UK crippling Africa's healthcare

The UK is crippling sub-Saharan Africa's healthcare system by poaching its staff, UK doctors have warned.

With the UK taking over the chair of the G8 in July, there is an ideal opportunity to stop the brain drain from poor to rich countries, they said.

The UK should encourage more home-grown doctors and limit the time period that overseas recruits can train and work in the country, they told the Lancet.

Financially compensating nations for lost staff will not work, they warned.

Brain drain

Nor will strategies that split the training of healthcare staff between developed and developing countries, according to Dr John Eastwood and his colleagues from St George's Medical School in London.

Industrialised countries like America and Britain must recognise that they have some responsibility for this crisis Dr Edwin Borman of the British Medical Association

He said: "One basic measure would be an agreement in consultation, with the World Health Organization, to establish a basis in developed countries for minimum annual numbers of health professionals in training.

"This would help to reduce developed country reliance on the investment in training made by developing countries."

Ethics

The UK does have an ethical code which means it will not actively recruit from certain developing countries, which includes sub-Saharan Africa.

However, healthcare professionals from these countries are free to apply for jobs in the UK.

In 2003, 5,880 UK work permits were approved for health and medical personnel from South Africa, 2,825 from Zimbabwe, 1,510 from Nigeria and 850 from Ghana.

Nearly a third of the doctors practising in the UK were trained overseas.

In comparison, only 5% of doctors in Germany and France are not home grown.

Dr Edwin Borman, chairman of the BMA's International Committee, said: "Shortages of doctors and nurses are having a devastating effect in the developing world.

"Sub-Saharan Africa alone needs around a million more healthcare workers, and unless the situation improves drastically rates of HIV will spiral, disability from childhood disease will rise, and thousands more lives will be lost.

"Industrialised countries like America and Britain must recognise that they have some responsibility for this crisis.

"At least the UK now has an ethical recruitment code, and we hope other countries will follow suit - but we also need to remove the financial barriers we have imposed on developing countries which are preventing them from investing in basic healthcare and training."

Progress

A spokeswoman from the Department of Health said: "The NHS leads the way in the ethical recruitment of healthcare professionals.

"The Department of Health has brokered a groundbreaking voluntary ethical recruitment agreement with the major players in independent sector healthcare.

"However, if healthcare professionals are determined to come here to work we cannot legally deny them that opportunity."

She said the government had provided £560 million over the last five years to support health and health systems development in Africa, including the training of nurses and doctors.

She said they were also putting huge investment into the expansion of UK medical schools.

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/4582283.stm

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AIDS Now Compels Africa to Challenge Widows' 'Cleansing'

May 11, 2005

MCHINJI, Malawi - In the hours after James Mbewe was laid to rest three years ago, in an unmarked grave not far from here, his 23-year-old wife, Fanny, neither mourned him nor accepted visits from sympathizers. Instead, she hid in his sister's hut, hoping that the rest of her in-laws would not find her.

But they hunted her down, she said, and insisted that if she refused to exorcise her dead husband's spirit, she would be blamed every time a villager died. So she put her two small children to bed and then forced herself to have sex with James's cousin.

"I cried, remembering my husband," she said. "When he was finished, I went outside and washed myself because I was very afraid. I was so worried I would contract AIDS and die and leave my children to suffer."

Here and in a number of nearby nations including Zambia and Kenya, a husband's funeral has long concluded with a final ritual: sex between the widow and one of her husband's relatives, to break the bond with his spirit and, it is said, save her and the rest of the village from insanity or disease. Widows have long tolerated it, and traditional leaders have endorsed it, as an unchallenged tradition of rural African life.

Now AIDS is changing that. Political and tribal leaders are starting to speak out publicly against so-called sexual cleansing, condemning it as one reason H.I.V. has spread to 25 million sub-Saharan Africans, killing 2.3 million last year alone. They are being prodded by leaders of the region's fledging women's rights movement, who contend that lack of control over their sex lives is a major reason 6 in 10 of those infected in sub-Saharan Africa are women.

