Africa

A selection of the week's best photos from across the continent and beyond.

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Family photo of part of the 111 participants in the First Latin American and Caribbean Assembly of Organisations of People Affected by Hansen's Disease, on the steps of the Morisco Palace, the headquarters of the Oswaldo Cruz Foundation, which hosted the three-day meeting in Rio de Janeiro, Brazil. Credit: Mario Osava/IPS

By Mario Osava
RIO DE JANEIRO, Mar 14 2019 (IPS)

With the decision to found a regional coalition to promote rights and greater participation in national and international forums and decisions, the First Latin American and Caribbean Assembly of Organisations of People Affected by Hansen’s disease, popularly known – and stigmatised – as leprosy, came to an end.

The final session of the meeting, on Mar. 14, approved 40 of the 58 proposals presented by the 111 participants in three days of debates at the headquarters of the Oswaldo Cruz Foundation, a renowned scientific, medical and epidemiological research centre in Rio de Janeiro, Brazil.

José Picanço, 46, separated from his family and taken as a newborn to an orphanage because his parents were diagnosed with the disease in 1972, is one of those affected whose right to reparations remains unfulfilled. His three siblings are in the same situation.

When the family was reunited eight years later, the father turned his back on the children. The mother took them in, but died shortly afterwards. “I only lived with her, a saint, for five months,” Picanço recalled, barely managing to hold in his tears while giving testimony at the meeting.

“Humiliated as the children of lepers, suffering bullying and sexual harassment, many of the other children who were with me at the orphanage fell into drug abuse and alcoholism. It was a holocaust,” he said. “I hit my brother on the head, not knowing he was my own brother.”

“Of the 15,000 to 20,000 children separated from their families, more than 80 percent suffer from depression,” said Picanço in an interview with IPS, detailing some of the damage caused by the old rule of segregating the people then called “lepers”.

Mandatory isolation was widespread around the world, during different historical periods, and continues in some countries, even though it is known that the disease is curable and that patients cease to be contagious shortly after starting treatment.

Officially, Brazil abolished this practice in 1976, although it actually lasted 10 more years. Its direct victims were compensated starting in 2007, but their children were not. The activists gathered in Rio de Janeiro called for working for policies of reparations for children separated from their families.

Their complaints and proposals will be taken to the World Congress of associations of people affected by leprosy in Manila in September, which will also receive contributions from Africa and Asia, approved at recent similar regional assemblies.

“The goal is to form a large network of activists, to strengthen the movement” for the eradication of the disease and for care and reparations for those affected, said Kiyomi Takahashi of the independent Nippon Foundation, which is driving this international process of debate and cooperation.

The meeting in Rio de Janeiro fostered “a high-level dialogue, the result of Morhan and Felehansen’s long history of activities,” the Japanese expert told IPS, referring to the Movement for the Reintegration of People Affected by Hanseniasis (Morhan) in Brazil, and the National Federation of Entities Affected by Leprosy or Hansen’s Disease (Felehansen) in Colombia, the two organisers of the regional meeting.

Brazilian activists José Picanço (front) and Evelyne Leandro testified about how Hansen’s disease affected them during a Latin American and Caribbean meeting in Rio de Janeiro. Picanço was separated from his parents when they were diagnosed with leprosy when he was born in 1972 and was only reunited with them eight years later, shortly before his mother died. Leandro wrote a book about the difficulties of being diagnosed with the disease in Germany, where she lives. Credit: Mario Osava/IPS

“Morhan is my safe haven, to preach that separated children should be heard and have opportunities,” said Picanço, who explained that he joined the movement in 1992. Today he gives talks on the direct and indirect effects of the stigma still surrounding the disease, that is suffered by those affected and their families.

A blessing

The disease “was a blessing for me,” Isaias Dussan Weck, 50, the vice-president of the Colombian association Felehansen, told IPS without hesitation.

The diagnosis in 2006 destroyed him, he said. He lost the desire to work or to go out, he let his business of supplying cleaning products to companies go bankrupt, he even contemplated suicide. He ignored the stains on his body that did not prevent him from working and traveling, until they spread to his face, and he noticed that parts of his body were going numb.

He received treatment and was cured, left with only slight numbness in one arm and pains in his left leg.

But everything went badly for him until he was invited to meetings with other people affected by leprosy. “I began to understand, when I heard their testimonies and tears, why a young black girl with severe disabilities said that leprosy was a blessing to her,” Dussan said.

