Posted on

Jaboya:Helping women to end sex-for-fish culture

The 'jaboya' system is thought to be a contributing factor to high levels of HIV in Nyanza Province, Picture by Joanne Chui (http://www.flickr.com/photos/jo_photography/5455766518/)

KISUMU, 19 December 2011 (PlusNews) – For the past five years, Achieng*, a 35-year-old widow and mother of six, has sold fish on the Kenyan shores of Lake Victoria; like many women in the fish trade, Achieng often has to have sex with fishermen in order to get the best catch of the day, a system known in the local Luo language as ‘jaboya’.

“When you are a woman and you want to get into the business of selling fish, you must be ready to lose your pride and use your body for bargaining,” she told IRIN/PlusNews. “Being ready to give sex as and when it is needed by the fishermen… it guarantees your survival here on the beach.”

‘Jaboya’ has long been associated with the high levels of HIV infection in Kenya’s western Nyanza Province, where HIV prevalence is over 14.9 percent, double the national average of 7.4 percent. It is even higher among fishing communities. The Kenya HIV Prevention Response and Modes of Transmission Analysis 2009 reported that HIV prevalence among fishing communities stands at 30 percent, while an estimated 25 percent of all new infections in Nyanza are attributed to this group.

An estimated 27,000 women are involved in the fish trade in Nyanza either directly or indirectly, according to the Ministry of Fisheries.

Achieng says she is aware of the risks, but the immediate needs of her family override any concern she may have about contracting HIV.

“You know you can get HIV… but then you remember you have a family that needs to be provided for, and you say, let me die providing for them,” she said

According to Charles Okal, the provincial AIDS and sexually transmitted infections coordinator for Nyanza, while efforts to reach out to fishing communities with HIV prevention messages have begun to show results, the continued poverty of women means they remain vulnerable to ‘jaboya’.

“Fish trade that goes along with sex-for-fish continues to be one of the greatest challenges in the prevention of HIV in Nyanza… There are still challenges which involve the economic and social vulnerabilities of the women involved in the trade,” he said.

Economic empowerment

A recent donation of six boats to women’s groups in Nyanza by the US Peace Corps shows some of the ways ‘jaboya’ can be addressed; the women are able to fish for themselves, eliminating dependence on fishermen.

“When you have nothing, those who have something must tell you to bend over backwards for them. Now we have boats and we will no longer be at anybody’s mercy,” Millicent Onyango, one of the beneficiaries of the US Peace Corps’ “No Sex for Fish” project.

According to Okeyo Owuor, director of the Victoria Institute for Research on Environment and Development, which is part of the initiative, empowering women economically is key to ending the dangerous fish-for-sex trade. “These women need fish but they don’t own any boat. This means they have to play along with whoever has the boat and these are men who will demand for sex before giving any fish. But when you empower them to own the boat, then they have the ultimate power to say no to sexual demands,” he said.

“Six boats might look small but many such initiatives can make an impact in ending the sex-for-fish trade if replicated over time. It is important to start from somewhere,” he added.

Many of the women trading in fish across Lake Victoria’s landing sites have formed groups to help them save money to buy their own fishing equipment.

“We want to help ourselves by putting some of our savings aside so that when we have enough, we can buy our own boats and nets and help each other. So we will have nearly all women who are at the beaches own a boat either individually, or as a group,” said Lillian Rajula, the leader of one such group.

According to Nyanza AIDS coordinator Okal, economic programmes must go hand in hand with other HIV prevention methods like the promotion of voluntary medical male circumcision, condom use and behaviour change communication.

“Apart from the need to empower the women, behaviour change communication targeting men is important so that they look at the women as business partners and not sex partners; these kind of efforts are ongoing and are being embraced, albeit slowly,” he said.

