ECW’s Yasmine Sherif and Graham Lang walk with UNHCR partners through Borota, where thousands of new refugees, most of them women, and children, have arrived after fleeing the conflict in Sudan. Credit: ECW
By Naureen Hossain UNITED NATIONS, Jul 20 2023 (IPS)
If you want lasting peace, the best investment you can make is in education, said Education Cannot Wait’s Executive Director Yasmine Sherif in an exclusive interview with IPS.
“(This will) make children and adolescents literate, learn critical thinking, address trauma and psycho-social challenges from being victims of a conflict or crisis, develop their potential, and become financially independent,” Sherif said, adding that these were critical skills to participate in good governance of their countries in the future.
She was speaking to IPS ahead of her participation in the ECOSOC High-Level Political Forum side event “Ensuring Education Continuity: The Roles of Education in Emergencies, Protracted Crises and Building Peace” at the UN Headquarters in New York.
Education is the answer to breaking the vicious circle of violence, conflict, and crisis – while this often is associated with war and conflict, the same applies to climate change.
“If the next generation that is today suffering from climate-induced disasters are not educated, do not understand or have an awareness of how to treat mother earth, and do not have the knowledge or skills to mitigate or prevent risks in the future, the negative impact of climate-induced disasters will only escalate.”
Unfortunately, conflicts and climate risks increasingly combine to multiply vulnerability, she said – and instead of declining, the number of children who need urgent support is increasing.
“Today, 224 million crisis-affected children do not receive a quality, continuous education. More than half of these children – 127 million – may have access to something that resembles a classroom, but they are not learning anything. They are not achieving the minimum proficiencies outlined in the Sustainable Development Goals (SDG4).”
Sherif stressed the crucial linkage between education and protection for children in crisis-affected countries and explained how protection is a core component of the holistic package of education ECW is supporting together with its partners.
“On the legal side, we advocate for the respect of the international humanitarian law, national human rights law, and the National Refugee Law, and for an end to impunity for those who violate these,” said Sherif. “We also call for additional countries to adopt the Safe Schools Declaration, and actively support its implementation at the national level.”
To prevent violence around and in schools, practical measures are included to ensure the children are safe.
“It’s important to ensure safe transport to and from the school. And that would, of course, bring a sense of safety to the parents, who may not be willing to send the girls to school because of that. You ensure the infrastructure of the school provides protection. You may need wards around the school so that nobody can walk into the school and abduct a girl.”
ECW funding also includes protections to prevent sexual and psychological violence.
“All the funding that we invest requires giving protection a priority. And that is essential wherever you operate or invest funding in a country of affected by armed conflict; you need to ensure protection is prioritized.”
Sherif said that in countries like Afghanistan, where the Taliban have banned girls from attending secondary school and upwards, ECW works with local partners to support non-formal education.
“There is a lot of work at the community level, with local authorities allowing ECW’s investments in civil society and UN agencies to continue to operate. So community-based schooling is pretty much (being) run now, where we are investing at the community level,” she said, and while it may not be ideal, it does work.
Likewise, non-formal learning centers have been set up in Cox’s Bazar, where the Rohingya refugees live after fleeing violence, discrimination, and persecution in Myanmar.
“Our aim is for every child to be able to access national education systems, but sometimes it is not possible politically or physically due to the dangers of the conflict. So we also support our partners to establish non-formal learning centers until another more sustainable solution can be found.”
During the Covid-19 pandemic, ECW’s partners were innovative in ensuring education continued – with remote learning programmes such as radio and TV-based education, where IT connections were available through phones and WhatsApp with learning kits and tools.
“Home-based, going from door-to-door, that was how it was done during COVID. There was some creativity and innovation. It is possible. It is not ideal, but it is possible.”
Sherif said ECW had developed a proven model to bring quality education to every child – even in the most challenging crisis-affected contexts of war and conflicts – but that the biggest hindrance is the financing.
“If we had the financing, we could reach the 224 million (children) immediately. So financing is the big hindrance today. While peace is the number one (solution), if peace is not possible, education cannot wait.”
“If financing for education is provided in crisis and climate disasters, ECW can reach 20 million children and adolescents in the coming four years. And that requires about another USD700 million for Education Cannot Wait between today and 2026. Just USD 700 million is a small amount when you consider the return on investment you get when you invest in human potential.”
Nelson Mandela, then Deputy President of the African National Congress of South Africa, raises his fist in the air while addressing the Special Committee Against Apartheid in the General Assembly Hall, June 22, 1990. Global alliance CIVICUS commemorated Mandela Day with a reminder that many rights defenders are jailed and intimidated. Credit: UN Photo/Pernaca Sudhakaran
By Joyce Chimbi NAIROBI , Jul 18 2023 (IPS)
As human rights increasingly deteriorate, rights defenders are being violently suppressed. Abducted, detained, tortured, and humiliated, many now live one day at a time. They have been told, in no uncertain times, that anything could happen. They are now asking the global community to stand as a witness.
