Photo of the week

English Version

One of the recent experiences I have had is that of visiting Togo as part of work done with the International Federation of the Red Cross. From this trip I would like to about a young woman of 25, named Samiétou.

She was visiting a midwife at Sokode polyclinique, in a region of Togo called Centrale. Samiétou, a mother of two children, is now 5 months pregnant, however this visit was her first prenatal visit. She is well aware of the importance of these visits for her health and that of her baby.

So why did it take 5 monhs for Samiétou to come to the clinic ?

The answer is very simple : 1500 CFA + 4800 CFA =6300… 6300 CFA (about 15 USD).It took 5 months for Samiétou to be able to collect the necessary amount to come to the visit. Infact not quite.. By this visit Samiétou only had 1500 CFA which will pay for her to obtain the pregnancy book. By coming to this visit she will also get a full diagnostic and will receive free preventive treatment against malaria. If she is willing an HIV/AIDS test also (photo).But in order to do the full blood tests required for a pregnant woman for a pregnancy check up she will have to find the 4800 CFA. This is clearly difficult since it took her 5 months to collect the 1500 CFA for the book. So for the 4800…………...

Samiétou doesn’t have an income and fully depends on her husband small income. She will have to convince him to find the money when she returns home. The midwife, Amèyo will play the intermediary between Samiétou and her husband and try to persuade him to find and give her the money as well as come for an HIV/AIDS test himself. Of course the expenses of this couple won’t stop here, Samiétou will have to pay for the delivery of the baby at this clinic.

In the developed world, we are living in a system where access to care and health is almost universal. In a majority of countries in Africa, if you are lucky enough to live not too far from a health center or a clinic, you still have major obstacles. Currently there are ongoing discussions on the idea of making people pay for goods like mosquito nets or drugs in extremely poor countries, to apparently “make people responsible, to teach them that what they buy has a value so they should take good care of it” . For me it would always be better to be alive and not fully responsible, than dead because one had no means to save enough to buy a needed drug.

Version Française

Une de mes récentes expérience, pour un travail pour la Féderation Internationale de la Croix Rouge m’a amené au Togo. De ce voyage je vais vous parler de d’une jeune femme de 25 ans, Samiétou. Elle venait consulter la sage femme de la polyclinique de Sokode, dans la region Centrale du Togo Samietou, mère de deux enfants, est enceinte de 5 mois et pourtant il s’agit de sa première visite prénatale. Elle connaît l’importance de ces visites pour sa santé et la santé de son enfant.

Alors pourquoi Samietou a attendu 5 longs mois pour venir à la clinique ?

La réponse est simple : 1500+4800=6300… 6300 francs CFA (environ 10 euros). Il a fallu 5 mois à Samiétou pour récolter la somme necessaire pour venir à la consultation…enfin pas tout a fait. Pour l’instant Samiétou à réussi à réunir 1500 CFA qui lui permettent d’acheter le carnet de suivi de grossesse. En venant à la consultation, elle sera examinée et recevra gratuitement un traitement préventif contre le paludisme. Si elle le souhaite, un test VIH pourra également être effectué gratuitement (cf photo). Mais pour pouvoir effectuer les tests sanguins (bilan de grossesse), Samietou va devoir trouver 4800 CFA. Il lui a fallu 5 mois pour récolter 1500 CFA..donc pour 4800 CFA…

Samiétou n’a pas de salaire ou de rentrée d’argent. Elle dépend de son mari, et elle devra le persuader de trouver cet argent en rentrant chez elle. Amèyo, la sage femme jouera le rôle d’intermediaire entre elle et son mari, afin de le persuader de donner cet argent et d’effectuer lui-même un test de depistage VIH. Bien sur, les dépenses de ce couple ne s’arrétent pas la car Samiétou devra également payer une somme conséquente pour accoucher si elle veut le faire à la clinique.

Nous vivons dans un système ou l’accès aux soins est quasiment universel. Dans une majorité de pays d’Afrique quand on a la chance d’avoir un centre de santé ou une clinique pas trop loin de chez soi, il faut encore passer la deuxieme barriere qui est de savoir comment payer. Il y a beaucoup de discussions sur le fait de faire payer les gens pour ds choses comme les moustiquaires ou encore les medicaments soit disant afin de « les responsabiliser, leur faire comprendre que parce qu’ils achetent quelque chose ça a de la valeur. » Pour moi il vaudra toujours mieux être vivant et un peu moins responsable que mort parce qu’on a pas pu se payer le medicament necessaire.

