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- 04/11/13--02:34: _Chad: Chad: Floods ...
- 04/11/13--02:35: _Mali: Mali : Urgenc...
- 04/11/13--03:07: _Mali: Mali: Complex...
- 04/11/13--03:36: _Mali: Mali: Humanit...
- 04/11/13--04:43: _Ethiopia: "Ringing ...
- 04/11/13--05:13: _Mali: Situation Upd...
- 04/11/13--05:38: _Mali: Far from Home...
- 04/11/13--06:07: _Mali: Sécuriser, di...
- 04/11/13--06:20: _Mali: Why are 10 mi...
- 04/11/13--07:22: _Mali: Dans le Nord,...
- 04/11/13--08:02: _Mali: Mali prime mi...
- 04/11/13--08:41: _Chad: Tchad : Revue...
- 04/11/13--08:50: _Mali: Security, Dia...
- 04/11/13--10:03: _Mali: Mali : Aperçu...
- 04/11/13--12:42: _Mali: Complex Cover...
- 04/11/13--17:01: _Mauritania: Strande...
- 04/11/13--18:35: _Chad: Field Blog: "...
- 04/11/13--19:05: _Ethiopia: Protectin...
- 04/11/13--20:18: _Mauritania: Echoués...
- 04/11/13--22:53: _Mali: Hunger at cri...
Disaster Relief Emergency Fund (DREF): CHF 125,920 was initially allocated on 11 September, 2012 to support the National Society in delivering immediate assistance to 11,770 beneficiaries.
The Emergency Appeal was launched on 21 October, 2012 for CHF 775,716 to support the Red Cross of Chad (RCC) to assist 4,400 households (30,800 beneficiaries) for six months.
Operation update n°1 was published on 10 December, 2012 and provided information about activities implemented within the timeframe of DREF
Operation update n°2 was on 1 March, 2013 and provided about the distribution of NFIs and the effective launch of activities within the timeframe of the DG ECHO partnership.
L’accès au nord reste limité par la continuité des opérations militaires, la présence des mines et des restes explosifs de guerre et donc une situation sécuritaire qui reste toujours volatile. Malgré cet environnement sécuritaire précaire, les acteurs humanitaires continuent leurs opérations là où les conditions le permettent afin de secourir les populations dont la grande majorité souffre depuis un an du fait de la crise.
Les spécialistes de la sécurité alimentaire ont alerté de nouveau sur l’insécurité alimentaire sévère qui prévaut dans les régions du nord.
Les mouvements des personnes affectées par la crise dans le nord se poursuivent à différents niveaux. Tandis que des mouvements de personnes du sud vers le nord ont été observés, de nouveaux déplacements de personnes du nord vers l’intérieur du pays et le Niger ont été aussi rapportés.
Les personnes déplacées internes (PDI) sont maintenant estimées à 282 548 et le nombre de réfugiés maliens dans les pays voisins à 175,211 par le HCR. La semaine dernière, des milliers de nouveaux réfugiés maliens sont arrivés au Niger selon le HCR.
Le Fonds Central d’Intervention d’Urgence (CERF) géré par OCHA vient d’allouer 16 millions de dollars aux agences des Nations Unies et à leurs partenaires au Mali pour la mise en oeuvre des projets vitaux liés aux effets du conflit au centre et au nord du pays.
- 04/11/13--03:36: Mali: Mali: Humanitarian Snapshot (as of 10 April 2013)
- 04/11/13--05:13: Mali: Situation Update: The Sahel Crisis - 11 April 2013
Despite good agricultural production in 2012 and good conditions for pastoralists, the situation in the Sahel remains critical, mostly due to the impact of the 2012 crisis (food insecurity, floods and the Mali conflict), as well as previous recent crises. Approximately 10.3 million people remain food insecure in 2013 and over 1.4 million children are at risk of severe acute malnutrition.
Large population movements are reported as a consequence of the conflict in Mali. It is estimated that there are currently 292 648 internally displaced persons (IDPs) in Mali and 177 637 refugees in neighbouring countries, mainly Burkina Faso, Mauritania and the Niger.
The risk of food insecurity is growing in northern Mali, where it is estimated that 585 000 people are food insecure and 1.2 million are at risk of food insecurity.
Based on current estimates, for 2013 FAO is requesting a total of USD 135.3 million to support almost 6 million people with livelihood interventions in the Sahel, including those related to the Malian conflict. To start the operations for the main agricultural campaign (May-October 2013), USD 99 million are immediately required, from which USD 6 million will be allocated to interventions in northern Mali.