“Like Nelson Mandela was, hundreds of human rights defenders around the world are in prison for their human rights activities. Just like him, they are unjustly treated, fictitious charges levelled against them and handed the most serious sentences that are often used against criminals. One of our priorities is to work with human rights defenders to advocate for their release,” says David Kode from CIVICUS, a global alliance of civil society with a presence in 188 countries around the world.
Inspired by the life story of the late iconic South African President Nelson Mandela, the Stand As My Witness Campaign was launched on Nelson Mandela Day in 2020 by CIVICUS, its members and partners.
In commemoration of the third anniversary of the Stand As My Witness campaign, CIVICUS and its partners, including human rights defenders, hosted a public event titled, ‘Celebrating Human Rights Defenders through Collaborative Advocacy Efforts’, to celebrate the brave contributions of human rights defenders and raise awareness about those who are still in detention.
David Kobe said that CIVICUS had profiled at least 25 human rights defenders since the Stand As My Witness Campaign started three years ago. Credit: Joyce Chimbi/IPS
“Over the last three years, we have profiled more than 25 human rights defenders collectively because some human rights defenders are profiled as individuals and others, such as those in Burundi, are profiled as a group because they were arrested as a group. More than 18 human rights defenders have been released over the last three years. As we celebrate, we must recognize that the journey has just started, it is quite long, and the battle is far from over,” Kode said.
The event brought together families and colleagues of detained human rights defenders, previously detained human rights defenders, representatives from the Office of the High Commissioner for Human Rights (OHCHR) and other human rights mechanisms and civil society organisations.
Lysa John, the Secretary General of CIVICUS, spoke about how special Mandela Day is, for it is the one day of the year when the spirit of solidarity is celebrated in his memory. It is also a day to look back at what has been achieved and how much more could be achieved in solidarity.
She further addressed issues of civic space restrictions, closure of civic space and how these restrictions impact societies and individuals. John stressed that the event was held in the context of the 25th anniversary of the adoption of the UN Declaration on Human Rights Defenders and the 75th anniversary of the UNDHR or Human Rights 75 to promote their objectives.
“One-third of the population of the world live in contexts which are closed. Where attacks on people who speak out or exercise their civic freedoms are attacked or arrested without any accountability. More and more people in the world, in fact, the largest section of the world, estimated at 44 percent live in countries where civic space and civic freedoms are restricted. In this regard, civic society is more than ever reinventing itself, and there is increased support for them,” she said.
Birgit Kainz from OHCHR spoke about the importance of bringing to life the UN Declaration on Human Rights Defenders for its adoption was a consensus that human dignity is at the core of everything.
She spoke about the need to be deliberate in the defence of civic space as it enables people to shape their future and that of their children. Kainz said that protection and security are two sides of the same coin and urged participants to network and connect to improve civic space and to also play a complementary role. Further emphasizing the need to maintain data, especially about who is in detention and where in line with SDGs.
Maximilienne Ngo Mbe from Cameroon is one of the most prolific human rights defenders in Africa. She spoke about the need to create safe spaces for women rights defenders. Credit: Joyce Chimbi/IPS
Maximilienne Ngo Mbe spoke about the life and times of human rights defenders today. She is one of the most prolific human rights defenders in Africa and continues to receive a lot of restrictions for her fearless human rights activities that often have her fleeing from Cameroon to other countries for safety.
“We need a network for women rights defenders because of the special challenges they face as girls, wives, mothers and vulnerable people. Women are engaging less and less because of these challenges and the multiple roles they play in society,” she said.
The event was an opportunity for released human rights defenders such as Maria Esperanza Sanchez from Nicaragua to speak about resilience in the face of brutal regimes. She spoke about how armed men often came to her house to threaten and intimidate her. Of her arrest, humiliation and torture in 2020, being sentenced to 10 years in prison and her eventual release.
It was also an opportunity to speak on behalf of those who cannot. They include Khurram Parvez, a prolific human rights defender in India. At the time of his arrest for human rights activities, he was leading two critical organizations at the national and regional levels.
Parvez is being charged as a terrorist. His story aligns with that of Kenia Hernandez, a 32-year-old indigenous Amuzga woman, mother of two, lawyer and an advocate for human rights who is currently detained in a maximum-security prison in Mexico and has been sentenced to 21 years. Her story is illustrative of the high-risk female rights defenders and people from marginalized groups face.
Ruben Hasbun from Global Citizen spoke about how to effectively advocate for the release of human rights defenders, sharing lessons from Stand As My Witness campaigners. The event further opened up space to address the role of the private sector.
Christopher Davis from Body Shop, a brand that continues to be at the forefront of supporting human rights and rights defenders, fighting social and environmental injustice.
At the end of the session, participants were invited to sign a petition to have the United Arab Emirates immediately and unconditionally release all those detained solely for the exercise of their human rights and end all abuse and harassment of detained critics, human rights defenders, political opposition members, and their families.
