DYING OF HUNGER

The shadows of girls pounding grain are cast on the mud wall of their hut in a village in Niger. REUTERS/Finbarr O’Reilly

Enough food is produced globally to feed the planet but even so roughly 923 million people go to bed hungry every night. Hunger is a leading cause of death, killing an estimated 9 million people every year – more than AIDS, tuberculosis and malaria combined.

A child dies of hunger every 5 seconds (U.N. World Food Programme -WFP)

More than a quarter of children in developing countries is underweight (UNICEF)Most of the world’s hungry are not short of food because of a one-off disaster or crop failure but because of chronic, long-term poverty that means they cannot afford the food that is readily available in their local markets.Additional stresses like food price rises, drought, flooding, war and disease can create local food shortages which, without government or aid agency intervention, can develop into food crises. However, even at the height of a famine, often only certain groups are affected within a particular region.While state or aid agency food handouts are seen as a short-term solution and a valuable tool to help, many aid experts say longer-term solutions are needed to address root problems.

DRC: MONUC denounces coalition between Mayi-Mayi and Rwandan rebels

Photo: Les Neuhaus/IRIN

Civilians, many of whom are displaced, bear the brunt of the violence in eastern Congo – file photo

GOMA, 7 July 2009 (IRIN) – The UN Mission in the Democratic Republic of Congo (DRC), MONUC, has denounced a coalition formed by Congolese militia, the Mayi-Mayi, and Rwandan Hutu rebels of the Forces démocratiques pour la libération du Rwanda (FDLR), targeted by the national army in the eastern provinces of North Kivu and South Kivu.

Jean-Paul Dietrich, MONUC’s military spokesman, told a news conference in Goma – capital of North Kivu – that several reports had revealed collaboration between the FDLR and some Mayi-Mayi militia groups.

He said the Alliance des patriots pour un Congo libre et démocratique (APCLS) and les Patriotes résistants Congolais (PARECO), which are active in Nyabiondo, south of Lubero in North Kivu, were some of the Mayi-Mayi groups collaborating with the FDLR.

“Many elements of the Mayi-Mayi groups and PARECO were seen fighting alongside the FDLR,” said Dietrich, referring to operations launched by the national army on 24 June against the FDLR in several villages, including Chanika in Lubero territory.

Dietrich said 13 bodies of Mayi-Mayi militiamen killed during these operations were found.

Fighting between the army and Mayi-Mayi elements resulted in seven militia deaths in the village of Misau, 20km southwest of Pinga, Dietrich said. The FDLR and their allies also attacked the army, killing two soldiers and wounding several more, he added.

Photo: Les Neuhaus/IRIN

A UN peacekeeper near a camp for the displaced in eastern Congo: MONUC has denounced a coalition formed by the Mayi-Mayi and the Forces démocratiques pour la libération du Rwanda – file photo

He said MONUC had identified 25 huts burned during an attack on the village of Kisheguru, 17km from Kiwanja, in Rutshuru territory.

“MONUC intervened to prevent fire from burning down the whole village,” Dietrich said.

Attacks and counterattacks have also occurred in South Kivu Province.

According to Human Rights Watch, rights violations have increased in eastern Congo since the beginning of military operations against the FDLR and rebels of the Ugandan Lord’s Resistance Army (LRA).

HRW said LRA and FDLR reprisals against civilians had increased.

“The FDLR and their allies have been involved in a lot of fairly serious crimes,” Anneke van Woudenberg, HRW’s senior researcher on the DRC, told IRIN. “Human Rights Watch has [evidence that] not only the FDLR but also their allies … are responsible for war crimes.”

MADAGASCAR: Unconvincing proposal fails to thaw EU aid

Photo:

HAT President, Andre Rajoelina, unable to charm the EU

JOHANNESBURG, 7 July 2009 (IRIN) – Madagascar’s self-appointed – and increasingly cash strapped – high authority (Haut Autorité Transitoire – HAT) has been unable to convince the European Union (EU) that it has made progress towards constitutional order and fresh polls, dashing any prospect of renewed engagement and aid.

HAT President Andry Rajoelina met with EU officials in Brussels on 6 July, hoping to thaw some US$880 million in frozen aid, but the EU “failed to note any satisfactory proposals from the Malagasy side”, an EU statement said.

