Senegal: Democracy in the Balance?

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Credit: Zohra Bensemra/Reuters via Gallo Images

LONDON, Aug 18 2023 (IPS) – Civic space is deteriorating in Senegal ahead of next February’s presidential election. Recent protests have been met with lethal violence and internet and social media restrictions. Senegal’s democracy will soon face a key test, and whether it passes will depend largely on whether civic space is respected.

Political conflict

Recent protests have revolved around the populist opposition politician Ousmane Sonko. Sonko came third in the 2019 presidential election and has grown to be the biggest thorn in President Macky Sall’s side. He’s won support from many young people who see the political elite as corrupt, out of touch and unwilling to tackle major social and economic problems such as the country’s high youth unemployment. He’s also been the subject of a recent criminal conviction that his supporters insist is politically motivated.

On 1 June, Sonko was sentenced to two years in jail for ‘corrupting youth’. This resulted from his arrest on rape charges in March 2021. Although he was cleared of the most serious charges – something women’s rights advocates have expressed concern about – his conviction likely makes him ineligible to stand in the next presidential election.

Sonko’s arrest in March 2021 triggered protests in which 14 people died. His conviction set off a second wave of protests. Sonko was arrested again on 28 July on protest-related charges, including insurrection. A few days later, the government dissolved his party, Pastef. It’s the first such ban since Senegal achieved independence in 1960.

All of this gave fresh impetus to Sonko’s supporters, who accuse the government of instrumentalising the judiciary and criminal justice system to stop a credible political threat.

Repressive reaction

The latest wave of protests saw instances of violence, including stone-throwing, tyre burning and looting. The state responded with lethal force. According to civil society estimates, since March 2021 over 30 people have been killed, more than 600 injured and over 700 detained.

In response to the recent protests, the army was deployed in the capital, Dakar. Live ammunition was used and armed people dressed in civilian clothes, evidently embedded with security forces, violently attacked protesters.

Journalists were harassed and arrested while covering protests. Recent years have seen a rise in verbal and physical attacks on journalists, along with legal action to try to silence them. Several journalists were arrested in relation to their reporting on Sonko’s prosecution. Investigative journalist Pape Alé Niang has been jailed three times in less than one year.

The government also limited internet access and TV coverage. TV station Walf TV was suspended over its protest coverage. On 1 June, social media access was restricted and on 4 June mobile internet was shut down for several days. In August, TikTok access was blocked. Restrictions harmed both freedom of expression and livelihoods, since many small traders rely on mobile data for transactions.

Third-term tussle

A major driver of protests and Sonko’s campaign was speculation that Sall might be tempted to seek a third presidential term. The constitution appeared to be clear on the two-term limit, but Sall’s supporters claimed constitutional amendments in 2016 had reset the count. Thousands mobilised in Dakar on 12 May, organised by a coalition of over 170 civil society groups and opposition parties, to demand that Sall respect the two-term limit.

On 3 July, Sall finally announced that he wasn’t running again. But it hasn’t ended suspicion that the ruling Alliance for the Republic (APR) party will go to any lengths stay in power, including using the state’s levers to weaken the opposition.

There’s precedent here: ahead of the Sall’s re-election in 2019, two prominent opposition politicians who might have presented a serious challenge were excluded. In both cases, barely weeks before the election the Constitutional Council ruled them ineligible due to prior convictions on corruption charges that were widely believed to have been politically motivated.

That Sonko and Pastef might have stood a chance in 2024 was suggested by the results of votes in 2022. In local elections, the APR lost control of Dakar and Sonko was elected mayor of Ziguinchor city. And then in parliamentary elections, the APR lost 43 of its 125 seats and Pastef finished second, claiming 56 seats, leaving no party with a majority.

Reputation on the line

Senegal long enjoyed an international reputation for being a relatively stable and democratic country in a region that’s experienced numerous democratic setbacks. With West African countries such as Burkina Faso, Guinea, Mali and now Niger under military control, and others like Togo holding deeply flawed elections, Senegal stood out. It’s held several free elections with changes of power.

The country’s active and youthful civil society and relatively free media have played a huge part in sustaining democracy. When President Abdoulaye Wade sought an unconstitutional third term in 2012, social movements mobilised. The Y’en a marre (‘I’m fed up’) movement got out the youth vote to oust Wade in favour of Sall. Wade himself rode a similar youth wave in 2000. So Sall and his party are surely aware of the power of social movements and the youth vote.

