10 humanitarian crises forgotten (but not gone) - Independent Online Edition > World Politics

10 humanitarian crises forgotten (but not gone)
If doctors edited newspapers... The frontline physicians at Médecins Sans Frontières have chosen the 10 humanitarian crises that should have been given more coverage in 2007. By Claire Soares and Daniel Howden
Published: 20 December 2007

Colombia

While the cocaine trade regularly features in the headlines, little attention is devoted to the scale of the internal refugee crisis. After four decades of civil conflict that has evolved from a war of political ideologies to a struggle for territory and control over the narcotics trade, large numbers of Colombians live in areas controlled by militia or guerrillas. With basic human rights under threat and unpredictable violence endemic in many rural areas, millions have fled to the shantytowns – or barrios – that ring every major town. Nearly four million people live in these insecure settlements cut off from basic state services such as mains electricity, water and health care. In the endless slums that now choke the capital, Bogota, areas are divided up and fought over by the same paramilitaries and left-wing rebels that blight and dominate the countryside.

Sri Lanka

After a quarter of a century of fighting, this year will be remembered among the bloodiest in Sri Lankan history. The civil war between the government forces and the separatist Tamil Tigers flared back into life last year and has kept worsening. International efforts to resolve the conflict have made no headway as key figures on both sides appear to have decided that a military solution is possible. Targeted bombings, mine attacks, suicide bombings, abductions, recruitment of child soldiers have all followed. The civilian toll in a country already flattened by the 2004 tsunami has been horrendous. Hundreds of thousands of people in need of humanitarian aid have been forced to flee to makeshift camps and the situation has been compounded by a climate of hostility and suspicion towards aid agencies. MSF is among the few agencies still operating in frontline areas, such as Point Pedro and Vavuniya, where doctors are desperately needed.

Somalia

Violence in Somalia hit some of the worst levels in more than 15 years in 2007, prompting UN officials to declare it the worst humanitarian crisis in Africa, surpassing even Darfur in its horror and hopelessness. Ethiopia invaded Somalia on Christmas Day last year and easily overpowered the Union of Islamic Courts, but ever since insurgents have been staging increasingly ferocious guerrilla style attacks, particularly in the capital, Mogadishu. Aid workers say one million people have fled their homes, including 60 per cent of Mogadishu's population. This week mortar shells slammed into a crowded market in the capital, killing a dozen people including a mother and her three children, and a foreign journalist was kidnapped. This precarious security situation means reaching those in need is increasingly difficult. Just yesterday, the UN called for the creation of "safe zones" so that aid could get through to the most vulnerable, particularly children.

Burma

The extraordinary democracy protests by the Buddhist monks in one of the most repressive countries on earth put Burma back atop the news agenda this year. But the nature of ordinary life under the military junta has remained a dim part of the picture. High levels of malaria and HIV are made unimaginably worse by the negligence of a regime that spent only 1.4 per cent of its budget on health care. Despite the overwhelming need, there are few humanitarian groups able to work within the country and those that do so have to operate under severe restrictions. Comparatively few donors are willing to fund operations in the country for fear of indirectly supporting the regime. Further complicating the situation is the absence of any clear statistics on the health situation. The UN says that as many as 360,000 Burmese, out of 50 million, are living with HIV.

Malnutrition

There may not have been a headline-catching food crisis in 2007 on a similar scale as the one that beset Niger last year, but malnutrition is still a disturbing way of life for many in west and east Africa and south Asia, and is associated with the deaths of five million children under the age of five. MSF is campaigning for international donors to scale up their funding for ready-to-use foods, milk and peanut-based pastes that do not need to be kept in a refrigerator, so can be sent out into the rural mud-hut villages where mothers can feed them to their babies at home, rather than being forced to trek miles to the nearest clinic. In Maradi, Niger aid workers are using these pastes to boost the diets of 62,000 children during the seasonal lean period and stop them becoming malnourished in the first place.

Chechnya

Ninety-nine per cent of the electorate here turned out to vote for Vladimir Putin in the recent Russian presidential election. Such a result defies belief in the breakaway Muslim republic crushed by Mr Putin's forces in the second Chechen war. The Putin-installed strongman who rules the republic, Ramzan Kadyrov, made sure that his boss would not be disappointed. Under his authoritarian rule, Mr Kadyrov has cowed the separatists and terrified their families through torture and abduction. The capital, Grozny, flattened by Russian bombs, has been rebuilt, and the airport reopened. But two wars have left psychological and physical scars on the civilian population with large numbers of people suffering from high levels of anxiety, insomnia and depression. As the military conflict with Russia fades into the background with only sporadic clashes now reported, and western leaders no longer openly challenge Russia on its human rights abuses in the republic, humanitarian needs remain critical.

