Health & Sanitation

  • Diseases from unsafe water and lack of basic sanitation kill more people every year than all forms of violence, including war. That’s wrong. We all have the right to clean water. Oxfam is providing life-saving clean water, and sanitation and hygiene education in some of the world’s poorest countries, as well as in areas struck by humanitarian crises.

One jar of paracetamol for 24,000 people - it just doesn't add up

I recently returned from a trip to Malawi, my second visit to the country with Oxfam Ireland. Like citizens everywhere, Malawians have a right to good healthcare. Sadly, this isn’t the case. An unfair tax system means that the nation’s medical facilities are overburdened – and even though Malawi has some of the best health policies in the world, ill-managed public funds means they can’t be put into practice.
 
(Top-Left) Maria Gilasiano with her baby daughter outside Phimbi Health Centre. Photo: Mathias Kafunda. (Top-Right)  Liness Pensulo and her baby daughter. Photo: Mathias Kafunda. (Bottom-Left) Disability Committee member Peter Simoni. Photo: Mathias Kafunda. (Bottom-Right) Clockwise from left: James Afuwa, Medical Assistant for Phimbi Health Centre; Niamh Ní Ruairc of Oxfam Ireland; Bettie Chumbu, DCT Project Officer; Alex Chiphathi , Monitor of Phimbi Radio Listening Club; Asima Stambuli, Ward Councillor for Utale Ward, and Zione Mayaya, DCT Project Coordinator. Photo: Mathias Kafunda 
 
During my trip I visited Phimbi Health Centre in Phimbi, Balaka South. It was originally built to serve a population of 10,000 but now facilitates at least 24,000. When I visited, there was just one container of paracetamol in the drugs cabinet. I was also shown the maternity ward’s four beds – that’s four beds for 200 births every month. And while the staff do their best, they too are struggling due to a lack of resources. A shortage of manpower doesn’t help – the centre should have 60 staff members but poor funding has seen that number cut to 30.
 
Over a small sink in the maternity ward a sign which reads ‘Sambani mmanja pano’ translates as ‘Wash your hands’. But there is no water, no drinkable water, at least. A borehole outside the centre was dug between two septic tanks. As you can imagine, that water isn’t safe to drink. Although the health centre doesn’t use the water, people living in the local community do – leaving them exposed to a whole host of diseases. Those who want clean water have to travel 2km to collect it. That means that women, despite being exhausted and still suffering the pain of childbirth, have to make a 4km-round trip on foot just to clean themselves.
 
Another lifeline pulled from the centre due to a lack of resources is an ambulance. Its vehicle was taken by the district hospital – which too was hit by underfunding – and was never replaced. These days, if the health centre can’t deal with a patient’s condition, the ambulance must be called from the District Hospital of Balaka, a two-and-a-half hour drive away. This has led to women giving birth – sometimes unaided – in the back of an ambulance as they are transferred to hospital.
 
I met one woman who found herself in that situation. Maria Gilasiano gave birth in the back of an ambulance as it made its way to the district hospital. She was being transferred due to complications during labour and ended up delivering her baby herself during the journey. Also in the ambulance at the time was Peter Simoni, a member of the local Disability Committee. Amid the chaos of the birth, Maria and Peter’s bloods got mixed – and while it was not a danger to life, it shows that a lack of resources can pose serious hygiene risks. 
 
Of course, these are risks that Peter knows all too well. There is no wheelchair ramp at the health centre so when he visits, he is forced to crawl on his hands and knees to get into the building – and the toilets, thereby exposing him to potentially dangerous bacteria and germs.
 
Those living in the community also face drugs shortages. Liness Pensulo, another woman I spoke to, couldn’t get malaria tablets for her young son as they weren’t available at the health centre at the time. Instead, she had to travel to a private chemist where she had to pay significantly more. Worse still, she didn’t get proper instructions on how to administer the drugs to her child. The potential consequences of incorrect dosages can be fatal. 
 
Every day, across the world, lives are put at risk due to unfair tax systems. In Malawi, Oxfam Ireland is working with our partner Development Communications Trust (DCT) to help marginalised communities get access to the healthcare they deserve.
 
