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As US Rolls Back Reproductive Rights, Sierra Leone Moves to Decriminalize Abortion
"I'm hopeful today's announcement gives activists in the U.S., and especially Black women given the shared history, a restored faith that change is possible and progress can be made."
Jul 01, 2022
As the U.S. Supreme Court and Republican-controlled state legislatures void the constitutional right to abortion in the United States, Sierra Leone on Friday joined the growing list of African nations that have moved to protect the health and rights of pregnant people by decriminalizing the medical procedure.
"Despite recent setbacks in the United States, feminist movements are stronger than ever and ready to persevere in the global struggle for democracy and reproductive justice."
"At a time in the world when sexual and reproductive health rights for women are either being overturned or threatened, we are proud that Sierra Leone can once again lead with progressive reform," Julius Maada Bio, president of the West African nation, said during his closing remarks at the 10th Africa Conference on Sexual Health and Rights in the capital city of Freetown.
"My government has unanimously approved a safe motherhood bill that will include a range of critical provisions to ensure the health and dignity of all girls and women of reproductive age in this country," he added.
The Safe Motherhood and Reproductive Health Act has been approved by Bio's cabinet and will now go to the nation's parliament for approval. If passed, the measure will overturn a strict ban on abortions dating back to when the country was a British colony and will help reduce the maternal mortality rate, which is currently the world's highest.
"Safe and legal abortion saves lives," the New York-based intersectional feminist group Fos Feminista tweeted in response to Sierra Leone's move.
"Unsafe abortion contributes to the high rate of maternal mortality in Sierra Leone," the group added. "One in 20 women die from causes related to pregnancy or childbirth, making Sierra Leone the third-most dangerous place in the world to become pregnant."
Fadekemi Akinfaderin, Fos Feminista's co-chief officer of global advocacy, said in a statement that "while we see the United States backsliding in protecting their citizens' sexual and reproductive rights, feminist movements in the Global South, including here in Sierra Leone, are decriminalizing abortion and advancing gender and reproductive justice."
"I'm hopeful today's announcement gives activists in the U.S., and especially Black women given the shared history, a restored faith that change is possible and progress can be made," she added.
While women face ongoing challenges in Sierra Leone--including gender-based violence, enduring inequality, discrimination, and genital mutilation--the country now joins African nations Benin, Cape Verde, Democratic Republic of Congo, Kenya, Mozambique, Tunisia, South Africa, and Zambia in legalizing or decriminalizing abortion.
Fos Feminista executive director and CEO Giselle Carino said Sierra Leone's progress "demonstrates the raw strength of global feminist movements."
"Despite recent setbacks in the United States, feminist movements are stronger than ever and ready to persevere in the global struggle for democracy and reproductive justice," she asserted.
"It is not lost on us that this victory comes days after the United States Supreme Court overturned Roe v. Wade," Carino continued. "We recognize the global impact of the United States' policies and funding in setting a global agenda and shaping policies far beyond its borders--the Global Gag Rule is a clear example of what this looks like."
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"Nevertheless, those determined to advance reproductive justice will never relent," Carino added, "not in the face of the United States' faltering leadership, and, as we've seen in Sierra Leone, not in the face of interlocking issues of colonialism, racism, and harmful practices against women."
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Opening and Closing US Embassies--From Sierra Leone to Afghanistan
U.S. officials are very well aware that local citizens who work with the U.S. military are endangering themselves and their families when the U.S. departs.
Aug 16, 2021
The people of Afghanistan are in a state of fear of the Taliban who now control Afghanistan's capital, major cities, and countryside--after the U.S. and NATO twenty-year occupation. Here are some of my personal observances during sixteen years in the U.S. diplomatic corps and experiencing the opening and closing of U.S. Embassies in Sierra Leone and Afghanistan and the effects on the civilian populations of the countries involved.
In December 2001, I was a part of a very small team from the U.S. Department of State that was sent to Kabul, Afghanistan to reopen the U.S. Embassy. The Embassy had been closed for 12 years following the Soviet exodus from Afghanistan and the subsequent civil war between the warlord militias that fought to gain land and influence. The U.S. had sent CIA paramilitary and some U.S. Army Special Forces into Afghanistan in October 2001 to chase down Osama bin Laden and Al Qaeda after the events of 9/11.
Now, twenty years later, the deaths of hundreds of thousands of Afghans and a few thousand international military including the U.S--the U.S. and its NATO partners are exiting Afghanistan under a pitiful agreement brokered during the Trump administration by former U.S. Ambassador to Afghanistan Zalmay Khalizad, himself an Afghan who came to the U.S. as a teenager. The deal with the Taliban sold out the government of Afghanistan and ended up with the release of 6,000 Taliban prisoners for an agreement that the Taliban would not fire on U.S. military during its departure from Afghanistan. No deal was struck for power-sharing or any other aspect that could have put the government of Afghanistan on a strong negotiating footing.
After the U.S. undercut the Afghan government, it is now left with no leverage in dealing with the Taliban and is facing the rapid takeover of the country as many of the 300,000 Afghan personnel trained by the U.S. and NATO militaries have surrendered to the Taliban or returned to the warlord militias from which they came.
I was told when I arrived in Afghanistan that there is a time-honored tradition of changing sides depending on whom has more personnel and firepower, to live to fight another day and we are definitely seeing that now. Today we see that the president of the country Asraf Ghani has fled to a neighboring country. I met Ghani when he arrived in Afghanistan as a private citizen in January 2002--just coming from a lengthy employment with the World Bank. He was minister of finance for a period during the administrations of Hamid Karzai.
5,000 U.S. military are arriving in Kabul to protect Kabul International Airport as over 4,000 U.S. government and contract employees leave Afghanistan. The State Department spokesperson Ned Price on August 12 said that it is "not an abandonment, not an evacuation, not a wholesale withdrawal, but is a reduction in the size of our civilian footprint." A skeleton staff may remain in Kabul to keep the U.S. Embassy nominally "open." Despite what the State Department calls it, the Afghan Ambassador to the U.S. on August 13 called U.S. actions "an abandonment."