ENGLISH (French version at the bottom)

This month I would like to talk to you about my experience in Chad. I visited the East of Chad for 20 days in June. I felt the situation in this region to be dramatic, especially in terms of health. The East of Chad is hosting about 200 000 refugees coming from the region of Darfour. In addition there are about more than 170 000 displaced people living in camps created to support them. Most of these people left running away from attacks on their villages, they have left their houses, they have nothing and have walked many days to get into the camps.

This displacement of people has had a huge impact on the lives of the people displaced but also in the lives of the local people. The camps are usually linked to an existing village, some of these villages have seen the number of people linked to them multiplied by hundreds or more. This places an additional strain on water resources, wood for cooking the food and the local fields for agriculture…

Humanitarian aid is now operating in the region, but it is not enough and can’t solve all the problems. For example trees are a scanty resource and currently humanitarian aid does not focus on this. The scarcity of trees, means less wood, which means, no fire, which means more and more people are unable to cook their food, boil their water and thus have no access to clean water. The World Health Organisation recommends 20 litres of water per person per day as the minimum requirement. For these refugees and displaced people 10 litres per day per person is all that is possible. Non governmental organizations like MSF and OXFAM Great Britain, are also trying to fill the gaps by providing water tanks but the need remains.

The result of this is that people keep going to get water from the rivers, which mainly consist of brown coloured water, filled with germs which are responsible for many diseases, such as diarrhea and hepatitis E . Health workers have seen a dramatic rise of these diseases in the camps. This brings another dynamic, to the question of curing diseases, “How can this be done when the basic elements are not available”. I have visited health centers where patients were taking their drugs drinking them with brown water, even at the health centre.

Access to health centers is also a subject for major concern, nationally. Some of the health centers are in charge of villages situated more than 70kms away, posing a big problem for a sick person with no transport to be expected to make it alive to receive care 70 kms away. One could buy all the drugs, fill the health centers with them…if people don’t have access to them they will carry on dying.

Maybe we should try to think more towards solutions based on basic training for the people living in the communities to be able to have an effective and quick response to some of the basic health problems - which if neglected for too long - can be fatal. The solutions also come with real political will to invest in community based solutions. There is no doubt that the camps are an emergency and require urgent support but this has to happen to while investing in the basics that communities need. This I believe will bring more long lasting solutions.

FRANCAIS

Ce mois-ci j’ai décidé de vous parler de mon expérience au Tchad. Je me suis rendu pendant 20 jours dans l’est du Tchad au mois de Juin. La situation dans cette région, specialement au niveau sanitaire, est dramatique. L’Est du Tchad accueille près de 200 000 réfugiés soudanais ayant fui le Darfour, et maintenant plus de 170 000 personnes déplacées. Ces personnes déplacées sont des tchadiens ayant fui les violences perpétrées dans leur villages. Nombres d’entre eux sont parti sans rien et ont du marcher des jours pour rejoindre des camps de fortunes.

Ces déplacements de populations ont un impact énorme sur la vie des personnes déplacées mais aussi des personnes locales. En effets les camps de déplacés se rattachent très souvent à des villages existant. Certains villages qui ne comptaient que quelques centaines d’habitants ont vu leur nombre multiplié par cent, voire plus. Les ressources en eau, en bois de chauffage pour faire cuire les aliments (et l’eau si elle ne vient pas d’une pompe), les ressources agricoles…

Bien sur l’aide humanitaire dans ces régions est maintenant en place, mais elle ne suffit pas et ne peut régler tous les problèmes. L’aide humanitaire ne fait pas repousser les arbres, et pourtant ceux-ci commence à réellement manquer dans certaines régions. Qui dit pas d’arbre, dit pas de feu. Pas de feu, veut dire impossibilité de faire chauffer les aliments. Qui dit pas de feu dit impossibilité de faire bouillir l’eau…etc..

