Wednesday, July 12, 2017
UN special envoy wants to restart talks as humanitarian chief warns that seven million are "on the cusp of famine".
Speaking before the UN Security Council on Wednesday, Ismail Ould Cheikh Ahmed, UN special envoy to Yemen, called on all parties "to act for the sake of peace," saying "excuses are unacceptable...especially when the solutions are in plain sight."
"The opportunity to reach peace is not yet lost," he said, urging the political leaders to recognise that "the continuation of the war can only lead to more human and physical loss". In the same meeting, UN humanitarian chief Stephen O'Brien said the warring parties and their outside backers should feel "deeply guilty" at driving a worsening conflict that has exposed millions of Yemeni civilians "to unfathomable pain and suffering", including seven million people now "on the cusp of famine."
He urged the Security Council to "lean much more heavily and effectively on the parties, and those outside Yemen who are leading this policy and action."
O'Brien said suspected cholera cases have been reported in nearly all the country's districts and at least 1,740 people have already died.
The $2.1bn humanitarian appeal for Yemen is only 33 percent funded, and the response to the cholera epidemic requires an additional $250m, of which just $47m has been received, he said.
"This cholera scandal is entirely man-made by the conflicting parties and those beyond Yemen's borders who are leading, supplying, fighting and perpetuating the fear and fighting," O'Brien said.
On Tuesday, the International Committee of the Red Cross reported that suspected cholera cases now surpassed 300,000.
Yemen has been engulfed in civil war since September 2014, when Houthi rebels swept into the capital of Sanaa and overthrew President Abdd-Rabbu Mansour Hadi's internationally recognised government.
In March 2015, a Saudi-led coalition, which is supporting the Hadi government, began a campaign against Houthi forces allied with ousted President Ali Abdullah Saleh.
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Mohammad Shubo is motionless when he is wheeled into the clinic. He had started experiencing diarrhoea and vomiting that morning; by evening, he had no pulse.
In an effort to rehydrate him quickly, the nurses give Shubo an IV of saline solution. His reanimation seems almost uncanny – within half an hour he is able to sit up and speak. He spends the next two days at the hospital to rehydrate and convalesce before returning to his cramped quarters. If Shubo had arrived at the clinic just 10 minutes later he would have died, a nurse says.
For those who have been fortunate enough not to see the effects of cholera first hand, David Sack, a professor of international health at the Johns Hopkins University Bloomberg School of Public Health, says Shubo’s case, which appears on a 2011 Al Jazeera documentary, gives “a good sense of the disease”. Thousands of patients develop the same symptoms as Shubo did, though not all are as lucky. Sack recalls a case from Uganda in which a woman was hospitalised with symptoms of cholera, but the hospital staff didn’t diagnose her properly, even though there was a cholera treatment facility on the hospital grounds. She was not closely monitored and died of dehydration overnight. Cases like this should never happen, Sack says. But clearly they do.
In some parts of the world, including Europe and the US, cholera is so rare that it seems to have been eradicated. Some may see it as an “old world” disease, gone the way of the plague and smallpox. But it continues to devastate communities elsewhere, sometimes to pandemic proportions – an outbreak is raging in Yemen, where more than 246,000 cases and 1,500 deaths have been reported.
“Cholera is a brutal infection,” says Jason Harris, an associate professor of pediatrics at Massachusetts General Hospital. “Patients can go from looking healthy to dying quickly with cholera. It’s a scary disease.”
In the mid-1800s, as cholera swept across nearly every continent and killed thousands, scientists rushed to understand the disease. In 1854, a British doctor, John Snow, undertook the first epidemiological study that determined water from a pump on Broad Street was sickening Londoners with cholera (he didn’t discover the true reason why, however – at the time the disease was thought to be spread by miasma, not microbes). Then in 1884, a German researcher, Robert Koch, studied the intestines of deceased cholera patients in Egypt and India, concluding that the comma-shaped bacteria Vibrio cholerae he found there was the cause of the disease.