*Not her real name

ko/kr/cb

Theme(s): Economy, Gender Issues, HIV/AIDS (PlusNews), Prevention – PlusNews,

Credit: Picture by Joanne Chui (http://www.flickr.com/photos/jo_photography/5455766518/)

[This report does not necessarily reflect the views of the United Nations]

Share
Posted on

Greater Local Ownership of HIV Research Needed in Africa

ADDIS ABABA, 9 December 2011 (PlusNews) – Unless African governments increase their funding for and engagement in HIV research, the continent cannot hope to attain equal status in determining its research agenda and priorities, speakers said at the 16th International Conference on AIDS and Sexually Transmitted Infections (STIs) in Africa.
“In most low-income or poor countries, health research is donor-driven, with insignificant local budgets compared to the 2 percent annual budget recommended by WHO [World Health Organization],” said Dr Beyene Petros, chair of the Ethiopian Bioethics Initiative.

Donor-driven funding often means that research starts and ends on the say-so of funders, rather than being based on a country’s needs. Beyene noted a Dutch grant of approximately US$13 million to the Ethiopian government to investigate capacity development in HIV/AIDS research for eight years.

When the grant ended in 2002, the Ethiopian government applied for a renewal. It was denied, leaving scientists, who had been hoping to launch a local vaccine initiative, at a loss. The Dutch government instead decided to fund family planning and HIV prevention activities in the country.

The field of HIV research – largely donor-driven – is vibrant in eastern and southern Africa. But “West Africa, in particular, is characterized by an absence in of clinical trials of potential HIV vaccines, and or microbicides, and a lack of data on drug-resistant tuberculosis,” said Dr Souleymane Mboup, of Senegal’s Cheikh Anta Diop University.

Prof Nelson Sewankambo, principal of the College of Health Sciences at Uganda’s Makerere University, said heavy donor involvement in local research can actually harm existing national institutions, which may lose strategic direction and become retarded by the loss of key staff to research projects and distortion of institutional structures and governance.

“Inequities in collaboration can lead to lack of transparency in the decision-making process, as well as disputes over publication rights, ownership of data, specimens and equipment,” Sewankambo said.

Speakers also noted that inadequate community engagement was common when partnerships were skewed in favour of the donor priorities. “There ought to be distributive justice and fair partnerships between sponsors, investigators, subjects, communities and countries,” said Cameroonian writer Prof Godfrey Tangwa, of the University of Yaounde.

Sewankambo noted that in the past, weak local institutions had allowed ethical violations in research projects, such as the use of placebos in studies on mother-to-child HIV transmission.

“Even when these issues were pointed out, the debate began in the North. Where were we Africans when these wrongs were going on? It is not enough for us to blame countries in the North for the state of health research – we need to look at what we in the South are not doing right in government funding of research and in negotiation of research partnerships,” he said.

Sewankambo noted that there was a need to build new, more equitable partnership models and expand local capacity to sustain research activities once donor-funded projects ended.

The involvement of policy-makers is key to ensuring that research is turned into evidence-based policy, said Anne Cockroft, of Canada’s Global Health Research Initiative (GHRI). She pointed out that there was often a gap in “knowledge translation” between researchers and policy-makers, leading to poor decisions being taken.

“[HIV] prevention research results have to be translated into policies and action, and research users and decision-makers need skills to evaluate findings and prioritise for action,” she said, adding that outside interests and funding often led to externally driven policy decisions, while poor understanding of research led to policies based partly on evidence, or based on poor evidence.

GHRI has been working with parliamentarians in Botswana to expand their ability to make decisions based on evidence after many said they experienced difficulties in interpreting scientific evidence.

There has been some progress in the past few decades. Wen Kilama, managing trustee of the African Malaria Network Trust, said partnerships have largely moved on from “colonial style” research, in which Africans had little or no say in research conducted in their countries, and African scientists are now more involved in priority-setting and actual research.

“The Ugandan government has created an enabling environment for research and recently came up with a law which led to the creation of the Uganda National Health Research Organization, which, if managed properly, has the potential to greatly improve the way research is conducted in the country,” Sewankambo said.

Kenya and Tanzania have similar bodies, and African scientists have created several networks to strengthen research capacity, but regulation has lagged behind the development of research capability.

The East Africa Consortium for Clinical Research has been established, but it has yet to develop a regional policy to guide the regulation of health research and clinical trials, and remains largely donor-dependent in the development of health research policy.