U.S. Embassy personnel have destroyed sensitive documents as they prepare to leave Afghanistan. U.S. Presidential Envoy Zalmay Khalilzad is attempting to extract a commitment from the Taliban that they will not attempt to take over the extensive U.S. Embassy compound "if it ever wants to receive foreign aid."
Evacuation of US Embassy in Sierra Leone in 1997
With the Embassy staff in Kabul in withdrawal/evacuation mode, it reminds me of what I and our Embassy staff went through 25 years ago in 1996 when a coup of militants and an element of the Sierra Leone, an Army overthrew the elected government of the West African country of Sierra Leone. The violence on the streets of Freetown, the capital of the country, including the temporary kidnapping of a U.S. marine and an Embassy local employee driver, caused the evacuation of the entire international community, Embassies, UN offices and international NGOS, and most of the Sierra Leonean government who felt they were in mortal danger.
While there was no U.S. military involvement in Sierra Leone's civil war, the U.S. Embassy had been the backstop of gunfire as the nearby State House was taken by the rebels. 90 windows were blown out of the embassy and the rebels made attempts to come into several Embassy properties but they were talked out of entering by our brave local employees.
After the U.N envoy, the British High Commissioner and I, as Charge d'Affaires of the U.S. Embassy, had discussions with the leadership of the coup about their giving up the coup in exchange for the government meeting several demands. The three of us were told by our higher-ups to stop discussions and prepare for evacuation as they had received indications that we might be kidnapped if we continued the talks.
That began the rapid organization to prepare for closing the Embassy in just a few days. The U.S. military sent the huge amphibious assault ship USS Kearsage for the main evacuation. The Kearsarge had been offshore Zaire for possible evacuation of Americans from that country so we had to wait for the main evacuation for the Kearsarge to arrive. We put some Embassy family members on a chartered flight that the British Embassy had arranged but over the next three days we evacuated over 2500 persons, including many U.S. Embassy local employees, by helicopter from a U.S. military secured hotel to the USS Kearsarge, a huge U.S. Navy ship several miles offshore. Thousands of Sierra Leonean citizens gathered at the hotel hoping they could be evacuated, but the decision in Washington was that the U.S. could not evacuate all of them. They were on their own to get to neighboring countries if they wanted to flee from the violent coup makers.
The Embassy remained closed for one year until a Nigerian military force pushed the coup makers off the peninsula on which the capital was located. The U.S. Embassy was closed six months later when rebel groups again came into the city. Peace in Sierra Leone was finally achieved with the introduction of 18,000 United Nations sponsored military units that stayed in the country for several years.
Back to Afghanistan
I was in Kabul in December 2001 on the small team that reopened the U.S. Embassy. I stayed for about six months. Our team never dreamed the U.S. would have stayed in Afghanistan for 20 years. In fact, our initial cables back to Washington predicted we should do what the U.S. intended to do in a short time and as foreign militaries in Afghanistan, no matter the rationale for their presence, eventually were pushed out by Afghans.
Possible Retaliation
U.S. officials are very well aware that local citizens who work with the U.S. military are endangering themselves and their families when the U.S. departs. The history of the U.S. wars in Vietnam, Iraq, and Somalia have seen retaliation against persons who have worked with U.S. forces, but the protection of those persons is never considered in the decision making of sending U.S. military into a situation much less during the fast withdrawal of forces. After 20 years in Afghanistan, it is estimated that 50,000 persons are eligible for some type of U.S. visa.
Retaliation by the Taliban against Afghan national military and national police forces trained by the U.S. and NATO were expected and have occurred. Afghan military units are surrendering to the Taliban in hopes they will not be killed in a time-honored tradition that rather than dying in fighting, if you recognize that the opposing forces have more personnel and weaponry, then you surrender to save your life. Government forces on the borders of Afghan have surrendered in droves. From May 1-27, at least 26 outposts and bases in four provinces--Laghman, Baghlan, Wardak and Ghazni--surrendered after the Taliban used village elders to deliver to outposts messages to surrender or be killed, some elders and government officials.
However, surrendering does not work for all units. In July 22 Afghan Special Forces commandos, including the son of an Afghan general, were executed by Taliban as they were surrendering.
The executions by the Taliban remind me of 2001 when General Dostum and U.S. forces executed Taliban prisoners taken from Sherboyan prison and executed in the desert as documented in the 2002 film: Afghan Massacre: Convoy of Death. Memories in Afghanistan are long and retaliation is a given.
I don't think the Taliban will take over the U.S. Embassy compound as the Taliban wants international aid, and I suspect we will have a substantial military force inside the Embassy to protect it. There were already 90 marines inside and I think many of the 5,000 will go into the compound to protect the facility as seeing the facility overrun would not be what any administration wants to have seen.
Warlords and Their Militias--Same Story 20 Years later
While in Kabul in 2001/2002 I also met regional warlords who had wrecked havoc on Kabul after they had pushed the Soviets out. With Khalizad, I met with General Dostum and warlord Mohammed Atta in Mazar-i-Sharf in January 2002 to try to get them to stop fighting among themselves--and ending up getting food poisoning from having lunch at Dostum's house. Dostum was the warlord whose militias killed over 3,000 Taliban and other prisoners from Sherboygan prison by shooting into containers that contained the prisoners and their bodies buried in the desert. Afghan Convoy of Death documents these murders and will be a basis for retaliation by the Taliban against Dostum and his militia twenty years later.
Similar Taliban retaliation should be expected by the Taliban against warlord Ismail Khan who has ruled the Herat region on the border with Iran for over 20 years. Khan was captured in Herat several days ago.
Presidential Palace in Kabul
Today we know the Taliban have entered the Presidential Palace which President Ghani fled from earlier today.