In the years since, scientists have figured out a lot more about the biology of cholera. Snow was correct: Vibrio cholerae is transmitted through contaminated water. Within as little as 12 hours or as long as five days, some people who have ingested the bacteria will start to show symptoms – uncontrollable vomiting and diarrhoea. But 80% of those who ingest the bacteria do not, possibly because of an existing immunity.
The scariest part of the disease, Harris says, is the sheer speed with which a patient can decline. If the condition isn’t treated quickly, people can die of dehydration within hours of showing symptoms.
“The amount of fluid loss from diarrhoea and vomiting [in patients] is shocking. It’s hard to believe unless you see it,” Harris says. It can be up to a litre per hour. And more people excreting the bacteria into water sources means more get infected, and it’s not hard to see how just a handful of cases could quickly balloon into an outbreak (there have beenseven pandemics over the past two centuries), which can last decades.
The last pandemic started in Indonesia in the 1960s and spread across Asia and Africa before coming to Europe in 1973. By 1991, it had spread to Latin America, which had been free of cholera for more than a century. Around 400,000 reported cases and 4,000 deaths were reported in 16 countries of the Americas that year.
These days the disease does not have to be a death sentence. Doctors know how to treat cholera effectively. If a patient can reach a clinic in time, the treatment is fairly straightforward. With a rapid infusion of fluids and antibiotics, they are usually back to normal in a few days. There is also a vaccine, which is taken orally and can prevent infection in about 60% of people.
But this apparent simplicity is deceptive; all this knowledge isn’t the same as stopping the disease. “The map of cholera cases is pretty much a map of poverty,” says Dominique Legros, the team lead of the cholera group at the World Health Organization. “We still have cholera in places like Yemen because people don’t have access to safe water.” People living in poverty may know that drinking polluted water can get them sick, but they don’t have an alternative.
“Because of inequality and a lack of access to safe water and sanitation, more than a billion people are still at risk [of cholera],” Harris says.
So outbreaks continue. In some places, such as Zambia and Uganda, they are predictable, starting every year with the rainy season. But often, outbreaks can’t be anticipated. There are factors that can make an outbreak more likely – natural disasters can scatter infected people to contaminate more water sources and war can close clinics that might have helped citizens receive treatment or inhibit the import of necessary medication.
But these factors are hardly predictive. After the 2010 earthquake, for example, American epidemiologists concluded that Haiti was at low risk of a cholera outbreak; just a few months later, an epidemic was raging, in part because UN peacekeeping forces accidentally introduced the bacteria.
Years of political turmoil are fuelling the epidemic in Yemen. The situation is dire – the WHO estimates that nearly 250,000 people had been infected by the end of June, almost doubling previous estimates based on academic models. WHO officials are working with other non-profits and what remains of the national healthcare system to bring treatment to rural clinics to help people get treatment more quickly. This week, the International Coordinating Group allocated one million cholera vaccines to be sent to Yemen.
These strategies, along with education campaigns so people at risk of cholera know how to treat their water (by boiling, or with chlorine tablets), can reduce the incidence of the disease. But these advances don’t address the main problem: a lack of access to clean water. So the solution to eradicating cholera then, doesn’t lie in the health sector. “Yes, you need to treat patients and prevent death,” Legros says. “But the long-term solution is in the development sector – giving people long-term access to sanitation.” There are some countries in which this may soon be possible. But in others, such as South Sudan and Somalia, the prospect of bringing safe water to the entire population seems remote.
Until the day when everyone has access to clean water and sanitation, researchers will work to answer more questions about the disease. One that remains is how – or if – Vibrio cholerae persists in the environment. “In places like Chad or on the western African coast, we see almost no cholera cases for several years, then there’s a big outbreak. It’s difficult to explain,” Legros says. “Some people say there is a reservoir in the environment that is maintained over years, though we don’t know how, and suddenly it erupts again, though again we don’t know how.” Harris also wonders about how the evolution of Vibrio cholerae may have affected its virulence and ability to cause pandemics.
As researchers work to answer these questions, and as nations move slowly towards improved infrastructure, public health officials will have to combat new outbreaks.
“I would hope that people appreciate how significant and serious a threat [cholera] is,” Harris says. “For people who think it’s a historical disease, they should know that it is still an important cause of morbidity and mortality around the world.”