Activism for the benefit of those affected, against the stigma and the damage caused by the disease, in the association of the department of Huila, in southwestern Colombia, allowed him “to gain new meaning for life and to understand and practice love for my neighbour.”

“Helping and seeing a patient’s life improve is a wonderful emotion, and you help other people want to live,” he concluded. That new passion led him to Felehansen, where he took on leadership roles in the federation.

Irma Romero, 42, president of the Nuevo Amanecer Foundation in Barranquilla, on Colombia’s northern coast, had a similar experience. Her lengthy odyssey to a specialist’s diagnosis five years ago reveals the medical system’s shortcomings when it comes to detecting and treating the disease, also known as hanseniasis, which is still viewed by many as “a divine punishment.”

Romero stopped working in the textile industry due to disability and depression. “I couldn’t even walk,” she recalled. “I even denied God,” she told IPS.

Colombian activist Irma Romero, a native of the city of Barranquilla, sitting on the bus that transported the participants of the First Latin American and Caribbean Assembly of Organisations of People Affected by Hansen’s Disease, held Mar. 12-14 in Rio de Janeiro, Brazil. Credit: Mario Osava/IPS

Treatment using medicinal herbs, self-medication, rejection by relatives, attempts to separate her from her two children and abandonment by her husband all formed part of her suffering, which did not end with her treatment and cure.

The only permanent physical effects are numbness in her hands and feet, and sciatic nerve pain. But the discrimination continued.

“My life changed when I joined the association of affected people” four years ago, she said. “There I found people who had things in common with me, and a newfound love of my neighbour that I did not feel before,” said the activist, who became president of the Foundation the following year and reconciled with God.

Her foundation currently has 60 members. In Barranquilla she estimates that there are “about 200 affected people, but many more are hidden.”

The foundation is one of the 10 associations that make up Felehansen, eight of which call the disease hanseniasis or Hansen’s disease, one of which uses the term leprosy, and another of which refers to disabled people and is made up of patients who received a very late diagnosis.

The World Health Organisation (WHO) defines leprosy – the term it uses – as an infectious and chronic disease “transmitted by air through droplets from the nose and mouth, during close and frequent contacts with untreated cases.” It also specifies that leprosy is “one of the least infectious diseases.”

WHO reports that in 2017 there were 211,009 new cases worldwide, according to official data from 159 countries. That amounts to 0.3 cases per 10,000 inhabitants, which means it classifies as having been “eliminated,” according to WHO criteria.

Change of name: another recommendation

Proposing hanseniasis as the official name for the disease is one of the proposals that came out of the Latin American meeting, headed by Brazil, which has already adopted it, even prohibiting the mention of leprosy in the health system since 1995.

They are different concepts, because leprosy and leper have very negative connotations of “dirt, plague, impurities and divine punishment,” strengthened by numerous mentions with that moral burden in the Bible, argued Faustino Pinto, one of Morhan’s national coordinators.

But the activists from Colombia are not convinced. “People only know leprosy, they don’t know it’s Hanseniasis. To explain the issue to the population, you have to mention leprosy,” argued Romero.

“It will be necessary to educate the new generations about the concept of Hansen,” the Norwegian doctor Gerhard Hansen who discovered the bacillus that causes the disease, because adults are not likely to forget the stigma, said Dussan. “It’s harder to unlearn than to learn,” he added.

Another proposal of the Latin American Assembly is to extend the current Committee for Assistance to Brazilian Immigrants Affected by Hanseniasis to all Latin Americans and people from the Caribbean, in addition to extending it to other regions.

The reference point in this is Evelyne Leandro, a 37-year-old Brazilian who has lived in Germany for nine years and had a lot of difficulties getting diagnosed with the disease in a country where it is very rare and where very few doctors are familiar with it.

She was helped by her mother’s suspicion, awakened in Brazil by an outreach campaign on the disease, and by the Institutes of Tropical Medicine in Germany.

Her case and those of other immigrants in Europe are recounted in her book “The Living Death: the struggle with a long forgotten disease”.

Related Articles

• In Latin America, the Term Leprosy Still Carries a Burden from Biblical Times
• People Affected by Leprosy Still Face Stigma in Latin America

The post People Affected by Leprosy in Latin America Unite for Their Rights and Their Voice appeared first on Inter Press Service.

