PREAMBLE: This issue draws attention to the apparent disregard for nuclear safeguards recently revealed by Canada’s “new” government. The minority Conservative government’s failure to respect the role of the Canadian Nuclear Safety Commission puts into question whether Canada takes nuclear safety seriously. For a synopsis of this episode, we paraphrased and updated the core content of a January 2008 article in The Star by Walkom (acknowledged below). Further down, we summarize a report from the Canadian Medical Association Journal that reveals the manipulative attitude of the Canadian medical isotope industry, paraphrased from a CTV News report. The main story is how Canada’s government put politics ahead of public health and safety. Clearly there are questionable commercial and political practices in Canada at present.
For late breaking news on this story, visit our sidebar.
CANADA’S AND NUCLEAR SAFETY – FIRE THE MESSENGER!
OTTAWA Jan 17, 2008: Doubts have been raised among experts around the world about Canada's ability to effectively regulate reactors, uranium mines, fuel manufacturers and other potentially dangerous installations. This is because Prime Minister Stephen Harper says that his Conservative government fired the country's top nuclear regulator for not doing her job. However, to the contrary, the evidence reveals that Canadian Nuclear Safety Commission (CNSC) head Linda Keen was fired because she was doing her job. As specified in the Nuclear Safety and Control Act, this was to ensure that radioactive material is created and used safely.
Two years ago, CNSC renewed Atomic Energy of Canada Ltd.'s (AECL) operating licence for a reactor at Chalk River (Ontario) that produces medical isotopes. As a condition of licensing, AECL was required to upgrade safety systems on the 50-year-old reactor by installing two new pumps. During a routine inspection in November 2007, inspectors found that the pumps had not been installed. CNSC shut the reactor down so that AECL would comply with its order.
Then media stories began to appear suggesting that Canada faced a severe isotope shortage that could lead to some medical tests and treatments being delayed. This promptly became a cause celebre for federal politicians seeking to make political hay of the regulatory agency. However, despite some local isotope shortages (that could have been averted by better federal-provincial health service planning) there is no record of anyone's health being harmed during this “crisis”. By the time politicians inserted themselves, AECL had already installed one of the pumps and was readying the second. On December 11, an AECL official told the House of Commons that the necessary safety upgrades could be completed with just 16 more days of reactor down time. Shortly after, Prime Minister Stephen Harper accepted the resignation of Michael Burns, chair of AECL (a heavily subsidized but under-funded Crown corporation), effective Dec 31.
The government's “case” against the regulatory agency, articulated by Natural Resources Minister Gary Lunn at a Commons committee (January 16), is that it was Keen's job to get Chalk River up and running. In fact, as the minister responsible for AECL, that task belonged to him. Lunn's additional “arguments” also make little sense. He characterized AECL's failure to meet the CNSC safety standards as a "dispute" between two agencies – which is rather like suggesting that someone who breaks the law is having a "dispute" with the judge! He also insisted the issue was one of "licensing" rather than safety, even though the rationale for licensing a reactor is to ensure its safe operation! And he made the disturbing claim, not reflected in law, that the government has the right to fire any head of the regulatory commission at will and without cause even though this would render impotent CNSC as a quasi-judicial commission that has its own legal mandate for good reason.
The game being played by Harper’s Conservatives is highly questionable. Green Leader Elizabeth May is probably close to the truth when she says he is trying to defang the regulatory watchdog at the behest of Canada's nuclear industry.
Source: Adapted from Thomas Walkom. The Star. Jan 17, 2008. http://www.thestar.com/News/Canada/article/294886
HOW CANADA COULD HAVE AVOIDED THE ISOTOPE "CRISIS"
CTV NEWS: Canada could have avoided the alleged isotope “crisis” if Canadian supplier MDS Nordion had joined international efforts to co-ordinate global production, a report in the Canadian Medical Association Journal (CMAJ) says. This states that MDS Nordion wouldn't co-operate with Europe's two large isotope suppliers (Nuclear Research and Consultancy Group in the Netherlands, and the Institut National des Radioelements in Belgium). These suppliers share concerns about safety and distribution, and co-ordinate production schedules to ensure one reactor is always running. They also communicate with another isotope supplier, Nuclear Technology Products in South Africa but apparently can't pry information out of MDS Nordion, which provides about half the world's supply, made at AECL’s Chalk River reactor.
Kevin Charlton of the Netherlands' Nuclear Research and Consultancy Group told CMAJ that "Nordion is represented at our meetings. (But) either AECL doesn't tell Nordion or they don't allow Nordion to tell us.'' The CMAJ article says Nordion did not grant an interview for the piece, but quoted an e-mail message in which Nordion said it was "focused and committed to providing medical isotopes to the medical community." Neither AECL or MDS Nordion responded to requests for reaction to the report in the CMAJ.
As reported in our opening article (above) the federal government instead very noisily laid the entire blame for the shortage on the nuclear regulatory agency! It fired CNSC president Linda Keen, arguing that she failed to take into account the impact of the reactor closure on isotope supply. Keen says she couldn't authorize the startup of the reactor because she was legally bound to ensure the safety of Canadians from nuclear accidents. Health Minister Tony Clement maintained the government had no choice but to legislate reopening the reactor given Keen's “intransigence” and the “absence of an alternate supply”. He insisted that the four other isotope-producing reactors in the world could not have filled the gap left by the Chalk River shutdown.
In contradiction to Canada’s Conservative politicians, University of Texas Professor Alan J. Kuperman, Policy Analyst for the Nuclear Control Institute in the United States, told CMAJ it's not in MDS Nordion's commercial interests to join in international contingency planning with rival suppliers. "They see themselves as the big dog,'' said Kuperman. ''They are not going to share information with the small ones nipping at their heels.'' Kuperman maintained there is plenty of "surplus capacity'' among isotope suppliers but MDS Nordion and AECL didn't want competitors to pick up the slack when the AECL reactor was shut down. "Instead, they went to the public and the Canadian government. That was misleading and… socially irresponsible.''
Source: The Canadian Press Mon. Feb. 4 2008 8:32 PM ET http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080131/chalk_river_080204/20080204?hub=Canada&s_name=
Editorial Comment:
So who to believe in this vaudeville production - the politicians and their industry bed-fellows, or the scientists and regulators? To the extent that there was an incipient health care crisis, the actual shortage of medical isotopes appears to have been minimal and would have been contained without political posturing. Fundamentally, there would have been no “crisis” if the respective Conservative Ministers for Natural Resources and Health had been doing their jobs. Instead, as a smokescreen for their own negligence and incompetence, vicarious though these may be as is Harper's ultimate responsibility for AECL as a Crown corporation (although to his credit, AECL President Burns resigned for that), they fired the regulator! Unbelievable? Sadly no, comic opera is in the Canada's “new” political tradition.
Given that AECL’s Chalk River reactor is the world’s largest supplier of medical isotopes, and its uncooperative behaviour (as documented by CMAJ), it has been speculated that Canada’s Conservative government was acting in cahoots with AECL and MDS Nordion to protect a lucrative export market, and needed a scapegoat. The end result of this raucous episode, designed to sow confusion over whose role it really is to do what, is to attract world attention to Canada’s willingness to sacrifice nuclear safety to the whims of politics and commercial profit. One likely outcome is that Canada will now face new, more ethical and more scientifically advanced (e.g., cyclotron technology) competition from other countries capable of scaling up isotope production.
On the abuse of a senior public servant acting with due diligence, the episode revealed the unsavoury mindset of a Prime Minister on the brink of mendacity when he almost unbelievably alleged that the regulatory decision was “partisan” because Keen was appointed by the previous government! This crass use of the bully pulpit exposes the PM for the partisan “leadership” he himself so clearly personifies. As for the unmanly Cabinet ministers busily holding his coattails, having fallen so short of the responsibilities required of their own portfolios, their instincts for political survival apparently led them to embellish this complex cover-up.
Except for the fact that the underlying issue of nuclear safety is so important, the whole episode could be rewritten as a farce (definition: a light dramatic work in which highly improbable plot situations, exaggerated characters, and often slapstick elements are used for humorous effect); but even then we would need better actors than currently offered up by Canada’s “new” government.
Due to the critical debate on Canada’s role Afghanistan, which diverted media attention immediately following this fiasco, the Conservatives may have escaped the full measure of public scrutiny that this deserved. For this reason, we are shining this light on the story for our global readers so that they may be aware of the kind of governance we are now experiencing in Canada.
At least one good thing comes out of this experience: the example of the principled Ms Keen on standing by her duty as the nuclear regulator. Despite being undermined by federal politicians, as a leader in her field (biosketch below), she wins respect from the science policy community.
The issue has not gone away, and there are calls for a public inquiry. However, most of the political parties are keeping their heads down now; the only party to have shown much gumption on the issue is the Green Party of Canada. It could well return as an election issue.
BIOSKETCH – Linda Keen
Linda J Keen was President of the CNSC since January 2001, and her term was renewed in 2005. As President, she chaired a quasi-judicial tribunal that sets regulatory policy and makes licensing decisions related to nuclear facilities. With 4,500 licenses covering all aspects of the industry from mining to refining, power and research reactors to clinics and industrial uses, CNSC provides regulatory oversight on behalf of Canadians. The CNSC is also the Canadian agency that implements measures respecting international control of the development, production, transport and use of nuclear energy and substances. The CNSC is crucial to Canada’s adherence to global agreements respecting the non-proliferation of nuclear weapons and explosive devices.
Ms. Keen was Chair of the International Nuclear Regulators Association (INRA) in 2003. She is now President of the Convention on Nuclear Safety, involving international peer review among 65 signatory countries to ensure worldwide nuclear safety. She was Honorary Chair of the 2006 Women in Nuclear Conference, held in Canada for the first time, and the keynote speaker of the 2005 International Conference of Women in Science and Engineering held in Seoul, South Korea. In January 2007, Ms. Keen was instrumental in establishing the Heads of Federal Administrative Tribunals Forum and is serving as the first Chair of this network. She was appointed in May 2007 as a director of the Canadian Council of Administrative Tribunals.
Source: http://209.85.173.104/search?q=cache:V1LSrNXXj8AJ:www.cnsc-ccsn.gc.ca/eng/about/organization/ljkeen/+linda+keen&hl=en&ct=clnk&cd=1&gl=ca
Friday, 15 February 2008
Tuesday, 15 January 2008
WORLD DEVELOPMENT CALLS FOR INVESTMENT IN AGRICULTURE 2008
PREAMBLE: The World Development Report 2008 (reference link below) calls for greater investment in agriculture in developing countries. This annual World Bank report warns that the sector must be placed at the center of the development agenda if goals of halving extreme poverty and hunger by 2015 are to be realized.
o While 75% of the world’s poor live in rural areas in developing countries, a mere 4% of official development assistance goes to agriculture.
o In Sub-Saharan Africa, a region heavily reliant on agriculture for overall growth, public spending for farming is also only 4% of total government spending and the sector is still taxed at relatively high levels.
o GDP growth originating in agriculture is about four times more effective in raising incomes of extremely poor people than GDP growth originating outside the sector.
Said World Bank Group President Robert B. Zoellick: “At the global level, countries must deliver on vital reforms such as cutting distorting subsidies and opening markets, while civil society groups, especially farmer organizations, need more say in setting the agricultural agenda.”
In this issue we focus on Malawi as a Case Study of the role of new subsidies to enhance agricultural production, despite decades of donor proscription not to subsidize, and take note of a World Trade Organization investigation into the use by the United States of truly massive trade-distorting farm subsidies in violation of international commerce rules.
Reference : World Development Report 2008: Agriculture for Development. http://econ.worldbank.org/WBSITE/EXTERNAL/EXTDEC/EXTRESEARCH/EXTWDRS/EXTWDR2008/0,,contentMDK:21410054~menuPK:3149676~pagePK:64167689~piPK:64167673~theSitePK:2795143,00.html
Case Study - ENDING FAMINE IN MALAWI
After a disastrous corn harvest in 2005, almost 40% of Malawi’s 13 million people needed emergency food aid. Move forward to 2007, and Malawi is selling more corn to the UN’s World Food Programe than any other country in southern Africa. Farmers explain the extraordinary turnaround with one word: fertilizer.
Over the past 20 years, the World Bank and some rich nations Malawi depends on for aid have periodically pressed this small, landlocked country to adhere to free market policies and cut back or eliminate fertilizer subsidies, even as the USA and Europe extensively subsidized their own farmers. But after the 2005 harvest, the worst in a decade, Bingu wa Mutharika, Malawi’s newly elected president, decided to follow what the West practiced, not what it preached, reinstating and deepening fertilizer subsidies.