A small step forward was taken recently when parliament voted to allow the two opposition candidates who’d been blocked in 2019 to stand in 2024. But the government needs to do much more to show its commitment to democratic rules.

Upholding protest rights would be a good start. The repeated use of violence and detention of protesters points to a systemic problem. No one has been held to account for killings and other rights violations. It’s high time for accountability.

Media freedoms need to be respected and people detained for exercising their civic freedoms must be released. For Senegal to live up to its reputation, Sall should strive to enter history as the president who kept democracy alive – not the one who buried it.

Andrew Firmin is CIVICUS Editor-in-Chief, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

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How Nigeria’s Legal System is Failing to Safeguard Widows’ Rights

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Nigerian law protects widows, but the reality they face is quite different.

Nigerian law protects widows, but the reality they face is quite different.

By Promise Eze
SOKOTO, NIGERIA, Aug 3 2023 (IPS)

In February this year, Chichi Okonkwo not only lost her husband but was stripped of everything they owned together. Her husband was severely injured in a car accident about a month earlier. Despite being rushed to a hospital in Enugu, where they resided, he succumbed to his injuries weeks later. To compound her grief, Okonkwo’s late husband’s male siblings forcibly entered her home in the city a few hours after his passing, confiscating her husband’s land documents, car, money, clothes, and marriage certificate.

In the wake of these heart-wrenching events, Okonkwo was left with nothing but her six children. The eldest is just 18.

“They took everything my husband and I owned and forcibly evicted me and my children from our home,” laments Okonkwo. “They heartlessly claimed that, as a widow, I had no rights to any of my late husband’s possessions.”

Okonkwo’s children are now out of school because she was a housewife who depended on her husband’s income and is now left with nothing. She revealed that her late husband’s siblings, who seized and were aware of his bank PIN, callously left her with a mere 1 000 naira (approximately USD 2) out of the 2 million naira ($2,600) he had in his account.

Okonkwo said her husband’s relatives swore to drag her to court to challenge her rights, but she cannot afford a lawyer due to her financial situation.

In Nigeria, there are around 15 million widows.

Unfortunately, widows in the country often face the denial of their basic human rights due to traditional and cultural practices rooted in patriarchal beliefs.

According to The World Bank, “In much of Africa, marriage is the sole basis for women’s access to social and economic rights, and these are lost upon divorce or widowhood.”

In a country like Nigeria, where men dominate the economic and political systems, women are often expected to be submissive. The challenges women face are particularly amplified when they become widows, creating a doubly marginalized subgroup. Moreover, this vulnerable position sometimes exposes widows to dehumanizing rituals and harmful practices.

These harmful practices include mourning rites that involve widows sleeping with their deceased husbands’ corpses, shaving of widows’ heads, seclusion, wearing black or white clothes, and being forced to sleep and sit on the floor or mat. Additionally, some widows are coerced into marrying other members of the deceased husband’s family.

Despite laws granting women the right to inherit their husbands’ assets, many widows can still not claim their rightful share of land and property.

Efforts to combat these practices, such as the Violence Against Persons Prohibition Act (VAPP) enacted in 2015, have faced challenges in implementation and adoption by all states. According to the law, offenders are subject to a 500,000 naira ($648) fine or two years in prison. But arrests and prosecution of offenders are rare. And gender-based violence has persisted, which includes violence towards widows.

The enforcement of laws against offenders has been hindered by religious and cultural norms that promote silence and suppression of victimization cases. Victims often face threats or pressure from family members, community, or religious leaders whenever they try to report incidents to law enforcement.

Like Okonkwo, Sarah Temidayo’s life took a tragic turn when she lost her husband of four years to lung cancer in 2019. However, her grief was compounded by the actions of her husband’s relatives, who invaded her home in Lagos mere hours after his passing, intent on claiming everything that belonged to him. They even went so far as to take her wedding gown, certificates, and her then-five-year-old daughter’s clothes. Devastated and without recourse, Temitope sought justice through the legal system, but her efforts have yielded no results.

“I did not pick a pin out of my house. I had to start my life all over again,” she says.

Unfortunately, the nightmare did not end there for Temidayo. She was subjected to constant threats from her husband’s mother, who continued to torment her and accuse her of killing her son through witchcraft. These threats escalated to a terrifying climax when assassins attacked her at a bus stop in March 2021. She managed to survive, albeit with six bullets lodged in her leg. Despite reporting the incident to the police, no investigation was conducted, leaving her feeling abandoned by the system meant to protect her.