Aggravated by existing chronic vulnerabilities, the negative effects of the recent crises in 2005, 2008, 2010 and 2012 remain. Vulnerable people have eroded their capacity to withstand external shocks and many continue to be heavily indebted and have been unable to restore their productive means. Time is of the essence for building resilience to strengthen the livelihoods of the most vulnerable people.
- 04/11/13--05:38: Mali: Far from Home, Malian Refugees Strive to Rebuild Their Lives
- 04/11/13--06:07: Mali: Sécuriser, dialoguer et réformer en profondeur
Les dirigeants politiques maliens doivent s’engager publiquement à promouvoir la paix et la réconciliation ; à défaut, la campagne électorale risque de renforcer les divisions, le scrutin d’attiser les tensions, et tout cela pourrait compromettre la mise en œuvre de réformes nécessaires.
La communication, notamment à travers les radios et chaines de télévision très écoutées dans le pays, est indispensable pour favoriser la participation politique et apaiser les tensions. Un nouveau mécanisme doit également être établi pour surveiller toute rhétorique incendiaire dans les médias.
Les partenaires du Mali doivent faire comprendre au Mouvement national de libération de l’Azawad (MNLA) qu’il est dans son intérêt de renoncer à la lutte armée et de participer au processus politique.
Les dirigeants à Bamako ne doivent pas fermer la porte à toute discussion, même discrète, en imposant des préconditions aux groupes armés. Le dialogue est essentiel pour donner à tous les Maliens du Nord la chance de participer aux élections, sans quoi le Nord pourrait à nouveau se transformer en base arrière pour une rébellion.
Il faut maintenir une distinction claire entre, d’une part, la mission de stabilisation des Nations unies, avec sa forte composante civile, et d’autre part, une « force parallèle » destinée à la lutte antiterroriste, dont il faudra clarifier la base juridique et la zone d’intervention.
- 04/11/13--06:20: Mali: Why are 10 million West Africans hungry?
- 04/11/13--08:02: Mali: Mali prime minister urges French troops to stay
- 04/11/13--08:41: Chad: Tchad : Revue de Presse Humanitaire du 5 au 11 avril 2013
- 04/11/13--08:50: Mali: Security, Dialogue and Meaningful Reform
- Give a firm and clear indication of its willingness to promote a policy of national reconciliation and peace and break with the political and administrative practices responsible for the current crisis by:
Indicate a willingness to include in the dialogue the representatives or supporters of any groups that commit to renounce their armed struggle, notably the MNLA, by remaining open to external facilitation and including the representatives of northern communities in any such process.
Ensure that the electoral process takes place in an atmosphere of trust and that it is completed, including legislative elections, by the end of 2013 and that all sectors of the Malian population can take part by:
Play an active role in the intercommunal reconciliation and peace process by participating in the organisation of inclusive dialogue at the local, regional and national levels and combating feelings of mistrust and attempts to settle scores.
Seek full involvement in the electoral process so it at least offers the possibility of a genuine change in governance and, with this in mind, use the media to publicise information about candidates, parties, programs and the origins of their financial resources.
Encourage the authorities to avoid adopting a uniquely security and repressive approach towards Malian citizens who, in 2012, joined certain armed Islamist groups; to understand the economic, social and cultural exclusion that led to Islamist radicalisation; and to initiate a public debate on the role of religion in society and the lessons that can be learned from the current crisis.
- Provide the UN mission with a strong mandate to support the political process, in its dual dimensions of promoting dialogue and preparing elections, by:
- Provide the mission with a large “civilian affairs” component able to assist the state in reestablishing administrative control in the north by paying special attention to the restoration of judicial institutions and the prison service and rapidly assessing the requirements for strengthening the capacities of the judicial apparatus.
- Ensure the security of the civilian population, especially the communities that might be persecuted because of their alleged association with armed groups, by:
- Cooperate fully with the European Military Training Mission (EUTM Mali) and overhaul the security sector, including the police forces.
Maintain a rapid reaction capacity on Malian territory after the gradual withdrawal of its troops and clarify the relationship between these forces and the future UN stabilisation mission.
Support the Malian authorities and AFISMA to protect the civilian population until the deployment of the UN mission.
- Provide, as quickly as possible, the AFISMA with the financial resources, logistics and intelligence support necessary to reach its target numbers and capacity, without waiting for the arrival of the UN mission, allow the deployment of all its components in accordance with the revised concept of operations devised jointly by the AFISMA and Malian forces.
