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Clean Water, Decent Toilets, Hygiene Challenge for Southern African Community

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A waste collection bin awaiting the city council’s collection. Markets are one of the places the SADC hygiene strategy is targeting. The picture was taken around 5 am as people gathered for the market day. It is a stone’s throw away from the health centre featured in the story. ​Credit: Charles Mpaka​/IPS​​by Charles Mpaka (blantyre, malawi)Monday, January 10, 2022Inter Press Service

The faulty facilities also serve as bathrooms.

Visiting the bathrooms and toilets is an act of courage, says Thokozani Paulo, who spent four days at the centre in November 2021, during the birth of her first child.

“When you want to bath or relieve yourself, the image is dreadful because half the time, there is a mess, and the stench is terrible,” she tells IPS.

At night, there is no light, and the rooms are swarming with mosquitoes.

In addition, there is not much dignity and privacy for users either. There are no doors, so women improvise using their wraps for privacy.

“So, you are bathing, and someone comes in looking to relieve themselves,” says the 23-year-old in an interview with IPS at her home. Her month-old baby girl is sleeping peacefully on her lap.
Workers at the facility clean the two toilets – but without detergent and only once every day in the morning. One day, the women in the ward and their guardians pleaded with the workers to clean the toilets at least twice a day.
“They shouted at us saying we were not the ones paying their salaries and that we should just focus on what we had gone to the health centre for,” Paulo says.

The only basin for handwashing in the ward was never supplied with soap in the four days she was at the health centre.

In November, this experience, and the experiences of many others like Paulo were top of the agenda at a meeting of health ministers from the Southern Africa Development Community (SADC) in Malawi’s capital, Lilongwe.
At that meeting, among other things, the ministers endorsed the SADC Hygiene Strategy (2021-2025).

According to the strategy developed by the SADC Secretariat, analysis of national blueprints in the region on health, water, sanitation, environmental health, and nutrition indicates there is “an enabling environment” for implementation of hygiene practices.

However, there are still considerable gaps in most of the 16 member states.

“There is still need to mainstream and integrate hygiene in most of the national policies in order to broaden the enabling environment base for effective and sustainable promotion of hygiene practices,” it reads.

The framework, therefore, challenges SADC governments to increase hygiene coverage and behaviour change across all settings. These settings include health care facilities, schools and day-care centres, workplaces and commercial buildings, prisons, markets and food establishments, transport centres and places of worship.

The key hygiene behaviours include handwashing with soap, safe drinking water management, faecal disposal, food hygiene, menstrual hygiene, and waste management.

In the case of health care centres, these need to have a safe and accessible water supply, clean and safe sanitation conveniences, hand hygiene amenities at points of care and toilets, appropriate waste disposal systems and environmental cleaning.

According to the strategy, infrastructure that supports hygiene and healthcare waste management practices helps prevent the spread of diseases within the health service facilities and in the surrounding community.

The strategy was developed with the support of UNICEF and WaterAid Southern Africa.

Maureen Nkandu, Regional Communications Manager for WaterAid Southern Africa, says the policy underlines the need for leadership, commitment, and accountability “to create a culture of hygienic behaviour and practices across all levels of society and to enable hygiene services, behaviour change and promote basic sanitation”.

“For these objectives to be effective, there will be a requirement for strong planning, financial resourcing, implementation, monitoring, and evaluation systems in each of the SADC countries,” Nkandu tells IPS.

She says WaterAid has rallied key partners, including WASH-oriented civil society and development agencies, to demand adequate resources to implement the strategy effectively.

Further, achieving sustainable hygiene behaviour across generations needs innovative behaviour change programmes of scale. This can be realised through adequate financing, coordination of relevant sectors and political leadership, Nkandu says.

For Malawi, the strategy presents an opportunity for the country to push harder towards attaining Sustainable Development Goals (SGDs) targets related to hygiene, says Maziko Matemba, a community health ambassador appointed by the Ministry of Health.

Matemba corroborates Paulo’s experience, observing that many healthcare facilities in Malawi are a source of infection for patients, guardians, and visitors because of poor hygiene.

“Sanitation and hygiene in most of our public health facilities is a serious concern. People go to hospitals to get treated, but we have cases where patients and guardians have returned home with new health conditions contracted due to poor hygiene,” he says, citing washrooms as hotspots.

Matemba argues that healthcare facilities could promote good hygiene in Malawi and SADC.

“People gather in these facilities to seek services. That’s a huge advantage to drive home awareness messages and demonstrate by own standards how people can promote good hygiene in their homes,” says Matemba, who is also Executive Director for Health and Rights Education Programme (HREP), a local organisation.