According to Ifeoma Oguejiofor, a legal practitioner in Southeast Nigeria, widows face challenges in seeking justice due to the understaffed courts, which can cause delays in the resolution of cases. Additionally, the financial burden of hiring a lawyer becomes a significant obstacle for many widows, making it difficult to access proper legal representation to handle their cases.

“There is a significant difference between the laws written in books and the actual pursuit of justice. According to the law, a surviving spouse, whether in a traditional marriage, a long period of cohabitation, or a marriage registered under the act, is entitled to inherit the estate of their deceased spouse. However, achieving justice through the legal system is often a prolonged and costly process, particularly for widows who have already lost a substantial portion of their assets to their husband’s relatives,” she explains.

“It’s high time the government, traditional rulers, and religious clerics enforce laws to protect widows in Nigeria. No woman should be discriminated against because she lost her husband,” says Hope Nwakwesi, the founder of Almanah Hope Foundation, a non-governmental organization focused on supporting Nigerian widows.

Nwakwesi, a widow who lost her police husband in 1994, endured distressing cultural rites, including having her hair shaved and wearing a mourning dress for a year. She faced further hardships as her relatives forcibly took her property, and she was expelled from her workplace and home in the police barracks. Despite seeking help, many, including police officers who offered assistance, demanded sexual favors in return.

Now, Nwakwesi is advocating for a bill in Nigeria’s legislative chamber. The bill aims to eradicate repressive cultural practices against widows and safeguard their fundamental human rights.

“My goal is to get the bill I’m fighting for approved and signed into law by the Senate. The current Violence Against Persons Prohibition Law is too vague and lacks specific clauses for protecting the rights of widows. Once the new bill becomes law, those who discriminate against widows will face arrest and prosecution by law enforcement agencies,” says Nwakwesi.

Abiola Akiyode-Afolabi, a civil rights activist and founding director of Women Advocates Research and Documentation Centre, noted that “For the government to protect widows effectively, they should review and update existing laws related to widows’ rights to ensure they are comprehensive, enforceable, and in line with international human rights standards.”

“Merely having laws in place is not enough; the government must ensure their effective implementation at all levels of the justice system. This requires training and sensitizing law enforcement officials, judges, and legal practitioners on the rights of widows and the importance of protecting them,” she adds.

IPS UN Bureau Report

 


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Afghan Girls, Women Deprived of Education, Find Hope in Africa

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Shabana Basij-Rasikh, co-founder and President of SOLA, speaks at the Women Deliver conference in Rwanda. Credit: Aimable Twahirwa/ IPS

Shabana Basij-Rasikh, co-founder and President of SOLA, speaks at the Women Deliver conference in Rwanda. Credit: Aimable Twahirwa/IPS

By Aimable Twahirwa
KIGALI, Aug 1 2023 (IPS)

When providing education to her small group of Afghan girls, who had been studying at a boarding school back home, became tenuous, Shabana Basij-Rasikh, relocated them to Rwanda.

She had set up a pioneering school under the project SOLA, the Afghan word for peace, and a short form for School of Leadership Afghanistan. But as the Taliban swept to power in August 2021, she closed the doors of the school, destroyed any school records which could help identify the girls, and on August 25, relocated 250 members of the SOLA community, including the student body and graduates from the programme, totally more than 100 girls, to Rwanda.

Basij-Rasikh, co-founder and SOLA’s President said a major challenge had been the lack of resources and capacity to teach Afghan girls after the return of the Taliban deprived right to education of girls in secondary schools and above.

As the Taliban swept back into power in Afghanistan in the summer of 2021, Shabana Basij-Rasikh, the founder of the nation’s only all-girls boarding school, initially ran the school out of a former principal’s living room. But that soon became untenable.

Speaking on the sidelines of The Women Deliver 2023 Conference (WD2023), which took place in Kigali from 17-20 July 2023, Basij-Rasikh, who completed her undergraduate studies in the United States, explained that when Kabul fell under the control of the Taliban, she managed within a short time to evacuate the entire school community to Rwanda.

“Although we managed to move the school to a safe country, it is still embarrassing and shameful for me since Afghanistan is the only country in the world where women and girls’ access to education has been suspended,” she said.

Initially, SOLA started as a scholarship program where Afghan youth would be identified and could access quality education abroad and, later on, go back to their home country as highly-skilled Afghans in whichever profession they chose.

