s dysfunction — and the prognosis doesn’t look good.

  • Paul Farmer’s ’Diary’ in the London Review of Books. Great pieces on #Ebola - long but worth it
    http://www.lrb.co.uk/v36/n20/paul-farmer/diary

    Weak health systems, not unprecedented virulence or a previously unknown mode of transmission, are to blame for Ebola’s rapid spread. [However] if patients are promptly diagnosed and receive aggressive supportive care ... the great majority, as many as 90 per cent, should survive

  • Ebola nurse treated “like a criminal” in New Jersey quarantine - World Socialist Web Site

    http://www.wsws.org/en/articles/2014/10/28/ebol-o28.html

    Ebola nurse treated “like a criminal” in New Jersey quarantine
    By Patrick Martin
    28 October 2014

    New Jersey state authorities abruptly released Kaci Hickox Monday after a three-day involuntary quarantine ordered by Governor Chris Christie. A nurse who had worked caring for Ebola patients in West Africa, Hickox was detained Friday at Newark International Airport and held against her will despite having no symptoms of the disease.

    Christie, a Republican, and New York Governor Andrew Cuomo, a Democrat, jointly announced the mandatory quarantine for all health care workers returning from Sierra Leone, Liberia and Guinea who had been in contact with Ebola victims there. The quarantine was based on no scientific or health considerations, since people without symptoms of Ebola, even if they later manifest the disease, are not contagious.

    #ebola #états-unis

  • Don’t fear #Ebola, fear fear itself

    Public health officials in America are trying to manage two serious threats right now. One is Ebola, the virus that causes horrible deaths from vomiting, diarrhea, and hemorrhagic bleeding in more than half the people it infects, and against which there is no protective vaccine. The other is fear. In the United States, between the two, fear is the far greater threat.

    http://thebulletin.org/don%E2%80%99t-fear-ebola-fear-fear-itself7745

    #Etats-Unis #peur #USA

  • We can no longer ignore Ebola’s wider impact – particularly on women | Jeanne Kamara | Global development | theguardian.com
    http://www.theguardian.com/global-development/poverty-matters/2014/oct/14/ebola-women-sierra-leone

    Women make up 51% of Sierra Leone’s population: they are the key to the country’s social and economic development. This is why gender activists and women’s advocacy groups in the country have joined forces in urging leaders to address the disproportionate effect of Ebola on the female population. It is estimated that 60% of the total fatalities in west Africa have been women (pdf); in Liberia, the figure is reportedly as high as 75%.

    In Sierra Leone’s patriarchal society, women are the primary care-givers at home and in the community. Custom dictates that they tend to sick family members, nurse children and work as traditional healers and healthcare assistants. It is sisters, daughters, aunts, mothers and grandmothers who have selflessly cared for relatives infected with Ebola; unwittingly, they have put themselves at great risk.

    #Ebola #femmes

  • #Ebola #Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections
    http://www.nejm.org/doi/full/10.1056/NEJMoa1411100#t=articleBackground

    Although the current epidemic of EVD in West Africa is unprecedented in scale, the clinical course of infection and the transmissibility of the virus are similar to those in previous EVD outbreaks. The incubation period, duration of illness, case fatality rate, and R 0 are all within the ranges reported for previous EVD epidemics.7,13-18 Our estimates of R 0 are similar to other recent estimates for this West Africa epidemic.19-23 The combination of signs and symptoms recorded between symptom onset and clinical presentation is also similar to that in other reports.14,17,24-26 We infer that the present epidemic is exceptionally large, not principally because of the biologic characteristics of the virus, but rather because of the attributes of the affected populations and because control efforts have been insufficient to halt the spread of infection.

    Certain characteristics of the affected populations may have led to the rapid geographic dissemination of infection. The populations of Guinea, Liberia, and Sierra Leone are highly interconnected, with much cross-border traffic at the epicenter and relatively easy connections by road between rural towns and villages and between densely populated national capitals. The large intermixing population has facilitated the spread of infection, but a large epidemic was not inevitable. In Nigeria, the number of cases has so far been limited, despite the introduction of infection into the large cities of Lagos (approximately 20 million people) and Port Harcourt (>1 million people). The critical determinant of epidemic size appears to be the speed of implementation of rigorous control measures.

    (...)

    Notwithstanding the geographic variation in case incidence within and among Guinea, Liberia, and Sierra Leone, the current epidemiologic outlook is bleak. Forward projections suggest that unless control measures — including improvements in contact tracing, adequate case isolation, increased capacity for clinical management, safe burials, greater community engagement, and support from international partners — improve quickly, these three countries will soon be reporting thousands of cases and deaths each week, projections that are similar to those of the Centers for Disease Control and Prevention.

    Experimental therapeutics and vaccines offer promise for the future but are unlikely to be available in the quantities needed to make a substantial difference in control efforts for many months, even if they are proved to be safe and effective. Furthermore, careful assessment of the most effective means of utilizing such interventions (e.g., vaccination or treatment of contacts versus health care workers) will be required while stocks remain limited. For the medium term, at least, we must therefore face the possibility that EVD will become endemic among the human population of West Africa, a prospect that has never previously been contemplated. The risk of continued epidemic expansion and the prospect of endemic EVD in West Africa call for the most forceful implementation of present control measures and for the rapid development and deployment of new drugs and vaccines.

    #Afrique #santé

  • Genomes reveal start of Ebola outbreak

    http://www.sciencemag.org/content/345/6200/989.full

    When the young woman arrived at the Kenema Government Hospital in Sierra Leone in late May, she had high fever and had just miscarried. The hospital suspected she had contracted Lassa fever, because the viral disease is endemic in the region and often causes miscarriages. But Ebola virus disease, another hemorrhagic fever illness, had been spreading in neighboring Guinea for months, so when she began bleeding profusely, staff tested her for that virus as well. The results were positive, making her the first confirmed case of Ebola in Sierra Leone.

    The young woman, who eventually recovered, is now at the heart of a tragic but potentially important research tale. In a paper online this week in Science, a collaboration led by Stephen Gire and Pardis Sabeti of Harvard University and the Broad Institute in Cambridge, Massachusetts, report sequencing and analyzing the genomes of Ebola virus samples from 78 people in Sierra Leone who were diagnosed with Ebola between late May and mid-June, including the young woman who came to Kenema’s hospital. The 99 complete sequences—some patients were sampled more than once—provide insights into how the virus is changing during the outbreak, which could help improve current diagnostic tests and, in the long term, guide researchers working on vaccines and treatments.

    #ebola