Denouncing the forcible transfer of powerin Madagascar on 17 March 2009 as a “flagrant violation of the essential elements of Article 9 of the Cotonou Agreement” – a development cooperation treaty between the EU and the African, Caribbean and Pacific Group of States – the EU said it would re-examine its position, pending a consensual agreement between Madagascar’s feuding political parties, “which allows a return to constitutional order”.

SOUTH AFRICA: Quality of health care depends on geography

Photo: Mujahid Safodien/PlusNews

Some rural districts scored better on health provision than urban ones

JOHANNESBURG, 7 July 2009 (PlusNews) – The quality of health care, including access to HIV prevention and testing services, depends to a large extent on which of South Africa’s 52 districts you happen to live in.

A man living in Cape Town received an average of 55 free condoms in 2007/08, while a man living in Kgalagadi, a rural district in Northern Cape Province, received only 1.7. On average, South African men were rationed to about one condom per month, according to the latest District Health Barometer (DHB), an annual report by the Health Systems Trust, a research NGO.

In KwaZulu-Natal Province’s Umzinyathi district 100 percent of pregnant women attending antenatal clinics were tested for HIV in 2007/08, but only half those in eThekwini, also in KwaZulu-Natal, were tested, despite eThekwini having an antenatal HIV-prevalence rate of 42 percent, the highest in the country.

Some of the inequities highlighted by the DHB can be traced to differences in health spending, with districts in Western Cape Province spending the most on primary health care and districts in Free State Province spending the least.

The uneven distribution of HIV infection in South Africa also influenced ratings: six out of 10 districts with the highest number of Caesarean births were in KwaZulu-Natal, the province with the highest number of HIV-infected pregnant women [HIV infection can complicate delivery].

District Extremes
	55.2 condoms per man per year in Cape Town (WC); 1.7 condoms in Kgalagadi (NC)
	100 percent of pregnant women tested for HIV in Umzinyathi (KZN); 52 percent in eThekwini (KZN)
	100 percent of pregnant HIV positive women received nevirapine in Uthukela (KZN); 12 percent in Lejweleputswa (FS)
	83 percent of TB patients cured in Overberg (WC); 37 percent in Sisonke (KZN)
	12 patients a day seen by nurses in Waterberg (LP); 44 patients a day in Fezile Dabi (FS)
	R633 (US$79) spent on primary healthcare per person in Namakwa (NC); R191 ($24) spent in Lejweleputswa (FS)
FS – Free State, KZN – KwaZulu-Natal, LP – Limpopo, NC – Northern Cape, WC – Western Cape

Writing in the DHB, Dr Tanya Doherty of South Africa’s Medical Research Council attributed a lack of improvement in child and maternal mortality rates to the HIV epidemic – under-five mortality barely shifted from 60 per 1,000 births in 1990, to 59 in 2007, while maternal mortality actually increased.

Prevention of mother-to-child HIV transmission (PMTCT) is vital to reducing maternal and child mortality and combating HIV, but health authorities have failed to properly monitor PMTCT interventions. “This is indicative of management neglect of the programme from national to facility level,” Doherty wrote.

Although HIV testing of pregnant women has risen in most of the country, Doherty warned that the national average of 80 percent for 2007/08 might be an overestimate, due to errors in recording the data.

Figures on the percentage of pregnant HIV-positive women who received a dose of nevirapine to reduce transmission were even more unreliable, partly because women could receive their dose in either an antenatal clinic or a labour ward, but the two facilities often failed to combine their data.

Based on the available information, the national average for nevirapine coverage was 76 percent, but five districts in Free State achieved less than 40 percent.

Fuelled by the HIV epidemic, tuberculosis (TB) infections have increased rapidly, with Cacadu in Eastern Cape Province recording the highest incidence: 673 new TB cases per 100,000 people, compared to a national average of 283 cases per 100,000.

Although TB cure rates are still far from the WHO target of 85 percent they have steadily improved, reaching 65 percent in 2006. Three districts saw declines, which the authors described as “an indictment of management at all levels”.

This edition of the DHB is the fifth since 2005. It not only highlights inequities in health provision and outcomes, but also reveals South Africa’s progress towards achieving the UN Millennium Development Goals and the targets set in the National Strategic Plan for HIV and AIDS.