“When the US announced that they were to withdraw their troops in Afghanistan, it created a lot of anxiety among young Afghans who were in the West hoping to return to the country.”

Basij-Rasikh regrets that some of her former students, who were able to leave Afghanistan after the Taliban’s return, are still struggling to continue their education overseas.

“We wish to see many Afghan girls return to schools,” she said, explaining that the migration status of the students in many countries restricted their access to education.

Since the school opened last year’s admissions season, Shabana Basij-Rasikh and her team have been inviting Afghan girls worldwide to apply and join the rest in Rwanda. Last year they enrolled 27 girls in their first intake.

“The major challenge is that there are several hundreds of thousands of girls who want to join our campus, but space is limited, and so places are being granted on merit and need,” Shabana told IPS.

Shabana argues investing in girls’ education is a smart investment; she is convinced that the current situation in Afghanistan must and should not be accepted or supported by any country around the world.

On September 18, 2021, a month after taking over the country, the Taliban ordered the reopening of only boys’ secondary schools. A few months later, in March 2022, according to human rights organizations, the Taliban again pledged to reopen all schools, but they officially closed girls’ secondary schools.

“These girls deserve the opportunity to realize their full potential, and the international community has an important role to play,” Shabana said.

UNESCO’s latest figures show that 2,5 million or 80 percent of school-aged Afghan girls and women are out of school.  The order suspending university education for women, announced in December last year, affects more than 100,000 students attending government and private institutions, according to the UN agency.

On the sidelines of the Women Deliver Conference 2023, Senegalese President Macky Sall pledged that his government would offer 100 scholarships for women who have seen their right to education decimated under Taliban rule in Afghanistan to pursue their university degrees in Senegal.

Rwanda is one of several African countries that agreed to temporarily host evacuated Afghans.

Sall, who was reacting to the concerns raised by Basij-Rasikhat, said his Government was ready to give chance to Afghan girls to pursue their studies.

So far, SOLA school has received 2,000 applications across 20 countries where some Afghans are living.

In 2022, it received 180 applications from Afghans living in 10 countries, but only 27 girls were admitted.

“That explains how families in Afghanistan are ready to support the girls in moving abroad to pursue their education,” Shabana said.

“Boarding schools that allow Afghan girls to study and live together are the best way to promote their education.”

IPS UN Bureau Report

 


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Human Rights Concerns Ahead of Zimbabwe Polls

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Analysts are concerned about pre-election violence and intimidation ahead of next month's Zimbabwean poll. Credit: Ignatius Banda/IPS

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.”

The developments come amid escalating economic hardships, with President Emmerson Mnangagwa accusing the business sector of deliberately sabotaging the economy to stoke anti-government sentiment.

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.

Already, police have banned or placed stringent conditions for opposition political rallies, such as outlawing the chanting of slogans, further setting the stage for possible confrontations and running battles with party supporters as has happened in past elections.

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.

IPS UN Bureau Report

 


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Vaccination Is the Best Bet Against Drug-Resistant Superbugs — Experts

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Experts encourage parents to vaccinate their children against typhoid to ensure that the child has access to clean drinking water. Credit: Zofeen Ebrahim/IPS

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

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

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

IPS UN Bureau Report

 


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Excerpt:

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

Human Rights Defenders in Exile Safety Imperiled by Host Countries’ Declining Civil Rights

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Irene Grace says human rights defenders hiding in Kenya fear harassment and intimidation due to a decline in civic rights. Credit: Joyce Chimbi/IPS

Irene Grace says human rights defenders hiding in Kenya fear harassment and intimidation due to a decline in civic rights. Credit: Joyce Chimbi/IPS

By Joyce Chimbi
NAIROBI, Jun 20 2023 (IPS)

While leaving one’s country and becoming a refugee is a last resort, it is a decision that many, like Steve Kitsa, have had to make. As conflict becomes increasingly protracted in many African countries, many others will take this step.

“In a matter of life and death, I fled the Democratic Republic of Congo (DRC) five years ago and left my elderly mother behind. One day we were seated in a group of young men, chatting and enjoying the morning sun, when a lone gunman in uniform approached us and started firing away unprovoked. Such incidences had become too common in the eastern region, and some of my friends were killed,” Kitsa tells IPS.

Kenya hosts one of the largest refugee populations in Africa. Kitsa is one of more than 520,000 registered refugees and asylum seekers. But human rights defender Irene Grace, who fled Uganda two years ago, says the number is much higher because borders are porous.