Now on TV are images of the Taliban in the Presidential Palace. I remember going to the Palace for the first time in 2001 and Hamid Karsai invited us to stay for lunch-a pilaf, the first hot meal we had had in Afghanistan, before we got our little stove working in the bunker we were staying in and doing take-out from the restaurant owned by the brother of one of our Embassy employees!!!
The paintings in the Presidential Palace were being retouched from having been protected by an overlay of paint to cover images that the Taliban would have destroyed.
A few weeks later, I was in the National Museum when statues and figures were returned by museum employees who had taken them to their homes or had buried them to protect them from destruction--as the Taliban had blown up the iconic massive Buddha statues in Bamiyan when they took into power in 1996.
Impact on Women in Afghanistan
We all are very concerned about the plight of women under another Taliban rule. While tens of thousands of Afghans were killed and hundreds of thousands were wounded by the violence of the U.S./NATO military operations after Al Qaeda was forced out of Afghanistan, the occupation did provide some positive aspects for the role of women:
- 3,135 functional health facilities created by 2018, giving 87% of Afghan people access to a medical facility within two hours distance;
- In 2003, 10% of girls in primary schools had increased to 33% in 2017;
- In 2003, 6% in Secondary education had increased to 39% in 2017;
- 2017 3.5 million Afghan girls in school with 100,000 studying in universities;
- Women's life expectancy grew from 56 years in 2001 to 66 in 2017;
- Childbirth mortality declined from 1,100 per 100,000 live births in 2000 to 396 per 100,000 in 2015;
- By 2020, 21% of Afghan civil servants were women (compared with almost none during the Taliban years), 16% of them in senior management levels, and 27% of Afghan members of parliament were women.
But according to a Brookings report, in the rural areas where 76% of Afghan women live, it's a different story. Gains for women have been unequal, with the increases far greater for women in urban areas. For many rural women, particularly in Pashtun areas but also among other rural minority ethnic groups, actual life has not changed much from the Taliban era where they are still dependent on men in their families for permission to access health care, attend school, and work.
Most importantly, many Afghan men remain deeply conservative. A study showed that only 15 percent of Afghan men think women should be allowed to work outside of their home after marriage, and 66% of men complain Afghan women now have too many rights. Families allow girls to have a primary or secondary education--up to puberty--and then will proceed with arranged marriages. Even if a young woman is granted permission to attend a university by her male guardian, her father or future husband may not permit her to work after graduation. Rural women said that the Taliban reduced sexual predation and robberies that debilitated their lives and most Afghan women in rural areas continue to be covered with the burqa.
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West Africa's Ebola Death Toll Continues to Climb: WHO
The international body has now confirmed nearly 20,000 infections in Liberia, Sierra Leone, and Guinea
Dec 20, 2014
The Ebola death toll in the three West African countries most impacted by the virus has climbed to at least 7,373 of 19,031 known infections, the World Health Organization revealed in data released Saturday.
Western Sierra Leone is the "hotspot" of the ongoing outbreak, according to the WHO, which notes that this country has the highest infection rate, followed by Liberia and then Guinea.
However, Liberia accounts for far more Ebola deaths, leading some to question the accuracy of the WHO's statistics on infection rates.
Nonetheless, the data shows an increase in overall cases, which are up by 500 since WHO data was last released on December 17.
The numbers were released following news Friday that Sierra Leone's top-ranking doctor had succumbed to Ebola, making him the 11th of the country's 120 doctors to die from the disease, according to the Guardian.
Meanwhile, humanitarian aid workers have criticized the global community for its failure to respond adequately as West African governments and grassroots initiatives such as the Citizens Alliance to Stop Ebola in Liberia struggle to stem the ongoing emergency.
"The international response to the Ebola crisis in West Africa has been slow and uneven leaving local people, national governments and non-governmental organizations (NGOs) to do most of the practical, hands-on work," the NGO Doctors Without Borders//Medecins Sans Frontieres declared earlier this month.
The lackluster global response comes despite the fact that Western-driven economic policies played a key role in gutting West African public health systems.
"People are still dying horrible deaths in an outbreak that has already killed thousands," said Dr. Joanne Liu, MSF international president. "We can't let our guard down and allow this to become double failure, a response that was slow to begin with and is ill-adapted in the end."
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US Proposes Major Debt Relief for Ebola-Hit Countries
Nov 14, 2014
WASHINGTON - The United States proposed this week that the international community write off $100 million in debt owed by West African countries hit hardest by the current Ebola outbreak. The money would be re-invested in health and other public programming.
U.S. Treasury Secretary Jack Lew will be detailing the proposal later this week to a summit of finance ministers from the Group of 20 (G20) industrialised countries. If the idea gains traction among G20 states, that support should be enough to approve the measure through the International Monetary Fund (IMF), where the United States is the largest voting member.
"The plan is for that money to be re-invested in social infrastructure, including hospitals and schools ... to deal with the short-term problem of Ebola but also the long-term failure of the health systems that allowed for this outbreak." --Jubilee USA's executive director Eric LeCompte"The International Monetary Fund has already played a critical role as a first responder, providing economic support to countries hardest hit by Ebola," Lew said in a statement to IPS.
"Today we are asking the IMF to expand that support by providing debt relief for Sierra Leone, Liberia and Guinea. IMF debt relief will promote economic sustainability in the worst hit countries by freeing up resources for both immediate needs and longer-term recovery efforts."
These three countries together owe the IMF some 370 million dollars, according to the U.S. Treasury, with 55 million dollars due in the coming two years. Yet there are already widespread fears over the devastating financial ramifications of Ebola on Guinea, Liberia and Sierra Leone, in addition to the epidemic's horrendous social impact.
Last month, the World Health Organisation warned that the virus now threatens "potential state failure" in these countries. The World Bank, meanwhile, estimates that the virus, which has already killed more than 5,000 people and infected more than 14,000, could cost West African countries some 33 billion dollars in gross domestic product.