Niamh Ní Ruairc is Programme Quality Officer with Oxfam Ireland
 

A third of tax dodged in poor countries enough to prevent 8m deaths a year, new Oxfam study reveals

Just a third of the $100bn [approx. €86bn/£78bn] tax that companies dodge in poor countries annually is enough to cover the bill for essential healthcare that could prevent the needless deaths of eight million mothers, babies and children, Oxfam revealed today as it launched a hard-hitting film illustrating the human cost of tax avoidance on the world’s poorest.

Experts estimate that $30bn [approx. €25.8bn/£23bn] is needed each year to pay for basic healthcare such as vaccinations, midwives and diarrhoea treatment that could prevent an average of 7.8m children and 210,000 women dying in 74 countries with large numbers of people living in poverty.

Jim Clarken, Oxfam Ireland’s Chief Executive, said: “Tax dodgers may not be literally stealing medicines from the pockets of the poorest but they are depriving poor countries of billions that could be invested in healthcare.

“Oxfam works in some of the poorest countries in the world and sees the impacts of tax dodging every day. For instance, we work in Tanzania which has an annual health budget of just €17 per person. Every medicine that is not bought for the lack of government funds due to tax dodging affects thousands of men, women and children across the world.

“While corporate tax avoidance strips developing countries of vital funds needed for hospitals, millions of the world’s poorest people are missing out on basic medical treatment that could save their lives and help them escape hardship. There can be no excuse for delaying tough action against tax dodging.

“As the EU tax transparency process is at a standstill, the Irish and UK governments should lead the way in helping to ensure companies pay their fair share of taxes everywhere they do business.

“Ireland should agree legislation with its EU partners to ensure that multinationals publically report on a country by country basis where they make their profits and pay their taxes.

“Making this information public will give both policy makers and the public the opportunity to understand how a country’s corporate tax system is actually operating, and provide them with the information to review and change it.

Oxfam is urging the UK Chancellor Phillip Hammond to use next month’s Budget to commit to implementing tougher tax laws for British multinationals, including those that operate in developing countries, by the end of 2019. As movement towards an EU tax transparency deal has stalled, it is calling on him to push ahead and build on the leadership some UK companies have already shown.

More than a year since the Government passed legislation to enable the introduction of comprehensive public country by country reporting for UK-based companies and nearly two years since the last Conservative government agreed the case had been made for the change, it is still no closer to being a reality.

Poor countries are twice as dependent as rich countries on corporate tax revenue as a proportion of the money they have available to buy medicines, pay nurses and pipe clean water to people’s homes. There is evidence to show that when poor countries increase their tax revenue – in particular from corporate and income tax – they spend more on healthcare, leading to healthier populations.

Greater tax transparency would make it easier to verify whether companies’ tax bills are in line with their real economic activity in every country where they do business – and to hold them to account if not.

However, until these public reporting requirements are mandatory for all large businesses, widespread tax avoidance will continue to deprive governments rich and poor of revenue needed to provide essential services and tackle poverty.

ENDS

For more information or interviews please contact Phillip Graham on 00 44 (0) 7841 102535 / phillip.graham@oxfamireland.org

 View and/or link through to the film here.

 

Cholera killing one person almost every hour in Yemen

08/06/2017

Oxfam calls for massive aid effort and immediate ceasefire.

Yemen is in the grip of a runaway cholera epidemic that is killing one person almost every hour and if not contained will threaten the lives of thousands of people in the coming months, Oxfam warned today. The aid agency is calling for an urgent, largescale aid effort and an immediate ceasefire in Yemen to allow health and aid workers to tackle the outbreak. 

According to the World Health Organisation, in the five weeks between 27 April and 3 June 2017, 676 people died of cholera and over 86,000 were suspected of having the disease. Last week the rate jumped to 2,777 suspected cases a day from 2,529 a day during the previous week. Given Yemen’s neglected medical reporting system and the widespread nature of the epidemic, these official figures are likely to be under reporting the full scale of the crisis. 

In the coming months there could be up to 150,000 cases of cholera, with some predictions as high as 300,000 cases. 