- Authorise a UN stabilisation mission to Mali with a mandate and format adapted to the country’s specific conditions and avoid standard responses, by;
- Start a frank discussion on preserving regional security interests, by:
- 04/11/13--10:03: Mali: Mali : Aperçu humanitaire (au 10 Avril 2013)
- 04/11/13--12:42: Mali: Complex Coverage Review - 9 April 2013
- 04/11/13--17:01: Mauritania: Stranded in the Desert
- 04/11/13--18:35: Chad: Field Blog: "Doctor, What About My Brother?"
- 04/11/13--20:18: Mauritania: Echoués dans le désert
- 04/11/13--22:53: Mali: Hunger at crisis levels in northern Mali
This Operation Update covers progress during the period from February to March, 2013 and announces a timeframe extension of 2 months until end of June in order to finalize the implementation of activities that were delayed. The final report will be made available by 30 September 2013.
Appeal target (current): CHF 775,716;
Appeal coverage: 60%;
Summary: Out of the 3,160 vulnerable households planned to benefit from NFIs distribution, a total of 2,392 (17,957 beneficiaries) households were reached by the Red Cross of Chad (RCC). In addition, 200 volunteers were trained and organized sanitation campaigns on hygiene practices in order to prevent water-borne diseases such as cholera and others. At the community level, five female community focal points were selected from the 12 target sites to carry sanitation activities within their respective communities. The activities carried out include: hand washing demonstrations, individual and collective hygiene, public sanitation and the importance of having a family latrine. Before providing shelter material to beneficiaries, families were requested to dig their own latrines in every household after which a Sanplat was provided. A total of 135 sanplats have been distributed out of which 72 were installed.
Distribution of shelter materials such as tarpaulin, bricks, laths and rafters is currently underway in the field for 200 families. Water treatment materials (bleach water and PUR bags) have been made available in seven out of the 12 targeted sites. The pool testing materials are yet to be dispatched in the field pending the training of volunteers on water portabilization techniques.
Due to the limited availability of standard relief items in country, international procurement and trucking from Cameroon was necessary. This process along with late deployment of international staff to the field has contributed to delays in implementation of activities, necessitating 2 months extension of the emergency appeal announced through this operations update to finalize the implementation of the delayed activities.
• Access to the north remains a challenge due to ongoing military operations, the presence of mines and explosive remnants of war which give way to a volatile security situation. Despite this precarious security environment, humanitarian actors continue their operations where possible.
• Food security experts have warned of severe food insecurity prevailing in the northern regions, which is likely to worsen in the coming months.
• The movements of people affected by the crisis in the north continue at various levels. While some return movements have been observed from the south to the north, there are reports of new displacements from the north to other parts of the country and to Niger.
• There are an estimated 282,548 internally displaced persons (IDPs). According to UNHCR, there are 175,211 Malian refugees in neighboring countries, and thousands of new refugees fled to Niger last week.
• The Central Emergency Response Fund (CERF) has allocated US$16 million to UN agencies and their partners in Mali to implement vital projects related to the crisis in the north.
In the arid Shinile region of eastern Ethiopia, pastoralist communities are now using mobile phones to monitor water points and provide early warning of droughts before they strike.
Every morning since he was a young boy, Elmi Farah has walked his family’s animals from their mountain home to the local water point. He’s seen good times and bad, some years of plentiful pasture and some years of drought. During the severe 2011 drought, half of the family’s 200 goats and sheep died. This year has been better, he says – but there are warning signs the situation could take a turn for the worse.
“In the past few months the number of animals coming here to get water has increased a lot.” This, Elmi explains, means there must be poor rains and a shortage of water in other areas, forcing people to come here to find water for their livestock – the main assets of people in this region.
It’s this kind of information and local knowledge that Oxfam hopes to capture more effectively using mobile phones – a new opportunity as phone networks spread to remote areas that still have few basic services, and where droughts are a fact of life.
“We used to write letters when things got bad,” says Ali Mohammed.
The letters laid out the local concerns – poor rains, decreasing pasture, weak or sick livestock – and a village representative took them by truck and hand delivered them to local authorities and aid agencies in Dire Dawa, the nearest big town. The process could take several days, and the response could take weeks or months as the information slowly filtered back up to head offices and decision makers, who could alert donors to the situation.