Of course, much of the multilateral machinery is often too cumbersome to respond to a fast-moving viral outbreak. Yet there is reason to believe that the U.S. plan could have both immediate and long-term impacts.
That's because the plan would see the IMF tap a unique fund set up in the aftermath of the 2010 Haiti earthquake, which facilitated the cancellation of nearly 270 million dollars of Haitian debt to the IMF. Called the Post-Catastrophe Debt Relief (PCDR) Trust, it is aimed specifically at responding to major natural disasters in the world's poorest countries.
Originally, the PCDR Trust was capitalised with more than 420 million dollars. Today, a U.S. Treasury spokesperson told IPS, the trust has some 150 million dollars in it - money that would be available almost immediately.
"Our proposal is for the IMF to provide debt relief for these Ebola-affected nations from this trust," the spokesperson said. "The U.S. would like to see around 100 million dollars put toward this effort, however the precise amount will need to be determined in consultations with the IMF and its membership."
The IMF, meanwhile, says it is preparing to consider the proposal. In September the Washington-based agency made available 130 million dollars in immediate support to Guinea, Liberia and Sierra Leone.
"We are very glad that some donors have expressed an interest in increasing support for the Ebola-affected countries. We are reaching out to all donors to see how we might be able to take this forward ... using all the tools available to us," an IMF spokesperson told IPS.
"[Debt relief] decisions are made according to the merits of the particular case and this would be approached in the same way. We would expect the Board to be briefed soon on this topic."
Ebola's "natural disaster"
For development and anti-poverty advocates, debt obligations on the part of poor countries constitute a key obstacle to a government's ability to respond to critical social needs, both in the short and long term.
In the West African epicentre of the current Ebola outbreak, many analysts have held chronic low national health spending directly responsible for allowing the epidemic to spiral out of control. And when looking at feeble public sector spending, it is impossible not to take into account often crushing debt burdens.
For instance, Guinea spent a little more than 100 million dollars on public health in 2012 but paid nearly 150 million dollars that same year on internationally held debt, according to World Bank figures provided by Jubilee USA, an anti-debt advocacy network that has spearheaded the push for the United States to make the current proposal.
"As bad as Ebola has been, some of these countries have far greater challenges with deaths from malaria than from Ebola," Eric LeCompte, Jubilee USA's executive director, told IPS.
"The amount is incredibly important because it cancels a significant portion of the debt completely. And the plan is for that money to be re-invested in social infrastructure, including hospitals and schools ... to deal with the short-term problem of Ebola but also the long-term failure of the health systems that allowed for this outbreak."
LeCompte was also involved in the creation of the Post-Catastrophe Debt Relief Trust, in the aftermath of the Haitian earthquake. His office has advocated for the fund's monies to be used since then - for instance, to react to flooding in Pakistan and Typhoon Haiyan in the Philippines.
But he says these and other proposals have been rejected by the IMF's membership, on the rationale that these countries were developed enough to be able to mobilise financing in other ways. (The IMF says PCDR funds are for response to "the most catastrophic of natural disasters" in "low-income countries", when a third of a country's population has been affected and a quarter of its production capacity destroyed.)
Not only are Guinea, Liberia and Sierra Leone among the poorest countries in the world, but the Ebola outbreak there has a potentially direct impact on the rest of the globe.
"This is a very clear opportunity to point to the 150 million dollars left in that fund and to note that Ebola is every bit the same as the Haitian earthquake in terms of being a regional calamity," LeCompte says.
"The difference is that this is also a long-term investment in the very problems that allow Ebola to spread. So we'd be not only addressing the current issue, but also the next disease outbreak in that region."
It is unclear whether there is a mechanism in place to top up the PCDR Trust in the future. The IMF states that "Replenishment of the Trust will rely on donor contributions, as necessary."
But for his part, LeCompte says the fund has the potential to fill a significant gap: offering a pot of money, immediately available, that could be quickly mobilised to deal with true crises afflicting the world's poorest countries, from hurricanes to major financial defaults.
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'We Need Intervention': Sierra Leone Sees Sudden Rise in Ebola Cases
UN statistics show 111 new cases reported Sunday as virus grows and remote communities plead for help
Nov 10, 2014
Ebola cases in Sierra Leone spiked on Sunday, with 111 new cases reported--the highest daily rate since the country's health ministry started publishing statistics in August.
The United Nations warned that the actual figures may be much higher, stating last week that cases are being underreported by up to 50 percent. A total of 4057 cases have been confirmed in the country, according to statistics released by the United Nations Mission for Ebola Emergency Response (UNMEER).
Sierra Leone's capital city of Freetown, which saw 40 new cases on Sunday and 62 total over the weekend, has some medical infrastructure in place to deal with the outbreak, in the form of Ebola hospitals built by foreign militaries--but more remote towns are without such health services and are still waiting for treatment centers. Port Loko, which is the third-most affected district out of 14 in Sierra Leone, is still waiting for construction to finish on a 100-bed clinic; while it is due to open in November, the World Health Organization (WHO) has said that cases are rising faster than treatment centers are being built.
By the time Port Loko opens its first clinic, there will be a need for 4,000 beds throughout the country, the WHO said. There are currently less than 500.
Doctors Without Borders/Medecins Sans Frontieres (MSF) has warned for months that Ebola would continue spreading without international support and aid. While the organization confirmed a decline of the disease in Liberia this week, MSF's Ebola response chief Chris Stokes told the BBC there was still a chance of a "flare up," noting that Guinea is seeing an increase in cases after two periods of seemingly getting it under control.
The region of Koinadugu is the latest to be hit by the disease. With no treatment centers in place and few resources to go around, as well as a lack of transport available for infected patients in the isolated community, Ebola spread rapidly in the area, killing at least 50 people in recent weeks.