By Murtaza Wahab
As we enter the fifth and final fiscal year of the incumbent PML-N government, it is important to review what the state of our economy and confidence of the people is and correlate it to Ishaq Dar, Pakistan’s finance minister and go-to man of the prime minister. This is the third time Mr Dar has held the position of finance minister, which in any emerging economy like ours is nothing less than the number two position in government.
Whilst the PPP government suffered at the hands of a challenging local and global financial market as well as the unsettled finance ministry, the PML-N government has been supposedly “blessed” with stable management in the Cabinet. Those appointed in the beginning of the term, especially in critical positions, continue to hold forte. The question is: is the economy better off or not? And more importantly, is the common Pakistani man deriving any benefit from the economy?
Pakistan is an economy which is dependent on internal consumption. A population of 200 million plus, with demographics tilted towards the younger demographic, economic growth on the back of consumption is an absolute certainty. Despite an unfavourable market situation and global financial crisis, Pakistan’s GDP grew year after year between 2008 and 2013 and so did the exports. Following the succession of events from the formation of the PML-N government, signing up to the IMF programme, relative stability in the government and the blessing of lowest oil prices, Pakistan’s economy should be doing better. But is it? Key indicators like the trade deficit has widened and remittances have slowed down. Stock of debt and its servicing is ballooning. The Pakistani rupee had remained under control, but the recent slide in rupee value once again shows that the alleged stability was only artificial as opposed to being backed by a stable economy. This may have disastrous effects as people may remember for years. Under the Musharraf regime, the US dollar remained stable between 60 and 63; come 2008, financial crisis caused the slide to be 36% within a year and so on. Inflation increased and overall prospects looked dim. Even right now, financial analysts and economists are anticipating a 10-12% devaluation of our currency against the greenback. This means that there isn’t sufficient supply of US dollars as compared to its demand which can be mainly attributed to a drop in our exports and remittances.
Our foreign exchange reserves stand at a paltry $16 billion despite the fact that oil prices have been consistently at an all-time low and the much-talked about foreign investment that this government claims to have secured. Needless to say, the oil bill constitutes the most significant chunk of our import bill. Historically, we have seen slumps after change of government. Is Mr Dar holding the rupee rates in order to protect his government and leave excuses to the next in line? A 10-12% decline is going to cause a direct shock to the liabilities that the government has added in the last four years, especially with regard to the foreign debt. It will cause inflation to rise and then interest rates will surely increase.
A 10% devaluation of the rupee will increase the external debt liability of the country by almost Rs800 billion. The shock will be very high. Additionally, with a widened trade deficit, the situation will snowball. On 5th July, the PKR had begun depreciating mainly because of change in reporting of Current Account Balance. While change in the method of calculating national accounts in line with International Standards is a good move, what has alarmed people is that the impact of change has been for the worse: due to the compilation of new information on foreign currency accounts transactions, imports have been revised upwards, leading to current account balance of July-May 2017 increasing from $8.9b to $10.6b. This sharp revision upwards was not expected and makes one worry about the state of the economy by way of data reporting.
While the ruling party talks about the growth under their watch, the inequitable distribution of wealth and resources across the federation is becoming stark. Provinces are suffering because arbitrary taxation measures being employed by the federal government are against the taxes which provinces have been trying to raise. The National Finance Commission Award, which provides 57.5% of Pakistan’s revenue to the provinces, expired on 30th June, 2015 and since then the provinces have been seeking an upward revision of their respective shares. However, Mr Dar, instead of paying heed to such genuine demands, is actively seeking to reduce the share of provinces to only 50% under the garb of various causes.
While Lahore and Islamabad are being cited as successes of the PML-N government, just off GT Road and M2, the effects of Pakistan’s growth story are less visible. The smaller provinces have time and again urged the federal government for its assistance in the development of infrastructure projects. However, we have failed to see a genuine, tangible response. The much talked about Karachi-Hyderabad Motorway portion inaugurated by the Prime Minister earlier this year presented a very sorry picture within a couple of weeks of its inauguration. The province of Sindh has actively sought the help of the federal government for an increased contribution in revised costs of national interest projects like construction of LBOD, K-4 & S-3. However, the response of the federal government has not been very comforting for the government of Sindh.