Nevertheless, official records show that about 287,000 refugees come from Somalia, 142,000 from South Sudan, 50,000 from DRC, and 32,000 from Ethiopia; many live in Dadaab and Kakuma camps.

Others, like Kitsa, have found their way into the urban centers of Nairobi, Kisumu, Mombasa, and Eldoret. Outdated statistics from 2017 indicate that more than 67,267 refugees live in Nairobi.

“There is a lot of exploitation because we need the locals to survive. Along the highways, you will find many young men hawking peanuts. You can tell they are from DRC because of the kind of Swahili they speak. They sell these peanuts under the hot sun, all day, every day, in exchange for a plate of food and somewhere to sleep as the profits go to the host. Most of us are desperate to go to France,” he explains.

Irene Grace fled Uganda for promoting the rights of the LGBTQI community as the country clamped down on their rights. As the government-endorsed crackdown against the community intensified, so did threats against her life.

“The issue of human rights defenders in exile is one aspect of the refugee situation that is hardly ever talked about. The risk is very high because you are under an alias in a foreign country, and if murdered, you are likely to remain unidentified for a long time, and it might take years to connect the dots. The question of who bears the duty of protection for us remains unanswered,” Grace says.

Her fears and concerns reflect the 2022 report findings by the global civil society alliance, CIVICUS, and the Kenya Human Rights Commission (KHRC), highlighting the decline in civil rights in Kenya. According to the report, the government was using excessive force to quieten dissent.

Kenya was placed on the CIVICUS Monitor’s human rights ‘Watchlist’ in June 2022. The Watchlist highlights countries with a recent and steady decline in civic freedoms, including the rights of free speech and peaceful assembly.

Kenya was rated Obstructed by the CIVICUS Monitor. There are 42 countries in the world with this rating. The rating is typically given to countries where power holders heavily contest civic space and impose a combination of legal and practical constraints on the full enjoyment of fundamental rights.

In 2021, Front Line Defenders released a report accusing the governments of Uganda and Kenya of giving the South Sudanese National Security Service (NSS) intelligence agency the freedom to target refugee human rights workers who fled the country.

“It is very difficult to continue with activism in such a hostile environment, on top of the many other challenges confronting us, such as a lack of documentation and access to services. Some of us left our families behind, exposed and unprotected. Over the eight years, I have lived in Kenya, I have received many threatening calls from South Sudan, but I know the information of my whereabouts came from within this country,” Deng G, an activist from South Sudan, tells IPS.

“Our situation worsens when local activists are targeted. In exile, you must connect with local networks to survive and continue with your activism. I am aware of activists in Kenya currently being held without trial for protesting against the high cost of living.”

KHRC continues to express concerns over the misuse of laws to undermine peaceful protest and recently responded with speed when five activists from the Social Justice Center, a Nairobi-based grassroots group, were arrested during a peaceful protest against the controversial Finance Bill 2023.

A pre-independence Public Order Act requires activists to notify authorities of protests at least three days in advance. Police have mistakenly understood the provision as a requirement for protests to be approved or denied, using it as an excuse to deem protests ‘unpermitted.’ Even though the right to peaceful assembly is guaranteed in Kenya’s constitution, it is continually undermined, says CIVICUS and KHRC.

Irene Grace says ongoing hostilities have derailed efforts to promote the safety and security of LGBTQI asylum seekers and refugees in the Kakuma Refugee Camp complex in northwestern Kenya whose lives are at risk. She says they are experiencing discrimination, and physical and sexual violence, among other forms of human rights violations.

“I am unable to travel there to determine how we can mobilize and improve their safety, working hand in hand with grassroots activists in Kenya. There are corrupt security officers, and once they discover you are hiding in the country, you become a target. They want you to pay them to turn a blind eye as you go on with your activities,” she says.

Kitsa says the issue of bribes is a most pressing challenge for many refugees seeking to integrate with the locals.

“They usually threaten to send you to the refugee camps despite having refugee documentation allowing you to live among the locals. They can create many problems for you.”

Against this backdrop, Irene Grace says activism is being suppressed from multiple angles, and human rights activists, local and those operating from exile, must now go back to the drawing board to find safer, impactful ways to speak truth to power and take the powers that be head-on.
IPS UN Bureau Report

 


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Excerpt:

Home Away From Home is the theme of World Refugee Day 2023. However, for many, including human rights activists who have fled their homes, a decline in civil rights in their host countries means their lives are often endangered and their activism curtailed. Source