"Nine people are now in the isolation [center] and two of these are seriously ill, with not much hope for them I'm afraid," John Marah, head of the Red Cross in Sierra Leone, told Agence France Presse on Monday. "The situation is really difficult."
The virus quickly claimed its hold last month over the mountainous region, previously the most unaffected in the country after local chiefs imposed a quarantine and forbid entry to traders and farmers. Its rapid spread was partly due to Koinadugu's inaccessibility by road and a slow response by medical organizations. The nearest treatment center is five to eight hours away by road.
Humanitarian agencies were slow to respond because "there was a lot of denial about Ebola at the beginning," Marah told AFP. About 250 people are now being monitored, he said, but the quarantine was quickly leading to a food shortage.
"There is no supply of rice there at the moment. Farmers cannot go to their farms and the World Food Programme is not getting them enough supplies," Marah told the Guardian on Monday.
Foday Jalloh, a chief in Koinadugu, told the Red Cross last week that the region was in desperate need of humanitarian aid. "We need medical supplies and medical equipment," he said. "We need intervention to give us support."
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Ebola Outbreak Threatens Food Crisis in West Africa
UNITED NATIONS - The widespread outbreak of Ebola in West Africa, which has resulted in over 4,500 deaths so far, is also threatening to trigger a food crisis in the three countries already plagued by poverty and hunger.
Dr. Shenggen Fen, director-general of the Washington-based International Food Policy Research Institute (IFPRI), told IPS the crisis is expected to be confined mostly to the countries directly affected by the spreading disease: Liberia, Sierra Leone and Guinea.
Oct 23, 2014
UNITED NATIONS - The widespread outbreak of Ebola in West Africa, which has resulted in over 4,500 deaths so far, is also threatening to trigger a food crisis in the three countries already plagued by poverty and hunger.
Dr. Shenggen Fen, director-general of the Washington-based International Food Policy Research Institute (IFPRI), told IPS the crisis is expected to be confined mostly to the countries directly affected by the spreading disease: Liberia, Sierra Leone and Guinea.
Asked whether the food shortages will also reach countries outside West Africa, he said Ebola is triggering a food crisis through a series of interrelated factors, including farmer deaths, labour shortages, rising transportation costs, and rising food prices.
"Within these countries, where undernourishment has long been a problem, the food crisis may persist for decades," he warned.
And because Sierra Leone, Guinea, and Liberia are all net food-importing countries, the Ebola-triggered food crisis is unlikely to spread to other countries in the region or beyond, Dr. Fan added.
Global food prices tend to have transmission effects on regional or national food prices, but for small markets (on a global scale) such as these three countries, the transmission effect of food prices is unlikely to pass beyond their own boundaries - so long as the disease itself is not transmitted, he said.
According to the latest figures released by the World Health Organisation (WHO), there are over 9,000 cases of Ebola, including 4,262 cases in Liberia, 3,410 in Sierra Leone and 1,519 in Guinea.
The death toll is highest in Liberia (2,484), followed by Sierra Leone (1,200) and Guinea (862).
U.N. Spokesperson Stephane Dujarric told reporters Monday the WHO has officially declared Nigeria free of Ebola virus transmission, after 42 days without a single case.
WHO called it "a spectacular success story that shows that Ebola can be contained".
"Such a story can help the many other developing countries that are deeply worried by the prospect of an imported Ebola case and are eager to improve their preparedness plans," he said.
Dujarric said the announcement comes only a few days after Senegal was also declared Ebola-free.
He said the trust fund set up by Secretary-General Ban Ki-moon to battle the deadly disease now has about 8.8 million dollars in deposits and 5.0 million dollars in commitments.
In total, 43.5 million dollars have been pledged and the secretary-general continues to urge countries to turn these pledges into action as soon as possible.
He expressed regrets over the Ebola-related death of a UN-Women staff member in Sierra Leone. His spouse is currently receiving treatment.
"All measures to protect staff at the duty station in Sierra Leone are being taken as best as possible under the current circumstances," Dujarric said.
This includes decontamination of the U.N. clinic, disposal of the isolation facility and contact tracing, he added.
In a statement released Tuesday, IFPRI painted a grim picture of the situation facing all three countries.
Schools in Sierra Leone have closed, shutting down critical feeding programmes for children. And restrictions on the consumption of bush meat, the suspected source of Ebola, have eliminated a traditional source of protein and nutrition from local diets.
"In addition, the costs of staple foods including rice and cassava are rising precipitously in the affected areas as crops are abandoned and as labor shortages grow," the statement added.
Food that would be imported from these areas is not making its way to other regions, either.
"So, as we weigh the dangers of this dreaded disease, we must not forget the very real threats it poses to food security," the group warned.
"The global community must come together to ensure that there are safety nets to protect not only those infected with the disease, but also those whose access to food is severely affected," IFPRI added.
Asked to identify these safety nets, Dr. Fan told IPS social safety nets are needed to protect not only those infected with Ebola, but also those whose access to food is severely affected.
These safety nets, which could be in the form of cash or in-kind transfers (context-specificity is important here), should be accompanied with nutrition and health interventions.
For example, a conditional cash transfer programme linked to health can help improve access to nutritious foods, particularly when prices are high, while promoting health service use, he added. "This is important, because investing in the nutrition and health of vulnerable populations could lower the mortality rate of diseases like Ebola, as nutritional status and infection are intricately linked."
In the post-Ebola era, Dr. Fan said, combined social protection and agricultural support interventions will be crucial to build resilience to future livelihood shocks.
Asked how many people will be affected by this impending food crisis, he said with Ebola claiming lives of thousands of people in Sierra Leone, Guinea, and Liberia, the mounting food crisis is impacting thousands more still.
Recent efforts by the World Food Programme (WFP) to provide food assistance to around 1.3 million people in these three countries indicate an idea of the scope of the current crisis.
The Food and Agriculture Organisation (FAO) is also providing food assistance to nearly 90,000 farming households to abate the food security crisis, he pointed out.