“Now we can send the information by mobile phone in two or three minutes,” Ali says. Holding the Nokia smartphone given to him by Oxfam, he shows me how each day he enters data into the phone’s specially designed software, which sets out questions in the local Somali language. Easy to fill in, the questions identify the location of the water point and record key indicators such as how many people are using it, how many hours a day and how many cubic metres of water it is pumping, and how many livestock are there. Ali also records any changes in the price of water and fuel.
Every day around 4pm he texts the data and it arrives simultaneously on the computers of Oxfam experts in Dire Dawa, Addis Ababa and Nairobi, helping them monitor the situation in real time and assess what kind of response is needed.
After a short training programme, Ali is now responsible for gathering data from water points in Shinile town. Many of the pastoralists worst affected by droughts live in small villages or isolated homes many miles away, but when times are hard they have to come into town. Monitoring the usage of the water points here can show trends across the district. “If there is rain and pasture where they live, then people stay away,” says Ali. “But if there’s no rain, this is where they come.”
The mobile project began in late 2012. Abdelmalik Sidad, an Oxfam public health engineer overseeing the project, says, “At that time there was rain and very few people were coming to town. Now there’s an increase. We know that when there are over 250 animals at the water point each day then the situation is getting serious.” At the moment the data shows around 200 animals a day. “It’s quite serious, but not yet a crisis.”
The software means Oxfam staff can provide a better and quicker response. Ali texts photos of broken parts or malfunctioning water points, meaning engineers can quickly assess the problem and respond appropriately. The information can be shared with local government, donors and other agencies.
“Without good information there is no response and people don’t get water,” says Ali.
An Oxfam and Save the Children report found the response to the 2011 Horn of Africa food crisis was vital but late, costing lives and money across the region. “In that drought, better data might have meant a quicker response,” Ali adds.
As he fills up jerry cans of water to carry home to his family, Elmi agrees: “During the rains we have plenty of water and pasture, but when it is dry there are big challenges. Anything that can increase the information available can only be good.”
The project is being implemented in drought-prone areas of Kenya and Ethiopia. The first phase of this project has been funded by the Mariposa Foundation
By Issa Sikiti da Silva
DAKAR , Apr 11 2013 (IPS) - Malian widow Mariama Sow, 30, and her three children are trying to find some semblance of normalcy in their lives in Dakar, Senegal, since they left the historic city of Timbuktu in northern Mali last June to escape the Islamist occupation.
Sow and her children are now living in relative safety with her eldest sister in this West African nation, as she helps her sibling run her two tangana (informal township restaurants).
“The (Islamist) occupation was not good at all, it affected many lives and will continue to haunt many of us for years to come,” Sow tells IPS, refusing to explain further, except to say it was “hell”.
“Though I’ll never forget what happened, I decided to get over it and focus on the future of my three children who are now eating well thanks to my elder sister’s support,” she says emotionally, adding that the imposition of Sharia Law in northern Mali affected not only women, but everybody in the occupied territories.
As she speaks, a group of men who work at a nearby construction site each wait their turn to be served with a plate of tchep (fried rice and fish).
But Sow is still concerned about the future of her eldest child. Her eight-year-old son has not attended school since armed Islamist groups allied with Al-Qaeda occupied northern Mali back in April 2012. Her daughters, aged four and two, are yet to attend school.
“My son’s first year at school was disrupted by the occupation. It’s now a dilemma because he has not been attending school since, and next year he will be nine. And I’m not sure when real peace will return to Mali so that he can go back to school again,” she says.
While a French-led international intervention in January – requested by Mali’s interim president Dioncounda Traore – eventually pushed the Islamist fighters out of the north, real peace in the West African nation seems a long way off. Defeated Jihadists have now resorted to suicide bombings and other guerrilla attacks.
A report, “Mali in the Aftermath of the French Military Operation”, released in late February by the South African-based Institute for Security Studies, called for the north to be quickly stabilised and secured now that it has been liberated.
“In order to consolidate the military gains achieved and given France’s expressed desire to scale down its presence or, at least, to ‘multilateralise’ its commitment, the idea now is to deploy a United Nations operation that will take over from AFISMA (African-led International Mission in Mali),” the report, authored by Lori Anne Théroux-Bénoni, states.
The war in northern Mali has driven thousands of men, women and children away from their homes. To date, there are 167,370 Malian refugees scattered in five countries in West Africa, the United Nations Refugee Agency (UNHCR) says.
Mauritania has the highest number, 68,385 refugees, followed by 50,000 refugees in Niger, and 48,939 in Burkina Faso. There are 26 and 20 refugees in Guinea and Togo, respectively.