Zimbabwe

With each new headline warning of economic meltdown in Zimbabwe the litany of impossible statistics has grown this year: inflation at 12,000 per cent, three million fleeing the country, 85 per cent unemployment. Under this extraordinary strain, what had been among the best healthcare systems in Africa has collapsed. As many as 3,000 people are dying every week from HIV/Aids and the chronic absence of life-extending antiretroviral drugs is accelerating this death march.

As many as four million people are in danger of starvation according the World Food Programme and the fuel crisis means that rural clinics are treating patients who have sometimes walked for days in search of medical treatment. The fate of the 83-year-old President, Robert Mugabe, continues to dominate coverage of the country that was once seen as the poster boy of post-colonialism, but it is the impoverished people of this beautiful southern African country paying the price of a man-made crisis.

Central African Republic

While neighbouring Chad and the western Sudan region of Darfur have made their way into global media coverage, the tiny landlocked Central African Republic finds itself starved of attention. This "phantom state" in the middle of Africa has no government institutions functioning outside the capital, in the north bandits and warring factions constitute the law of the land. Rights groups say hundreds of civilians have been executed and at least 100,000 people caught in the crossfire of rival armed groups have fled their villages and are hiding in forests and bush. Complicating a perilous internal situation are the CAR's unpredictable neighbours. The potential for the whole region to tip over into chaos is immense. A small contingent of EU peacekeepers is due to be deployed in the New Year.

Democratic Republic of Congo

With the country's first democratic elections in decades successfully completed in 2006, the Congolese might have been forgiven for expecting an easier time in 2007. But those out in the east, in the North Kivu region, have seen little sign of the stability that re-elected President Joseph Kabila promised. Instead, fighting between armed groups has raged for much of the year and the government is in open combat with rebel leader Laurent Nkunda. Hundreds of thousands of homeless people are hiding in the forest because their villages are no longer safe. They are scavenging food to stay alive and trying to dodge the cholera that is rampant throughout much of the region. And for the women living in this area, there is another nightmare to face: sexual violence is alarmingly high. A peace conference has been scheduled for next week to try to calm the troubled region, but few are optimistic of a rapid solution.

Tuberculosis

Kairat, from Uzbekistan, on the right, was among the 500,000 people to be diagnosed with multi-drug-resistant tuberculosis this year. But he was one of the lucky ones, moving to one of the few hospitals in the region to get specialist care. But even those who do get treatment have to rely on a highly toxic and expensive cocktail of drugs that often trigger violent side-effects and has to be taken for two years. Amazingly, there have been no major advances in treatment of the disease since the 1960s, and the most commonly used test to diagnose TB was developed at the end of the 19th century and detects only half the cases. An estimated $900m is needed every year for research and development but only $206m has been made available.

Having just done a masters in control of infectious disease with a subset in conflict and health, I am all over those humanitarian crises and more. Did you know the so called neglected diseases (leprosy, leishmaniasis, lymphatic filariasis, schistosomasis etc) cause more DALYs together than HIV/AIDS or malaria? But most people have no idea what they are.

i remembered your m.a was in a related area,
thought you might find it interesting

che guevara was a mass murderer.

to amend what you have: the political stories not covered were political.

journalists were ad hominem. they attacked people and danced lightly around the edges of issues. indymedia did this as well, because the Left mean to exploit mass murder and pose as a FORCE of freewill, which remains an objective contradiction.

ad hominem (latin for at the man) approaches prevailed and political overviews and true savvy were hated in a blind, fevered rush to call all but Bushitude 'bullshit.'

this was copied on the left by bizzare supporters of the Bush Leftist, Chavez, who since he made his big negative attack has proven to be exactly no different, right down to the flavor of the oil (crude, snake, sweet.)

the difference was that the true 'information', while hated by both far right and far left fascists, found a home, and here it is. which is to say - in cyberspace -- but that left Americans to cull. would they be suckered by evil stalky nerds and people who hated Britney and could give a shit about international oil plays?

The underlooked story of 2008 will be international socialism, as Cold War secretly continues.

che guevara was a charismatic and bloody mass murderer and reverse racist. this is not conjecture but the truth of his -- and our -- time. he was a Hispanic Hitler given momentum by what George Orwell frankly said was doublethink -- a way of leading class people saying one thing and doing another. What do fascists do? They stand behind a Man With A Gun and say 'do as we say or he will kill you.' In New Orleans they called that anarchy today. They were shocked by how wrong they were. Real anarchists were smoking pot in Amsterdam and shaking our heads, "bad move, punk...bad move."

International Socialists were maintaining an anti-intellectual pose, saying "how can you say that? You must be -- " to ANYONE who had a different opinion.