The country’s successful use of subsidies is contributing to a broader reappraisal of the crucial role of agriculture in alleviating poverty in Africa and the pivotal importance of public investments in the basics of farm economies: fertilizer, improved seed, education, credit and agricultural research. Malawi’s leaders long favored fertilizer subsidies, but reluctantly acceded to donor prescriptions, often shaped by foreign-aid fashions in Washington, that featured faith in private markets and antipathy to public intervention.
In a withering evaluation of the World Bank’s record on African agriculture, the bank’s own internal watchdog concluded in October not only that removal of subsidies had led to exorbitant fertilizer prices in African nations, but that the bank itself often failed to recognize that improving Africa’s declining soil quality was essential to lifting food production.
In Malawi, deep fertilizer subsidies and lesser ones for seed, abetted by good rains, helped farmers produce record-breaking corn harvests in 2006 and 2007. An independent evaluation, financed by the USA and the UK, found that the subsidy program accounted for a large share of this year’s increase in corn production. The harvest also helped the poor by lowering food prices and increasing wages for farm workers.
Malawi’s determination to heavily subsidize fertilizer and the payoff in increased production are beginning to change donor attitudes, say economists who have studied Malawi’s experience. The UK (DFID) contributed $8 million to the subsidy program last year. Bernabé Sánchez, an economist with the agency in Malawi, estimated the extra corn produced because of the $74 million subsidy was worth $120 million to $140 million. The US, which has shipped $147 million worth of American food to Malawi as emergency relief since 2002, but only $53 million to help Malawi grow its own food, has not provided any financial support for the subsidy program, except for helping pay for the evaluation of it. Over the years, the USAID has focused on promoting the role of the private sector in delivering fertilizer and seed, and saw subsidies as undermining that effort. But Alan Eastham, the US ambassador to Malawi, said in a recent interview that the subsidy program had worked “pretty well,” though it displaced some commercial fertilizer sales. And the World Bank now sometimes supports the temporary use of subsidies aimed at the poor and carried out in a way that fosters private markets.
In Malawi, bank officials now support Malawi’s policy, though they criticize the government for not having a strategy to eventually end the subsidies, and... say there is still a lot of room for improvement in how the subsidy is carried out. “The issue is, let’s do a better job of it,” said David Rohrbach, a senior agricultural economist at the bank. Though donors are ambivalent, Malawi’s farmers have embraced the subsidies. And the government moved this year to give its people a more direct hand in their distribution.
Source: Adapted from the article by Celia Dugger. Ending Famine, Simply by Ignoring the Experts. New York Times Dec 2, 2007 http://www.nytimes.com/2007/12/02/world/africa/02malawi.html
WORLD TRADE ORGANIZATION INVESTIGATION INTO US SUBSIDIES
GENEVA (AP) — The WTO has opened an investigation into whether the US was violating international commerce rules that limited subsidies to American farmers, three days after the US Senate approved a $286 billion farm bill. Brazil and Canada, frustrated by US resistance to cutting back on subsidies, asked the WTO to condemn Washgton for exceeding permitted levels of what it called trade-distorting handouts to American producers of crops like corn, cotton, rice, soybean and wheat. The panel is expected to issue a first ruling in 2008. The dispute system often takes years before a final decision is reached, but can force countries to change their legislation or face billions of dollars in retaliatory sanctions. The battle over farm subsidies could become a landmark dispute for the WTO because Brazil’s complaint includes payments for ethanol production. The trade body has largely steered clear of energy issues in its 12-year history.
Source: Bradley S. Klapper. Associated Press. December 18, 2007
o While 75% of the world’s poor live in rural areas in developing countries, a mere 4% of official development assistance goes to agriculture.
o In Sub-Saharan Africa, a region heavily reliant on agriculture for overall growth, public spending for farming is also only 4% of total government spending and the sector is still taxed at relatively high levels.
o GDP growth originating in agriculture is about four times more effective in raising incomes of extremely poor people than GDP growth originating outside the sector.
Said World Bank Group President Robert B. Zoellick: “At the global level, countries must deliver on vital reforms such as cutting distorting subsidies and opening markets, while civil society groups, especially farmer organizations, need more say in setting the agricultural agenda.”
In this issue we focus on Malawi as a Case Study of the role of new subsidies to enhance agricultural production, despite decades of donor proscription not to subsidize, and take note of a World Trade Organization investigation into the use by the United States of truly massive trade-distorting farm subsidies in violation of international commerce rules.
Reference : World Development Report 2008: Agriculture for Development. http://econ.worldbank.org/WBSITE/EXTERNAL/EXTDEC/EXTRESEARCH/EXTWDRS/EXTWDR2008/0,,contentMDK:21410054~menuPK:3149676~pagePK:64167689~piPK:64167673~theSitePK:2795143,00.html
Case Study - ENDING FAMINE IN MALAWI
After a disastrous corn harvest in 2005, almost 40% of Malawi’s 13 million people needed emergency food aid. Move forward to 2007, and Malawi is selling more corn to the UN’s World Food Programe than any other country in southern Africa. Farmers explain the extraordinary turnaround with one word: fertilizer.
Over the past 20 years, the World Bank and some rich nations Malawi depends on for aid have periodically pressed this small, landlocked country to adhere to free market policies and cut back or eliminate fertilizer subsidies, even as the USA and Europe extensively subsidized their own farmers. But after the 2005 harvest, the worst in a decade, Bingu wa Mutharika, Malawi’s newly elected president, decided to follow what the West practiced, not what it preached, reinstating and deepening fertilizer subsidies.
The country’s successful use of subsidies is contributing to a broader reappraisal of the crucial role of agriculture in alleviating poverty in Africa and the pivotal importance of public investments in the basics of farm economies: fertilizer, improved seed, education, credit and agricultural research. Malawi’s leaders long favored fertilizer subsidies, but reluctantly acceded to donor prescriptions, often shaped by foreign-aid fashions in Washington, that featured faith in private markets and antipathy to public intervention.
In a withering evaluation of the World Bank’s record on African agriculture, the bank’s own internal watchdog concluded in October not only that removal of subsidies had led to exorbitant fertilizer prices in African nations, but that the bank itself often failed to recognize that improving Africa’s declining soil quality was essential to lifting food production.
In Malawi, deep fertilizer subsidies and lesser ones for seed, abetted by good rains, helped farmers produce record-breaking corn harvests in 2006 and 2007. An independent evaluation, financed by the USA and the UK, found that the subsidy program accounted for a large share of this year’s increase in corn production. The harvest also helped the poor by lowering food prices and increasing wages for farm workers.
Malawi’s determination to heavily subsidize fertilizer and the payoff in increased production are beginning to change donor attitudes, say economists who have studied Malawi’s experience. The UK (DFID) contributed $8 million to the subsidy program last year. Bernabé Sánchez, an economist with the agency in Malawi, estimated the extra corn produced because of the $74 million subsidy was worth $120 million to $140 million. The US, which has shipped $147 million worth of American food to Malawi as emergency relief since 2002, but only $53 million to help Malawi grow its own food, has not provided any financial support for the subsidy program, except for helping pay for the evaluation of it. Over the years, the USAID has focused on promoting the role of the private sector in delivering fertilizer and seed, and saw subsidies as undermining that effort. But Alan Eastham, the US ambassador to Malawi, said in a recent interview that the subsidy program had worked “pretty well,” though it displaced some commercial fertilizer sales. And the World Bank now sometimes supports the temporary use of subsidies aimed at the poor and carried out in a way that fosters private markets.
In Malawi, bank officials now support Malawi’s policy, though they criticize the government for not having a strategy to eventually end the subsidies, and... say there is still a lot of room for improvement in how the subsidy is carried out. “The issue is, let’s do a better job of it,” said David Rohrbach, a senior agricultural economist at the bank. Though donors are ambivalent, Malawi’s farmers have embraced the subsidies. And the government moved this year to give its people a more direct hand in their distribution.
Source: Adapted from the article by Celia Dugger. Ending Famine, Simply by Ignoring the Experts. New York Times Dec 2, 2007 http://www.nytimes.com/2007/12/02/world/africa/02malawi.html
WORLD TRADE ORGANIZATION INVESTIGATION INTO US SUBSIDIES
GENEVA (AP) — The WTO has opened an investigation into whether the US was violating international commerce rules that limited subsidies to American farmers, three days after the US Senate approved a $286 billion farm bill. Brazil and Canada, frustrated by US resistance to cutting back on subsidies, asked the WTO to condemn Washgton for exceeding permitted levels of what it called trade-distorting handouts to American producers of crops like corn, cotton, rice, soybean and wheat. The panel is expected to issue a first ruling in 2008. The dispute system often takes years before a final decision is reached, but can force countries to change their legislation or face billions of dollars in retaliatory sanctions. The battle over farm subsidies could become a landmark dispute for the WTO because Brazil’s complaint includes payments for ethanol production. The trade body has largely steered clear of energy issues in its 12-year history.
Source: Bradley S. Klapper. Associated Press. December 18, 2007
Saturday, 15 December 2007
INTERNATIONAL & GLOBAL DEVELOPMENT - YEAR IN REVIEW 2007
LATE BREAKER: For a thought-provoking critical analysis of what the Bhutto assassination on December 27 means for Pakistan and the "war on terror", see the new addition in our sidebar.
PREAMBLE: This issue also completes our first full year of blogging. Drawing from topics covered during the year, we offer below: overviews views on three major issues for humankind, followed by paraphrases from our monthly themes in 2007.
THREE LEADING ISSUES FROM 2007: Flowers or Fertilizer?
1. GLOBAL STEWARDSHIP: In our view, the lead issue here is Climate Change (May, October), which is already displacing some of the world’s vulnerable populations, and ultimately threatening life on this planet. This is followed closely by global food security (February) and displacement by rich countries of grain for use as automotive fuel, thereby creating pressure on its use in food in developing countries, and even the price of food in developed ones, impacting on access and affordability. Flowers: to the European Community for its global leadership on climate. Fertilizer: To Canada’s Conservative government which has set the world’s worst example of procrastination on climate.
Note: At the recently concluded UN Climate Summit in Bali, Canada received a “Fossil Award” for its dismal performance on addressing climate change, while the tactics adopted by our Conservative government to undermine the developing global consensus on the need for binding targets now were described by numerous observers as "hypocritical" and “deceitful”.
2. INTERNATIONAL DEVELOPMENT: Viewed broadly, we consider the leading issue here to be Maternal & Child Health (April, November). The determinants include gender inequality, global poverty, and insufficient policy and program development at all levels. Even in developed western countries this is an issue: taking our own country Canada as an example, the “new” Conservative government’s reneged on the Kelowna Accord to improve conditions for aboriginals, and failed to ensure an adequate child care platform (March, April). Further, with the exception of the Nordic nations, official development assistance from wealthy developed countries is still far less than targets agreed decades ago. Flowers: Norway, whose 4.7 million people already contribute almost $4 billion a year to aid developing countries ($850 for each Norwegan man, woman and child). Fertilizer: The powerful G7 nations for allocating proportionally less Gross National Income (GNI) for international development: 0.30%, compared with .50% for non-G7 nations.
3. HUMAN RIGHTS ABUSES: Still topping the list continues to be the War in Iraq (January, August). Primary responsibility is shared between the Bush and Blair regimes (not equally) for promoting false rumours of weapons of mass destruction, unsupported by UN inspections led by Hans Blix. While insurgents share responsibility for the mayhem and catastrophe, the end results include over half a million Iraqis killed (a genocide?), massive numbers of refugees, and the undermining of Geneva Conventions that were born out of the worst excesses of World War 2. Flowers: Pastor Martin Niemoller (1892-1984). Fertilizer: George Bush (most dangerous US President in history).
Historical Notes:
1) For a revealing 2003 interview of Hans Blix, visit: http://www.truthout.org/docs_03/041203A.shtml
2) For an October 2006 update on JHU estimates of Iraqi deaths: http://www.jhsph.edu/publichealthnews/press_releases/2006/burnham_iraq_2006.html
2007 AS WE RECORDED IT:
January: PEACE, SECURITY, HEALTH & HUMAN RIGHTS: In our first issue of 2007, we took note of the incoming UN Secretary General Ban Ki-moon, acknowledging the immense contribution of former Secretary-General Kofi Annan, focused on war and peace in the Middle East, and completed the transfer of reports and commentaries from our News & Reports site (as announced in our December 2006 posting).