Ligoria Felipe dos Santos poses for a photo on her agroecological farm that mixes corn, squash, fruits, vegetables and medicinal herbs. She is part of the women’s movement that is trying to prevent the installation of wind farms in the Borborema mountain range, in the northeastern Brazilian state of Paraíba. CREDIT: Mario Osava / IPS
By Mario Osava ESPERANÇA, Brazil , Jul 14 2023 (IPS)
Zé Pequeno cried when he learned that the heirloom seeds he had inherited from his father were contaminated by the transgenic corn his neighbor had brought from the south. Fortunately, he was able to salvage the native seeds because he had shared them with other neighbors.
Euzébio Cavalcanti recalls this story from one of his colleagues to highlight the importance of “passion seeds” for family farming in Brazil’s semiarid low-rainfall ecoregion which extends over 1.1 million square kilometers, twice the size of France, in the northeastern interior of the country.”These are seeds adapted to the semiarid climate. They can withstand long droughts, without irrigation.” Euzébio Cavalcanti
Saving heirloom seeds is a peasant tradition, but two decades ago the Brazilian Semiarid Articulation (ASA), a network of 3,000 social organizations that emerged in the 1990s, named those who practice it as individual and community guardians of seeds. By September 2021, it had registered 859 banks of native seeds in the region.
Cavalcanti, a 56-year-old farmer with multiple skills such as poet, musician and radio broadcaster, coordinates the network of these banks in the Polo de Borborema, a joint action area of 14 rural workers’ unions and 150 community organizations in central-eastern Paraíba, one of the nine states of the Brazilian Northeast.
“These are seeds adapted to the semiarid climate. They can withstand long droughts, without irrigation, that is why they are so important,” he explained. They also preserve the genetic heritage of many local crop species and family history; they have sentimental value.
“Don’t plant transgenics, don’t erase my history”, is a slogan of the movement that promotes agroecological practices and is opposed to the expansion of genetically modified organisms in local agriculture. “Corn free of transgenics and agrotoxins (agrochemicals)” is the goal of their campaign.
In Paraíba, the name “passion seeds” has been adopted, instead of native or heirloom seeds, since 2003, when the state government announced that it would provide seeds from a specialized company to family farmers.
“If the government offers these seeds, I don’t want them. I have family seeds and I have passion for them,” reacted a farmer in a meeting with the authorities.
“‘Passion seeds’ spread throughout Paraíba. In other states they’re called ‘seeds of resistance’,” Cavalcanti said.
Agroecology is one of the banners of the Polo de Borborema, as it is for ASA in the entire semiarid ecosystem that covers most of the Northeast region and a northern strip of the southeastern state of Minas Gerais.
“Passion seeds,” as heirloom seeds are known locally, ensure better harvests on semiarid lands, free of transgenics or “agricultural poisons,” according to Euzébio Cavalcanti, a small farmer, poet and musician who helped lead the struggle for agrarian reform and cares for the seeds in the highlands of Borborema, in northeastern Brazil. CREDIT: Mario Osava / IPS
Learning to coexist with semiarid conditions
This approach arose from a change in the development strategy adopted on the part of local society, especially ASA, since the 1990s. “Coexisting with semiarid conditions” replaced the traditional, failed focus on “fighting the drought”.
Large dams and reservoirs, which only benefit large landowners and do not help the majority of small farmers, gave way to more than 1.2 million tanks for collecting rainwater from household or school rooftops and various ways of storing water for crops and livestock.
It is a process of decolonization of agriculture, education and science, which prioritizes knowledge of the climate and the regional biome, the Caatinga, characterized by low, twisted, drought-resilient vegetation. It also includes the abandonment of monoculture, with the implementation of traditional local horticultural and family farming techniques.
The Northeast, home to 26.9 percent of the national population, or 54.6 million inhabitants according to the 2022 demographic census, concentrates 47.2 percent of the country’s family farmers, according to the 2017 agricultural census. There are 1.84 million small farms worked mainly by family labor.
Brazil’s semiarid region is one of the rainiest in the world for this type of climate, with 200 to 800 millimeters of rain per year on average, although there are drier areas in the process of desertification.
A stand at the ecological market in the municipality of Esperança, in northeastern Brazil, is a link between urban consumers and family farmers opposed to agrochemicals, monoculture and transgenic products. CREDIT: Mario Osava / IPS
Borborema, the name of a high plateau that obstructs the humidity coming from the sea, making the territory to its west drier, is the scene of various peasant struggles, such as the mobilization for agrarian reform since the 1980s and for small-scale agriculture “without poisons” or agrochemicals, of which the “seeds of passion” are a symbol.
Cavalcanti is a living memory of local history, also as a founder of the local Landless Workers Movement (MST) and an activist in the occupations of unproductive land to create rural settlements, on one of which he gained his own small farm where he grows beans, corn and, vegetables and has two rainwater collection tanks.