Any intellectual who dared disagree with them was tagged. They went on to support the unfriendly fascism that empowered Fidel Castro with a blind spot the dead can see. That is why they are internazis. As in - National Socialists -- ergo...

but no one is intellectual and anarchist here, so
i expect to only pm with the same people i have pm'd with since 2000!

how improbable, how DAZZLING is that for punk.

I'm studying up on TB for my boards. Sorry to be stupid but what does DALYs mean? And what drugs are currently available for resistant TB? I know the mainstays are isoniazid, rifampin, ethambututol, pyrazinamide and streptomycin.

bit of an assumption,

it's just continually posting the same stuff in ever less intelligible ways isn't exactly going to endear you to people, is it?

and again, relevence? chavez, guevara and indymedia are all in their own ways worthy targets, but don't really have jack to do with this

DALYs are Disability Adjusted Life Years, its basically a combination of the years lost due to you dying before your time and the years of healthy life lost (like if you contract polio as a child and are left crippled for life by it). Its a way of calculating the global burden of disease by a single comparison measure. So say, a disease that kills 1,000 at 75 is going to have less of an impact on the population than a disease that cripples 1,000 5 year olds. The WHO probably explains it better than me:

WHO | Disability adjusted life years (DALY)

Drugs for resistant TB depend on where you are drawing the line. For multi drug resistant TB, it depends which of the first line drugs you are resistant to as to your treatment. Most cases of MDR-TB are resistant to both isoniazid and rifampicin but you can be resistant to more than that. If it is just those two people are resistant to, then you use the other three firstline drugs, pyrazinamide, ethambutol and streptomycin. If they are resistant to those, then you move onto second-line drugs like the aminoglycosides, polypeptide antibiotics, fluroquinolines, thioamides, cycloserine and p-aminosalicyclic acid. However a lot of the cases of MDR-TB happen in the developing world where they don't have access to such expensive drugs so use a ragbag of other drugs.

If you are unlucky enough to get XDR-TB- extensively drug resistant TB (to quinolones and also to any one of kanamycin, capreomycin, or amikacin), you are basically fucked. A lot of the people with XDR TB also have HIV, but one of the few studies of their mortality showed that 52 of 53 died during the study. Even MDR-TB has a terrible survival rate- overall its about a 50% mortality rate (rising to 80% in some areas), which is about the same as untreated normal TB.

I tell you, TB, not fun.

The DRC basically typifies how little the West on the whole cares about Africa. They reckon 4 million people died in the DRC's five year long civil war (1998-2003) but most people have never even heard of it. I have to go with the black humour of The Onion's Our Dumb World, whose entry for the neighbouring Republic of the Congo (entitled At least we are not the Democratic Republic of the Congo) reads:

"The Republic of Congo, though not a perfect nation by its own admission, is always quick to point out that at least it is doing a heck of a lot better than the Democratic Republic of Congo."

Thanks for your info! I'm even more pissed now at the US government. I could shit on Iraq right now.

Incidentally- Somalia really is a nightmare situation and its so dangerous it isn't even very well known how bad it is because journalists are at such risk out there. And I can't see the conflict ending anytime soon. There is a saying in Somalia:

"Its me against my brother, my brother and I against our family, our family against our clan, our clan against Somalia, Somalia against the World".

It doesn't inspire hope of a peaceful solution soon.

Maybe the US will help Somalia if they bomb one of our buildings.

If you are looking for a less America/West centric news site (I find even the BBC a bit lacking in world news sometimes), you could try:

Al Jazeera English - Front Page

We have al jazeera TV news here and its unfairly tainted with the whole "supports terrorism because it shows Osama videos" brush. Its really good at in depth journalism about issues you just didn't know about. Like I was completely unaware of the epidemic of violence towards female politicians in Kenya.

^Excellent. Thank you^

Unlikely! The infamous events of the US troops in Somalia in 1993 during "Operation Restore Hope" put off the US touching Africa ever again and is basically held responsible for the international communities refusal to get involved in the Rwandan genocide because it had been so thoroughly humiliated in Somalia.

They pretty much ran away after these pictures got out of dead US soldiers being dragged through the streets:

Holy fuck! That's nasty....Guess they don't need any help from us then?

I think they all united together on the whole "Somalia against the world" thing there. So despite the fact that Somalia is thought to be a genuine hotbed of Al Qaeda training grounds (cause god, anything could go on there and we wouldn't know), everyone stays strangely silent on the issue. A friend of mine (whose Iraqi- so you would have thought he'd be tired of conflict) is working out there at the moment as a doctor. I am really interested to know what its like if/when he gets back.

ignorance is bliss indeed

when does your friend get back? i bet his stories are amazing