L’eau, qui est un des éléments fondamentaux de la santé, est une denrée rare. De nombreux forrages ont été éffectués pour répondre à l’urgence mais ce n’est pas encore assez. 10 litres d’eau par kour et par personnes sont distribués, alors que 20 litres seraient le minimum necessaire. Des ONG comme MSF et OXFAM GB tentent de combler le manque en distribuant de l’eau avec des camions citernes mais le manque reste flagrant. Le résultat de ce manque est que les populations continuent de puiser l’eau des rivières. Une eau marron et porteuse de nombreux germes. Dans les camps les cas de diahrrées et d’hépatite E ne se comptent plus. Comment peut-on espérer combattre les maladies si l’accès au éléments vitaux n’est pas possible ou respecté. J’ai visité des centres de santé ou les patients prenaient leur médiacaments en buvant cette eau marron à l’intérieur même du centre de santé. Les centres de santés, l’autre énorme problème de cette région (problème national d’ailleurs). Certains centres de santé regroupent des villages situés a plus de 70km. Comment peut-on espérer qu’une personne malade puisse venir se faire soigner dans un centre de santé situé si loin de son domicile. On pourra mettre tous les médiacaments necessaire pour soigner toutes les maladies du monde dans ce centre de santé…si les gens n’y ont pas accès ils continueront de mourir. Peut être faudrait il entrevoir une solution plus dirigée vers la formation basique de personnes habitant dans les communautés, qui permettrait un suivi des populations et une action plus rapide en cas de probleme.

Pour moi, l’état d’urgence (plus que légitime) ne doit pas faire oublier que les solutions locales au sein des communautés sont souvent les meilleurs fondements pour des actions plus larges et avec une durée de vie plus longue.

English version after the french version

551.003.880 CFA soit 840.000 Euros.

C'est la somme que l'Etat français via son service de coopération à dépensé pour aider à financer la construction d'une "Académie des Arts Martiaux" à Niamey au Niger et cela pour, soi disant, les besoins des jeux de la Francophonie. Chouette, doivent se dire les nigériens, maintenant on peut mourrir de faim mais au moins on peut faire du karaté.

Pourquoi? Pourquoi de tel agissement sont encore possible? Comment peut on laisser le gouvernement français dépenser l'argent public de la sorte. Le Niger est le pays le plus pauvre du monde, l'espérance de vie est l'une des plus faible du monde, des enfants meurent par milliers tous les jours faute d'accès aux soins à l'eau ou à de la nourriture. Et qu'est ce que le gouvernement français trouve de mieux à faire? Dépenser 840.000 euros dans la construction d'une "Académie des Arts Martiaux", qui depuis ces Jeux de la Francophonie n'a quasiment jamais été utilisée et n'est pas accessible au public.

Petit rappel de ce que représente 840.000 euros:

276.614 moustiquaires imprégnées.

1.005.869 doses de traitements antipaludéen à base d'artémésinine

110.645 traitements de 6 mois contre la tuberculose

79.039 années de préservatifs (moyenne des pays en voie de developpement)

2.235 microscopes

35.000 kgs de viande

700.000 kgs de pommes

...

Alors pourquoi? Pourquoi ne pas avoir utilisé des structures existantes pour le déroulement de ces jeux, et utiliser cet argent à des fins plus utiles. La colonisation n'est pas morte. Ce genre de comportement, lache et irresponsable demontre bien la non volonté des états du Nord quand à la résolution des problèmes africains. Plus un pays est pauvre, plus il est facile à controler.

L'année dernière j'ai visité un service de l'hôpital principal de Niamey, le service ou l'on traite les cas de malnutrition, de paludisme sevère ainsi que les enfants prématurés. La photo de cette semaine à été prise dans ce service. Pas de climatisation (au mois de mai la température moyenne de Niamey est de 45° C à l'ombre), des chambres surpeuplées, une hygiène inexistante comme le matériel (pas de couveuse pour les prématurés, la seule qu'ils avait est en panne et non réparée faute de moyens, pas de moustiquaires...) c'est ça l'hôpital pour les enfants au Niger, mais maintenant au moins si ils survivent assez longtemps il pourront peut être aller faire du karaté à "L'académie des Arts Martiaux" si gracieusement financée par la France.

Le choix est pourtant simple, sauver des milliers de vies ou permettrent à 10 personnes de faire du karaté ou du judo pendant 1 semaine.

Comble de l'ignorance le sport roi au Niger est la lutte traditionnelle. Elle se déroule en extérieur et dans le sable.

...consternant.

""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""

ENGLISH VERSION

551.003.880 CFA or 840.000 Euros

That is the amount of money the French government through its Coopération Department spent to help finance the building of a « Martial Arts Academy » in Niamey, Niger. This building was apparently for the Francophone games organized in Niger, December 2006. “Great!” The people of Niger must have thought. “We can die of hunger but at least we can play some karate before”. Why? Why such actions are still possible? How can we let the French government spend public money like this? Niger is the poorest country in the world. Life expectancy is one of the lowest in the world and thousands of children are dying because they don’t have any access to health care, to water or to food. And instead what does the French government decide to do? Spend 840.000 euros to build a « Martial Arts Academy » which, since the games has almost never been used and is not accessible to the public.