Women help drive the expansion of agroecology
Women have played a key role in the drive towards agroecology. The March for Women’s Lives and Agroecology is an annual demonstration that since 2010 has defended family farming and the right to a healthy life.
This year, on Mar. 16, 5,000 women gathered in Montadas, a municipality of 5,800 inhabitants, to block the creation of wind farms that have already caused damage to the health of small farmers by being installed near their homes.
Borborema is “a territory of resistance,” say the women. About 15 years ago, they succeeded in abolishing the cultivation of tobacco.
The president of the Union of Rural Workers of the municipality of Esperança, Alexandre Lira (C) and other leaders pose in front of a poster declaring the union’s current goals: “Agroecological Borborema is no place for a wind farm,” he says about this area in Brazil’s semiarid Northeast region. CREDIT: Mario Osava / IPS
When the citrus blackfly arrived, the government tried to combat it with pesticides, but “we resisted; we used natural products and solved the problem for our oranges and lemons,” said Ligoria Felipe dos Santos, a 54-year-old mother of three.
“That is agroecology, which is strengthened in the face of threats. Farmers are aware, they resort to alternative defenses, they know that it is imbalance that leads to pests,” she told IPS.
“Agroecology is a good banner for union activity,” said Lexandre Lira, 42, president of the Rural Workers Union of Esperança, a municipality of 31,000 people in the center of the Polo de Borborema.
It is also a factor in keeping farmers’ children on the farms, because it awakens the interest of young people in agriculture, said Edson Johny da Silva, 27, the union’s youth coordinator.
Maria das Graças Vicente and Givaldo Firmino dos Santos stand next to the machine they use for making pulp from native fruits little known outside Brazil, such as the umbu (Brazil plum), cajá (hog plum), acerola (Amazon or Barbados cherry), along with cashews, mangos, and guava. CREDIT: Mario Osava / IPS
Pulp, added value
Maria das Graças Vicente, known as Nina, 51, along with her husband Givaldo Firmino dos Santos, 52, is an example of agroecological productivity. On 1.25 hectares of land they produce citrus fruits, passion fruit, acerola (Amazon or Barbados cherry), mango and other fruits, as well as sugar cane, corn, beans and other vegetables.
Grafted fruit tree seedlings are another of the products they use to expand their income, as IPS was shown during a visit to their farm.
Using their own harvest and fruit they buy from neighbors, they make pulp in a small shed separate from their home, with a small machine purchased with the support of the Advisory and Services to Projects in Alternative Agriculture (AS-PTA), a non-governmental organization that supports farmers in Borborema and other parts of Brazil.
“Luckily we have a microclimate in the valley, where it rains more than in the surrounding areas. Everything grows here,” Santos told IPS.
But the couple created three reservoirs to collect rainwater and withstand droughts: a 16,000-liter water tank for household use, another that collects water on the paved ground for irrigation, and a small lagoon dug in the lower part of the farm.
But in 2016 the lagoon dried up, because of the “great drought” that lasted from 2012 to 2017, Vicente said.
The fruit pulp factory has grown in recent years and now has seven small freezers to store fruit and pulp for sale to the town’s stores and restaurants. The couple decided to purchase a cold room with the capacity of 30 freezers.
“I work in the mornings on the land, in the afternoons I make pulp and my husband is in charge of the sales,” she said.
Hiring workers from outside the family to reduce the workload costs too much and “we try to save as much as possible on everything, to sell the pulp at a fair price,” Santos said.
Analysts are concerned about pre-election violence and intimidation ahead of next month’s Zimbabwean poll. Credit: Ignatius Banda/IPS
By Ignatius Banda BULAWAYO, Jul 13 2023 (IPS)
Zimbabwe holds general elections next month amid growing human rights and press freedom concerns in what analysts say could mar conditions for undisputed poll results.
Lawyers representing opposition political activists have not been spared assaults from police and suspected ruling Zimbabwe African National Union Patriotic Front (Zanu PF) party supporters as economic conditions worsen.
In January, Kudzayi Kadzere, a human rights lawyer, was beaten up by police and his arm broken after being dispatched to a local police station in the capital city, Harare, to represent arrested opposition political party supporters. The police accused him of being a “criminal nuisance.”
Early this month, the country’s security forces allegedly attacked Obey Shava, a human rights lawyer who has represented several opposition Citizens for Coalition for Change (CCC) officials and other human rights abuse victims. Unknown assailants broke his legs.
However, the country’s main political opposition led by Nelson Chamisa, the CCC, was quick to point fingers at ruling party activists and the country’s secret police for Shava’s attack. The CCC has routinely been tipped to win successive elections without success.
These incidents have been met with widespread condemnation on the eve of what is seen as crucial elections slated for 23 August, with the British parliament discussing and raising concerns early this month about what is seen as deteriorating human rights conditions in Zimbabwe ahead of the polls.