As the harvest season is beginning, labour shortages are putting the food security of tens of thousands of people at risk in particularly affected areas, he declared.
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What West Africa Can Teach the US About Ebola
Nigeria and Senegal have declared victory on Ebola even as healthcare workers in Texas contract it.
Oct 20, 2014
When the Texas Health Presbyterian Hospital missed a crucial diagnosis of the Ebola virus and released Liberian Thomas Eric Duncan to go home, it unleashed a sequence of events that is still unfolding rapidly.
As in the great AIDS panic, the introduction of the Ebola infection into the American populace has resulted in confusion, speculation, and hysteria. Even perfectly healthy individuals, such as American reporters who have been to the West African region, find themselves being shunned because of irrational fears.
For better or worse, the response of the authorities to this crisis will go down in history. Certain categorical declarations will particularly stand out--and in some cases return as painful ironies. As an example, in late July, Stephen Monroe--the deputy director of the CDC's National Center for Zoonotic Infectious Disease--stated, "Ebola poses little risk to the U.S. general population," adding that, "the likelihood of the outbreak spreading outside of West Africa is very low."
In an effort to tamp down fears over Ebola, CDC director Thomas Frieden asserted in October that "Ebola is scary. It's a deadly disease. But we know how to stop it." It is unclear whether the "we" refers to the CDC, health facilities more generally, or some other entity, but this firm and sweeping assertion was called into question as news broke of the first and then a second case of Ebola transmission to Thomas Duncan's caregivers at Texas Presbyterian Hospital.
Earlier this month, David Lakey, commissioner of the Texas Department of State Health Services, famously said of Dallas, "This is not West Africa. This is a very sophisticated city." Still not sophisticated enough, apparently, to prevent one fumble after another.
U.S. Lapses
The supposed "mystery" as to how these caregivers contracted Ebola when they were supposedly shielded from transmission by their personal protective equipment (PPE) is actually no mystery at all.
As a physician at a wound care center in Southern California, I go through 10 to 20 units of protective gear every day, one for each patient. A quick, self-administered test on removing my PPE revealed that I did it with less than 100 percent safety. It is, quite frankly, not easy.
With Ebola, even 99 percent safety is not good enough. Many hospitals in the United States use PPE for procedures such as wound repair and colonoscopies. And in many wards and intensive care units, healthcare staff don PPE for cases of MRSA or VRE. But not only does the care required in such "ordinary" protection pale beside the vigilance involved in Ebola exposure, the PPE itself is quite different.
So the answer to whether "we," as Frieden put it, know how to stop the virus here in the United States might well be a "no" at worst and a "sort of" at best.
Indeed, National Nurses United Executive Director RoseAnn DeMoro has claimed that there is an absence of any protocol at the Texas Presbyterian hospital on how to deal with the deadly virus. Other hospitals have opted for the World Health Organization's Ebola protocol instead of the CDC's because of its extra guidelines for hand sanitation.
The CDC poster for removal of PPE shows the use of only a single pair of gloves and appears highly lacking compared to the painstaking measures described by Australian nurse Sue Ellen Kovack at a Sierra Leonean Ebola treatment center. Of note in her account is the liberal dousing with a chlorine (or bleach) spray from head to toe, a chlorine hand rinse, hand washing at least eight times during the procedure, and the use of two pairs of gloves instead of just one as recommended by the CDC. On October 16, the CDC effectively admitted that its own guidelines were lax and has moved to the more exacting guidelines.
Ironically, rough-and-ready Ebola treatment centers like the tents constructed by agencies like Doctors Without Borders are much better equipped for safety procedures like the chlorine bath than many modern Western facilities. To do this in a technologically advanced U.S. hospital, separate alcoves would need to be built in designated spaces to accommodate a "spraying area." That could be extremely complicated in the average intensive care unit.
Learning from Africa
Perhaps we in the United States are learning a small lesson in humility.
Is it possible, for example, that Nigeria, of all places, might have some wisdom to convey to the United States? Both Nigeria and Senegal moved quickly to quell an Ebola outbreak through meticulous contact tracing, coordinated national action, exhaustive interviews, and activation of an Ebola Incident Management Center. Both countries are now reportedly free of the disease.
Although the story is not yet over, the U.S. government has lauded Nigeria's initial management of the outbreak. Indeed, the CDC has now ordered dozens of high-tech, infrared, no-touch thermometers to be used in screening procedures at U.S. gateway airports--the same ones that are already being used in West Africa.
David Lakey is right: Texas is not West Africa. But every once in a while, the West African example is worth following.
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Ebola and Islamic Extremism: An Ounce of Prevention is Worth a Pound of Cure
Although American officials are making lots of reassuring noises about screening passengers coming from West Africa for signs of the dreaded Ebola virus, the truth is that the only way to totally safeguard against the spread of the disease is to close our borders entirely. And I don't see that happening anytime soon.
Oct 11, 2014
Although American officials are making lots of reassuring noises about screening passengers coming from West Africa for signs of the dreaded Ebola virus, the truth is that the only way to totally safeguard against the spread of the disease is to close our borders entirely. And I don't see that happening anytime soon.
Talk about an unexpected side effect of globalization. Goods and services spread around the globe at the stroke of a keyboard or the roar of a jet engine, but the same mechanisms we celebrate as having pumped up the global economy also, potentially, have a darker side.
What was it Marx said about the bourgeoisie digging its own grave?
I keep hearing the undertone, in the media reporting on Ebola, of the "blame-the-victim" complaint, "What's wrong with these people? Why are they living in such poverty? Why don't they have doctors, nurses, hospitals? Look how their squalor is putting us all at risk?!"
There is truth to this. The poor folks in Liberia, Guinea and Sierre Leone, former colonies of the U.S., France and Great Britain, respectively, have not managed to modernize their societies. This is due to a number of factors, including corrupt leadership (strongmen often propped up by the Western powers), violent civil wars (armed by Western weapons manufacturers and distributors), and banana republic-style economies where Western corporations rule by extraction, extortion and exploitation, without giving anything back in taxes, infrastructure or education for the local people.