The whole country has been on tenterhooks for the past several months on account of the Panama Papers and JIT investigations, but what is being ignored is the economy and the effects of that is becoming visible on a daily basis. Maybe the PML-N is seeing the writing on the wall in the next general elections and wants to leave a weak economy, however, the efforts will be considered as nothing but deliberate and with criminal intent.
Malala Yousafzai said that education is the only way to make Pakistan’s future brighter and urged the Pakistani government to fulfill its commitment to provide the basic right of education to every child.
In her 20th birthday statement released on Wednesday, Malala said that Pakistanis can only change their destination by seeking education. She urged her fellow Pakistanis to speak up for their rights because education is necessary for the development and prosperity of Pakistan.
Malala appealed her countrymen, especially women to accord utmost importance to education. She said: “My message to all parents is, if you can give something [precious] to your children, it is education. Through education they can progress and contribute to their country and family.”
Malala urged the government to give priority to education. “I ask the government to spend on education, to fulfill its promise of allocating 4% budget to education. The government must ensure that all children are given the opportunity to acquire education, so that they can make their country proud.”
EVERY GIRL CAN BE MALALA: On the same occasion of her birthday, Pakistan People’s Party (PPP) Chairman Bilawal Bhutto Zardari has said that he wants to see every girl of Pakistan studying like Malala Yousafzai. In his message honouring the Pakistani nobel prize laureate, he said that his party wants women of Pakistan to come to the front lines in every field of life. He said that Benazir Bhutto Shaheed proved that women of this country can get any post including judge, teacher and politician. He further said that he wants to see women of this country progressing on lines of Benazir Bhutto and Malala Yousafzai, adding that his party is working for promotion of women’s education.
She's a global education advocate. She's survived an attack on her life. She's a Nobel Peace Prize winner. And on Wednesday, she turns 20.
Malala Yousafzai has inspired a generation to advocate for girls to have adequate, safe access to education. In honor of her birthday, here's a look at five of the most powerful ways she's done it.
At the age of 11, Malala began anonymously blogging for BBC Urdu. She gave vivid accounts of what it was like attending school as a girl in the Swat district of Pakistan. Her first post read, in part:
On my way from school to home I heard a man saying 'I will kill you.' I hastened my pace and after a while I looked back if the man was still coming behind me. But to my utter relief he was talking on his mobile and must have been threatening someone else over the phone.
She did not stay anonymous for long. At the age of 12, she was featured in a vivid New York Times documentary about her school being shut down by the Taliban.
On Oct. 9, 2012, a lone member of the Taliban entered Malala's school bus and shot her in the head. Malala nearly died. She underwent surgery, was transferred to the United Kingdom and spent months in the hospital before coming out stronger than before.
Shortly after the attack, Malala and her father put the wheels into motion to establish the Malala Fund, which aims to help support education for children across the world. Malala herself announced the fund in a February 2013 video saying, "This is a second life, this is a new life. And I want to serve."
On Dec. 10, 2014, Malala spoke after receiving a Nobel Peace Prize, the youngest person to ever be awarded the honor. She took the opportunity to speak not about herself, but about the girls around world she represents.
"I am Malala," she said. "I am those 66 million girls who are deprived of education. And today I am not raising my voice. It is the voice of 66 million girls."
Even though the United Nations declared her birthday to be "Malala Day,"she has never let the day be about her. She uses her position as a public figure -- especially on July 12 -- to raise awareness about girls' education. After finishing high school and joining Twitter last week, Malala announced that she will be traveling to continue her advocacy work this week.
In a series of statements, Bilawal Bhutto criticised the Sharif family, stating that fake documents were presented before the JIT. He said that Prime Minister Nawaz Sharif has been involved in money laundering.
Bilawal said that his party was keeping all options on the table, including introducing a change within the parliament or outside it.
"Parliament will decide whoever will be the prime minister but at the moment Nawaz Sharif has to go," he said.