The cholera crisis comes on top of two years of brutal war which has decimated the health, water and sanitation systems, severely restricted the essential imports the country is dependent upon and left millions of people one step away from famine. 

Colm Byrne, Oxfam Ireland’s Humanitarian Manager, said: “Yemen is on the edge of an abyss. Two years of war has plunged the country into one of the world’s worst humanitarian crises, leaving it facing devastating famine. Now it is at the mercy of a deadly and rapidly spreading cholera epidemic. 

“Cholera is simple to prevent and treat but while the fighting continues, that task is made difficult and at times impossible. Lives hang in the balance - a massive aid effort is needed now. Those backing this war in Western and Middle Eastern capitals need to put pressure on all parties to the fighting to agree an immediate ceasefire to allow public health and aid workers to get to work saving lives.”

Oxfam said that the outbreak is set to be one of the worst this century if there is not a massive and immediate effort to bring it under control. It is calling on rich countries and international agencies to generously deliver on promises of $1.2bn of aid they made last month.

Money, essential supplies and technical support are needed to strengthen Yemen's embattled health, water and sanitation services. Health workers and water engineers have not been paid for months while hospitals, health centres, public water systems have been destroyed and starved of key items, such as medical supplies, chlorine and fuel. Even basic supplies such as intravenous fluids, oral rehydration salts and soap are urgently needed to enable an effective, speedy response - some of which will have to be flown into the country. Communities also need to be supported with their efforts to prevent the disease spreading and quickly treat people showing the first signs of infection. 

Oxfam Ireland is appealing to the public to donate to its hunger crisis appeal and support people facing famine in Yemen, as well as in East Africa, South Sudan and Nigeria: oxfamireland.org/hunger  

ENDS

CONTACT: For interviews or more information, contact:

ROI: Alice Dawson on 00353 (0) 83 198 1869 / alice.dawson@oxfamireland.org  

NI: Phillip Graham on 0044 (0) 7841 102535 / phillip.graham@oxfamireland.org

Notes to Editors: 

Stats on cholera outbreak: http://reliefweb.int/report/yemen/yemen-cholera-outbreak-dg-echo-who-ech...

Cholera is easily prevented with simple and affordable efforts at home and in the community, such as disinfection of water with chlorine, safe collection and storage of water, washing hands with soap, and understanding the myths, behaviours associated with cholera. When people suspect they have the symptoms they can drink a mix salt and sugar to rehydrate them while they make their way to the medical centre. 

 

Nepal now facing a double disaster

Just over two weeks since a devastating earthquake struck Nepal, there has been a second major quake.

Our teams there are rapidly assessing the situation. They include Dubliner Colm Byrne, who experienced the quake in Chautara (approx. 40km from the epicentre). 

Chautara is in the Sindhupalchowk province, the region worst affected by the first earthquake on April 25. Colm says people were afraid of the aftershocks and landslides that could follow.

“It was very powerful,” Colm says. “The ground was shaking and buildings were collapsing. I’ve also seen people being carried on stretchers.”

Oxfam is helping over 60,000 people over seven districts in Nepal, delivering clean water, emergency toilets, shelter, food assistance and hygiene kits. Reaching communities in the country’s rural districts has been challenging and initial reports suggest fresh landslides have cut off some areas.

Colm and his colleagues were fortunate not to have been beside buildings when the earthquake struck at around 12:35 Nepali time (approx. 07:50 Irish time). They were very shaken but immediately got back to work. Their concern is for those thousands of families who must now cope with what is a double disaster.

It was already a race against time to reach people before the monsoon season arrived at the beginning of June. It’s now more vital than ever for us to be able to reach as many people as possible.

“People are shocked and scared by what’s happened. They are too afraid to sleep in their homes so one of things Oxfam is trying to do is to provide spaces for people to sleep outdoors,” Colm says.

“One of the big challenges is that this is a hugely mountainous country with very few large, flat open air spaces where people can gather safely. We’ve just done an assessment this afternoon to find alternative locations.

“Whilst we don’t yet know the full extent of this second major earthquake, we do know that the people of Nepal will need much more support to help them put their lives back together.”