But change is coming slowly, village by village, hut by hut. In a region where belief in witchcraft is widespread and many women are taught from childhood not to challenge tribal leaders or the prerogatives of men, the fear of flouting tradition often outweighs even the fear of AIDS.

"It is very difficult to end something that was done for so long," said Monica Nsofu, a nurse and AIDS organizer in the Monze district in southern Zambia, about 200 miles south of the capital, Lusaka. "We learned this when we were born. People ask, Why should we change?"

In Zambia, where one out of five adults is now infected with the virus, the National AIDS Council reported in 2000 that this practice was very common. Since then, President Levy Mwanawasa has declared that forcing new widows into sex or marriage with their husband's relatives should be discouraged, and the nation's tribal chiefs have decided not to enforce either tradition, their spokesman said.

Still, a recent survey by Women and Law in Southern Africa found that in at least one-third of the country's provinces, sexual "cleansing" of widows persists, said Joyce MacMillan, who heads the organization's Zambian chapter. In some areas, the practice extends to men.

Some Defy the Risk

Even some Zambian volunteers who work to curb the spread of AIDS are reluctant to disavow the tradition. Paulina Bubala, a leader of a group of H.I.V.-positive residents near Monze, counsels schoolchildren on the dangers of AIDS. But in an interview, she said she was ambivalent about whether new widows should purify themselves by having sex with male relatives.

Her husband died of what appeared to be AIDS-related symptoms in 1996. Soon after the funeral, both Ms. Bubala and her husband's second wife covered themselves in mud for three days. Then they each bathed, stripped naked with their dead husband's nephew and rubbed their bodies against his.

Weeks later, she said, the village headman told them this cleansing ritual would not suffice. Even the stools they sat on would be considered unclean, he warned, unless they had sex with the nephew.

"We felt humiliated," Ms. Bubala said, "but there was nothing we could do to resist, because we wanted to be clean in the land of the headman."

The nephew died last year. Ms. Bubala said the cause was hunger, not AIDS. Her husband's second wife now suffers symptoms of AIDS and rarely leaves her hut. Ms. Bubala herself discovered she was infected in 2000.

But even the risk of disease does not dent Ms. Bubala's belief in the need for the ritual's protective powers. "There is no way we are going to stop this practice," she said, "because we have seen a lot of men and women who have gone mad" after spouses died.

Ms. Nsofu, the nurse and AIDS organizer, argues that it is less important to convince women like Ms. Bubala than the headmen and tribal leaders who are the custodians of tradition and gatekeepers to change.

"We are telling them, 'If you continue this practice, you won't have any people left in your village,' " she said. She cites people, like herself, who have refused to be cleansed and yet seem perfectly sane. Sixteen years after her husband died, she argues, "I am still me." Ms. Nsofu said she suggested to tribal leaders that sexual cleansing most likely sprang not from fears about the vengeance of spirits, but from the lust of men who coveted their relatives' wives. She proposes substituting other rituals to protect against dead spirits, like chanting and jumping back and forth over the grave or over a cow.

Headman Is a Firm Believer

Like their counterparts in Zambia, Malawi's health authorities have spoken out against forcing widows into sex or marriage. But in the village of Ndanga, about 90 minutes from the nation's largest city, Blantyre, many remain unconvinced.

Evance Joseph Fundi, Ndanga's 40-year-old headman, is courteous, quiet-spoken and a firm believer in upholding the tradition. While some widows sleep with male relatives, he said, others ask him to summon one of the several appointed village cleansers. In the native language of Chewa, those men are known as fisis or hyenas because they are supposed to operate in stealth and at night.

Mr. Fundi said one of them died recently, probably of AIDS. Still, he said with a charming smile, "We can not abandon this because it has been for generations."

Since 1953, Amos Machika Schisoni has served as the principal village cleanser. He is uncertain of his age and it is not easily guessed at. His hair is grizzled but his arms are sinewy and his legs muscled. His hut of mud bricks, set about 50 yards from a graveyard, is even more isolated than most in a village of far-flung huts separated by towering weeds and linked by dirt paths.