February: GLOBAL FOOD SECURITY – A MATTER OF SURVIVAL: In 1996, the World Food Summit set a target to halve the number of undernourished people by 2015. However, in 2007, it appears unlikely that this target will be met. This issue focused on the conflict between grain for fuel or for food, the stalled Doha round, and food security.
March: COLONIZED MINORITIES IN DEVELOPED COUNTRIES: Colonized racial, cultural or religious minorities exist throughout the world, within powerful societies eg., Tibet in China, Japan's Ainu, India's Dalits, Amerindian enclaves in the Caribbean, tribal minorities in Africa, Boznian Muslims, the Kurds of Iraq, others in all continents and among the Pacific islands. The issues apply to several economically advanced western countries where it is sometimes said that one may find “3rd world conditions in 1st world settings”. Because these countries claim leadership for human rights, they also must live up to these principles.
April: EARLY CHILD DEVELOPMENT – POLICY SHIFTS, GLOBAL VIEWPOINTS, AND THE EVIDENCE BASE: This issue focused on Canadian policy shifts of global interest. Sadly, Canada’s reputation for enlightened social policy is being undermined by a neo-conservative ideology. Over a million Canadian children live in poverty and cannot access child care. In support of child-friendly interventions, we included evidence reviewed by the US-based RAND Corporation showing that childhood intervention programs yield benefits in behavior, educational progression and attainment, delinquency and crime, and labor market success, among other domains.
May: CLIMATE CHANGE, KYOTO ACCORD, EUROPE RESPONDS & CANADA REMAINS CHALLENGED: The European Community (EU) takes Climate Change seriously, and is making progress towards its Kyoto targets. On April 26, 2007, Canada’s Conservative government released its first “climate-change plan”. Despite Canada leading the world in reducing ozone destroying chlorofluoro-carbons (Montreal Protocol 1987), signing the Kyoto Protocol (1997), and hosting its ratification (2005), this plan is incapable of meeting Canada’s Kyoto targets. Ranked 27th of 29 by the OECD on Greenhouse Gas (GHG) emissions, Canada remains among the most environmentally delinquent industrialized countries.
June: OFFICIAL DEVELOPMENT ASSISTANCE & GLOBAL HEALTH TRENDS: This issue reviews the vexing issue of development assistance from wealthy developed countries such as Canada, references a report on global social and economic trends, then selects reports from a discipline essential to understanding global health trends: Health Situation Analysis. Selected examples included Africa, the State of the World Children, and Projections of Mortality and Burden of Disease to 2030.
July: CELEBRATING THE AFRICAN MEDICAL AND RESEARCH FOUNDATION: In 1957, three surgeons in Kenya had a vision that could revolutionize health care in Africa. They launched a Flying Doctor Service (FDS). Over the next 5 decades, men set foot on the moon, satellites explored our solar system, the universe was probed with powerful orbital telescopes, robots explored the surface of Mars, and shuttles began servicing an international space station. In the meantime, with poverty and ill-health still pervading the planet, FDS became Africa’s largest indigenous health organization: the African Medical and Research Foundation.
August: FIRST THEY CAME... VIGNETTES IN THE DISMANTLING OF DEMOCRATIC MYTHS: In this issue we offered a selection of extracts from reputable sources that focus on the disastrous trajectory of the current US administration in undermining the beliefs that underpin western democracies. We dedicate the issue to Pastor Martin Niemoller (1892–1984), whose famous poem “First they came…” about the inactivity of German intellectuals during the Nazi rise to power and the subsequent purging of their chosen targets, group by group, most devastatingly to German Jews.
September: THIRD WORLD AID TO FIRST WORLD COUNTRIES: This issue featured the "brain drain" from sub-Saharan Africa, citing a report from Juan Ramos of ProCOR (website listed in sidebar). Practical responses re examined: striving for better compensation for indigenous health professionals, attention to policies that determine recruitment and retention of health professions in low income countries, fixing the ethics of western firms that raid poor countries to meet the service demands of rich ones, and finding ways to compensate third world "donor" countries for their loss of human resources. Through official inaction, "first world" countries benefit from a massive subsidy from the "third world", equal to the direct and indirect costs of their investment in this health human resource, and the opportunity costs entailed by its loss.
October: IS CLIMATE CHANGE AN ACT OF AGRESSION?: In this issue we abstracted an article carried by The Economist (on-line Sept 24th, 2007) that reported on Ugandan President, Yoweri Museveni's declaration that climate change is an act of aggression by the rich world against the world’s poor. We also noted a statement from the Church World Service (CWS): "The issue... is how climate change frames development and justice", said Rajyashri Waghray, CWS director, education & advocacy.
For stark contrast we noted Canada’s uncertain posture, quoting from a Globe and Mail Editorial (September 26): “Prime Minister Stephen Harper’s progress from a climate-change skeptic to an environmental convert has been a perplexing odyssey. After a half-hearted attempt to tackle greenhouse-gas emissions late last year, his Conservative government hurriedly introduced new regulations and incentives, which made a good start in fostering reductions. Earlier…(in September), in Australia, he even announced his personal commitment to ‘careful environmental stewardship’. That seemed heartfelt. Now it is fair to question the sincerity of that conversion. On… (Sept 24), at a UN climate change conference aimed at saving the Kyoto Protocol, Mr Harper announced that Canada had asked to join a rival climate-change pact, the Asia-Pacific Partnership. The six members of that pact include nations that have refused to ratify the protocol, such as the United States, and others among the world’s worst polluters, such as India and China. Together they account for nearly half of all greenhouse gas emissions”.
November: MATERNAL MORTALITY: WHAT DO SOUTH ASIA, THE UNITED STATES, AND AFRICA SHARE?: Maternal Mortality represents the largest rich-poor disparity tracked by the World Health Organization. On the heels of a study released by the United Nations (UN), the Women Deliver Global Conference in London, 18-20 October, assessed high levels of maternal mortality round the world. Little progress has been made in reducing maternal deaths in many countries. Areas of major focus were South Asia, parts of Africa, and even the United States, as it lags the developed world in its maternal health performance. The conference was supported by non-governmental, intergovernmental and development agencies as well as private sector and philanthropic entities aiming to create the political will to improve the health of pregnant mothers and their children, and to strengthen health systems around the world to prevent the deaths during pregnancy or childbirth of "one woman every minute of every day ".
“The eradication of poverty and hunger… cannot be achieved if questions of population and reproductive health are not addressed”. Kofi Annan
HOLIDAY GREETINGS: We extend to readers our best wishes for the holiday season and the New Year. We hope you found our selections during 2007 thought provoking and factually informative, and that you will continue to monitor this report.
PREAMBLE: This issue also completes our first full year of blogging. Drawing from topics covered during the year, we offer below: overviews views on three major issues for humankind, followed by paraphrases from our monthly themes in 2007.
THREE LEADING ISSUES FROM 2007: Flowers or Fertilizer?
1. GLOBAL STEWARDSHIP: In our view, the lead issue here is Climate Change (May, October), which is already displacing some of the world’s vulnerable populations, and ultimately threatening life on this planet. This is followed closely by global food security (February) and displacement by rich countries of grain for use as automotive fuel, thereby creating pressure on its use in food in developing countries, and even the price of food in developed ones, impacting on access and affordability. Flowers: to the European Community for its global leadership on climate. Fertilizer: To Canada’s Conservative government which has set the world’s worst example of procrastination on climate.
Note: At the recently concluded UN Climate Summit in Bali, Canada received a “Fossil Award” for its dismal performance on addressing climate change, while the tactics adopted by our Conservative government to undermine the developing global consensus on the need for binding targets now were described by numerous observers as "hypocritical" and “deceitful”.
2. INTERNATIONAL DEVELOPMENT: Viewed broadly, we consider the leading issue here to be Maternal & Child Health (April, November). The determinants include gender inequality, global poverty, and insufficient policy and program development at all levels. Even in developed western countries this is an issue: taking our own country Canada as an example, the “new” Conservative government’s reneged on the Kelowna Accord to improve conditions for aboriginals, and failed to ensure an adequate child care platform (March, April). Further, with the exception of the Nordic nations, official development assistance from wealthy developed countries is still far less than targets agreed decades ago. Flowers: Norway, whose 4.7 million people already contribute almost $4 billion a year to aid developing countries ($850 for each Norwegan man, woman and child). Fertilizer: The powerful G7 nations for allocating proportionally less Gross National Income (GNI) for international development: 0.30%, compared with .50% for non-G7 nations.
3. HUMAN RIGHTS ABUSES: Still topping the list continues to be the War in Iraq (January, August). Primary responsibility is shared between the Bush and Blair regimes (not equally) for promoting false rumours of weapons of mass destruction, unsupported by UN inspections led by Hans Blix. While insurgents share responsibility for the mayhem and catastrophe, the end results include over half a million Iraqis killed (a genocide?), massive numbers of refugees, and the undermining of Geneva Conventions that were born out of the worst excesses of World War 2. Flowers: Pastor Martin Niemoller (1892-1984). Fertilizer: George Bush (most dangerous US President in history).
Historical Notes:
1) For a revealing 2003 interview of Hans Blix, visit: http://www.truthout.org/docs_03/041203A.shtml
2) For an October 2006 update on JHU estimates of Iraqi deaths: http://www.jhsph.edu/publichealthnews/press_releases/2006/burnham_iraq_2006.html
2007 AS WE RECORDED IT:
January: PEACE, SECURITY, HEALTH & HUMAN RIGHTS: In our first issue of 2007, we took note of the incoming UN Secretary General Ban Ki-moon, acknowledging the immense contribution of former Secretary-General Kofi Annan, focused on war and peace in the Middle East, and completed the transfer of reports and commentaries from our News & Reports site (as announced in our December 2006 posting).
February: GLOBAL FOOD SECURITY – A MATTER OF SURVIVAL: In 1996, the World Food Summit set a target to halve the number of undernourished people by 2015. However, in 2007, it appears unlikely that this target will be met. This issue focused on the conflict between grain for fuel or for food, the stalled Doha round, and food security.
March: COLONIZED MINORITIES IN DEVELOPED COUNTRIES: Colonized racial, cultural or religious minorities exist throughout the world, within powerful societies eg., Tibet in China, Japan's Ainu, India's Dalits, Amerindian enclaves in the Caribbean, tribal minorities in Africa, Boznian Muslims, the Kurds of Iraq, others in all continents and among the Pacific islands. The issues apply to several economically advanced western countries where it is sometimes said that one may find “3rd world conditions in 1st world settings”. Because these countries claim leadership for human rights, they also must live up to these principles.
April: EARLY CHILD DEVELOPMENT – POLICY SHIFTS, GLOBAL VIEWPOINTS, AND THE EVIDENCE BASE: This issue focused on Canadian policy shifts of global interest. Sadly, Canada’s reputation for enlightened social policy is being undermined by a neo-conservative ideology. Over a million Canadian children live in poverty and cannot access child care. In support of child-friendly interventions, we included evidence reviewed by the US-based RAND Corporation showing that childhood intervention programs yield benefits in behavior, educational progression and attainment, delinquency and crime, and labor market success, among other domains.
May: CLIMATE CHANGE, KYOTO ACCORD, EUROPE RESPONDS & CANADA REMAINS CHALLENGED: The European Community (EU) takes Climate Change seriously, and is making progress towards its Kyoto targets. On April 26, 2007, Canada’s Conservative government released its first “climate-change plan”. Despite Canada leading the world in reducing ozone destroying chlorofluoro-carbons (Montreal Protocol 1987), signing the Kyoto Protocol (1997), and hosting its ratification (2005), this plan is incapable of meeting Canada’s Kyoto targets. Ranked 27th of 29 by the OECD on Greenhouse Gas (GHG) emissions, Canada remains among the most environmentally delinquent industrialized countries.
June: OFFICIAL DEVELOPMENT ASSISTANCE & GLOBAL HEALTH TRENDS: This issue reviews the vexing issue of development assistance from wealthy developed countries such as Canada, references a report on global social and economic trends, then selects reports from a discipline essential to understanding global health trends: Health Situation Analysis. Selected examples included Africa, the State of the World Children, and Projections of Mortality and Burden of Disease to 2030.