But in all this, funding is a major factor, he observes.

“Hospital administrators tell us that if they have no money for a primary commodity like drugs, hence these perennial drug shortages we see, how can mops, handwashing materials and chemicals to clean toilets with become a priority?”

Matemba tells IPS that although civil society organisations have been campaigning for ages for the government to address the critical shortage of funding to hospitals, not much has changed.

“Development budget is always inadequate. Recurrent expenditures, already less than required, are further cut, and the little that remains hardly goes to the facilities in time. Treasury always says the resource envelope is limited,” says Matemba.

He says the strategy challenges Malawi as SADC Chair to lead the way for member states to improve the hygiene situation in the region by fixing their own.

A spokesperson for the Ministry of Health, Adrian Chikumbe, tells IPS that the SADC strategy is an important approach in minimising transmission of infection in health facilities and communities.

According to Chikumbe, a recent assessment by the ministry reveals that almost a third of Malawi’s health care facilities lack running water and 80 percent of patient latrines had no associated hand washing facility.

The assessment also found that environmental cleanliness was generally below average, characterised by poor waste management practices.

He says most of the lower-level facilities in the country lack resources to maintain functional WASH infrastructure.

“The Government recognises that it cannot do everything alone. It, therefore, has plans to mobilise partner support led by district authorities to plan and prioritise water, sanitation and hygiene infrastructure in all health facilities,” he says.

© Inter Press Service (2022) — All Rights ReservedOriginal source: Inter Press Service


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From Milan to Glasgow, Young Moroccans Commit to Fighting Climate Change

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A new way to recycle large amounts of coffee grounds; a platform connecting young African activists; technology to produce electricity from ocean waves or recycle plastic. A new energy-efficient construction method – an innovative carpooling app. 

Read the full story, “From Milan to Glasgow, young Moroccans commit to fighting climate change”, on globalissues.org

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Health Workers Lauded for Role in Leprosy Treatment During Pandemic

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Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination and Chairperson of the Nippon Foundation, thanks participants at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. He is with other participants from Japan, India and Nepal in the “Don’t Forget Leprosy” campaign event. by Joyce Chimbi (nairobi, kenya)Thursday, January 20, 2022Inter Press Service

Sasakawa, the WHO Goodwill Ambassador for Leprosy Elimination and Chairman of the Nippon Foundation, was speaking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative.

A leprosy-free world was one where “patients and those cured of leprosy live free of discrimination and, people around them will be free of the misunderstanding, ignorance and fear that perpetuate discrimination”, he told the webinar.

Sasakawa Leprosy Initiative is a strategic alliance between WHO Goodwill Ambassador for Leprosy Elimination, the Nippon Foundation and Sasakawa Health Foundation for achieving a world without leprosy and problems related to the disease. The initiative spearheaded a campaign, “Don’t Forget Leprosy”, to raise awareness about the condition in the face of the coronavirus pandemic.

The WHO Goodwill Ambassador envisions a post-COVID world where those affected by leprosy will be liberated from such stigma and discrimination in keeping with human rights.

Sasakawa says this world is now at risk of delaying leprosy elimination due to the COVID-19 pandemic, as there was a 37 percent drop in reported new cases and leprosy programs in many countries have stalled or scaled back.

Participants heard about the role of health professionals in combating leprosy, recognition of this role and the successes and challenges faced in addressing leprosy during the ongoing health pandemic.

Their role, Sasakawa said, was a central pillar to the vision of a leprosy free world as it helps reduce transmission and disability.

An estimated three to four million people live with some form of disability caused by leprosy, also known as Hansen’s disease.

“The ‘Don’t Forget Leprosy’ is a global campaign because our voices alone are not enough. Stopping leprosy requires (the involvement of) all of us, from India and Nepal to all other countries around the world,” he said.

Dr Rashmi Shukla outlined efforts in India to identify and treat patients with leprosy. He was speaking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. Credit: Joyce Chimbi/IPS

Dinesh Basnet, Central President of the International Association for Integration, Dignity and Economic Advancement (IDEA) in Nepal, said he was happy to see progress in recent years.

“More so Nepal’s efforts to track and eliminate leprosy. Even during the pandemic, detection and treatment interventions were uninterrupted, and this has been possible due to government commitment and unrelenting efforts of health professionals,” said Basnet.

“People affected by leprosy were not forgotten as communication continued through WhatsApp groups, and this was critical during the lockdown.”

Dr Indra Napit, a senior Orthopedic Surgeon at Anandaban Hospital, Nepal, spoke about innovative technology in the trial of Autologous Blood products to promote ulcer healing in Leprosy. He added that a new drug was on trial to manage reactions to this form of treatment at this leprosy mission.