Ethiopia’s Beyene pointed out that “Unless we strengthen our own research capacity, dependence on donors will be perpetuated.”

kr/he

Theme (s): Care/Treatment – PlusNews, HIV/AIDS (PlusNews),

[This report does not necessarily reflect the views of the United Nations]

Share
Posted on

HIV-positive Women in Africa Still Confused About Infant-feeding Choices

ADDIS ABABA, 9 December 2011 (PlusNews) – The latest guidelines on infant-feeding options for HIV-positive mothers in Africa have not been disseminated in many countries, leaving women dangerously confused about the best nutritional path to protect their children from contracting the virus, a new report shows.

The UN World Health Organization’s (WHO) 2010 guidelines recommend exclusive breastfeeding with an antiretroviral (ARV) treatment intervention for the first six months of a child’s life to reduce transmission, and continued breastfeeding – with complementary feeding – until the child is at least a year old. Alternatively – where it is acceptable, feasible, affordable, sustainable and safe – WHO recommends complete avoidance of all breastfeeding.

For HIV-positive mothers in most sub-Saharan African nations, exclusive breastfeeding is the most practical option. According to a large African study, Kesho Bora, giving HIV-positive mothers a combination of three ARVs during pregnancy, delivery and breastfeeding cuts HIV infections in infants by 43 percent by the age of 12 months and reduces transmissions during breastfeeding by 54 percent compared with WHO’s 2006 recommendations, where ARV drug regimens ended at delivery.

“The six months of exclusive breastfeeding is what is crucial for mothers to understand – that not doing it is what raises the child’s HIV risk; but we are finding that while many countries have officially adopted the WHO guidelines, they have not trickled down, and health centres, policy-makers and communities are still unclear on what advice to give mothers,” said Aditi Sharma, of the International Treatment Preparedness Coalition (ITPC), and coordinator of a report, The Long Walk: Ensuring comprehensive care for women and families to end vertical transmission.

Based on new research by community health workers from Cameroon, Cote d’Ivoire, Ethiopia and Nigeria, the report – launched at the 16th International Conference on AIDS and STIs in Africa (ICASA) in Addis Ababa, Ethiopia – found that prevention of mother-to-child transmission programmes were focused too narrowly on the provision of ARVs to HIV-positive pregnant women, rather than more comprehensive approaches that involved family planning, maternal healthcare and exclusive breastfeeding.

Confusion

“Nutritional counselling doesn’t exist in rural areas,” the report quoted one Cameroonian woman as saying. “Health personnel are not trained and women do not know how to care for their children.”

In Cote d’Ivoire, the report found that national guidelines did not meet the most recent WHO recommendations on infant feeding.

Although the Nigerian government had revised guidelines to comply with the WHO, consensus did not exist in support of the recommendations, and some clinicians and researchers continued to oppose breastfeeding because they believed it deliberately exposed babies to possible HIV infection. Several focus group participants indicated they assumed that replacement feeding was preferable to breastfeeding, and that it had been recommended by health practitioners.

“The guidance on infant-feeding options needs to urgently get into the curriculum and training of health workers and other people who support community healthcare, such as traditional birth attendants,” said Sharma, adding that efforts needed to be made to support mothers to exclusively breastfeed their children.

“It is not enough to issue guidelines – in places where women may complain of insufficient breast milk or inadequate nutrition, they need nutritional support to ensure they can continue to exclusively breastfeed,” she added.

Conference speakers said community health systems were crucial to the success of prevention of mother-to-child HIV transmission services, as community health workers and traditional birth attendants were often the first port of call for a confused mother. Community health systems can also be used to engage men – frequently absent from ante-natal visits – in their wives’ experiences.

Supporting partners

Beatrice Ochieng, author of a study on infant feeding choices in poor settings in the Kenyan capital, Nairobi, noted that just 23 percent of 357 women in the study discussed their chosen feeding option with their partners. “There is a need to support partner involvement through partner counselling and testing, during antenatal and postnatal care,” she said.

According to Ncumisa Vika, who works with the Elizabeth Glaser Paediatric AIDS Foundation (EGPAF) in South Africa, male involvement in reproductive health services, including PMTCT, remains low, creating challenges and barriers around disclosure of HIV-positive status to a partner, psychosocial support, adherence to treatment, and infant-feeding decisions. In 2010, in collaboration with community health organizations in South Africa’s Tshwane District, EGPAF was able to send invitation letters to the partners of all HIV-positive women who attended antenatal clinics, which boosted male participation in reproductive and family health matters.