What Tradition Dictates

He and the headman like to joke about the sexual demands placed upon a cleanser like Mr. Schisoni, who already has three wives. He said tradition dictates that he sleep with the widow, then with each of his own wives, and then again with the widow, all in one night. Mr. Schisoni said that the previous headman chose him for his sexual prowess after he had impregnated three wives in quick succession.

Now, Mr. Schisoni, said he continues his role out of duty more than pleasure. Uncleansed widows suffer swollen limbs and are not free to remarry, he said. "If we don't do it, the widow will develop the swelling syndrome, get diarrhea and die and her children will get sick and die," he said, sitting under an awning of drying tobacco leaves. "The women who do this do not die."

His wives support his work, he said, because they like the income: a chicken for each cleansing session. He insisted that he cannot wear a condom because "this will provoke some other unknown spirit." He is equally adamant in refusing an H.I.V. test. "I have never done it and I don't intend to do it," he said.

To protect himself, he said, he avoids widows who are clearly quite sick . Told that even widows who look perfectly healthy can transmit the virus, Mr. Schisoni shook his head. "I don't believe this," he said. At the traditional family council after James Mbewe was killed in a truck accident in August 2002, Fanny Mbewe's mother and brothers objected to a cleanser, saying the risk of AIDS was too great. But Ms. Mbewe's in-laws insisted, she said. If a villager so much as dreamed of her husband, they told her, the family would be blamed for allowing his spirit to haunt their community on the Malawi-Zambia border.

Her husband's cousin, to whom she refers only as Loimbani, showed up at her hut at 9 o'clock at night after the burial.

"I was hiding my private parts," she said in an interview in the office of Women's Voice, a Malawian human rights group. "You want to have a liking for a man to have sex, not to have someone force you. But I had no choice, knowing the whole village was against me."

Loimbani, she said, was blasé. "He said: 'Why are you running away? You know this is our culture. If I want, I could even make you my second wife."

He did not. He left her only with the fear that she will die of the virus and that her children, now 8 and 10, will become orphans. She said she is too fearful to take an H.I.V. test.

"I wish such things would change," she said.

Author: SHARON LaFRANIERE
New York Times

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OPINION - ROBERT MUGABE, PRESIDENT OF ZIMBABWE
By Jerry Okungu in Nairobi, Kenya

As an African who grew up during the struggle for liberation of many modern states in Africa, it may not be easy for me to discuss Robert Mugabe in the context of his current political inclination and his relationship with powerful western nations like the United States of America and Britain.

If Idid that I would be missing the point and missing out on the big picture all together.

For starters, which Mugabe are we talking about here? Mugabe the freedom fighter, the statesman of his earlier years as a renowned articulate African spokesman or an ageing and ailing Mugabe who rediscovered his revolutionary streak to revolt against neocolonialism in his twilight years?

Let us look at the old and much maligned Mugabe in the context of Tony Blair and George Bush, his most outspoken critics. What do the duo criticize him for? That he has disenfranchised white farmers in Zimbabwe by repossessing tracks and tracks of their land for redistribution to black Zimbabweans. The other charge is that Mugade is an undemocratic tyrant who has repeatedly rigged the elections against the more 'credible' opponents in the eyes of the Western powers.

Let us take the first accusation that he has grabbed white men's farms and given them to his fellow freedom fighters. If my memory does not fail me, the struggle for liberation in Zimbabwe, like Kenya and other British colonies in Africa before it was a struggle to liberate the native and get back land forcibly acquired by the colonial master.

Africans in Zimbabwe, like in Kenya hated the fact that they had to squat in their own ancestral lands just because some white foreigners with guns came and displaced them and turned into farm slaves for a daily loaf of bread.

This colonial strong man mentality did not manifest itself in Africa alone. Indigenous Americans, commonly referred to as the Red Indians, the Asian Sub Continent and the Aborigines of Australia suffered the same fate.