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A cigarette vendor in Manila sells a pack of 20 sticks for less than a dollar. Credit: Kara Santos/IPS

By Wendell Balderas and Mary Assunta
BANGKOK, Thailand, Mar 14 2019 (IPS)

International Women’s Day on 8 March recognized and celebrated the progress women are making globally. The day also acknowledged the risks, exploitation and suffering many continue to endure.

The Southeast Asia Tobacco Control Alliance (SEATCA) puts the spotlight on the tobacco industry’s marketing tactics targeting women and girls especially in Asia to market its deadly products.

While smoking prevalence among females remains relatively low in Asia, smoking rates among adolescent girls in the Philippines, Malaysia, and Thailand however are higher than the rate among adult women respectively (9.1% vs 5.8%; 2.4% vs 1.4%; 5.2% vs 1.7%). Despite governments’ efforts to protect public health, tobacco use remains at epidemic proportions.

This is no coincidence. The tobacco industry needs “replacement” customers to maintain and increase its profits, and women and girls are an important market segment which represent the largest product-marketing opportunity the tobacco industry exploits.

Internal tobacco industry documents reveal that the tobacco industry has been notoriously targeting women and girls through their ads and novel products that promote social desirability, independence, sophistication, glamor, romance, and fun.

Women and girls, especially in low and middle-income countries (LMICs), are smoking in greater numbers than ever before. The tobacco industry has been introducing new products framed as “innovation” by refreshing brand marketing devices and imagery to appeal to women and young girls.

Through these product “innovation”, transnational tobacco companies (TTCs) introduce cigarette brands with new characteristics as flavored capsules and flavored filters and packaged and labelled with glitzy promotion.

These so-called innovations are gimmicks on specific product designs including filters, capsules, flavors, shape, color and perceived product’s strength or mildness.

Credit: Bigstock

Some of the tobacco industry’s deceptive tactics which blur the truth about the hazards of tobacco and instead promote smoking in developing countries among women and girls include the following:

• • In Indonesia, Malaysia and Singapore, some cigarettes brands are in “Lipstick” packs. Female-targeted elegant slims or super slim cigarettes are also packaged in slimmer packs and influences beliefs about smoking and weight control – an important predictor of smoking behavior among women.

 

• • In Malaysia, Cambodia and Vietnam “Less smoke smell (LSS)” technology has been used to promote cigarettes designed to reduce secondhand smoke odor.

 

• • Kiddie packs (10 to 12 sticks) are also available in Indonesia and the Philippines.

 

• • Flavor capsules in cigarettes are becoming increasingly popular and increase attractiveness of smoking. Some cigarettes sold in Cambodia, Indonesia, Malaysia, Philippines, Singapore and Vietnam have capsule filters that can be crushed to release additional menthol or other flavoring.

 

• Colors play an important role to enhance cigarette packaging and labeling to represent flavors and strength within brand families. The brand image is created by attention-grabbing designs and appealing colors to indicate flavors (such as strawberry, orange and apple) and communicate the false impression of lower tar or mild cigarette. Gold and silver convey ‘low-tar’, green for menthol and blue for ‘light’ or icy/cool.

To divert public attention away from the harm and damage caused by the industry, the TTCs have been conducting public relations stunts about employment and gender equity.

Philip Morris International boasted an ‘Equal-Salary certification’ it received, conveniently timed for International Women’s Day. TTCs routinely receive an obscure ‘top employer’ awards while simultaneously fighting smoke-free policies.

According to the US Centers for Disease Control and Prevention (CDC), “a woman’s risk of dying from smoking has more than tripled and is now equal to men’s risk”. This means that women are also at higher risk for heart attacks, strokes, lung cancer, emphysema, and other serious chronic illnesses such as diabetes.

A sudden concern for smoking is the new public rhetoric of the tobacco industry to justify a new range of so-called “less harmful” products such as heated tobacco products, while simultaneously selling regular cigarettes which form the bulk of their profits.

The current sixty-third session of the Commission on the Status of Women (CSW) at the United Nations Headquarters in New York, (11 – 22 March) is expected address women empowerment and their vital roles as agents of development in making progress across all Sustainable Development Goals (SDGs) and targets.

It is timely to discuss the tobacco epidemic among women especially in the LMICs and the concerted effort governments must make to curb this scourge.

Preventing an epidemic of tobacco-related diseases among women in the LMICs is one of the greatest public health opportunities for governments of our time. The global health treaty, WHO Framework Convention on Tobacco Control (FCTC) has been explicitly identified as a means to achieve the SDG health goal.