July: CELEBRATING THE AFRICAN MEDICAL AND RESEARCH FOUNDATION: In 1957, three surgeons in Kenya had a vision that could revolutionize health care in Africa. They launched a Flying Doctor Service (FDS). Over the next 5 decades, men set foot on the moon, satellites explored our solar system, the universe was probed with powerful orbital telescopes, robots explored the surface of Mars, and shuttles began servicing an international space station. In the meantime, with poverty and ill-health still pervading the planet, FDS became Africa’s largest indigenous health organization: the African Medical and Research Foundation.
August: FIRST THEY CAME... VIGNETTES IN THE DISMANTLING OF DEMOCRATIC MYTHS: In this issue we offered a selection of extracts from reputable sources that focus on the disastrous trajectory of the current US administration in undermining the beliefs that underpin western democracies. We dedicate the issue to Pastor Martin Niemoller (1892–1984), whose famous poem “First they came…” about the inactivity of German intellectuals during the Nazi rise to power and the subsequent purging of their chosen targets, group by group, most devastatingly to German Jews.
September: THIRD WORLD AID TO FIRST WORLD COUNTRIES: This issue featured the "brain drain" from sub-Saharan Africa, citing a report from Juan Ramos of ProCOR (website listed in sidebar). Practical responses re examined: striving for better compensation for indigenous health professionals, attention to policies that determine recruitment and retention of health professions in low income countries, fixing the ethics of western firms that raid poor countries to meet the service demands of rich ones, and finding ways to compensate third world "donor" countries for their loss of human resources. Through official inaction, "first world" countries benefit from a massive subsidy from the "third world", equal to the direct and indirect costs of their investment in this health human resource, and the opportunity costs entailed by its loss.
October: IS CLIMATE CHANGE AN ACT OF AGRESSION?: In this issue we abstracted an article carried by The Economist (on-line Sept 24th, 2007) that reported on Ugandan President, Yoweri Museveni's declaration that climate change is an act of aggression by the rich world against the world’s poor. We also noted a statement from the Church World Service (CWS): "The issue... is how climate change frames development and justice", said Rajyashri Waghray, CWS director, education & advocacy.
For stark contrast we noted Canada’s uncertain posture, quoting from a Globe and Mail Editorial (September 26): “Prime Minister Stephen Harper’s progress from a climate-change skeptic to an environmental convert has been a perplexing odyssey. After a half-hearted attempt to tackle greenhouse-gas emissions late last year, his Conservative government hurriedly introduced new regulations and incentives, which made a good start in fostering reductions. Earlier…(in September), in Australia, he even announced his personal commitment to ‘careful environmental stewardship’. That seemed heartfelt. Now it is fair to question the sincerity of that conversion. On… (Sept 24), at a UN climate change conference aimed at saving the Kyoto Protocol, Mr Harper announced that Canada had asked to join a rival climate-change pact, the Asia-Pacific Partnership. The six members of that pact include nations that have refused to ratify the protocol, such as the United States, and others among the world’s worst polluters, such as India and China. Together they account for nearly half of all greenhouse gas emissions”.
November: MATERNAL MORTALITY: WHAT DO SOUTH ASIA, THE UNITED STATES, AND AFRICA SHARE?: Maternal Mortality represents the largest rich-poor disparity tracked by the World Health Organization. On the heels of a study released by the United Nations (UN), the Women Deliver Global Conference in London, 18-20 October, assessed high levels of maternal mortality round the world. Little progress has been made in reducing maternal deaths in many countries. Areas of major focus were South Asia, parts of Africa, and even the United States, as it lags the developed world in its maternal health performance. The conference was supported by non-governmental, intergovernmental and development agencies as well as private sector and philanthropic entities aiming to create the political will to improve the health of pregnant mothers and their children, and to strengthen health systems around the world to prevent the deaths during pregnancy or childbirth of "one woman every minute of every day ".
“The eradication of poverty and hunger… cannot be achieved if questions of population and reproductive health are not addressed”. Kofi Annan
HOLIDAY GREETINGS: We extend to readers our best wishes for the holiday season and the New Year. We hope you found our selections during 2007 thought provoking and factually informative, and that you will continue to monitor this report.
Thursday, 1 November 2007
MATERNAL MORTALITY: What do South Asia, the United States and Africa share?
PREAMBLE: Maternal Mortality represents the largest rich-poor disparity tracked by the World Health Organization. On the heels of a study recently released by the United Nations (UN), the Women Deliver Global Conference in London, 18-20 October, assessed high levels of maternal mortality round the world. Delegates learned that little progress has been made in reducing maternal deaths in many countries. Areas of major focus were South Asia, parts of Africa, and even the United States came under scrutiny, as it lags the developed world in its maternal health performance. The conference was supported by non-governmental, intergovernmental and development agencies as well as private sector and philanthropic entities aiming to create the political will to improve the health of pregnant mothers and their children, and to strengthen health systems around the world to prevent the deaths during pregnancy or childbirth of "one woman every minute of every day ".
Visit Our Sidebar, with reference to the topic: "BEYOND THOSE HEALH CARE NUMBERS - commentary on a vacuous analysis", for our views on the US need to improve its health system.
SOUTH ASIA
Status of Women reflected in Preventable Deaths: "Maternal mortality levels are a key indicator of the status of women in society. They show how well a country's health service is performing and what cultural position women hold in society," says UNICEF spokesperson Katey Grusovin. South Asia's high maternal mortality rates account for almost half of all maternal deaths globally. UNICEF says that the lack of adequate resources and knowledge not only results in preventable maternal deaths, but it severely impacts on children who are left motherless. Some studies suggest that these children are 10 times more likely than their peers to die within two years of their mothers' deaths. "In South Asia, every year around 188,000 women die from complications in pregnancy and childbirth." Several countries in South Asia are responsible for the bulk of these mostly preventable deaths: India with 117,000 annual maternal deaths, Afghanistan 26,000, Bangladesh 21,000, and Pakistan 15,000. In many countries, the majority of births occur at home in rural areas without qualified medical help.
Poor Transportation and Inadequate Service Provisions: In the region if a woman does not survive the often long and perilous journey to hospital, there is every chance there will be no doctor, nurse or anaesthetist on duty to help her, nor any drug or blood supplies available with which to treat her. "And if there are - payment for these services may be well beyond the means of the women and her family," says Grusovin.
Gender Insensitivity: South Asia has been described as the most "gender insensitive region in the world". UNICEF says that from birth women are given a smaller share of food (60% of women in their childbearing years suffer from malnutrition), a larger share of work and little or no say in their own healthcare. They are likely to marry earlier and have had little or no education and live on or below the poverty line.
The Face of Huge Economic Disparities: "Throughout the region there is a huge disparity between its desolate performance on most indicators of human development on the one hand, and the stunning economic growth and prosperity experienced in several countries on the other," a UNICEF report says. "The fact that these positive developments have failed to trickle down to the poorest sectors of society is due to a host of factors, including religious and cultural practices, political and economic exclusion and gender bias." UNICEF says that steps to tackle the problem should be simple to implement. For example, 2.3 million South Asian infants who die annually could be saved along with their mothers if obstetric care was improved.
Is a Woman’s Life Worth Saving? The experience of Kalama, a 26-year-old Nepalese woman, is typical of many. She was brought to a District Hospital with labour complications. The hospital is a 3-hour walk from her village, so she had to be carried on a stretcher. She was admitted with full dilation of the cervix. The labour was prolonged, and she did not have energy to synchronise her efforts with labour contractions. The baby had to be vacuum delivered, asphyxiated and died. UNICEF says in many hospitals of the region there are no facilities to help mothers who lose their babies at birth. Says Grusovin "These women are dying not because we don't have the means to save them, but because we (the world) have not determined whether they are worth saving."
Poverty: The continual loss of millions of women from every generation has devastating implications for surviving family members, affecting infant survival rates and forcing young girls to leave school to care for siblings. Families then sink deeper into poverty. In short, the health of the mother is critical not only to her family, but to her nation.
Sources: 1. BBC News on-line: http://news.bbc.co.uk/2/shared/spl/hi/picture_gallery/07/south_asia_fighting_maternal_mortality/html/4.stm
2. Women Deliver Global Conference: http://www.womendeliver.org/overview/index.htm
UNITED STATES
Oct 13 (IPS) - Despite its enormous wealth and advanced technology, the United States (US) lags far behind other industrialized countries, and even some developing ones, in providing health care to women during pregnancy and childbirth. The US. ranks 41st in a new analysis of maternal mortality rates in 171 countries released by the UN.
The survey shows that even a developing country like South Korea is ahead of the US. "Women are unnecessarily dying from pregnancy and childbirth complications because the U.S. is moving in a wrong direction," said Beneva Schulte of Women Deliver, a Washington-based group campaigning for women's reproductive rights and access to health care.
Based on 2005 estimates, the UN analysis suggests that one in 4,800 women inthe US carry a lifetime risk of death from pregnancy. By contrast, among the 10 top-ranked industrialized countries, fewer than one in 16,400 are facing a similar situation. The reason? According to experts, in many European countries and Japan in the industrialized world, women are guaranteed good-quality health and family planning services that minimize their lifetime risk.
Many independent experts and sympathetic legislators hold the current US public health policy responsible for its dismal record because some 47 million US citizens have no access to health insurance, most of them African Americans and other minorities. According to Congresswoman Lois Capps, a California Democrat, "Even if we have the best technology, not everyone has the access to health care."
Responding to inquiries by IPS, a US public health official identified "racial disparity" as the most significant factor underlying the high U.S. maternal mortality rate. "Black women are 4 times more vulnerable than whites," Eve Lackritz, chief of the Maternal and Infant Health branch of the Centers for Disease Control (CDC), told IPS. In Lackritz's view, obesity and hypertension are two leading causes of pregnancy-related risks in the US.
Source: Maternal Mortality Shames Superpower U.S.By Haider Rizvi http://www.ipsnews.net/news.asp?idnews=39642
AFRICA & the MILLENNIUM DEVLOPMENT GOALS:
There are 10 countries, all in Africa (except Afghanistan), where high fertility and shattered health care systems cause extreme risks for pregnant women. In Somalia, Mali, Chad, and Niger, more than one in every 15 women is likely to die of pregnancy-related causes. In Niger, one in 7 women is vulnerable to death during pregnancy.
This analysis comes at a time when many development agencies and UN officials are trying to evaluate how far the world has progressed in meeting the Millennium Development Goals (MDGs) agreed upon by the world leaders 7 years ago. When the leaders attended a summit in New York in September 2000, they agreed that the MDGs must be achieved by 2015, a commitment that included initiatives to reduce maternal mortality by 75%.
Many experts believe that nothing much has changed since then for millions of poor women with regard to economic wellbeing and access to health care. As reported by the Lancet medical journal, at the current pace, there is almost no hope that the world will be able to achieve the 75% target. Annually, about 20 million women undergo unsafe abortions, which, according to the journal, is a major factor in maternal deaths and illness.
Reproductive rights activists say that governments must take drastic steps to reverse the situation if they are serious in meeting the MDGs on reducing the maternal mortality rates in the next seven years. "We still have the situation we had 20 years ago," said Ann Starrs of the independent group Family Care International in a statement. "Half a million women die every year from the complications of childbirth."
A recent study by Harvard University professor Ken Hill found that between 1990 and 2005, maternal deaths did fall, but by less than one percent a year. Hill and many other researchers estimate that at least 10 to 20 million women suffer injuries from the complications of childbirth every year. Experts say this suffering could be easily avoided if international donors contributed just $ 6.1 billion over the next seven years. (Editorial Comment: To place this global amount in local perspective, Canada's conservative government just anounced a reduction of 1% in its Goods and Services Tax, a cut of $34 billion annually).
Sources: 1. Haider Rizvi http://www.ipsnews.net/news.asp?idnews=39642
2. The Lancet Blog. Oct 18, 2007. http://blogs.thelancet.com/archive/2007/10/12/women-deliver
Visit Our Sidebar, with reference to the topic: "BEYOND THOSE HEALH CARE NUMBERS - commentary on a vacuous analysis", for our views on the US need to improve its health system.
SOUTH ASIA
Status of Women reflected in Preventable Deaths: "Maternal mortality levels are a key indicator of the status of women in society. They show how well a country's health service is performing and what cultural position women hold in society," says UNICEF spokesperson Katey Grusovin. South Asia's high maternal mortality rates account for almost half of all maternal deaths globally. UNICEF says that the lack of adequate resources and knowledge not only results in preventable maternal deaths, but it severely impacts on children who are left motherless. Some studies suggest that these children are 10 times more likely than their peers to die within two years of their mothers' deaths. "In South Asia, every year around 188,000 women die from complications in pregnancy and childbirth." Several countries in South Asia are responsible for the bulk of these mostly preventable deaths: India with 117,000 annual maternal deaths, Afghanistan 26,000, Bangladesh 21,000, and Pakistan 15,000. In many countries, the majority of births occur at home in rural areas without qualified medical help.
