The Humanitarian Times

December 21, 2000

- POWER PLANT #3 TURNS OFF IN CHERNOBYL AFTER DONORS COMMIT $1.5B for alternate power & employment programs in Ukraine. Plant 3 was the final (of 4, north near the Belarus border) reactor operational. It will take years for the highly radioactive fuel to be safely removed. Cancer rates (mostly thyroid & leukemia) surrounding Chernobyl appear to be elevated sixteen-fold, as a result of the April 26 1986 crisis when radiation from plant #4 carried over much of Europe. OCHA appeals for intl. cooperation on Chernobyl (April): http://www.reliefweb.int/ocha_ol/index.html. Ukraine's current severe ice storm requires generators, cables, tents, electrical repair kits. Despite intl. concerns other unsafe, older nuclear plants continue to operate in Bulgaria & the Czech Rep which have few other sources of energy. Last week Cuba told Russia that it no longer wished to complete a nuclear plant begun with Russian assistance.

- MALNUTRITION LIKELY TO INCREASE IN GUINEA, AS AID PROGRAMS PAUSE & World Food Programme suspends food aid to refugees in southern Guinea due to fears of violence against aid workers.

- EBOLA HEMORRHAGIC EPIDEMIC IN UGANDA KILLED 162 IN 3 MONTHS, beginning in Sept, but the rate of new cases has declined markedly & WHO declared the epidemic "contained" Nov 29. 39% of 421 cases have died, most - 381 - in Gulu district (north), plus Masindi & Mbarara districts. This epidemic did not cross the border into Sudan where displacement & famine would have made containment more difficult. Dr. Matt Lukwiya of Gulu's Lacor Hospital who oversaw early cases died earlier this month of Ebola. Case fatality rates in earlier epidemics (Sudan, Congo) were higher (85%) than in Uganda (30% death rate) in part because they were smaller in scope & less attended with appropriate health care. Infected persons become most contagious when the condition cascades into vomiting & bleeding. WHO has coordinated rapid field investigation & verification & surveillance along with MSF, CDC, Pasteur Institute, Istituto Superiore di Sanità, ACF, Amref, Save Children, World Vision, HealthCanada, & NGOs. The Govt of Uganda has been open & aggressive in publishing info about the epidemic. 50 Ugandan Red Cross volunteers educated citizens in Gulu about the disease. In Gulu, 4,000 individuals who made contact with known cases (e.g. in hospitals, at burials) will be monitored closely both to contain further transmission & to initiate early care which can reduce the case-fatality rate. Many case survivors have faced social exclusion by their fearful communities. Little attention has been given or revealed about how Ebola pathogenesis may differ among individuals also infected by HIV. Last month, the US National Inst. of Health said a new DNA-based (not protein based) vaccine against Ebola protects monkeys & may be effective in humans.

- REPATRIATION OF AFGHANS FROM PAKISTAN HALTED WHILE SANCTIONS IMPOSED by the UN Security Council yesterday. New refugee flows into Pakistan are likely, as the new economic & arms sanctions against Afghanistan will make the famine worse, increasing malnutrition & death. After the UN's action this week, the ruling Taliban party in Afghanistan severed peace discussions, meeting with the UN, & announced a boycott of US goods.

- WORLD HEALTH ORGANIZATION PROMOTES SURVEILLANCE IN EMERGENCIES of communicable diseases, as discussed in Geneva at WHO last week, with case studies of polio eradication, Ebola readiness, & HIV monitoring. Participants from NGOs, Epicentre, CDC & govts encouraged WHO lead in ensuring a consolidated surveillance system in all emergencies, using standardized disease case definitions for only the few priority disease; & with intelligence & planning feeding back to local health agencies.

- INTL CRISIS GROUP PROJECTS INCREASING VIOLENCE IN INDONESIA'S MALUKU islands in late December: http://www.intl-crisis-group.org/projects/showreport.cfm?reportid=112

- CONF. 2000: FINDINGS ON REPRODUCTIVE HEALTH OF DISPLACED POPULATIONS was held in WashDC Dec. 5-6, with participation from NGOs (250 people) with case studies from 22 countries, dealing not only with refugees but also conflict zones. Findings included field usage of "Reproductive-health Kits", of which midwife & clean delivery sub-kits have been high-demand. Reviewing death records among Afghan refugees in Pakistan, IRC found that reproductive health (maternal mortality & neonatal) accounted for more deaths (22%) than any other cause. Sexual violence against women proved to correlate with refugee camp experience & national conflict. A study conducted by the Women's Commission for Refugee Women & Children found that adolescent girls are primary targets for sexual violence perpetrated as a weapon of war, yet sexual violence prevention programs rarely target men. The Goal of the Reproductive Health for Refugees Consortium is to increase access to a broad range of quality, voluntary reproductive health services to refugees & displaced persons around the world. Other results dealt with unplanned pregnancies & sexually transmitted diseases. Proceedings will be available in Feb on the web: http://www.rhrc.org/ or hard-copy from: Rachelatintrescom.org.

- CARE'S REPORT ON ACTION AGAINST WORLD HUNGER SITES CASE EXPERIENCES: www.care.org/info_center/world_reports/hunger/wr_freedomfrom.html

- "HEALTH, A KEY TO PROSPERITY" RELEASED THIS WEEK BY WHO, UNICEF, the World Bank, UNESCO, UNFPA & UNAIDS argues forcefully, from case experience, that the prevalence of major diseases can be decreased dramatically, if programs are financed. The report reviews 20 country cases, & covers tuberculosis, malaria, HIV/AIDS, major communicable diseases affecting children & maternal/perinatal threats. For example Kenya, Ethiopia & Azerbaijan have reduced malaria deaths, a 97% drop in Vietnam, through use of new drugs & through population use of insecticide-impregnated bednets. The Mexico case shows how oral rehydration fluids, improved sanitation & measles immunization have decreased deaths from diarrhea 60%.

- NEW REPORT ON "DEMOBILIZATION & IMPLICATIONS FOR HIV/AIDS" (2000, by Intl. Centr Migration & Health; email: icmhatworldcom.ch) finds that the impact on HIV transmission by military movements & demobilization/reintegration has been almost entirely ignored & warns that "interventions targeting non-regular forces pose particular difficulties; they are more difficult to reach & may have little incentive to participate." The report points to the disparity that HIV infected military personnel stand to receive dramatically better health care by staying in the military than by reinsertion into civilian life, particularly in sub-Saharan Africa (the focus of the report) where HIV care remains under-funded.

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December 21, 2000 The Humanitarian Times

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