Overall, ITPC’s Sharma said, there was a need for more comprehensive delivery prevention of mother-to-child services in Africa. “Countries must ensure that policy filters down to the women in all aspects of PMTCT – from HIV prevention for women to family planning, to the best ARV prophylaxis option to proper infant feeding to proper healthcare for the mother, child and family,” she said. “It is the only way we can achieve the 2015 targets of reducing vertical transmission by 90 percent.”

kr/mw

Theme (s): HIV/AIDS (PlusNews),

[This report does not necessarily reflect the views of the United Nations]

Provided by PLUS NEWS

Share
Posted on

Food Security Concern Grows in Kenya as Farmers Switch from Maize to Coffee

ELDORET, 23 November 2011 (IRIN) – The switch by many farmers in Kenya’s Rift Valley province from staple cereals to more profitable coffee is likely to increase the country’s dependence on grain imports and possibly affect food security, agricultural experts have warned.

“It is unsafe to use our land for crops with the hopes of being fed by other countries,” said James Nyoro, managing director for Africa of the Rockefeller Foundation, which works to “promote the wellbeing of humanity around the world”.

“What if these countries do not harvest excess for us?”

Kenya will have to import 2.3 million tonnes of cereal during the 2011-2012 marketing year to meet demand, a year-on-year increase of 37 percent, according to the UN Food and Agricultural Organization, which estimated domestic harvests of maize – a staple for 90 percent of Kenyans – at 2.5 million tonnes, down 18 percent because of poor weather.

This import dependency and the threat posed by increased coffee growing could be mitigated with the use of improved inputs by cereal growers, Nyoro said. Another food security specialist recommended improving storage conditions of grain after it is harvested, when some 30 percent of production is traditionally lost.

In the meantime, any additional costs accrued by importing will be passed on to consumers.

“There is inflation already, joblessness and low purchasing power for many Kenyans; if food prices go higher than they have in the recent past then the number of people accessing even two meals a day will be much lower,” he said.

Feasibility study

“The Rift Valley is the country’s granary; it is where most people get their food from. Increased coffee growing could compromise the country’s grain basket,” said one food security specialist, who asked not to be identified.

“If we lose significant land in the province to coffee, we have to weigh what we gain in the process. If coffee pays better and farmers can [by investing in inputs] improve the yield of maize crop in the acreage they put under maize, perhaps this could be the trade-off,” the specialist said, recommending that the government undertake a feasibility study on the implications of expanding coffee production in the Rift Valley.

A draft of Kenya’s land-use policy has been submitted to parliament and has yet to be debated for subsequent enactment.

There is little data available about how much former cereal-growing land in the province is now used to produce coffee. But in just one of its 50-odd districts, Trans Nzoia, the area under maize cultivation has fallen by 450 hectares over the last year, according to an agricultural officer there.

Across the province, areas of coffee cultivation grew by an annual 20 percent over the past two years, said Bonface Wekesa, manager of a new milling plant in the town of Eldoret.

“We have distributed over one million seedlings of coffee over the last one year and have even run short as the current demand stands at double what we have distributed to farmers,” Wekesa said, explaining that typically 2,200 seedlings would be planted on each hectare of land.

Coffee offers much better returns to farmers at a time when traditional coffee-growing areas in the centre of the country have been greatly reduced by real-estate developments.

In the past year, more than 2,000ha of coffee-growing land in Kiambu County, which neighbours the capital, Nairobi, have been given over to developers.

“Payback time”

Farmers in Rift Valley, according to agronomist Zabron Njoroge, “have been growing a lot of cereals to feed the nation while their pockets are left empty. It is their time to fill their pockets with income from the same farms.

“Maybe it’s time the government started massive irrigation in arid and semi-arid areas,” he said.

Joseph Kurui, a farmer and father of 10 in Tindiret, in Rift Valley’s Nandi County, told IRIN: “I have already planted coffee in 14 [5.7ha] out of my 21 acres [8.5ha]. I am waiting for seedlings to plant in six more acres and will only reserve one acre to plant maize for family consumption.”