The John Wayne Macho Man syndrome that drove the colonialist to massacre and burn rebellious villagers in the name of new order and new wealth exploitation.

If Mugabe finally forced Ian Smith out of the Unilateral Declaration of Independence(UDI) of Southern Rhdesia and finally forced the then toothless British government to come to the negotiating table, the mere fact that he did not get everything he wanted was no excuse to stop pursuing the ultimate goal for which millions of Zimbbweans lost their lives in the firsat place

In Kenya, the land issue was so lethal that it forced the British government to lend Jomo Kenyatta cash so that Kenyatta could buy White farms for distribution to the landless peasants. For Zimbawe not even this token arrangement was made.

On the issue of Mugabe being branded a tyrant, who is not a tyrant in this day and age? Haven't the Israelis been killing Palestinians in their own homeland for nearly sixty years? Didn't George Bush and Tony Blair lie to the world that Saddam had weapons of Mass Destruction and used terror and firepower to massacre thousands of Iraqis?

Who rigged the elections in Florida in 2000? Was it not George Bush and his Governor brother? A day after the bombing of the Twin Towers in New York and the Pentagon was a blaze with remnants of the previous event, who was dining out a Saudi Diplomat and Osama Bin Laden's cousin on the veranda's of the White House?

Mugabe may be a tyrant and a despot, but where white tyranny has passed by, nothing is left standing! Better the devil you know, than the angel you are not sure of.

Jerry Okungu - Executive director of Infotrack, marketing and media consultants - Nairobi, Kenya.

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Kenya's First Lady Runs Amok!

First Lady disrupts Diop's party
Story by JOHN MUCHIRI and PHILIP MWANIKI
Publication Date: 05/01/2005
Source: http://www.nationmedia.com/dailynation/nmgcontententry.asp?category_id=1&newsid=48098

First Lady Lucy Kibaki



First Lady Lucy Kibaki dramatically disrupted a farewell party at the Nairobi home of outgoing World Bank country director Makhtar Diop on Friday night.

An angry Mrs Kibaki invaded the house demanding that the loud music be switched off.

At that time musicians Mercy Myra, Eric Wainaina and Suzanne Kibukosya were on stage entertaining the guests.

A confrontation ensued as Mrs Kibaki engaged Mr Diop and his wife in an angry exchange.

At one time she told Mr Diop that no man in Kenya has dared talk back to her.

Mr Diop, who leaves the country today, is a tenant of the Kibakis in the exclusive Muthaiga neighbourhood.

He rented the house lived in by the First Family for many years until President Kibaki was elected and moved to State House.

The family built another house in an adjacent plot where the First Lady sometimes stays.

Mrs Kibaki was protesting that the music was too loud. First signs that there might be trouble were seen in the afternoon when technicians and musicians were setting up and testing the sound system. Mrs Kibaki came over and ordered them to dismantle everything.

They only resumed after Mr Diop consulted State House and told them to proceed. Then at night when the party was getting into full swing, Mrs Kibaki stormed in accompanied by bodyguards, demanding that the music be switched off.

Singer Eric Wainaina recalls: "I was still on stage preparing to do my second song when she turned up. She had like five bodyguards and ordered the music to be stopped from playing. It was so embarrassing since she is the First Lady and even diplomats had been invited.

"She could not listen to anyone, not even to Mr Diop himself. In fact she started asking irrelevant questions such as ‘who is your mother?’ It was so bad. What she was wearing was not very clear to me, but it looked more like some blue track suit or pyjamas."

Mercy Myra concurred, telling her version of the same incident, and recalling how Mrs Kibaki came in at around midnight yelling at the guests to leave.

"She shouted at Mr Diop that he would not be allowed to disrupt her peace just because he is leaving the country," Mercy said.

Some of those present witnessed Mrs Kibaki trying to unplug the music system and shouting that "This is Muthaiga, not Korogocho".

She told the guests that they could go and continue their party in Korogocho, one of Nairobi's biggest slums.