In a video message, Birodh Khatiwada, Nepal’s Minister of Health and Population, spoke of Nepal’s undisrupted program to address leprosy, including the continued supply of leprosy medication despite the pandemic.

He says Nepal has already prepared the National Leprosy Roadmap, 2021-2030, National Leprosy Strategy 2021-2025, in line with the Global Leprosy Strategy, Neglected Tropical Diseases Roadmap and the Sustainable Development Goals (SDGs).

Sasakawa emphasized that it was indeed the ultimate goal for India and other affected countries worldwide to reach zero leprosy cases by 2030.

Despite challenges in the fight to eliminate leprosy, a ray of hope shines through, with Anju Sharma sharing good practices in case finding in India amid the ongoing health pandemic.

Sharma is an accredited Social Health Activist and is considered a driving force behind India’s public health system and an essential link between the community and the public health system.

“Screening for leprosy during the pandemic is much more difficult. As COVID-19 cases increase, so does my responsibilities because I have to strictly follow COVID-19 protocols, and this takes a lot of time,” Sharma explained.

“Due to the pandemic, people are hesitant about getting screened. But I reassure them that protocols will be observed and remind them that failure to detect and treat leprosy can lead to disability.”

Dr Venkata Ranganadha Rao Pemmaraju, acting team leader, WHO Global Leprosy Programme, emphasized that discussing the role of health workers was critical, and hearing from those in the frontlines helps efforts to eliminate the pandemic move forward.

WHO, he said, subscribes to the Don’t Forget Leprosy campaign. He lauded ongoing efforts to sustain counselling for those affected by leprosy and those who tracked and managed Nepal-India cross border leprosy cases despite challenges COVID-19 protocols like restrictions on movement and lockdowns.

Dinesh Basnet, a person affected by leprosy thanked health care workers and others for their efforts in eliminating the disease. He was talking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. Credit: Joyce Chimbi/IPS

Similarly, Dr Rabindra Baskota, the Leprosy Control and Disability Management Section director in Nepal’s Ministry of Health and Population, confirmed that health workers had been relentless to find new cases, raising awareness on leprosy and treating patients despite ongoing challenges.

“Still, there is a need to train community health workers to detect new cases and manage reactions to leprosy treatment even as older and more experienced health workers retire,” he said.

Dr Anil Kumar, the deputy director-general (Leprosy) in India’s Ministry of Health and Family Welfare, who spoke about good practices in combating leprosy said that a leprosy-free India was not very far off.

Despite a notable decline in screening and detecting cases due to COVID-19, he said critical interventions were nonetheless rolled out, and that leprosy-related services continued at the grassroots level.

“Migrant labourers were screened for leprosy at point of return to home districts and patients on treatment tracked. Treatment defaulters were cross notified based on the address in treatment record,” Kumar said.

“A WhatsApp group titled Leprosy Action Group was created for cross notification, and members included state leprosy officers and partners. Supportive supervision and monitoring up to sub-district level using virtual platforms continues.”

Executive Director of the Sasakawa Health Foundation, Dr Takahiro Nanri, moderated a panel discussion that included a session to further shed light on additional support needed to achieve leprosy elimination milestones.

Sasakawa suggested that health workers’ training included human rights, and the panel lauded health workers for their passionate and proactive steps to eliminate the disease.


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© Inter Press Service (2022) — All Rights ReservedOriginal source: Inter Press Service


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Ominous History in Real Time: Where We Are Now in the USA

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US President Joseph R. Biden Jr. addresses the general debate of the UN General Assembly’s 76th session last year. In his inaugural address to the annual gathering of world leaders at the UN, Biden called for a new era of global unity against the compounding crises of COVID-19, climate change and insecurity. Credit: UN Photo/Cia PakOpinion by Norman Solomon (san francisco, usa)Monday, January 17, 2022Inter Press Service

Dollar figures can look abstract on a screen, but they indicate the extent of the mania. Biden had asked for “only” $12 billion more than President Trump’s bloated military budget of the previous year — but that wasn’t enough for the bipartisan hawkery in the House and Senate, which provided a boost of $37 billion instead.

Overall, military spending accounts for about half of the federal government’s total discretionary spending — while programs for helping instead of killing are on short rations at many local, state, and national government agencies. It’s a nonstop trend of reinforcing the warfare state in sync with warped neoliberal priorities. While outsized profits keep benefiting the upper class and enriching the already obscenely rich, the cascading effects of extreme income inequality are drowning the hopes of the many.