Just a little reminder of what represents 840.000 euros:

256.614 long lasting treated bed nets.

1.005.869 ACT doses against malaria

110.645 6 month treatments against tuberculosis

79.039 years of condom (in average across developing countries)

336 incubators (when you know that even the national hospital doesn’t have one)

2.235 microscopes

35.000 kgs of meat

700.000 kgs of apples

...

The list could be endless….

Why did they not use existing buildings and structures for these gamesand use the money for a more useful end. Colonisation is not dead. This kind of irresponsible behaviour shows the non willingness of the Northern countries when it comes to investing in things that could help support African countries.

Last year, I visited some parts of Niamey’s National Hospital including where they are taking care of malnutrition problems, malaria cases and premature babies. The photo of this week was taken in one of these rooms. The rooms had no bed-nets, no air conditioning (in May the average temperature in Niamey is 45° C in the shade), they were over-crowed, unhygienic and lacked the necessary equipment. For instance there were no incubators for premature babies, except for 1 malfunctioning one which could not be fixed due to lack of funds. (a new incubator costs 2500 euros). That’s what is a hospital for the children of Niger, but at least now, those who will survive know that they will be able to do karate in the « Martial Arts Academy » financed by the French public.

The choice is simple, save thousands of lives or allow 10 people to play Karate or Judo for a week…my choice is done

On top of that a simple matter was missed, the national sport in Niger is the traditional fight, which takes place outside and in the sand…

Concerning…

This week, i've chosen a picture taken in Bobo-Dioulasso in Burkina Faso. Burkina Faso is one of the enclaved country of West Africa. People from Burkina don't have any access to the ocean, which means of course that they are very dependant on the road and train traffic coming from the countries that have access to the sea. The train on the picture does the trip between Abidjan (Capital of Ivory Coast) to Ouagadougou (capital of Burkina Faso). 1200 kms from the coast of Ivory coast to Ouagadougou in approximativly 27 hours... The train is the only one linking these to country and one of the only one in all of the subregion. During the crisis in Ivory Coast the train line has been closed. This has been an economical catastrophy for many people, from the ones selling fruits and food through the windows at each stops which was representing a real economy and a leaving business for thousands of familly along the railway, to the people that are running a business in Burkina needing to get what they shipped through the port of Abidjan. Even the people from Niger suffered from this closing as the ones leaving not far from the border were also benefiting from the railway. Before the crisis the port of Abidjan was the central point for all the equipment, merchandises and food coming from overseas. With the crisis, and almost all the roads closed, this traffic went dramatically down forcing the people to find another place to ship their goods.. Cotonou (Benin), and Accra (Ghana) became the new places for the boat traffic, but there is no railway from Brukina Faso to these two towns..and for Accra, people have even now to deal their business in English! On top of that, since the railway company has been bought by the french company Bolloré the prices of the tickets went dramatically up. Luckily the traffic is back on the line between Abidjan and Ouagadougou, but it seems to stop everytime the tension is going up and the activity that was going on along the railway is far from being back... That really shows how linked and interdependant these countries are and how important that they stay politicaly stable, otherwise it's not only the country itself that suffers but the whole region.

I have just came back from the AIDS Conference in Toronto. This week has been amazing and very educational. I will present some of the people i met in next week's blog. But this week i would like to focus on an experience that happened to me on my way back from Toronto and that must have happened to many of the delegations and communities that came to Toronto. Air Canada has been comunicating on the last month on the fact that they were key partners and supportive of the AIDS conference. I was checking in the presentation boards from the exhibitions of the AIDS conference that i was kindly bringing back to Geneva on behalf of another orgznisation in addition to my own luggage. Air Canada made me pay USD 350 as each passeneger was not allowed more than two pieces regardless of weight, which was 3/4 kgs each. Many people who came from their countries to present on their work in their communities would be faced witht the same challenge as they return their exhibitions.

All week i have been hearing about the lack of political will and the lack of commitment. Air Canada was very pleased to annonced their so called "support" to the AIDS conference. These two boards were brought to the Roll Back Malaria booth to educate and to do advocacy on the impact of malaria on people living with HIV/AIDS. Maybe not a big deal, Roll Back Malaria should be able to afford this extra cost. But what about all these delegations and communities that surely don't have the same financial power. What about the idea that this 350 USD represents more than 200 hundred treatments that could cure malaria and save lives. More than 200 children could have been saved with this 350 USD. So i am kind of wondering what kind of support and partnership companies like Air Canada are developing. They should feel ashamed and stop pretending to support causes that they don't care about.