Steps governments should take to prevent this epidemic include banning tobacco advertising and promotions such as pack displays and applying plain packaging which requires cigarette packs to be sold in a standardized size, shape, and drab brown color, free of any logos or images.

In September 2019, Thailand’s legislation on standardized packaging of tobacco will take effect and Singapore will follow soon. Standardized packaging removes the attractiveness of tobacco products and reduces the ability of tobacco packaging to mislead consumers about its harmful effects.

Other equally important actions in the FCTC include increasing tobacco taxes and making public and work places 100% smoke-free.

*SEATCA is a multi-sectoral non-governmental alliance promoting health and saving lives by assisting ASEAN countries to accelerate and effectively implement the evidence-based tobacco control measures contained in the WHO FCTC. Acknowledged by governments, academic institutions, and civil society for its advancement of tobacco control movements in Southeast Asia, the WHO bestowed on SEATCA the World No Tobacco Day Award in 2004 and the WHO Director-General’s Special Recognition Award in 2014.

The post Tobacco Industry Targets Women in Asia appeared first on Inter Press Service.

Excerpt:

Wendell Balderas is Media & Communications Manager & Mary Assunta is Senior Policy Advisor, Southeast Asia Tobacco Control Alliance (SEATCA)*

The post Tobacco Industry Targets Women in Asia appeared first on Inter Press Service.

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In the panel on Hanseniasis versus Leprosy, the need to change the name of a disease surrounded by stigma with no scientific basis was debated, during the Latin American and Caribbean Assembly of Organisations of People Affected by Hansen's Disease, in Rio de Janeiro, Brazil. Credit: Fabiana Frayssinet/IPS

By Fabiana Frayssinet
RÍO DE JANEIRO, Mar 13 2019 (IPS)

Known scientifically as Hansen’s disease, leprosy carries a symbolic burden from the past that people affected by the disease and experts from around Latin America are fighting, including the terminology used.

The debate took place during a panel called Hanseniasis versus Leprosy, at the First Latin American and Caribbean Assembly of Organisations of People Affected by Hansen’s Disease, taking place in Rio de Janeiro, Brazil Mar. 12-14.

“People still use the term leprosy as an instrument of prejudice and discrimination, but that causes those affected to be afraid and to refrain from seeking medical attention and early treatment,” Francisco Faustino, a Brazilian who received treatment and was cured, told IPS."We're not going to change Hollywood movie concepts about lepers, nor the biblical stories. What we need to change are attitudes. It's as if we have to create a new concept, work on a new product. No bank would be called a 'bankrupt corporation' because everyone would be afraid to put money in that bank." -- Artur Custodio

The activist is a member of the Movement for the Reintegration of Persons Affected by Hanseniasis (MORHAN), which organised the conference together with the Colombian National Federation of Organisations of People Affected by Leprosy.

The meeting brings together international institutions and representatives from seven Latin American countries along with others from the industrialised North and is being held with the special support of the Brazilian Health Ministry and the independent Nippon Foundation, which is accompanying the process of regional meetings ahead of the World Congress on leprosy, to take place in the Philippines in September.

Brazil is the only country that has replaced the word leprosy in its health campaigns. Hansen’s disease or hanseniasis is often used as official terminology in most countries along with leprosy, while the World Health Organisation (WHO) uses Hansen’s disease as a second name but still mainly uses the term leprosy.

Regardless of what name is used, this country is the only one in the Americas that, according to official data, has failed to eliminate the disease, and is the one that accounts for 95 percent of the roughly 30,000 new diagnoses annually in Latin America.

Organisations such as the Brazilian Society of Hansenology say the number of unregistered cases could be four or five times that.

WHO considers the disease eliminated when there is less than one case detected per 10,000 inhabitants.

Faustino attributes this largely to the “prejudice still surrounding the term.” “We hope that the health community will change its stance and begin to treat it as a disease that has a diagnosis, treatment and a cure,” he said.

He continues to suffer stigma and discrimination even now that he is cured. “People still think it’s a disease that is spread merely by contact, by being near you,” he said.

According to the Pan-American Health Organisation (PAHO), “Leprosy is transmitted via droplets, from the nose and mouth. Prolonged, close contact with someone with untreated leprosy over many months is needed to catch the disease. You cannot get leprosy from casual contact with a person who has Hansen’s disease.”