Whereas 0.4047ha of maize earns him about Ksh25,000 (US$280) coffee delivers 10 times that, he said.

“A serious farmers who follows instructions from agronomists can make even more than Sh500,000 per acre,” said Wekesa.

Symon Mahungu, a food and agricultural scientist at Egerton University in Nakuru, Rift Valley’s provincial capital, said although coffee’s growing popularity could reduce cereal production, it would not affect people’s access to food, at least in the province.

“If these farmers are not accessing food through selling their maize but are well fed buying food from the proceeds of coffee, then this means they are food secure,” Mahungu told IRIN, adding that food security was not a matter of the amount of food produced from farms but, rather, people’s ability to access food.

He added: “Maize has been imported even when local farmers have their granaries full; let them [farmers] grow what suits their pockets best

Share
Posted on

Italian Prime Minister Silvio Berlusconi Resigns

ROME — Italy’s presidential palace has confirmed that Premier Silvio Berlusconi has resigned, setting in motion a transition aimed at bringing Italy back from the brink of economic crisis.

Cheers broke out in front of the palace by the hundreds of people who gathered to witness Berlusconi’s final act in office, ending a 17-year political era.

THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP’s earlier story is below.

ROME (AP) – An Italian news report says Premier Silvio Berlusconi’s political party will conditionally support a technical government headed by economist Mario Monti.

Italy’s president is expected to ask Monti to try to form a new government once Berlusconi’s resignation is confirmed Saturday night. Monti will be tasked with trying to bring Italy back from the brink of a Greek-style economic crisis.

The LaPresse news agency quotes a statement issued after Berlusconi chaired a meeting of his People of Liberties Party, saying the party would tell President Giorgio Napolitano that it would back Monti. But it said the party would meet again to ensure that Monti’s Cabinet, legislative agenda and the timeframe of his government meet its requirements.

Share
Posted on

Africa Mobile Market Is Fastest Growing On Earth

Africa is the world’s fastest growing mobile phone market and soon poised to have 735 million people using their phones for everything from transferring money to tracking animals for wildlife studies, an industry group said Wednesday.

Mobile penetration in Africa is now second only to Asia, according to the report by the industry group GSMA, or Groupe Speciale Mobile Association. Its report found that subscriber levels have grown by almost 20 percent for each of the past five years, and the total is expected to hit 735 million by the end of 2012.

Mobile phone users in South Africa can receive text messages anytime there’s activity on their bank account or credit card. Gertrude Kitongo also uses her phone as a radio, library, mini cinema, instant messenger and bank teller.

“I use my phone for everything,” exclaimed the 24-year-old Kenyan-Ugandan, who says she cherishes the link to family and friends – from her grandmother in a Ugandan village to her former schoolmates in Zimbabwe.

When she has a spare moment, Kitongo downloads and watches movies, or catches up on her Oprah magazine subscription. She makes payments and checks her bank balance using her smart phone, and her bank sends her a text message when she receives a payment.

Many African consumers, particularly in rural areas, often lack easy access to bank branches. Earlier this year, global credit giant Visa paid $110 million for Fundamo, a South African company that helps mobile companies and banks allow their customers to instantly transfer money between phones.

“It’s cheap, it’s a one-on-one relationship, it’s fast, it’s secure,” Fundamo senior vice president Reg Swart said in an interview Wednesday.

Cape Town-based Fundamo has taken mobile phone banking beyond Africa into the Middle East, Asia and the Americas, tailoring technology to work on the most sophisticated phones as well as those that can handle only text messages.

Peter Lyons, a GSMA policy expert, said that there will be more “mobile savvy citizens” like Kitongo in Africa who will demand better coverage and affordable service. Already Lyons estimated that at least 5.5 million Africans are directly or indirectly employed by the mobile industry.

GSMA called on governments to allocate more mobile broadband spectrum, and to cut taxes on operators to further spur expansion.

For all the convenience and opportunity, Kitongo questions some of the changes mobile technology has brought to social interaction. When friends get together for a coffee, she finds they’re often paying more attention to their phones than to the people across the table.