“What we are seeing in this election cycle is lawfare or the weaponisation of the law,” said Ringisai Chikohomero, a senior analyst at the Institute for Security Studies (ISS) in Pretoria, South Africa.
“This has led to a lot of prosecution and persecution, and what this has done is to create an atmosphere of fear that you can be locked up for a long time without actually going to trial,” Chikohomero told IPS.
These comments come when human rights organisations say almost a hundred political prisoners are incarcerated, with former opposition legislator Job Sikhala having spent more than a year behind bars and accused of obstruction of justice.
Amnesty International has condemned Sikhala’s long detention, with Flavia Mwangovya, Deputy Director for East and Southern Africa, Amnesty International saying in a May statement that “there is a worrying restriction of civic space underway in Zimbabwe with growing attempts to persecute anyone who dares to freely express themselves.”
While Mnangagwa has used the campaign trail and radio jingles to denounce violence and appeal for peaceful elections, human rights defenders have questioned the continuing human rights abuses despite its condemnation from the highest office in the land.
“The challenge about the pre-election conditions is that can it be proven that there have been systematic human rights violations,” said Piers Pogue, senior analyst at the International Crisis Group.
“Though international observers from the EU are coming, it is quite clear that six weeks before elections doesn’t constitute long-term observation,” Pogue told IPS.
However, analysts say there is a need for the country to move from continued disputed poll outcomes, and one of the recommendations is to have long-term observer teams from such groups as the African Union and the Southern African Development Community (SADC).
“Ideally, the AU and SADC should have deployed longer-term observer teams. We have seen in the past that only long-term missions manage to get to grips with election conditions. Differences between long and short-term observer missions expose the contradictions of how electoral conditions are assessed,” Pigou said.
Zimbabwe’s elections have for years hogged regional and international headlines after successive controversial victories by the founding Zanu (PF) party amid decades-old worsening economic conditions; with eleven presidential candidates in next month’s general election, the stage could be set for yet another contentious poll outcome.
Meanwhile, as election day approaches, the Zimbabwe Catholic Bishops Conference has added its voice to concerns about the pre-election conditions, appealing to voters to exercise their democratic right to vote.
“Do not be intimidated, coerced or manipulated to vote against your will. Please refuse to be used in violent attacks against your fellow brothers and sisters,” the Catholic bishops said on 9 July.
The clerics also appealed to the country’s security services, long accused of doing the ruling party’s bidding, to maintain law and order without taking sides.
“To members of the security sector, we appeal to you to work to maintain peace and justice and let all the perpetrators of political violence be held accountable,” the bishops said.
Experts encourage parents to vaccinate their children against typhoid to ensure that the child has access to clean drinking water. Credit: Zofeen Ebrahim/IPS
By Zofeen Ebrahim KARACHI, Jul 6 2023 (IPS)
The first thing you notice about eight-month-old Manahil Zeeshan is how tiny she looks on the adult-size hospital bed at the government-run Sindh Institute of Child Health and Neonatology (SICHN) in Korangi, a neighbourhood in Karachi.
Her right foot is taped with a cannula, and she whimpers incessantly. “I have been in and out of the hospital for the last seven days,” said Uzma Mohammad, Zeeshan’s mom, with worry lines on her forehead. “High fever that refused to come down, severe cough for days and breathlessness,” were some of the symptoms Mohammad described. She was convinced someone had “put a spell” on her daughter.
The doctors, however, suspected she had typhoid.
Salmonella Typhi bacteria cause typhoid fever, and Salmonella Paratyphi bacteria cause paratyphoid fever. According to the US-based public health agency, Centers for Disease Control and Prevention, along with a fever that can be as high as 103 to 104°F (39 to 40°C), the sick person can have weakness, stomach pain, headache, diarrhoea or constipation, cough, and loss of appetite. Some people have a rash of flat, rose-coloured spots. Internal bleeding and death can occur but are rare. It affects between 11 and 20 million people each year, leading to 128,000 to 161,000 deaths, according to the World Health Organization (WHO). The highest fatality rates are reported in children under four years of age.
While Zeeshan’s blood culture report had yet to come to ascertain the cause of her sickness, she needed urgent medical care, said Dr Shabita Bai, who had admitted her.
“We could not wait for five days for the blood culture report as she was not doing well. And because she had already been given an antibiotic (a medicine used to kill bacteria) from outside, our chances of finding if the baby had typhoid for sure were slim, and we had to rely on the history,” justified Bai.
Decisions had to be made. Based on her condition, symptoms, and clinical diagnosis, the baby was given Ceftriaxone, an intravenous antibiotic, but she showed no improvement. The doctors then administered the stronger Meropeneme intravenously, a last-resort antibiotic.
Manahil Zeeshan’s foot has a drip in an effort to bring her temperature down and fight suspected typhoid. Credit: Zofeen Ebrahim/IPS
Battling the Superbug
But even if she had typhoid, the bacteria in her body had taken on the form of a superbug — the extensively drug-resistant (XDR) typhoid and the current antimicrobials had become ineffective, said paediatrician Dr Jamal Raza, the executive director of the SICHN.