Thousands of you have already generously donated to this crisis and your money is helping to provide immediate aid to those in desperate need. If you haven't done so already, you can donate here, in your local Oxfam shop or by calling 1850 30 40 55.

AIDS 2014: Taking stock of achievements, honouring the dead and protecting the most vulnerable

14,000 people have arrived in Melbourne, Australia to attend the 20th International AIDS Society Conference. It takes place every two years and is the most prestigious gathering of the AIDS community, attracting leading AIDS researchers, activists, practitioners and policy-makers in the world. People living with HIV, community workers along with President Bill Clinton and Sir Bob Geldof are in attendance.

They have come here to take stock of what has been achieved to date and to discuss how to keep up the pace in the future. But they are also in mourning as a number of delegates on route to the conference sadly lost their lives in the MH17 plane crash in Ukraine. While this is an unimaginable tragedy for their families and friends, and a terrible blow to the AIDS movement; it is not the first time lives have been lost needlessly.

Since AIDS was discovered in 1981 around 36 million men, women and children have died. In 2012 alone 1.6 million died (nearly the population of Dublin and Cork put together), 210,000 of them children. And while many died at the early stages of the epidemic, when we didn't know enough about AIDS or did not have the drugs to treat it, the lives lost in recent years have happened at a time when we have the medicine at hand to treat the disease and the ‘know how’ to end AIDS.

Above: Women join in singing and dancing at the end of a short play performed by the Oxfam drama group to educate people about some of the high-risk behaviour that leads to HIV infection through traditional song, dance, poetry and plays. Photo: Annie Bungeroth/Oxfam

Yet there is progress to be proud of. According to UNAIDS (the joint United Nations Programme on HIV/AIDS), the number of deaths has been halved since 2005; the number of new infections has also declined by 33% since 2001. We have put 10 million people on treatment. Those who died on flight MH17 have contributed to that. But we still have a lot to do. Sub-Saharan Africa is bearing the brunt of the epidemic with 69% of HIV positive people living there. Entire countries such as Central African Republic, Democratic Republic of the Congo, South Sudan or population groups such as sex workers, men having sex with men and injecting drug users are being left behind with regard to HIV and AIDS services.

However, another less talked about vulnerable group are people with disabilities, estimated at 650 million or 10% of the developing world’s population. New research conducted by Oxfam Ireland, Trinity College Dublin and University College Dublin in Sub-Saharan Africa – where much of Oxfam Ireland’s work is concentrated including programmes that help people living with HIV and AIDS to get the services and support they need – found little evidence of effective HIV interventions for those with disabilities.

Where such practices existed – e.g. information made available in alternative forms to suit people with hearing, vision or intellectual impairment, or clinics adjusted to make them accessible to people with physical disability – they were of small scale and almost none were systematically evaluated. Less than half of national HIV strategic plans in East and Southern Africa recognised disability as an issue of concern, though a small number of countries – notably South Africa and Kenya – identified people with disabilities as a vulnerable group, and provided specific interventions for them.

We found a five-prong approach to be best practice. Participation (where people with disabilities are included as partners in HIV/AIDS initiatives from the outset and not just contacted for approval at the end of the process), peer led (members of the disability community lead on constructing and implementing HIV/AIDS programmes, e.g. by being trained as outreach workers for both general public and those with disabilities), integration (integrating disability friendly services into the mainstream delivery of programmes), sensitization (sensitising the disability population to information and issues around HIV/AIDS) and the creation of strategic partnerships by NGOs and service providers and government representatives with people with disabilities to pool funding and resources.

‘A country is as good as it treats its most vulnerable citizens,’ an Irish mother of a child with disability once told me. The AIDS community, in particular donors, researchers and practitioners, must continue on the path of achievements made so far to ensure people with disabilities who are living with HIV get the support and services they need. This means more research, evaluations, application of the five-prong approach and a 10% participation rate of people with disabilities in all HIV interventions. This might go some way in helping to protect one of the most vulnerable groups in our society and honouring those who have died so needlessly, including those who perished on flight MH17.

Dr. Enida Friel is Oxfam Ireland’s HIV Programme Coordinator

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