Awo Dede Cromwell, reporting officer for the situation in Mali at the UNHCR’s regional office for West Africa, tells IPS that there are 31 Malian asylum seekers in Senegal whose status has yet to be examined by the National Commission of Eligibility at the Interior Ministry. “They are seven females and 24 males. There are three children among the 31 asylum seekers,” Cromwell explains.
Sow, however, is one of a number of refugees in Senegal who have not registered with the UNHCR, as she was lucky to be taken in by a relative. Many Malians are not so lucky, as they have been forced to live in refugee camps in Niger, Mauritania and Burkina Faso.
But the situation her son faces with his schooling is the same as that of other Malian refugee children.
“In the refugee camps, many Malian children have already missed crucial weeks and months of schooling. If they don’t get access to education quickly, they may even miss the entire school year and be at risk of dropping out of school when returning to Mali,” Laurent Duvillier, regional communication specialist at U.N. Children’s Fund (UNICEF) West and Central Africa, explains to IPS.
“The future of these Malian schoolchildren shouldn’t be jeopardised because they are refugees. How can Mali rebuild after the conflict if thousands of its children are deprived from access to education?” he asks.
Duvillier says children who fled violence in Mali have been through a lot of suffering and that getting access to education also means getting back to a “normal life” – playing with other children, learning and smiling.
He says parents who are refugees have little time to look after their children. “If children are left alone, they can easily be at risk of all kinds of abuse and violence. It’s a great relief for parents if they know there is a safe place where their children can learn and play without being in danger.”
Duvillier says that together with the UNHCR, UNICEF is working to train volunteer teachers, distribute school supplies to refugee and displaced children from Mali, and set up tents where teaching can take place in Niger, Mauritania, Burkina Faso and Mali.
“But unfortunately, many Malian refugee children still have no access to education. We need more children in temporary learning spaces, we need more trained and equipped teachers, we need to make sure that what refugee children learn in the camps can be of great use once they go back to Mali.
“More resources are needed as requirements for education needs remain largely underfunded to date,” he concludes.
Dakar/Bruxelles | 11 avr. 2013
Le Mali et ses partenaires internationaux doivent saisir l’occasion d’instaurer un dialogue national pour empêcher l’émergence d’une nouvelle crise politique ou sécuritaire.
Mali : sécuriser, dialoguer et réformer en profondeur, le dernier rapport de l’International Crisis Group, analyse la situation au Mali après l’intervention militaire française qui visait un retour du Nord sous le contrôle de l’Etat, à l’heure où le déploiement et le mandat d’une mission de stabilisation des Nations unies sont à l’étude au Conseil de sécurité. Des combats continuent sporadiquement au Nord, les menaces sur la sécurité restent redoutables, et l’élection présidentielle prévue pour juillet représente un immense défi. Un processus politique inclusif mettant l’accent sur le dialogue national et la réconciliation entre les communautés maliennes est indispensable pour empêcher le retour de la violence. A terme, seule l’amélioration de la gouvernance peut garantir durablement la paix et la stabilité.
Les conclusions et recommandations principales du rapport sont :
« Il faut organiser rapidement des élections, mais pas à n’importe quel prix », affirme Gilles Yabi, le directeur du projet Afrique de l’Ouest de Crisis Group. « La réconciliation doit commencer dès maintenant, tout comme la fourniture de services économiques et sociaux au Nord. La radicalisation de l’opinion publique est réelle et il faut une forte volonté politique pour combattre les amalgames entre rebelles, terroristes, narcotrafiquants et Touareg ou Arabes ».
« La focalisation sur le terrorisme risque de masquer les véritables problèmes », ajoute Comfort Ero, la directrice du programme Afrique de Crisis Group. « Dans la hiérarchie des causes de la crise, la corruption et le laxisme dans la gouvernance viennent loin devant un problème terroriste, touareg ou même Nord-Sud. Le défi le plus important pour la région et l’ONU est d’aligner leurs positions sur le processus politique, et d’exiger des Maliens qu’ils prennent leurs responsabilités pour combattre la mauvaise gouvernance et empêcher l’émergence d’une nouvelle crise ».
The outlook for West Africa’s hunger crisis in 2013 has improved in some parts of the region compared to 2012 when 18 million people were at risk of hunger.
But 2013 started with a warning from a UN official that more than 10 million people across the region are still at risk of starvation, including 1.4 million children facing severe acute malnutrition.
Experts say food crises like those in 2005, 2010 and 2012 indicate an underlying trend for increasing chronic vulnerability.