Poor Transportation and Inadequate Service Provisions: In the region if a woman does not survive the often long and perilous journey to hospital, there is every chance there will be no doctor, nurse or anaesthetist on duty to help her, nor any drug or blood supplies available with which to treat her. "And if there are - payment for these services may be well beyond the means of the women and her family," says Grusovin.
Gender Insensitivity: South Asia has been described as the most "gender insensitive region in the world". UNICEF says that from birth women are given a smaller share of food (60% of women in their childbearing years suffer from malnutrition), a larger share of work and little or no say in their own healthcare. They are likely to marry earlier and have had little or no education and live on or below the poverty line.
The Face of Huge Economic Disparities: "Throughout the region there is a huge disparity between its desolate performance on most indicators of human development on the one hand, and the stunning economic growth and prosperity experienced in several countries on the other," a UNICEF report says. "The fact that these positive developments have failed to trickle down to the poorest sectors of society is due to a host of factors, including religious and cultural practices, political and economic exclusion and gender bias." UNICEF says that steps to tackle the problem should be simple to implement. For example, 2.3 million South Asian infants who die annually could be saved along with their mothers if obstetric care was improved.
Is a Woman’s Life Worth Saving? The experience of Kalama, a 26-year-old Nepalese woman, is typical of many. She was brought to a District Hospital with labour complications. The hospital is a 3-hour walk from her village, so she had to be carried on a stretcher. She was admitted with full dilation of the cervix. The labour was prolonged, and she did not have energy to synchronise her efforts with labour contractions. The baby had to be vacuum delivered, asphyxiated and died. UNICEF says in many hospitals of the region there are no facilities to help mothers who lose their babies at birth. Says Grusovin "These women are dying not because we don't have the means to save them, but because we (the world) have not determined whether they are worth saving."
Poverty: The continual loss of millions of women from every generation has devastating implications for surviving family members, affecting infant survival rates and forcing young girls to leave school to care for siblings. Families then sink deeper into poverty. In short, the health of the mother is critical not only to her family, but to her nation.
Sources: 1. BBC News on-line: http://news.bbc.co.uk/2/shared/spl/hi/picture_gallery/07/south_asia_fighting_maternal_mortality/html/4.stm
2. Women Deliver Global Conference: http://www.womendeliver.org/overview/index.htm
UNITED STATES
Oct 13 (IPS) - Despite its enormous wealth and advanced technology, the United States (US) lags far behind other industrialized countries, and even some developing ones, in providing health care to women during pregnancy and childbirth. The US. ranks 41st in a new analysis of maternal mortality rates in 171 countries released by the UN.
The survey shows that even a developing country like South Korea is ahead of the US. "Women are unnecessarily dying from pregnancy and childbirth complications because the U.S. is moving in a wrong direction," said Beneva Schulte of Women Deliver, a Washington-based group campaigning for women's reproductive rights and access to health care.
Based on 2005 estimates, the UN analysis suggests that one in 4,800 women inthe US carry a lifetime risk of death from pregnancy. By contrast, among the 10 top-ranked industrialized countries, fewer than one in 16,400 are facing a similar situation. The reason? According to experts, in many European countries and Japan in the industrialized world, women are guaranteed good-quality health and family planning services that minimize their lifetime risk.
Many independent experts and sympathetic legislators hold the current US public health policy responsible for its dismal record because some 47 million US citizens have no access to health insurance, most of them African Americans and other minorities. According to Congresswoman Lois Capps, a California Democrat, "Even if we have the best technology, not everyone has the access to health care."
Responding to inquiries by IPS, a US public health official identified "racial disparity" as the most significant factor underlying the high U.S. maternal mortality rate. "Black women are 4 times more vulnerable than whites," Eve Lackritz, chief of the Maternal and Infant Health branch of the Centers for Disease Control (CDC), told IPS. In Lackritz's view, obesity and hypertension are two leading causes of pregnancy-related risks in the US.
Source: Maternal Mortality Shames Superpower U.S.By Haider Rizvi http://www.ipsnews.net/news.asp?idnews=39642
AFRICA & the MILLENNIUM DEVLOPMENT GOALS:
There are 10 countries, all in Africa (except Afghanistan), where high fertility and shattered health care systems cause extreme risks for pregnant women. In Somalia, Mali, Chad, and Niger, more than one in every 15 women is likely to die of pregnancy-related causes. In Niger, one in 7 women is vulnerable to death during pregnancy.
This analysis comes at a time when many development agencies and UN officials are trying to evaluate how far the world has progressed in meeting the Millennium Development Goals (MDGs) agreed upon by the world leaders 7 years ago. When the leaders attended a summit in New York in September 2000, they agreed that the MDGs must be achieved by 2015, a commitment that included initiatives to reduce maternal mortality by 75%.
Many experts believe that nothing much has changed since then for millions of poor women with regard to economic wellbeing and access to health care. As reported by the Lancet medical journal, at the current pace, there is almost no hope that the world will be able to achieve the 75% target. Annually, about 20 million women undergo unsafe abortions, which, according to the journal, is a major factor in maternal deaths and illness.
Reproductive rights activists say that governments must take drastic steps to reverse the situation if they are serious in meeting the MDGs on reducing the maternal mortality rates in the next seven years. "We still have the situation we had 20 years ago," said Ann Starrs of the independent group Family Care International in a statement. "Half a million women die every year from the complications of childbirth."
A recent study by Harvard University professor Ken Hill found that between 1990 and 2005, maternal deaths did fall, but by less than one percent a year. Hill and many other researchers estimate that at least 10 to 20 million women suffer injuries from the complications of childbirth every year. Experts say this suffering could be easily avoided if international donors contributed just $ 6.1 billion over the next seven years. (Editorial Comment: To place this global amount in local perspective, Canada's conservative government just anounced a reduction of 1% in its Goods and Services Tax, a cut of $34 billion annually).
Sources: 1. Haider Rizvi http://www.ipsnews.net/news.asp?idnews=39642
2. The Lancet Blog. Oct 18, 2007. http://blogs.thelancet.com/archive/2007/10/12/women-deliver
Monday, 1 October 2007
IS CLIMATE CHANGE AN ACT OF AGRESSION?
PREAMBLE: In this issue we abstract an article carried by The Economist (on-line edition Sept 24th, 2007). The article reported on Ugandan President, Yoweri Museveni's declaration that climate change is an act of aggression by the rich world against the world’s poor. We also note, on the same topic, the following statement from the Church World Service (CWS): "The issue for CWS is how climate change frames development and justice", said Rajyashri Waghray, who directs education and advocacy for the CWS.
For stark contrast we note Canada’s uncertain posture, now quoted from a Globe and Mail Editorial of September 26: “Prime Minister Stephen Harper’s progress from a climate-change skeptic to an environmental convert has been a perplexing odyssey. After a half-hearted attempt to tackle greenhouse-gas emissions late last year, his Conservative government hurriedly introduced new regulations and incentives, which made a good start in fostering reductions. Earlier…(in September), in Australia, he even announced his personal commitment to ‘careful environmental stewardship’. That seemed heartfelt. Now it is fair to question the sincerity of that conversion. On… (Sept 24), at a UN climate change conference aimed at saving the Kyoto Protocol, Mr Harper announced that Canada had asked to join a rival climate-change pact, the Asia-Pacific Partnership. The six members of that pact include nations that have refused to ratify the protocol, such as the United States, and others among the world’s worst polluters, such as India and China. Together they account for nearly half of all greenhouse gas emissions”.
And now The Economist’s discussion of the Ugandan Prime Minister’s proposition, and their assessment of the situation and implications in Africa...
CLIMATE CHANGE AS AN ACT OF AGGRESSION
At a recent African Union summit, Uganda's president, Yoweri Museveni, declared climate change an act of aggression by the rich world against the world’s poor. Indeed, if predictions of the UN's Intergovernmental Panel on Climate Change (IPCC) hold true, climate change may have a graver effect on Africa than on any other continent. One may well ask…Why should the poorest die for the continued excesses of the richest?
According to The Economist, the IPCC's most recent regional report raises the spectre of rising mortality. It predicts a minimum 2.5°C increase in temperature in Africa by 2030; drylands bordering deserts may get drier, wetlands bordering rainforests may get wetter. The panel suggests the supply of food in Africa will be “severely compromised” by climate change, with crop yields in danger of collapsing in some countries.
In the drylands, water may become a critical issue. Soaring temperatures and erratic rainfall may dry up surface water. Between 75m and 250m Africans, out of the 800m or so now living in sub-Saharan Africa, may be short of water. The soil will hold less moisture, bore-holes will become contaminated, and women and girls will have to walk ever greater distances to fetch water. Vegetative cover will recede. The IPCC guesses that 600,000 square kilometres (232,000 square miles) of cultivable land may be ruined.
Warming may also hurt animal habitats and biodiversity. More algae in freshwater lakes will hit fishing. The glaciers of Uganda's Rwenzori mountains, of Tanzania's Kilimanjaro and of Kenya's eponymous mountain may disappear; only 7 of the 18 glaciers recorded on Mount Kenya in 1900 still remain. At the same time, a likely rise in sea levels may threaten the coastal infrastructure of northern Egypt, the Gambia, the Gulf of Guinea and Senegal.
There are two caveats to this gloomy scenario: 1) some parts of Africa may benefit from climate change. Increased rainfall in highland areas in eastern Africa could, for example, be beneficial. 2) though climate-change models have improved, they have been unreliable in Africa; the detail is guesswork.
Still, states The Economist, some scientists think that climate change may be even crueler to parts of Africa than the IPCC predicts. The important point, they say, is not the degree of warming but the continent's vulnerability to it. A University of Pretoria study estimates that Africa might lose $25 billion in crop failure due to rising temperatures and another $4 billion from less rain. The already impoverished drylands would suffer most. Some cite the war in Sudan's Darfur region as proof of the damage done by climate change, soil erosion and overpopulation.
Unfortunately, in the opinion of The Economist, few African leaders have grasped the scale of the challenge... Most oil-producers have squandered their bonanza. Nigeria has failed to plan for how to stem the dreadful pollution in its oil-producing Delta region or to prevent desertification tearing at the fabric of its dry Muslim north. South Africa is only just beginning to own up to its coal addiction. Uganda's Mr Museveni is fighting off a rare insurrection from his supporters against plans to turn a piece of Ugandan rainforest over to farming. The World Meteorological Organisation says that weather-data collection in Africa has recently got worse, just as the need for accurate figures has grown; many of the automatic weather stations it helped set up have fallen into disrepair. The African Union has done little to sound the climate-change alarm.
Kenya's president, Mwai Kibaki, says that Africa should “join hands” with its friends in the rich world over climate change. He wants more carbon-trading projects to come to Africa; so far, most have gone to Asia. His advisers admit that Mr Kibaki's ambitious plan to turn Kenya into an industrial country by 2020 worries environmentalists, but say that reforestation, thermal power and better management of water and grazing would, if they materialized, offset the damage.
Africa emits far less carbon than other continents, so its recently faster-growing economies do not gravely menace its environment. Some rich-country consumers, however, want to punish African countries for air freighting northwards some of their produce, from flowers to wine.
Hardier new varieties of staple crops, drip irrigation schemes and technologies such as solar power should help Africa adapt to climate change. But so can simple shifts in policy. For instance, a government decision in Burkina Faso to let farmers own the trees on their land has increased the country's tree cover.
The Economist’s conclusion: As the G8 rich countries are failing so far to fulfill the promises they made in 2005 to boost aid to Africa, the continent should not expect much new money to protect the environment. In the short run, Africa's own politicians need to take a lead, even if the people most culpable for the damage done by climate change live elsewhere.
Sources:
. Church World Service and partners prepare to act on climate change. May 2, 2007. http://www.churchworldservice.org/Educ_Advo/news/2007/climatechange.html
. Globe and Mail. Lead Editorial. Sept 26, 2007.
. Economist.com. Global Warming in Africa – drying up and flooding out. Sept 24, 2007. http://www.economist.com/world/africa/displaystory.cfm?story_id=9163426
COMMENT: What is important about the contrasting viewpoints presented, from those of President Museveni, to the Church World Service, The Economist, to the anti-Kyoto stance of Prime Minister Harper and the Asian-Pacific partnership, is that ultimately they highlight climate change as an ethical issue that almost inevitably will come up as a focus for discussion at the UN negotiations on climate change scheduled for Bali in December.