When she was in high school, she said, boys used to write letters to ask her on dates. Now, she said, no one takes time to do more than dash off a text message, or SMS.

“Now, people break up by SMS,” she said.

Share
Posted on

Abuse of Painkillers is Epidemic in the United States, Government Reports

Abuse of prescription painkiller have reached “epidemic” levels in the US, a government report says.

Overdoses of pain relievers cause more deaths than heroin and cocaine combined, the report has found.

It says sales and prescriptions of the drugs rose sharply in recent years and this was linked to the rise in overdoses.

Narcotic painkillers are prescribed to relieve chronic pain but the drugs can be “highly addictive”, the report says.

The report, published by the Centers for Disease Control and Prevention (CDC), said fatalities caused by narcotic pain relievers have more than tripled in the last 10 years – equivalent to 40 deaths a day.

Last year, a national survey on drug use and health showed that one in 20 Americans over the age of 12 said they had used painkillers for non-medical reasons.

Named as the fastest growing drug problem facing the US, narcotic painkillers are increasingly used recreationally – for the high they cause.

Surging sales

“Almost 5,500 people start to misuse prescription painkillers every day,” said Pamela Hyde, administrator for the Substance Abuse and Mental Health Services Administration, a federal body.

Sales of the drugs to pharmacies and health care facilities have surged more than 300% since 1999, according to figures from the Drug Enforcement Administration.

But prescriptions of the drug have risen sharply too.

The report says enough medicine was prescribed last year to keep every American adult medicated for one month.

Florida was found to have the highest rate of sales of narcotic painkillers per person, almost three times the rate in Illinois, which had the lowest rate.

Officials believe state health policies can help reverse the trend.

The report recommends tracking prescriptions more carefully and cracking down on “pill mills” (clinics that prescribe drugs inappropriately) and “doctor shopping” (when patients collect prescriptions from several doctors).

“This highlights the importance of states getting policies right on preventing drug abuse,” CDC Thomas Frieden told the Associated Press news agency.

In 2008, almost 15,000 deaths were caused by prescription painkillers, including the death of actor Heath Ledger.

Share
Posted on

Africa’s Industrialization Through Green Economic Growth

The green economy may be in the way of Africa’s industrialization even if some of the continent’s industries are still grappling with efficient use of energy issues related to climate change.

These were the conclusions of some of the papers on Structural Transformation and Industrial Policies presented at the African Economic Conference, which went into its second day in Addis Ababa.

Salifou Issoufou and Nama Ouattara, from Universite Paris 11, France, in their paper entitled “Does Green Investment Raise Productivity?” indicated that there were three motivating factors for the green economy on the economic, environmental dimensions. These include an estimated U.S.$50-170 billion per year adaptation cost by the year 2030, the contribution of green investment to reduce carbon emissions, and the ability to address famine and poverty by applying green agricultural methods.

The researchers said that they presented new cross-country evidence on the macroeconomic impacts of green investment. In the study they conducted using various data from 1987-2007 from 46 African countries, they arrived at the conclusion that green investment was detrimental to productivity growth.

“Given the negative impacts of green investment, African countries may have to forgo climate change issues in their quest for industrialization,” the study said. “Overall, African countries should be cautious in their eagerness to adopt green technologies.”

In the paper, which they hoped would further the intellectual and policy discourse about the costs and benefits of the green economy for African countries, that countries may need to address, or continue to address the issues of absorptive capacity, efficiency of investment, structural and cultural gridlocks in order to fully reap the benefits of green investment.

“Energy Use and Sustainable Development: Evidence from the Industrial Sector in Nigeria”, a paper by Fidelis O.Ogwumike and Omo Aregbeyen, from the University of Ibadan, highlighted the case of Nigeria, where they criticized low-level awareness of energy efficiency issues among major Nigerian companies.

Finance for investment in energy efficiency is also not readily available either from retained earnings or bank loans due mainly to the financial crisis, according to the paper.

The presenters made their cases for the adoption of industrial energy efficient technologies and practices in developing countries as well as the introduction of incentives for energy efficiency practices.

African Development Bank

Share