She paid no heed to Mr Diop's explanations, even as the World Bank executive tried to tell her that he had informed President Kibaki about the party, and the president had no problem with it.

Mrs Kibaki came to the residence three times, ignoring angry party goers who started singing in defiance. On her last call at around 1.00am, she was denied entry by the security guards and went away.

Two of her children, Judy and David, were present at the party and tried to calm down their mother without success.

Mr Diop is an amateur musician and jazz enthusiast and often joins jam sessions, with his bass guitar, at various city clubs.

His farewell party had been billed a "wild" affair and guests included various local musicians and other celebrities, as well as World Bank staff, diplomats and NGO staff. A few government officials were also present, including Investment Secretary Esther Koimet.

Many of the guests are regular patrons of Club Sikiliza at Gigiri area where Mr Diop plays the guitar.

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Listening for the Sounds of Africa

In my youth I used to listen to shortwave news in the evening when reception was best. I would get updates via the BBC, Swiss and Austrian Stations, Radio Moscow and, of course, various German stations; all of them putting me in touch with the world both near and far. Oh-- I almost forgot, there was the AFN Network, the US Armed Forces Radio in Germany, and even though I did not speak English at the time, I enjoyed listening to the music they played!

In those days, I would be resting in my bed, listening to hours of news via shortwave radio, especially when I came down with scarlet fever and was confined to my room for months. It was then that I learned something of the art of listening to the news and just letting it soak in, making mental notes; taking in history as it was being made. I became a news buff and today I am an avowed newsaholic, especially regarding news from Africa.

Before the Internet, my favorite news source was the shortwave radio stations from around the world. I was always on the lookout for a better Grundig Shortwave Radio that would put me in touch with news that one could not hear or read locally.

When I went to Africa, my Grundig radios came along (three left my suitcase in a mysterious manner at Jomo Kenyatta Airport). I would spend many a night in Nairobi, Kampala, and Kigali, or at the UN camp in Lokichoggio underneath a clear African night listening to BBC or Voice of America, Deutsche Welle, or some other far off place that brought news from afar and often about the very place where I was at that moment in time.

Nowhere else in the world did I find a deeper interest for the latest news as amongst the Southern Sudanese. Everyone, who was someone, had a shortwave receiver. Morning coffee, showers, breakfast, all accompanied by BBC World Service bringing the latest updates from around the world, Africa and including what was happening in the Sudan.

I am still listening to radio from far away, but now I do it via high speed Internet access allowing me to listen to radio programs about Africa or from Africa. The sounds are great! On BBC I can listen to musical presentations from Kampala, or a play written by a retired man in Nigeria. It is a far cry from my scratchy Grundig reception but times are changing. Today I can listen to the sounds of Africa while sitting at my computer or in my bed with my laptop, reminding me of those early days of my news addiction. It is a delight to hear the ideas and input of Kenyan, Ugandans, Ethiopians, all while sitting near my computer or simply doing my chores and hearing some new song with a haunting melody that reminds me of driving through the majestic Rift Valley of Kenya, or coming down toward Lake Victoria from the Highlands.

It is good to listen to African sounds, African voices, and African ideas. Maybe, just maybe, all those who want to "fix" Africa and its problems, maybe all those with their so-called "solutions," have not been listening to Africa and its people.
Just recently, Sir Bob Geldof, of Live Aid Africa fame, made some comments about why President Museveni should not run for a third term. Geldof said that his admiration for Mr. Museveni's fight against poverty and Aids had now been lost.

"Get a grip Museveni. Your time is up, go away," Geldof said at the launch of the Commission for Africa Report, which is supposed to map out how best to raise living standards in Africa.

Ugandans took offense and thousands protested Sir Geldof in the streets of Kampala and rightfully so. It seems that most of the time the West comes with "Father knows best" advice, but does not take the time and effort to listen. After all, the Western mindset assumes that Africa had no history until the colonial powers came to enlighten the uncivilized savages of the continent by bringing "civilization." It would be quite a shock for many of those so-called discoverers to discover that the oldest human beings have been found in East Africa and that history started in Africa.