For stark contrast we note Canada’s uncertain posture, now quoted from a Globe and Mail Editorial of September 26: “Prime Minister Stephen Harper’s progress from a climate-change skeptic to an environmental convert has been a perplexing odyssey. After a half-hearted attempt to tackle greenhouse-gas emissions late last year, his Conservative government hurriedly introduced new regulations and incentives, which made a good start in fostering reductions. Earlier…(in September), in Australia, he even announced his personal commitment to ‘careful environmental stewardship’. That seemed heartfelt. Now it is fair to question the sincerity of that conversion. On… (Sept 24), at a UN climate change conference aimed at saving the Kyoto Protocol, Mr Harper announced that Canada had asked to join a rival climate-change pact, the Asia-Pacific Partnership. The six members of that pact include nations that have refused to ratify the protocol, such as the United States, and others among the world’s worst polluters, such as India and China. Together they account for nearly half of all greenhouse gas emissions”.
And now The Economist’s discussion of the Ugandan Prime Minister’s proposition, and their assessment of the situation and implications in Africa...
CLIMATE CHANGE AS AN ACT OF AGGRESSION
At a recent African Union summit, Uganda's president, Yoweri Museveni, declared climate change an act of aggression by the rich world against the world’s poor. Indeed, if predictions of the UN's Intergovernmental Panel on Climate Change (IPCC) hold true, climate change may have a graver effect on Africa than on any other continent. One may well ask…Why should the poorest die for the continued excesses of the richest?
According to The Economist, the IPCC's most recent regional report raises the spectre of rising mortality. It predicts a minimum 2.5°C increase in temperature in Africa by 2030; drylands bordering deserts may get drier, wetlands bordering rainforests may get wetter. The panel suggests the supply of food in Africa will be “severely compromised” by climate change, with crop yields in danger of collapsing in some countries.
In the drylands, water may become a critical issue. Soaring temperatures and erratic rainfall may dry up surface water. Between 75m and 250m Africans, out of the 800m or so now living in sub-Saharan Africa, may be short of water. The soil will hold less moisture, bore-holes will become contaminated, and women and girls will have to walk ever greater distances to fetch water. Vegetative cover will recede. The IPCC guesses that 600,000 square kilometres (232,000 square miles) of cultivable land may be ruined.
Warming may also hurt animal habitats and biodiversity. More algae in freshwater lakes will hit fishing. The glaciers of Uganda's Rwenzori mountains, of Tanzania's Kilimanjaro and of Kenya's eponymous mountain may disappear; only 7 of the 18 glaciers recorded on Mount Kenya in 1900 still remain. At the same time, a likely rise in sea levels may threaten the coastal infrastructure of northern Egypt, the Gambia, the Gulf of Guinea and Senegal.
There are two caveats to this gloomy scenario: 1) some parts of Africa may benefit from climate change. Increased rainfall in highland areas in eastern Africa could, for example, be beneficial. 2) though climate-change models have improved, they have been unreliable in Africa; the detail is guesswork.
Still, states The Economist, some scientists think that climate change may be even crueler to parts of Africa than the IPCC predicts. The important point, they say, is not the degree of warming but the continent's vulnerability to it. A University of Pretoria study estimates that Africa might lose $25 billion in crop failure due to rising temperatures and another $4 billion from less rain. The already impoverished drylands would suffer most. Some cite the war in Sudan's Darfur region as proof of the damage done by climate change, soil erosion and overpopulation.
Unfortunately, in the opinion of The Economist, few African leaders have grasped the scale of the challenge... Most oil-producers have squandered their bonanza. Nigeria has failed to plan for how to stem the dreadful pollution in its oil-producing Delta region or to prevent desertification tearing at the fabric of its dry Muslim north. South Africa is only just beginning to own up to its coal addiction. Uganda's Mr Museveni is fighting off a rare insurrection from his supporters against plans to turn a piece of Ugandan rainforest over to farming. The World Meteorological Organisation says that weather-data collection in Africa has recently got worse, just as the need for accurate figures has grown; many of the automatic weather stations it helped set up have fallen into disrepair. The African Union has done little to sound the climate-change alarm.
Kenya's president, Mwai Kibaki, says that Africa should “join hands” with its friends in the rich world over climate change. He wants more carbon-trading projects to come to Africa; so far, most have gone to Asia. His advisers admit that Mr Kibaki's ambitious plan to turn Kenya into an industrial country by 2020 worries environmentalists, but say that reforestation, thermal power and better management of water and grazing would, if they materialized, offset the damage.
Africa emits far less carbon than other continents, so its recently faster-growing economies do not gravely menace its environment. Some rich-country consumers, however, want to punish African countries for air freighting northwards some of their produce, from flowers to wine.
Hardier new varieties of staple crops, drip irrigation schemes and technologies such as solar power should help Africa adapt to climate change. But so can simple shifts in policy. For instance, a government decision in Burkina Faso to let farmers own the trees on their land has increased the country's tree cover.
The Economist’s conclusion: As the G8 rich countries are failing so far to fulfill the promises they made in 2005 to boost aid to Africa, the continent should not expect much new money to protect the environment. In the short run, Africa's own politicians need to take a lead, even if the people most culpable for the damage done by climate change live elsewhere.
Sources:
. Church World Service and partners prepare to act on climate change. May 2, 2007. http://www.churchworldservice.org/Educ_Advo/news/2007/climatechange.html
. Globe and Mail. Lead Editorial. Sept 26, 2007.
. Economist.com. Global Warming in Africa – drying up and flooding out. Sept 24, 2007. http://www.economist.com/world/africa/displaystory.cfm?story_id=9163426
COMMENT: What is important about the contrasting viewpoints presented, from those of President Museveni, to the Church World Service, The Economist, to the anti-Kyoto stance of Prime Minister Harper and the Asian-Pacific partnership, is that ultimately they highlight climate change as an ethical issue that almost inevitably will come up as a focus for discussion at the UN negotiations on climate change scheduled for Bali in December.
Saturday, 1 September 2007
THIRD WORLD AID TO FIRST WORLD COUNTRIES... The “Brain Drain”
PREAMBLE: In this issue we feature the "brain drain" (migration of professionals from low-resource settings to more developed ones) from sub-Saharan Africa. The report was developed by Juan Ramos, Program Coordinator of ProCOR, a web community focusing on cardiovascular disease problems in the developing world, that offers free-ranging debate on a range of related health and social issues (SEE: Recommended Links in sidebar, adjacent to June 1 blog below). The crisis is enormous, and some potential solutions are outlined in the report. It is to be hoped that there will be some practical response to these, such as striving for better compensation for indigenous health professionals, attention to policies that determine recruitment and retention of health professions in low income countries, fixing the ethics of western firms that raid poor countries to meet the service demands of rich ones, and finding ways to compensate third world "donor" countries for their loss of human resources. Through official inaction, "first world" countries benefit from a massive subsidy from the "third world", equal to the direct and indirect costs of their investment in this health human resource, and the opportunity costs entailed by its loss.
Also in the main section below we elevate an item previously presented in our sidebar: on "Corporate Hybrids". Your host, Pacific Health & Development Sciences Inc. (PacificSci), is an example of such an organization, now in its 4th year of operation.
In our sidebar: Once again we focus on Canada's political scene, with a brief capsule on Prime Minister Stephen Harper’s limited popularity, as revealed in a recent poll. We then focus on a troubling police action that may have been politically directed. Whether or not one agrees or disagrees with opposition on any given policy issue, the legal and democratic right to protest is supposed to be protected in our society. However, the recent undermining of a legal protest in a designated area adjacent to the “Security and Prosperity Summit” (involving the leadership of Canada, Mexico and the US) through use of agents provocateurs has alarmed our civil society. That Canada’s police forces were used to discredit the use of this right is cause for serious concern, and it is disturbing that the Honourable Stockwell Day, Minister for Public Security is ignoring calls for a public inquiry, issuing statements designed to diminish political accountability.
BRAIN DRAIN FROM SUBSAHARAN AFRICA
Significant numbers of African-trained health workers migrate every year to developed regions, leaving severely crippled health systems in countries where life expectancy is only age 50 and 16% of children die before age five. However, the critical shortage of health care workers in many parts of the world is beginning to receive attention from donors and international agencies. Donors are increasingly realizing that without enough trained workers to deliver drugs, vaccines and care, funding projects will not have the desired effects.
The population of sub-Saharan Africa totals over 660 million, with a ratio of fewer than 13 physicians per 100,000. The continent bears 24% of the global burden of disease but has only 3% of the health care workforce and 1% of the world's financial resources. Africa suffers more from brain drain due to economic conditions, wage differentials, rapid population growth among young people and conflict than any other continent.The worker shortage derives from a combination of underproduction, internal maldistribution and emigration of trained workers. Sub-Saharan Africa needs approximately 700,000 physicians to meet the Millennium Development Goals. Many African countries cannot meet widely accepted basic standards for health care coverage by physicians, nurses and midwives. An additional 2.4 million physicians, nurses and midwives are needed, along with an additional 1.9 million pharmacists, health aides, technicians and other auxiliary personnel.
Fewer health professionals from African countries than from other countries work in the US, according to the Least Developed Countries Report 2007. Data from the report demonstrate that the percentage of doctors practicing in the US relative to the total number of doctors back home range from 43% in Liberia to 10% in Zambia. This would not be a problem if the number of doctors remaining in their country of origin was sufficient to meet the needs of the population, but this is not the case. For example, Zambia has only seven doctors per 100,000 people, compared with the US level, which is close to 300. Even though the absolute number of professionals from the poorest countries working abroad may be small, the impact on professional services back home can be severe.
Efforts to retain workers focus on health care systems. For example, Swaziland provides HIV/AIDS services for health care workers who, practicing in high-prevalence areas with minimal resources for safety measures, are at an increased risk for occupational exposure. Other efforts build on the belief that providing workers with needed resources for care motivates them to stay and work in their home countries.Improved wages are also a key to retention. Salary support can help motivate health care workers to remain in their countries, even if it means working with fewer resources. Other types of inducements have been offered, such as lunch allowances, care loans and affordable housing.Some countries have begun to recruit trainees from rural areas. In South Africa, local students can receive scholarships for health care training on the condition they agree to return to their home district to practice. A study of the program found that trainees from rural areas were three to eight times as likely as those from urban areas to practice in rural regions after graduation.
The documented shortage of health care workers has inspired the American Public Health Association to pass a policy statement on "Ethical Restrictions on International Recruitment of Health Professionals to the United States." The policy addresses the role of the US in exacerbating the international crisis, calling on employers to adopt voluntary codes for ethical recruitment and on the government to contract only with employers who have done so. The future of global health and development in the 21st century lies in the management of the crisis in human resources for health.
More information is available from these resources on brain drain:
* "Providing the providers-remedying Africa's shortage of health care workers." N Engl J Med 2007; 356(25): 2564-67.http://content.nejm.org/cgi/content/extract/356/25/2564
* The Brain Drain of Health Professionals from Sub-Saharan Africa to Canada (3.5 MB):http://www.queensu.ca/samp/sampresources/samppublications/mad/MAD_2.pdf
* The Least Developed Countries Report 2007 (2.54 MB):http://www.unctad.org/en/docs/ldc2007_en.pdf
Source: Juan Ramos. ProCOR. Aug 9, 2007 Jramos3@partners.org
NOTE: To visit ProCOR, scan column at right to locate URL under “Recommended Links”.
CORPORATE HYBRIDS
“… organizations driven by both social purpose and financial promise that fall somewhere between traditional companies and charities…distinct from those operating in the government, business and non-profit sectors…Whatever participants call it, the fourth sector faces challenges. Current legal and tax structures draw strict lines between for-profits and non-profits… The social benefits that fourth-sector firm seek to unlock are not easily quantified and often take decades, not quarters, to attain.”
Reference: Stephanie Strom. The New York Times. May 6, 2007.
COMMENT: By definition, PacificSci is a hybrid or "fourth sector" organization. Ineligible for grants available to non-profits, nor driven by the bottom line as a purely business enterprise, nor financially underwritten by the tax payer as are universities, government bodies and international agencies, yet our contractual work, advocacy efforts and pro bono activities are all guided by our secular humanist mission: seeking solutions to the health and social impacts of development. Now in its 4th year, our philosophical model is proving operationally viable and productive.