PAHO and WHO explain that leprosy is caused by a bacillus, Mycobacterium leprae, also known as Hansen’s bacillus. It is infectious and chronic, multiplies very slowly and the incubation period is on average about five years, although some people do not show symptoms until 20 years later.

Francisco Faustino, who had leprosy and was completely cured, is a Brazilian activist who advocates replacing that term with hanseniasis, as he explained during a special panel at the Latin American and Caribbean Assembly of Organisations of People Affected by Hansen’s Disease, held in Rio de Janeiro, Brazil. Credit: Faiana Frayssinet/IPS

The disease mainly affects the skin, the peripheral nerves, the mucosa of the upper respiratory tract, and the eyes. If left untreated, it can lead to nerve damage, loss of feeling and paralysis of muscles in the hands, feet and face.

Artur Custodio, coordinator of Morhan, recalled that in ancient times leprosy was the name given to a group of diseases such as syphilis, elephantitis, vitiligo, and today’s hanseniasis.

“Biblical leprosy refers to scaly skin, dirtiness and sin, and hanseniasis is nothing like that. We have to give a new meaning to this disease in order to combat the stigma. The word is strong,” he told IPS.

“We’re not going to change Hollywood movie concepts about lepers, nor the biblical stories. What we need to change are attitudes. It’s as if we have to create a new concept, work on a new product. No bank would be called a ‘bankrupt corporation’ because everyone would be afraid to put money in that bank,” he said, by way of comparison.

Custodio said the debate on the name and the burden of its meaning is also occurring in countries such as Colombia, Japan and the United States.

“This is an important movement. Words do carry stigma. The word used for a name is a strategy,” he maintained.

Luciano Curi of the governmental Federal Institute of the Mineiro Triangle in Brazil did research for his doctoral degree on the history of ancient, medieval and modern leprosy that convinced him that the term did not refer to today’s hanseniasis.

“Treating it as a synonym, in addition to lacking a historical and scientific basis, is very dangerous. The leper of the ancient and medieval world was seen from a religious foundation, and was associated with the impure. And hanseniasis is seen from a medical point of view. The first medical works date back to the 19th century, when the disease began to be understood scientifically,” he told IPS.

The figure of the leper, he said, existed in several ancient populations of the region of Mesopotamia or Egypt, and also among the Hebrews, and they were seen as having “some kind of spiritual pollution,” while priests were instructed to expel them.

In Brazil and other Latin American countries, this definition led them from exclusion to isolation, in leper colonies isolated from everyone, including their families, until the mid-twentieth century.

According to Curi the “change of terminology is urgently necessary.” He noted that Brazil was a pioneer in changing other terminologies. “We don’t say ‘madness’ any more, we say ‘mental illness’, we no longer use the word ‘plague’. That effort, at a worldwide level, is important. The name is not a minor issue,” he argued.

Jorge Domínguez, a representative of Peru’s Health Ministry, also told IPS that the name “leprosy” does not help bring patients in for consultations in health clinics.

During his 10 years working as regional coordinator of Hansen’s disease in the province of Alto Amazonas, bordering Ecuador, he witnessed numerous cases of people “hiding” from the health authorities for fear of being sent to the “leprosarium”, as some Latin American countries called these now-abolished institutions, some of which were virtually citadels.

“It was just like during the times of Christ, when lepers were banished and isolated. The same thing happened in the jungle. When I started to work, I went to visit once and there was a person who had leprosy and was shunned by his own family. They had made him a room and passed his food to him under the door,” said Domínguez, a nurse by profession.

“People’s lack of knowledge about the disease was very great,” he said.

Domínguez pointed out that in their health network they began to work on “the issue of stigma and rejection,” training doctors and nurses mainly “because there were even some who hid when they saw a patient with leprosy.”

That campaign reduced the number of reported cases of leprosy in his region from 35 or 45 a year, to between eight and 10 today.

“No matter how much awareness-raising we have done through the media, many people still get scared. Changing the terminology would help people avoid discrimination,” he said.

But above and beyond the question of terminology, Dominguez believes that research on a disease about which very little is known should be strengthened.

“Why does it affect some people more than others? Why are there so many cases in Brazil and we have so few of them, and people living along the border don’t get it?” he wondered.

“It is also important to strengthen communication, and information for the public. The treatment for Hanseniasis, which lasts six months to a year, is free, the disease is curable, and even people who already have suffered damage can mitigate it,” Custodio concluded.

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The post In Latin America, the Term Leprosy Still Carries a Burden from Biblical Times appeared first on Inter Press Service.