As European nations colonized Africa, anything African was considered inferior to European ways. Some used religion to subjugate the African people causing Jomo Kenyatta, the first President of Kenya to say, "The missionaries came with the Bible in their hand and we had the land. They taught us to pray with our eyes closed, and then when we opened them, we had the Bible in our hand and they had the land." (One will not encounter many atheists in sub-Sahara Africa. Africans have embraced Islam and Christianity. In fact, African Christian Churches are now evangelizing the West by starting churches in the USA and Europe.)

If one looked more closely, when those early explorers, missionaries and merchants set foot on Africa, there was not just a loss of land. A greater loss had begun much earlier to the Mid-East and East, but the Europeans used Africa as their manpower resource to staff their plantations in the new world of North and South America with African slaves. The nations of the Caribbean and the Americas imported millions of slaves from all over Africa, causing a people drain the world had never seen before or since. Africa not only lost millions of its people to the slave trade, people from many different tribes and kingdoms, that had existed for centuries before, but Africa lost with its people, its heart and soul, its self-respect. Africa was subjugated by other powers at home and abroad from Charleston South Carolina to Rio de Janeiro. No one listened to the cries of Africa for years to come, Africa cried from its soul, but its cries were ignored.

If you look at how the present states of Africa came into being, many of the present problems have to do with the way the map was drawn at a table in Berlin far from Africa. Far from the tribes and kingdoms such lines would separate, far from the families that were now part of different nations. Certainly no one was listening to Africa back then.

As I write this newsletter, Tony Blair's Commission on Africa is publishing another European report on Africa. A lot of good things have been said and written by Africans and non-Africans alike, yet if you would ask people on the streets of Africa, you would find a bit of skepticism. They have seen many important people come to Africa to write reports, take pictures, give interviews and fly back home without listening to the average person on the streets of Africa's cities.

Africa will not change, unless one listens to Africa, listens to what is really needed instead of our Western solutions based on a world model that does not take Africa's needs, resources, and of course its people into consideration.

When one listens to Africa, one hears that the world needs to buy the products of Africa at a fair price, eliminate Western subsidies to American, European, Canadian farmers in order that the African farmers who receive no subsidies can compete in the world market on a level playing field.

I pray for the day that the riches of Africa's earth will no longer be extracted by foreign companies and processed in the West or East. I hope for the day that African leaders will no longer take out the billions of dollars and put them into Western banks, but instead take that money and invest it in Africa s schools, industries, factories, and its people and their well-being.

Africa does not need Western pity, but Western respect. Change in Africa will take time. It has taken the West many years and a few wars to live in peace; it will take a few more years in Africa. Changes are taking place on a daily basis in Africa. Democratic elections are taking place everywhere, we only read about those things that go sour. The cell phone is revolutionizing Africa. Farmers are using it to check on the present prices of their crops, people are staying in touch. Email at the Internet cafes of Africa is keeping Africans in touch with relatives; the wealth of the Internet comes to Africa through those screens throughout the larger cities in Africa.

Countries like Uganda are prospering with an annual growth rate of over 6 percent. New shopping centers are popping up yearly and the Ugandan middle class has choices. Africa is changing from within.

Africa is reclaiming its soul, decolonizing its heart and mind, and the day will come when Mother Africa will be made of nations that are listened to and have the respect as an equal at the global table. I hope I live to see that day.

Today I listen to the sounds and happenings in Africa from a distance, I listen to the heart of Africa via the letters I receive, the news I read, the literature of African writers, and I like what I hear, I enjoy listening to Africa. Try listening to Africa; it might give you a whole new perspective as to what Mother Africa is really like.

Author: Jon Blanc - Jon owns and runs Kabiza.com. Jon's site presents Africa in a balanced, un-biased and optimistic style. His website is not so much about the scenic wonders and wildlife, but about the heart of Africa & its people. Click here to enjoy Kabiza.com

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