Corporate power constrains just about everything, whether healthcare or education or housing or jobs or measures for responding to the climate emergency. What prevails is the political structure of the economy.

Class war in the United States has established what amounts to oligarchy. A zero-sum economic system, aka corporate capitalism, is constantly exercising its power to reward and deprive. The dominant forces of class warfare — disproportionately afflicting people of color while also steadily harming many millions of whites — continue to undermine basic human rights including equal justice and economic security.

In the real world, financial power is political power. A system that runs on money is adept at running over people without it.

The words “I can’t breathe,” repeated nearly a dozen times by Eric Garner in a deadly police chokehold, resonated for countless people whose names we’ll never know. The intersections of racial injustice and predatory capitalism are especially virulent zones, where many lives gradually or suddenly lose what is essential for life.

Discussions of terms like “racism” and “poverty” too easily become facile, abstracted from human consequences, while unknown lives suffocate at the hands of routine injustice, systematic cruelties, the way things predictably are.

An all-out war on democracy is now underway in the United States. More than ever, the Republican Party is the electoral arm of unabashed white supremacy as well as such toxicities as xenophobia, nativism, anti-gay bigotry, patriarchy, and misogyny.

The party’s rigid climate denial is nothing short of deranged. Its approach to the Covid pandemic has amounted to an embrace of death in the name of rancid individualism. With its Supreme Court justices in place, the “Grand Old Party” has methodically slashed voting rights and abortion rights.

Overall, on domestic matters, the partisan matchup is between neoliberalism and neofascism. While the abhorrent roles of the Democratic leadership are extensive, to put it mildly, the two parties now represent hugely different constituencies and agendas at home. Not so on matters of war and peace.

Both parties continue to champion what Martin Luther King Jr. called “the madness of militarism.” When King described the profligate spending for a distant war as “some demonic, destructive suction tube,” he was condemning dynamics that endure with a vengeance.

Today, the madness and the denial are no less entrenched. A militaristic core serves as a sacred touchstone for faith in America as the world’s one and only indispensable nation. Gargantuan Pentagon budgets are taken for granted, as is the assumed prerogative to bomb other countries at will.

Every budget has continued to include massive outlays for nuclear weapons, including gigantic expenditures for so-called “modernization” of the nuclear arsenal. A fact that this book cited when it was first published — that the United States had ten thousand nuclear warheads and Russia had a comparable number — is no longer true; most estimates say those stockpiles are now about half as large.

But the current situation is actually much more dangerous. In 2007, the Doomsday Clock maintained by The Bulletin of the Atomic Scientists pegged the world’s proximity to annihilation at five minutes to apocalyptic Midnight.

As 2022 began, the symbolic hands were at one hundred seconds to Midnight. Such is the momentum of the nuclear arms race, fueled by profit-driven military contractors. Lofty rhetoric about seeking peace is never a real brake on the nationalistic thrust of militarism.

With the withdrawal of U.S. troops from Afghanistan, the third decade of this century is shaping up to unfold new wrinkles in American hegemonic conceits. Along the way, Joe Biden has echoed a central precept of doublethink in George Orwell’s most famous novel, 1984: “War is Peace.”

Speaking at the United Nations as the autumn of 2021 began, Biden proclaimed: “I stand here today, for the first time in twenty years, with the United States not at war. We’ve turned the page.” But the turned page was bound into a volume of killing with no foreseeable end.

The United States remained at war, bombing in the Middle East and elsewhere, with much information withheld from the public. And increases in U.S. belligerence toward both Russia and China escalated the risks of a military confrontation that could lead to nuclear war.

A rosy view of the USA’s future is only possible when ignoring history in real time. After four years of the poisonous Trump presidency, the Biden strain of corporate liberalism offers a mix of antidotes and ongoing toxins. The Republican Party, now neofascist, is in a strong position to gain control of the U.S. government by mid-decade.

Preventing such a cataclysm seems beyond the grasp of the same Democratic Party elites that paved the way for Donald Trump to become president in the first place. Realism about the current situation — clarity about how we got here and where we are now — is necessary to mitigate impending disasters and help create a better future. Vital truths must be told. And acted upon.

This article is adapted from the new edition of Norman Solomon’s book “Made Love, Got War,” just published as a free e-book.

Norman Solomon is the national director of RootsAction.org and the author of a dozen books including Made Love, Got War: Close Encounters with America’s Warfare State, published in a new edition as a free e-book in January 2022. His other books include War Made Easy: How Presidents and Pundits Keep Spinning Us to Death. He was a Bernie Sanders delegate from California to the 2016 and 2020 Democratic National Conventions. Solomon is the founder and executive director of the Institute for Public Accuracy.


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