Also in the main section below we elevate an item previously presented in our sidebar: on "Corporate Hybrids". Your host, Pacific Health & Development Sciences Inc. (PacificSci), is an example of such an organization, now in its 4th year of operation.
In our sidebar: Once again we focus on Canada's political scene, with a brief capsule on Prime Minister Stephen Harper’s limited popularity, as revealed in a recent poll. We then focus on a troubling police action that may have been politically directed. Whether or not one agrees or disagrees with opposition on any given policy issue, the legal and democratic right to protest is supposed to be protected in our society. However, the recent undermining of a legal protest in a designated area adjacent to the “Security and Prosperity Summit” (involving the leadership of Canada, Mexico and the US) through use of agents provocateurs has alarmed our civil society. That Canada’s police forces were used to discredit the use of this right is cause for serious concern, and it is disturbing that the Honourable Stockwell Day, Minister for Public Security is ignoring calls for a public inquiry, issuing statements designed to diminish political accountability.
BRAIN DRAIN FROM SUBSAHARAN AFRICA
Significant numbers of African-trained health workers migrate every year to developed regions, leaving severely crippled health systems in countries where life expectancy is only age 50 and 16% of children die before age five. However, the critical shortage of health care workers in many parts of the world is beginning to receive attention from donors and international agencies. Donors are increasingly realizing that without enough trained workers to deliver drugs, vaccines and care, funding projects will not have the desired effects.
The population of sub-Saharan Africa totals over 660 million, with a ratio of fewer than 13 physicians per 100,000. The continent bears 24% of the global burden of disease but has only 3% of the health care workforce and 1% of the world's financial resources. Africa suffers more from brain drain due to economic conditions, wage differentials, rapid population growth among young people and conflict than any other continent.The worker shortage derives from a combination of underproduction, internal maldistribution and emigration of trained workers. Sub-Saharan Africa needs approximately 700,000 physicians to meet the Millennium Development Goals. Many African countries cannot meet widely accepted basic standards for health care coverage by physicians, nurses and midwives. An additional 2.4 million physicians, nurses and midwives are needed, along with an additional 1.9 million pharmacists, health aides, technicians and other auxiliary personnel.
Fewer health professionals from African countries than from other countries work in the US, according to the Least Developed Countries Report 2007. Data from the report demonstrate that the percentage of doctors practicing in the US relative to the total number of doctors back home range from 43% in Liberia to 10% in Zambia. This would not be a problem if the number of doctors remaining in their country of origin was sufficient to meet the needs of the population, but this is not the case. For example, Zambia has only seven doctors per 100,000 people, compared with the US level, which is close to 300. Even though the absolute number of professionals from the poorest countries working abroad may be small, the impact on professional services back home can be severe.
Efforts to retain workers focus on health care systems. For example, Swaziland provides HIV/AIDS services for health care workers who, practicing in high-prevalence areas with minimal resources for safety measures, are at an increased risk for occupational exposure. Other efforts build on the belief that providing workers with needed resources for care motivates them to stay and work in their home countries.Improved wages are also a key to retention. Salary support can help motivate health care workers to remain in their countries, even if it means working with fewer resources. Other types of inducements have been offered, such as lunch allowances, care loans and affordable housing.Some countries have begun to recruit trainees from rural areas. In South Africa, local students can receive scholarships for health care training on the condition they agree to return to their home district to practice. A study of the program found that trainees from rural areas were three to eight times as likely as those from urban areas to practice in rural regions after graduation.
The documented shortage of health care workers has inspired the American Public Health Association to pass a policy statement on "Ethical Restrictions on International Recruitment of Health Professionals to the United States." The policy addresses the role of the US in exacerbating the international crisis, calling on employers to adopt voluntary codes for ethical recruitment and on the government to contract only with employers who have done so. The future of global health and development in the 21st century lies in the management of the crisis in human resources for health.
More information is available from these resources on brain drain:
* "Providing the providers-remedying Africa's shortage of health care workers." N Engl J Med 2007; 356(25): 2564-67.http://content.nejm.org/cgi/content/extract/356/25/2564
* The Brain Drain of Health Professionals from Sub-Saharan Africa to Canada (3.5 MB):http://www.queensu.ca/samp/sampresources/samppublications/mad/MAD_2.pdf
* The Least Developed Countries Report 2007 (2.54 MB):http://www.unctad.org/en/docs/ldc2007_en.pdf
Source: Juan Ramos. ProCOR. Aug 9, 2007 Jramos3@partners.org
NOTE: To visit ProCOR, scan column at right to locate URL under “Recommended Links”.
CORPORATE HYBRIDS
“… organizations driven by both social purpose and financial promise that fall somewhere between traditional companies and charities…distinct from those operating in the government, business and non-profit sectors…Whatever participants call it, the fourth sector faces challenges. Current legal and tax structures draw strict lines between for-profits and non-profits… The social benefits that fourth-sector firm seek to unlock are not easily quantified and often take decades, not quarters, to attain.”
Reference: Stephanie Strom. The New York Times. May 6, 2007.
COMMENT: By definition, PacificSci is a hybrid or "fourth sector" organization. Ineligible for grants available to non-profits, nor driven by the bottom line as a purely business enterprise, nor financially underwritten by the tax payer as are universities, government bodies and international agencies, yet our contractual work, advocacy efforts and pro bono activities are all guided by our secular humanist mission: seeking solutions to the health and social impacts of development. Now in its 4th year, our philosophical model is proving operationally viable and productive.
Wednesday, 1 August 2007
FIRST THEY CAME… VIGNETTES IN THE DISMANTLING OF DEMOCRATIC MYTHS
PREAMBLE: In this issue we offer a selection of extracts from reputable sources that focus on the disastrous trajectory of the current US administration in undermining the beliefs that underpin western democracies. We dedicate the issue to Pastor Martin Niemoller (1892–1984), whose famous poem “First they came…” about the inactivity of German intellectuals during the Nazi rise to power and the subsequent purging of their chosen targets, group by group, most devastatingly to German Jews.
For historical perspective on this poem visit: http://en.wikipedia.org/wiki/First_they_came...
The Sidebar addresses Canada’s posture on US Foreign Policy, and related vignettes.
SUPPORT BUILDING FOR IMPEACHMENT
Impeachment is the first step under the US Constitution for removing a president from office, a process by which possible crimes may be investigated and charges laid. In a Gallup survey recently released by USA Today, 36% of respondents believe there is justification for Congress to begin impeachment proceedings against George W. Bush. [1] Since 2006, Democratic lawmakers have openly discussed Bush’s impeachment, either for not telling the truth about his reasons for going to war in Iraq, and/or for authorizing wiretapping of Americans. [2] State and local governments can also play a major role in the impeachment process by sending charges to the Congress for it to act on. Eleven states have initiated Impeachment Resolutions. Vermont has passed its resolution, while numerous cities and counties have also passed such resolutions. Efforts are now underway in several other states to initiate impeachment. [3]
Sources: 1. Angus Reid Global Monitor. July 12, 2007. http://www.angus-reid.com/polls/index.cfm/fuseaction/viewItem/itemID/16461 2. Atlanta Progressive News, Global Research. March 11, 2006 http://www.globalresearch.ca/index.php?context=viewArticle&code=20060311&articleId=2085 3. Editorials and information on how to impeach Bush and Cheney. http://www.impeachbush.tv/impeach/bystate.html
THE TRAGIC CASE OF THE STATELESS UIGHARS
Tirana, Albania: Ahktar Qassim Basit says he is not angry about the 4 years he spent incarcerated at Guantanamo Bay. He and fellow Muslims from western China’s Uighar ethnic minority, were living in a hamlet near Tora Bora (Afghanistan), when US Forces bombed the area in 2001.Taken prisoners, then interned at Guantanamo, the men were “freed” after being found to pose no threat to the US. Their captors mumbled a perfunctory apology before flying them to Albania as “refugees” versus repatriation, citing China’s past treatment of the minority. Living for over a year in a squalid government refugee centre under armed guard, they are told that to gain their liberty, they must first learn Albanian to get work permits, and somehow must accomplish this on their own; they are losing hope of seeing their wives and children again.
Source: Tim Golden. New York Times. June 10, 2007. http://www.nytimes.com/2007/06/10/world/europe/10resettle.html?amp;amp;amp;ei=5088&en=5c446ec162d28fc6&ex=1339128000&partner=rss&pagewanted=print
NOTE: US political influentials such as former Secretary of State Colin Powell are now pressing for closure of the Guanatamo prison camp, surely too long a silence. BBC News June 11, 2007.
WEB OF DECEIT – Book Review
Because of restrictions imposed by the Special Tribunal prosecuting Saddam Hussein, the role of the US and its allies in his crimes was never explored at his trial. This investigative history reveals the full extent of western complicity in Iraq. The deceit described by author Barry Lando, ranges from CIA backed coups to help the Baath Party seize power, to the US encouraging Saddam to invade Iran, to America’s willful ignorance of his chemical weapons use, and the tragic impact of trade sanctions, maintained long after being proven ineffective and despite huge numbers of Iraqi civilians (mainly children) dying as a result. An unrestricted international trial might have divulged these facts, but victor’s justice prevented it. Most media coverage has ignored these facts; Web of Deceit breaks the silence.
Reference: Lando B. Web of Deceit - the History of Western Complicity in Iraq: from Churchill to Kennedy to George W Bush. Doubleday Canada. 2007.
NOTE: Lando is a graduate of Harvard and Columbia universities, and for 25 years was an investigative producer with 60 Minutes.
BELATEDLY UPHOLDING THE RULE OF LAW
For several years, President Bush has claimed that congressional authority to attack Afghanistan after 9/11 was a “declaration of a war on terror” that gave him power to decide who combatants are and incarcerate them in military prisons indefinitely without charges, even foreign nationals living legally within the US. On June 11, 2007 in a 2-1 decision, a 4th US Circuit Court of Appeals rejected this claim, demonstrating how threatening this policy is to the US Constitution and the rule of law. The court said that the Constitution and precedents made it clear that foreigners living legally in the US have the same right to due process as any citizen.
Source: Editorial. International Herald Tribune. June 13, 2007.
IRAQ’s HUMANITARIAN DISASTER
The US-led invasion in March 2003 caused many civilian casualties, but did not immediately create a major humanitarian crisis or set off mass migration. Soon after however, counter-insurgency operations, including attacks on Iraq cities eg., Falluja, led to increased mortality and displacement affecting hundreds of thousands of people. Beginning in 2006, sectarian clashes and communal violence led to rising death and injury, with massive new displacement.[1]
According to OXFAM child malnutrition rates have risen from 19 % before the US-led invasion in 2003 to 28% now, and 8 million people are in need of emergency assistance.[2] This includes:
• 4 million who are ‘food-insecure and in dire need of different types of humanitarian assistance’
• >2 million displaced people inside Iraq
• >2 million Iraqis in neighbouring countries, mainly Syria and Jordan, making this the fastest-growing refugee crisis in the world.
According to the United Nations Development Programme, 1/3 of the population now lives in poverty.[1] Education has broken down. Worse, basic needs such as drinking water, food, sanitation and electricity are not being met. Hospitals lack basic supplies and are understaffed. The international relief system is not able to respond to the growing humanitarian challenges.
References:
1. Global Policy Forum. July 11, 2007. http://www.globalpolicy.org/security/issues/iraq/attack/crisisindex.htm
2. OXFAM Briefing Paper. July 30, 2007. http://news.bbc.co.uk/1/shared/bsp/hi/pdfs/18_07_07_oxfam_iraq.pdf
JUXTAPOSING MORAL CHOICES
“But what is $1.5 billion in today’s world? That is what we spend every day on the Pentagon. That’s our daily military budget. So here is the calculation, and here is the choice. One day’s Pentagon spending would provide all sleeping sites in Africa with five years of bed-net coverage, to fend off a disease (malaria) which kills millions every year. That’s a choice. We haven’t made it. My suggestion is, the Pentagon take off next Thursday”.
Source: Jeffrey Sachs, Director of the Earth Institute, Columbia University. Convocation Address to Ursinus College. As reported in: New York Times, June 10, 2007.
US DOMESTIC IMPACTS OF THE IRAQ WAR Example: Education
13 Days in Iraq: $3.4 billion = Cut in education budget in President's FY 07 budget from FY 06 funding support for the arts, technology and parent resource centers.