According to a Lancet study published in 2022, multidrug-resistant (MDR) typhoid has been seen in Pakistan, while typhoid bacteria resistant to the widely-used antibiotic azithromycin have been found in Bangladesh, Nepal and India. “Our analysis revealed a declining trend of MDR typhoid in south Asia, except for Pakistan, where XDR S Typhi emerged in 2016 and rapidly replaced less-resistant strains,” stated the study, which researchers claim is the largest ever examination of the S.Typhi bacterium.
The reason why antibiotics are losing their punch against some types of bacteria, said Raza, was the “indiscriminate use of antibiotics” that health practitioners prescribe to provide immediate relief. Another big problem was self-medication by people. “I know people often use an old prescription by a doctor to get the same medicine if they feel they have the same symptoms, thinking they do not need to visit the doctor.”
But he pointed out viruses, which are also small germs like bacteria, are causing bacteria-like infections, like a cold or the flu.
“Taking an antibiotic for the latter does not treat the disease; it only leads to antibiotic resistance,” said Raza.
A study conducted by researchers from three medical institutions, namely, the Aga Khan University (AKU) in Karachi, the Armed Forces Institute of Pathology (AFIP) in Rawalpindi, and the Shaukat Khanum Memorial Cancer Hospital & Research Center (SKH) in Lahore in 2018, found indiscriminate use of antibiotics to be causing new drug-resistant “superbugs.”
It found a high prevalence of multidrug and fluoroquinolone resistance for both S.Typhi and S. Paratyphi strains of typhoid bacteria. From 20% in 1992, the resistance was found to have increased to around 50% in 2015. The stubborn bacteria were resistant to antibiotics like ampicillin, chloramphenicol (and co-trimoxazole), as well as fluoroquinolone (ciprofloxacin and/or ofloxacin).
“The situation is quite grim,” said Dr Mashal Khan, chairperson of the government-run paediatric medicine department at Karachi’s National Institute of Child Health, referring to the increase in the number of children developing resistance to typhoid drugs. His worry is not that the bacteria has spread; his concern is the bacteria has mutated and become resistant to the drug.
“We’re running out of new antibiotics to treat bacterial infections; Meropeneme is the last one, and a very expensive one too,” he said resignedly, adding: “Although the development of newer antibiotics is the need of the day, I must emphasise the rational use of the ones being used is more urgent.”
Developing new drugs is challenging, and antibiotics more so, as the science is tricky.
“Antibiotics are not the most lucrative drugs to develop for pharmaceuticals as their utility is limited in the future due to the bacteria developing the ability to resist them,” said Infectious Diseases specialist and epidemiologist Dr Faisal Mahmood at the Aga Khan University Hospital in Karachi. “A lot of money goes into developing new drugs, and since most of the funding is from the global north, they prefer to work on infections which concern them directly. Typhoid is unfortunately endemic in the low and middle-income countries in the South, which have poorer water quality and have warmer, more humid climates.”
And that is why the only sure-shot way of reducing the disease burden of typhoid is to vaccinate the children.
In 2019, Pakistan became the first country to get the World Health Organization (WHO)-recommended single-dose typhoid conjugate vaccine (TCV) injected intramuscularly, added to its routine immunisation (RI) regime. This is given to babies at nine months, alongside measles-rubella vaccinations, without impacting either vaccine.
“Childhood vaccination complemented with clean drinking water and improved hygiene practices is the much more cost-effective way of eradicating typhoid than pumping antibiotics in a child,” said Raza. Meropenem costs as much as Rs. 30,000 (USD 105) for a 10-day course, and if hospitalisation is included, it can go up to Rs 100,000 ($349), said the doctor. Being in a government hospital, Zeeshan is treated free of cost.
Eight-month-old Manahil Zeeshan is treated for typhoid at the government-run Sindh Institute of Child Health and Neonatology (SICHN) in Korangi, a neighbourhood in Karachi. Credit: Zofeen Ebrahim/IPS
Typhoid Vaccine Launch Hits a Snag as Covid-19 Surfaces
The 2019 TCV campaign was first launched in the two cities of Sindh – Karachi and Hyderabad (children up to 15 years of age were also given a shot), which reported the highest number of typhoid cases among children. There was a pause when Covid-19 hit the world. But by 2022, TCV had been launched across Pakistan, and 35.5 million children were vaccinated, after which it was added to the government-run Expanded Programme on Immunisation (EPI) programme.
“Many parents do not know that the TCV is a more effective vaccine but only available at government vaccination centres, and not at private clinics and hospitals as Gavi has only given it to the government of Pakistan,” said paediatrician Dr D.S. Akram.
“There is another typhoid vaccine available in the private sector (typhoid polysaccharide vaccine), but it can only be given to children over two years of age, and it needs boosters every three years. My advice to parents is to vaccinate their kids against typhoid bacteria at nine months,” she said.