This is where the West has made its big mistake. How could we in the so-called developed world be so naive as to think that we could ignore the poverty and suffering of other parts of the globe without that poverty and suffering coming back to haunt us?
If we had invested in schools, medical facilities and housing in Liberia, instead of sending endless supplies of assault rifles and ammunition, we would not be worrying about Ebola now.
Likewise, if we had invested in education and economic development in the Middle East, instead of relying corrupt warlords to keep the population in line, we would not be dealing with a seemingly endless morphing insurgency of Taliban-Al Quaeda-Islamic State terrorists.
It really is true that an ounce of prevention is worth a pound of cure.
In a globalized society, pretending that vast disparities of wealth don't matter is just plain stupid. Imagining that a vicious virus can be contained by airport thermometer checks is as ridiculous as imagining that an international terrorist network can be stopped by a few fly-by bombings.
The world's leaders need to take a lesson from Malala Yousefzai, the 17-year-old girl who won the 2014 Nobel Peace Prize for her steadfast insistence, even after nearly having her head blown off by the Taliban, that girls should be educated.
Study after study has shown that when a society educates and empowers women, it becomes more economically successful and more politically stable.
This week, in my African Women Writing Resistance class, I've been reading and discussing the autobiography of Ellen Johnson Sirleaf, President of Liberia and first woman head of state in modern Africa.
Sirleaf, who won the Nobel Peace Prize in 2011, has been in the news a lot lately, begging for help in containing the spread of Ebola and warning grimly of the consequences of international inaction.
She came to office vowing to take her country back from the warlords and reintegrate child soldiers, to educate girls and boys and build a sustainable economy. She's made great strides, but the stark pictures of the pathetic state of the nation's health care infrastructure make it clear how far Liberia, like other poor African nations, still has to go.
The bottom line is this: if we want safety, we have to build towards it, step by step, from the ground up. We can't ignore poverty and then get mad when impoverished sick people dare to infect us, or when desperate people turn to radical Islam as a way out of their misery.
There is no excuse, in our globalized world, for the dramatic disparities of wealth and poverty that exist today. Those of us lucky enough to live comfortably in the U.S. or Europe should be using our privilege to advocate for those less fortunate.
Not just out of altruism. Out of self-preservation, too.
If we had been helping Liberia and other West African nations build good social infrastructure, instead of extracting profits from diamonds, rubber and gun sales, we would not be worrying about the spread of Ebola today.
If we had been educating children in Syria, Yemen and Iraq instead of supporting corrupt dictators and ignoring the plight of ordinary people, we would not be facing the spread of Islamic extremism today.
How many innocent humans will have to die before we begin to understand that simple adage? An ounce of prevention is worth a pound of cure.
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Militarizing the Ebola Crisis
Few would oppose a robust U.S. response to Ebola, but the Obama administration's deployment of 3,000 troops to Liberia comes amid a broader U.S.-led militarization in West Africa
Sep 25, 2014
Six months into West Africa's Ebola crisis, the international community is finally heading calls for substantial intervention in the region.
On September 16, President Obama announced a multimillion-dollar U.S. response to the spreading contagion. The crisis, which began in March 2014, has killed over 2,600 people, an alarming figure that experts say will rise quickly if the disease is not contained. Obama's announcement comes on the heels of growing international impatience with what critics have called the U.S. government's "infuriatingly" slow response to the outbreak.
Assistance efforts have already stoked controversy, with a noticeable privilege of care being afforded to foreign healthcare workers over Africans.
After two infected American missionaries were administered Zmapp, a life-saving experimental drug, controversy exploded when reports emerged that Doctors Without Borders had previously decided not to administer it to the Sierra Leonean doctor Sheik Umar Khan, who succumbed to Ebola after helping to lead the country's fight against the disease. The World Health Organization similarly refused to evacuate the prominent Sierra Leonean doctor Olivet Buck, who later died of the disease as well. The Pentagon provoked its own controversy when it announced plans to deploy a $22 million, 25-bed U.S. military field hospital--reportedly for foreign health workers only.
One particular component of the latest assistance package promises to be controversial as well: namely, the deployment of 3,000 U.S. troops to Liberia, where the U.S. Africa Command (AFRICOM) will establish a joint command operations base to serve as a logistics and training center for medical responders.
According to Think Progress, this number represents "nearly two-thirds of AFRICOM's 4,800 assigned personnel" who will coordinate with civilian organizations to distribute supplies and construct up to 17 treatment centers. It's unclear whether any U.S. healthcare personnel will actually treat patients, but according to the White House, "the U.S. Government will help recruit and organize medical personnel to staff" the centers and "establish a site to train up to 500 health care providers per week." The latter begs the question of practicality, and where these would-be health workers will be recruited from.
According to the Obama administration, the package was requested directly by Liberian President Ellen Johnson Sirleaf. (Notably, Liberia was the only African nation to offer to host AFRICOM's headquarters in 2008, an offer AFRICOM declined and decided to set up in Germany instead). But in a country still recovering from decades of civil war, this move was not welcomed by all. "Every Liberian I speak with is having acute anxiety attacks," said Liberian writer Stephanie C. Horton. "We knew this was coming but the sense of mounting doom is emotional devastation."
Few would oppose a robust U.S. response to the Ebola crisis, but the militarized nature of the White House plan comes in the context of a broader U.S.-led militarization of the region. The soldiers in Liberia, after all, will not be the only American troops on the African continent. In the six years of AFRICOM's existence, the U.S. military has steadily and quietly been building its presence on the continent through drone bases and partnerships with local militaries. This is what's known as the "new normal": drone strikes, partnerships to train and equip African troops (including those with troubled human rights records), reconnaissance missions, and multinational training operations.