2.5 days in Iraq: $ 664 million = Perkins Loan program cut in president's FY 07 budget (would help 463,000 low-income students attend college).
9 hours in Iraq: $99 million = Even Start (eliminated in President's budget).
Source: Congressman John Murtha (Pennsylvania D). Information Clearing House. July 13, 2006. http://www.informationclearinghouse.info/article13976.htm
THE ASSAULT ON REASON – Book Review
According to former US Vice President Al Gore’s new work “The Assault on Reason”, the Bush administration, in pursuit of its “war on terror”, has violated international laws and norms of conduct, seriously damaged alliances, and thrown away the global goodwill that emerged following 9/11. Gore also addresses global warming, the insidious power of televised control of public discourse, and the role of wealth in US politics, and calls for a rebirth of democracy. Parenthetically, we note that current impacts and consequences of global warming dwarf terrorism, even while noting that the latter has been hyper-stimulated by the war in Iraq.
According to Gore, the Bush Administration’s use of extra-judicial measures at home and abroad has undermined basic principles of law, justice, human rights and democracy. The Geneva Conventions are not being observed (termed “quaint" by the Attorney-General Gonzales), despite the seminal role of the US in their origins. By facilitating torture the Administration has placed its own troops at moral hazard and also physical risk (in the event of their capture). Its practice of “extraordinary rendition” (kidnapping “terror suspects” and forcible relocation to marginal states for interrogation so as to circumvent habeas corpus), has resulted in imprisonment and torture of innocent people (see sidebar on Canadian Mahar Arar). More troubling, it has suppressed its own legal processes in support of what appear to be show trials, in which defence lawyers are unable to gain access to information that would allow them to properly defend their clients. A code of secrecy prevents evidence of human rights abuses from coming to light.
According to the International Committee of the Red Cross, some 90% of Guantanamo Bay inmates, held without charge, are innocent of any unlawful activity.
Background Source: BBC World. Mystery Flights. June 10, 2007.
Reference: Gore A. The Assault on Reason. The Penguin Press. New York. 2007.
A BREAKDOWN IN TRUST
July 24: “I don't trust you” asserted Sen. Patrick Leahy, Vermont Democrat, and chair of a Senate Judiciary Committee oversight panel, to Attorney General Alberto Gonzales's on his handling of the U.S. Attorneys firings and civil liberties abuses by the FBI. He stated doubts about the sincerity of Mr. Gonzales' vow to fix "problems" at the Justice Department, and criticized his promise to better police the use of counter-terrorism information gathering tools as insufficient. "With a history of civil liberties abuses and cover-ups, this administration has squandered our trust," Mr. Leahy said. The criticism is bipartisan: ranking Republican Sen. Arlen Specter, Pennsylvania, stated "a very heavy cloud" hangs over the Justice Department, and asked "Is your department functioning?" Mr. Gonzales did not respond to these criticisms in the opening statements, but instead asked the panel to help the Justice Department fight terrorism.
Source: Jon Ward, White House correspondent, The Washington Times. Posted July 24, 2007. http://video1.washingtontimes.com/fishwrap/2007/07/i_dont_trust_you.html
For historical perspective on this poem visit: http://en.wikipedia.org/wiki/First_they_came...
The Sidebar addresses Canada’s posture on US Foreign Policy, and related vignettes.
SUPPORT BUILDING FOR IMPEACHMENT
Impeachment is the first step under the US Constitution for removing a president from office, a process by which possible crimes may be investigated and charges laid. In a Gallup survey recently released by USA Today, 36% of respondents believe there is justification for Congress to begin impeachment proceedings against George W. Bush. [1] Since 2006, Democratic lawmakers have openly discussed Bush’s impeachment, either for not telling the truth about his reasons for going to war in Iraq, and/or for authorizing wiretapping of Americans. [2] State and local governments can also play a major role in the impeachment process by sending charges to the Congress for it to act on. Eleven states have initiated Impeachment Resolutions. Vermont has passed its resolution, while numerous cities and counties have also passed such resolutions. Efforts are now underway in several other states to initiate impeachment. [3]
Sources: 1. Angus Reid Global Monitor. July 12, 2007. http://www.angus-reid.com/polls/index.cfm/fuseaction/viewItem/itemID/16461 2. Atlanta Progressive News, Global Research. March 11, 2006 http://www.globalresearch.ca/index.php?context=viewArticle&code=20060311&articleId=2085 3. Editorials and information on how to impeach Bush and Cheney. http://www.impeachbush.tv/impeach/bystate.html
THE TRAGIC CASE OF THE STATELESS UIGHARS
Tirana, Albania: Ahktar Qassim Basit says he is not angry about the 4 years he spent incarcerated at Guantanamo Bay. He and fellow Muslims from western China’s Uighar ethnic minority, were living in a hamlet near Tora Bora (Afghanistan), when US Forces bombed the area in 2001.Taken prisoners, then interned at Guantanamo, the men were “freed” after being found to pose no threat to the US. Their captors mumbled a perfunctory apology before flying them to Albania as “refugees” versus repatriation, citing China’s past treatment of the minority. Living for over a year in a squalid government refugee centre under armed guard, they are told that to gain their liberty, they must first learn Albanian to get work permits, and somehow must accomplish this on their own; they are losing hope of seeing their wives and children again.
Source: Tim Golden. New York Times. June 10, 2007. http://www.nytimes.com/2007/06/10/world/europe/10resettle.html?amp;amp;amp;ei=5088&en=5c446ec162d28fc6&ex=1339128000&partner=rss&pagewanted=print
NOTE: US political influentials such as former Secretary of State Colin Powell are now pressing for closure of the Guanatamo prison camp, surely too long a silence. BBC News June 11, 2007.
WEB OF DECEIT – Book Review
Because of restrictions imposed by the Special Tribunal prosecuting Saddam Hussein, the role of the US and its allies in his crimes was never explored at his trial. This investigative history reveals the full extent of western complicity in Iraq. The deceit described by author Barry Lando, ranges from CIA backed coups to help the Baath Party seize power, to the US encouraging Saddam to invade Iran, to America’s willful ignorance of his chemical weapons use, and the tragic impact of trade sanctions, maintained long after being proven ineffective and despite huge numbers of Iraqi civilians (mainly children) dying as a result. An unrestricted international trial might have divulged these facts, but victor’s justice prevented it. Most media coverage has ignored these facts; Web of Deceit breaks the silence.
Reference: Lando B. Web of Deceit - the History of Western Complicity in Iraq: from Churchill to Kennedy to George W Bush. Doubleday Canada. 2007.
NOTE: Lando is a graduate of Harvard and Columbia universities, and for 25 years was an investigative producer with 60 Minutes.
BELATEDLY UPHOLDING THE RULE OF LAW
For several years, President Bush has claimed that congressional authority to attack Afghanistan after 9/11 was a “declaration of a war on terror” that gave him power to decide who combatants are and incarcerate them in military prisons indefinitely without charges, even foreign nationals living legally within the US. On June 11, 2007 in a 2-1 decision, a 4th US Circuit Court of Appeals rejected this claim, demonstrating how threatening this policy is to the US Constitution and the rule of law. The court said that the Constitution and precedents made it clear that foreigners living legally in the US have the same right to due process as any citizen.
Source: Editorial. International Herald Tribune. June 13, 2007.
IRAQ’s HUMANITARIAN DISASTER
The US-led invasion in March 2003 caused many civilian casualties, but did not immediately create a major humanitarian crisis or set off mass migration. Soon after however, counter-insurgency operations, including attacks on Iraq cities eg., Falluja, led to increased mortality and displacement affecting hundreds of thousands of people. Beginning in 2006, sectarian clashes and communal violence led to rising death and injury, with massive new displacement.[1]
According to OXFAM child malnutrition rates have risen from 19 % before the US-led invasion in 2003 to 28% now, and 8 million people are in need of emergency assistance.[2] This includes:
• 4 million who are ‘food-insecure and in dire need of different types of humanitarian assistance’
• >2 million displaced people inside Iraq
• >2 million Iraqis in neighbouring countries, mainly Syria and Jordan, making this the fastest-growing refugee crisis in the world.
According to the United Nations Development Programme, 1/3 of the population now lives in poverty.[1] Education has broken down. Worse, basic needs such as drinking water, food, sanitation and electricity are not being met. Hospitals lack basic supplies and are understaffed. The international relief system is not able to respond to the growing humanitarian challenges.
References:
1. Global Policy Forum. July 11, 2007. http://www.globalpolicy.org/security/issues/iraq/attack/crisisindex.htm
2. OXFAM Briefing Paper. July 30, 2007. http://news.bbc.co.uk/1/shared/bsp/hi/pdfs/18_07_07_oxfam_iraq.pdf
JUXTAPOSING MORAL CHOICES
“But what is $1.5 billion in today’s world? That is what we spend every day on the Pentagon. That’s our daily military budget. So here is the calculation, and here is the choice. One day’s Pentagon spending would provide all sleeping sites in Africa with five years of bed-net coverage, to fend off a disease (malaria) which kills millions every year. That’s a choice. We haven’t made it. My suggestion is, the Pentagon take off next Thursday”.
Source: Jeffrey Sachs, Director of the Earth Institute, Columbia University. Convocation Address to Ursinus College. As reported in: New York Times, June 10, 2007.
US DOMESTIC IMPACTS OF THE IRAQ WAR Example: Education
13 Days in Iraq: $3.4 billion = Cut in education budget in President's FY 07 budget from FY 06 funding support for the arts, technology and parent resource centers.
2.5 days in Iraq: $ 664 million = Perkins Loan program cut in president's FY 07 budget (would help 463,000 low-income students attend college).
9 hours in Iraq: $99 million = Even Start (eliminated in President's budget).
Source: Congressman John Murtha (Pennsylvania D). Information Clearing House. July 13, 2006. http://www.informationclearinghouse.info/article13976.htm
THE ASSAULT ON REASON – Book Review
According to former US Vice President Al Gore’s new work “The Assault on Reason”, the Bush administration, in pursuit of its “war on terror”, has violated international laws and norms of conduct, seriously damaged alliances, and thrown away the global goodwill that emerged following 9/11. Gore also addresses global warming, the insidious power of televised control of public discourse, and the role of wealth in US politics, and calls for a rebirth of democracy. Parenthetically, we note that current impacts and consequences of global warming dwarf terrorism, even while noting that the latter has been hyper-stimulated by the war in Iraq.
According to Gore, the Bush Administration’s use of extra-judicial measures at home and abroad has undermined basic principles of law, justice, human rights and democracy. The Geneva Conventions are not being observed (termed “quaint" by the Attorney-General Gonzales), despite the seminal role of the US in their origins. By facilitating torture the Administration has placed its own troops at moral hazard and also physical risk (in the event of their capture). Its practice of “extraordinary rendition” (kidnapping “terror suspects” and forcible relocation to marginal states for interrogation so as to circumvent habeas corpus), has resulted in imprisonment and torture of innocent people (see sidebar on Canadian Mahar Arar). More troubling, it has suppressed its own legal processes in support of what appear to be show trials, in which defence lawyers are unable to gain access to information that would allow them to properly defend their clients. A code of secrecy prevents evidence of human rights abuses from coming to light.
According to the International Committee of the Red Cross, some 90% of Guantanamo Bay inmates, held without charge, are innocent of any unlawful activity.
Background Source: BBC World. Mystery Flights. June 10, 2007.
Reference: Gore A. The Assault on Reason. The Penguin Press. New York. 2007.
A BREAKDOWN IN TRUST
July 24: “I don't trust you” asserted Sen. Patrick Leahy, Vermont Democrat, and chair of a Senate Judiciary Committee oversight panel, to Attorney General Alberto Gonzales's on his handling of the U.S. Attorneys firings and civil liberties abuses by the FBI. He stated doubts about the sincerity of Mr. Gonzales' vow to fix "problems" at the Justice Department, and criticized his promise to better police the use of counter-terrorism information gathering tools as insufficient. "With a history of civil liberties abuses and cover-ups, this administration has squandered our trust," Mr. Leahy said. The criticism is bipartisan: ranking Republican Sen. Arlen Specter, Pennsylvania, stated "a very heavy cloud" hangs over the Justice Department, and asked "Is your department functioning?" Mr. Gonzales did not respond to these criticisms in the opening statements, but instead asked the panel to help the Justice Department fight terrorism.
Source: Jon Ward, White House correspondent, The Washington Times. Posted July 24, 2007. http://video1.washingtontimes.com/fishwrap/2007/07/i_dont_trust_you.html
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