But it is still a drop in the ocean, and the fight against typhoid and other childhood diseases continues. The WHO places Pakistan among the ten countries that account for almost two-thirds of the world’s unimmunised children.
When Covid-19 hit the country’s already crumbling health system, it also brought the country’s immunisation programme to a halt too. An estimated 1.5 million children across Pakistan missed out on basic vaccines from March to May 2020, according to Gavi.
For Pakistan, which already has low immunisation coverage (the percentage of fully immunised children aged 12-23 months is just 66%), it meant a further dip in coverage which led to an unprecedented rise in the number of zero-dose children (those that have not received any routine vaccine). Add to these were the almost 19,000 new births every day. But when the lockdown eased and vaccinators returned to work, there was less demand for vaccination, having been replaced by fear of the new virus.
While Pakistan has yet to reach the optimal immunisation coverage of 90%, during Covid-19, Pakistan’s EPI received plaudits internationally for taking both vaccine coverage and the number of zero-dose children close to pre-pandemic levels in 2021. “What Pakistan achieved needs to be celebrated. In fact, Pakistan and Chad are used as examples internationally of how to get it right in an emergency,” said Huma Khawar, an immunisation and child health advocate working closely with EPI.
“Despite a year’s delay due to Covid-19, which was unforeseen, I think it is the best thing that the government has done for its country’s children,” said Khawar. She credited the RI programme that bounced back to the pre-pandemic level in 2021.
Clean water, Good Hygiene Key to Preventing typhoid
While immunisation can protect children from getting infected, clean drinking water and improved hygiene practices can reduce the risk of catching the disease to a great extent.
“Vaccines provide immunity when there is exposure to the bacteria,” agreed Dr Jai Das, assistant director at the Institute for Global Health and Development at the Aga Khan University and one of the co-authors of the 2018 report on typhoid, but emphasised the need for improved water and sanitation, a situation that continues to remain dismal and compromised in Pakistan.
The same study not only found a strong correlation between water and sanitation but to literacy levels as well. In addition, it stressed improving the country’s food safety protocols and implementing regulations.
While Mohammad believes that her daughter is under a curse, one reason could be that the unpasteurised cow’s milk she gives her daughter may not be properly boiled at home. “I was unable to breastfeed her,” she said. Further, she confessed to diluting it with unboiled tap water to make it last longer.
Doctors say giving Pakistani babies a lease of life is simple and costs nothing. “Exclusive breastfeeding up to at least six months of age (right now it is only 43%), attaining 90% coverage of RI across Pakistan and improving water and sanitation quality,” according to Dr Akram.
Bacteria Don’t Respect Geographic Borders
The XDR typhoid bacteria propagating in Pakistan has crossed borders and reached as far as the UK, Canada and the US. Earlier this year, a team of Pakistani and US researchers published their findings in the American Journal of Tropical Medicine and Hygiene, stating that with numerous typhoid bacteria variants circulating in Pakistan have also been identified in Southeast Asia and Eastern and Southern Africa and have been introduced into the United Kingdom, Canada, and the United States by travellers.
The Lancet study said strains from South Asia had spread 200 times to other countries since 1990. When these superbugs grow and spread, they can cause infections that are hard to treat. Sometimes they can even spread the resistance to other bacteria they meet.
The future looks frightening. While the need for improving water and sanitation cannot be overemphasised, along with the need for vaccinating children, newer and stronger antibiotics need to be developed and fast as typhoid may surface in deadlier ways than now since very few antibiotics remain effective against the bacteria.
Note: This story was supported by the Sabin Vaccine Institute and Internews
Childhood vaccination, complemented with clean drinking water and improved hygiene practices, are the key to eradication of typhoid XDR, not indiscriminate use of antibiotics, say Pakistan health experts. Source
By Inés M. Pousadela MONTEVIDEO, Uruguay, Jul 5 2023 (IPS)
When Guatemalans went to the polls on 25 June, distrust and disillusionment were rife. First place in the presidential contest was claimed by none of the candidates: it went to invalid votes, at 17 per cent. Many didn’t bother, resulting in an abstention rate over 40 per cent.
But an unexpected development brought some hope: Bernardo Arévalo, leader of the progressive Movimiento Semilla, made it to the runoff.
Arévalo’s promise to fight against systemic corruption and bring back the numerous justice operators – people such as judges, prosecutors and public defenders – currently in exile to help clean up institutions is causing great concern for those who profit from the current state of affairs. The fact that Arévalo could become Guatemala’s next president has made the election results an instant object of contention.
Corruption and democratic decline
Guatemalan electoral processes aren’t pristine, but that isn’t where the most serious problems lie. Civic freedoms are steadily deteriorating and state institutions have been weakened by predatory elites and coopted by organised crime. Transparency International finds evidence of strong influence by organised criminals over politics and politicians, with some criminals themselves in office.