To build PR for its military exercises, AFRICOM relies on soft-power tactics: vibrant social media pages, academic symposia, and humanitarian programming. But such militarized humanitarianism--such as building schools and hospitals and responding to disease outbreaks--also plays more strategic, practical purpose: it allows military personnel to train in new environments, gather local experience and tactical data, and build diplomatic relations with host countries and communities.
TomDispatch's Nick Turse, one of the foremost reporters on the militarization of Africa, noted that a recent report from the U.S. Department of Defense "found failures in planning, executing, tracking, and documenting such projects," leaving big questions about their efficacy.
Perhaps more importantly, experts have warned that the provision of humanitarian assistance by uniformed soldiers could have dangerous, destabilizing effects, especially in countries with long histories of civil conflict, such as Liberia and Sierra Leone. At the outset of the crisis, for example, efforts by Liberian troops to forcefully quarantine the residents of West Point, a community in the capital of Monrovia, led to deadly clashes. Some public health advocates worry that the presence of armed troops could provoke similar incidents.
The U.S. operation in Liberia warrants many questions. Will military contractors be used in the construction of facilities and execution of programs? Will the U.S.-built treatment centers be temporary or permanent? Will the treatment centers double as research labs? What is the timeline for exiting the country? And perhaps most significantly for the long term, will the Liberian operation base serve as a staging ground for non-Ebola related military operations?
The use of the U.S. military in this operation should raise red flags for the American public as well. After all, if the military truly is the governmental institution best equipped to handle this outbreak, it speaks worlds about the neglect of civilian programs at home as well as abroad.
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'Ebola Is Winning': Sierra Leone Quarantines 1.2 Million People
As United Nations leaders prepare for Ebola talks, countries plagued by the disease make desperate moves
Sep 25, 2014
As world leaders gather in New York to discuss the Ebola epidemic, Sierra Leone put more than a million of its citizens under an indefinite quarantine "with immediate effect" on Thursday, in a desperate effort to curb the crisis.
President Ernest Bai Koroma announced Wednesday that the northern districts of Port Loko and Bombali, as well as the southern area of Moyamba, would be closed down, cutting off roughly 1.2 million people from leaving the region. The move comes as residents in Kenema and Kailahu, the country's eastern districts, continue grappling with their own curfews, leaving almost a third of the country's population of six million under strict quarantine.
The deadliest Ebola epidemic in history has infected more than 6,000 people in West Africa and killed nearly half of them, according to the World Health Organisation (WHO). Guinea has managed to wrangle control over its outbreak, but the situation has worsened in Sierra Leone, where 1,940 are infected and almost 600 dead, WHO said on Thursday.
"The situation in Guinea, although still of grave concern, appears to have stabilised: between 75 and 100 new confirmed cases have been reported in each of the past five weeks," WHO said in a statement.
But WHO's statistics for the outbreak in Sierra Leone come from the country's Ministry of Health, which international health officials say are inaccurate. The real death toll may be much higher, the Western diplomat in Sierra Leone told the New York Times.
"The W.H.O. added a veiled caveat to the statistics in its latest report as in the preceding one, saying that they were 'subject to change' because of 'ongoing reclassification,'" the Times writes. "Indeed cemetery workers here in the capital report that Ebola deaths far exceed what the government has so far acknowledged."
Forced quarantines and lockdowns of sick communities have been criticized by health organizations like Doctors Without Borders/Medecins Sans Frontieres (MSF), who said earlier this month that those measures "end up driving people underground and jeopardizing the trust between people and health providers."
MSF issued that statement in response to a planned, three-day nationwide lockdown that took place last week; at the time, presidential adviser Ibrahim Ben Kargbo told Reuters that the "aggressive approach is necessary to deal with the spread of Ebola once and for all."
On Wednesday, after announcing his plan to impose the new, indefinite quarantine, President Koroma told reporters that "The isolation of districts and chiefdoms will definitely pose great difficulty, but the lives of everyone and the survival of our country takes precedence over these difficulties."
WHO has warned that the number of cases in the area could soar in the coming months without an immediate response by world leaders. At the UN meeting on Thursday, President Barack Obama likewise stressed the urgency of a coordinated international effort to address the crisis.
"If unchecked, this epidemic could kill hundreds of thousands of people in the coming months," Obama said. "Ebola is a horrific disease... If ever there were a public health emergency deserving a strong and coordinated international response, this is it."
Obama's call to action comes as the Centers for Disease Control and Prevention (CDC) released new estimates that Ebola may infect 1.4 million people in Liberia and Sierra Leone by the end of January.
"This disease could cause a humanitarian catastrophe across the region," Obama said. "Stopping Ebola is in the interest of all of us."
The President's contribution to fighting the disease was military-based, as he announced last week that the U.S. would send 3,000 troops to West Africa to "support" doctors and scientists in containing and finding new treatments for the outbreak. It remains unclear what the role of the military will be in the public health crisis. As Foreign Policy in Focus writes:
[T]heWhite House plan comes in the context of a broader U.S.-led militarization of the region...
Perhaps more importantly, experts have warned that the provision of humanitarian assistance by uniformed soldiers could have dangerous, destabilizing effects, especially in countries with long histories of civil conflict, such as Liberia and Sierra Leone.
The use of the U.S. military in this operation should raise red flags for the American public as well. After all, if the military truly is the governmental institution best equipped to handle this outbreak, it speaks worlds about the neglect of civilian programs at home as well as abroad.
On Thursday, Joanne Liu, president of MSF, planned to appear at the UN conference to tell delegates that "the promised surge has not yet delivered," according to her prepared remarks, the Washington Post reports.
"Pledges of aid and unprecedented U.N. resolutions are very welcome. But they will mean little, unless they are translated into immediate action," Liu planned to say. "Fear and panic have set in, as infection rates double every three weeks. Mounting numbers are dying of other diseases, like malaria, because health systems have collapsed...Today, Ebola is winning."
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