No wonder Guatemalans have a low level of confidence in state institutions. In the latest Latinobarómetro report, the church was by far the most trusted institution, winning the trust of 71 per cent of people, followed at some distance by the armed forces and police. But only nine per cent of people trust political parties, and trust is also very low in Congress, electoral bodies and the judiciary.
At 25 per cent, satisfaction with the performance of democracy is extremely low – as is the number of people who think the country is ruled for the benefit of all rather than just elites.
The run-up to the vote
Those denouncing corruption, collusion, illegal private sector practices and human rights abuses have increasingly been subjected to smear campaigns, surveillance, harassment and criminalisation by state authorities. Many have been pushed into exile. Rising violence against journalists and human rights defenders, including killings – the latest being that of journalist Orlando Villanueva – recently led the CIVICUS Monitor to downgrade its civic space rating for Guatemala to the second-worst category, repressed.
Restrictions on civic freedoms increased in the run-up to elections, ranging from smear campaigns to criminalisation. On 14 June, José Rubén Zamora, head of the newspaper elPeriódico, which had exposed more than 200 corruption cases, was sentenced to six years in prison for alleged money laundering. Zamora had been subjected to harassment and intimidation for years and had survived an assassination attempt.
An observation mission carried out by Reporters Without Borders and others ahead of voting warned that the absence of basic press freedoms made it impossible to guarantee a legitimate electoral process.
The process was indeed marred by multiple irregularities, starting with the disqualification of several contenders, including Indigenous leader Thelma Cabrera and her running mate, Jordán Rodas Andrade, the only left-wing candidacy polls showed stood a fighting chance. The candidate who led opinion polls, conservative business leader and TikTok star Carlos Pineda, was also disqualified.
What happened on 25 June
With two dozen candidates competing in the presidential race, it was no surprise that none reached the 50 per cent threshold required to avoid a runoff. What was unexpected was Arévalo’s good performance.
The front-runner, Sandra Torres of National Unity of Hope, is a political insider, Guatemala’s first lady between 2008 and 2011. Now standing for the third time in a row, she received 16 per cent of the vote. If elected, she would become Guatemala’s first female president. But she’s by no means a champion of women’s rights: she’s a vocal anti-abortion activist and her running mate is an evangelical pastor.
Runner-up Arévalo is an unusual politician at the head of an unusual party. Originally an academic with social-democratic views, he’s currently a member of Congress, where he leads a five-member progressive caucus. His running mate, low-key feminist Karin Herrera, is a microbiology researcher and university professor.
Unlike many Guatemalan parties, Arévalo’s party wasn’t created as a vehicle for someone’s presidential ambitions or corrupt interests: it was the creature of a group of concerned people that grew out of mass anti-corruption protests that broke out in 2015. In 2019, its presidential candidate was disqualified. But it found its footing among middle class groups, young people and women, particularly in Guatemala City.
The aftermath
Opinion polls had placed Arévalo eighth or ninth among the many contenders, so his performance caught elites off guard.
There’s no guarantee he’ll win the run-off. He’d have to gain the votes of the many who abstained or cast blank and invalid votes. But the fact that Arévalo might win has galvanised those who currently profit from the corrupt status quo, and they’re trying to push him out of the race. A majority of pro-establishment parties, including Torres’s party, have submitted complaints demanding a recount. Their supporters converged outside the Supreme Electoral Tribunal (TSE), quickly pushing further and calling for a rerun.
While various incidents were recorded on election day – including instances of vote buying, mostly by parties linked to the ruling alliance – international and domestic observers alike concluded that the results were valid and the gap of more than 200,000 votes between Semilla and the next contender, the outgoing president’s party, was insurmountable.
Mirador Electoral, a civil society platform, denounced pressures on the TSE as an attempted ‘electoral coup’. The European Union’s observer mission and the Organization of American States have called for the will of voters to be respected. Arévalo condemned it all as an intimidatory manoeuvre and called for the TSE, the Supreme Court and the Constitutional Court to act quickly and responsibly.
Instead, the Constitutional Court ordered the TSE to suspend official certification of results until complaints are resolved. Some fear an attempt to annul the elections will come next.
Guatemala stands at a crossroads. On the eve of voting it seemed on the verge of autocracy. An unexpected result hinted at the possibility of a much brighter path – one that fills many with hope but scares those who see their wealth and power endangered. The coming days and weeks will witness an arm-wrestling match between the past and the future, with three potential outcomes.
In the worst-case scenario, the runoff continues to be delayed by legal appeals and the task of appointing a president ultimately falls to Congress. In the second-worst scenario, a vote-by-vote recount is conducted instead of a simple cross-check of tally sheets, fraud occurs along the way and the ruling party’s candidate takes Arévalo’s runoff spot. Either way, the past wins.
Only if the recount is properly conducted, the results are corroborated and the runoff is held on 20 August will the future have a fighting chance. The corrupt establishment may still beat Arévalo – but this decision belongs to no one but the citizens of Guatemala.