So why are so many people in the region frequently locked in a hunger crisis?
Burkina Faso, Chad, Mali and Niger are among the poorest countries in the world, where most of the population rely on the land to make a living and to put food on the table.
So when inadequate rains at the end of 2011 led to poor harvests in many staple crops, such as millet, it was bad news for millions. Livestock too took a significant hit and pastoralists suffered as well.
Even in normal harvest years, people’s ability to feed themselves is tested by the ‘hunger gap’ - a period of months between when food from the previous growing season is exhausted and when new crops are ready for harvesting.
For example, in Chad even in good harvest years one third of the 11 million population is chronically undernourished.
Every year a staggering 300,000 children die from hunger in the Sahel region of West Africa. But during the 2012 crisis, the number of children at risk rose to more than a million.
It’s predicted that the impact of climate change on weather patterns will increase, resulting in more crop failures, scarcity and high food prices.
Crop yields from agriculture are likely to fall dramatically because of climate change – by up to half by 2020 in some African countries.
West Africa frequently suffers climatic shocks, such as droughts and floods, and you only have to go back to 2010 and 2005 to see the impact.
A key part of Tearfund’s work in the region is to help people cope with this changing climate, assisting them to grow drought resistant crops, introducing vegetable market gardening and improving access to water.
Every time these shocks occur, families’ livelihoods take a hit and the cumulative effect is that after each shock it takes them longer to recover.
To survive, household assets, such as animals, often have to be sold to get cash to buy food which then means people have little to fall back on.
High food prices
Those that have money to buy food are finding that their purchasing power is drastically diminished as shortages push up the cost of everyday staples, rising by 60 per cent in some cases.
Poorer households spend 60-80 per cent of their income on food. When prices rise they have little financial margin to absorb the difference.
Last July, the price of key crops on the global market, such as maize and soya beans, reached record all-time highs.
The uprising in Libya, insecurity in Nigeria and the conflict in Mali have all contributed to the human misery in the region.
Mali has seen 227,000 people being displaced internally and more than 140,000 others fleeing to neighbouring countries such as Niger, Burkina Faso and Mauritania.
The UN says 4.3 million people in Mali need humanitarian aid.
The plight of the peoples of Burkina Faso, Chad, Mali and Niger also needs to be seen in the context of chronic poverty. All four are in the bottom 12 countries in the UN’s Human Development Index.
One illustration of the impact of poverty is that it deprives many people of access to basic healthcare, which contributes substantially to malnutrition among children under five and pregnant and breastfeeding women.
Up to 20 per cent of the expected one million children who are severely malnourished are likely to develop serious medical complications such as diarrhoea and pneumonia.
So what’s the outlook? In 2011, a report called Escaping the Hunger Cycle asserted: ‘Food crises can no longer be treated as limited events, caused by occasional hazards like droughts or ﬂoods. Food and nutrition insecurity have become long-term, chronic problems.
‘The growing level of poverty and inequality in the Sahel mean that there is no buffer when things go wrong. It only takes a small shock to send the system into disequilibrium.’
The report advocated the need for greater investment in building up the long term resilience of hunger-prone communities.
04/11/2013 13:41 GMT
Par Serge DANIEL
GAO (Mali), 11 avr 2013 (AFP) - Le Premier ministre malien par intérim Diango Cissoko a exhorté jeudi à Gao (nord) l'armée française à rester au Mali, trois mois après le début de son intervention contre les islamistes armés et un début de retrait amorcé cette semaine.
La visite de M. Cissoko à Gao est la première d'un Premier ministre malien depuis le déclenchement de la crise il y a plus d'un an dans cette région occupée et meurtrie par les islamistes liés à Al-Qaïda pendant presque toute l'année 2012, en partie chassés par l'intervention française.
Accueilli par plusieurs personnalités civiles et militaires, parmi lesquelles des officiers français, M. Cissoko a rendu hommage à l'intervention de la France au Mali pour en chasser les islamistes armés. "La Nation malienne vous en sera éternellement reconnaissante", a-t-il dit.
Il a exhorté la France à "continuer dans cette voie", c'est-à-dire à rester au Mali, quelques jours après un début de retrait - une centaine d'hommes - des quelque 4.000 soldats français déployés dans le pays depuis janvier pour stopper une avancée des islamistes armés vers le Sud et la capitale Bamako.
Cela fait trois mois jour pour jour que l'intervention française a débuté au Mali, le 11 janvier.
Paris a annoncé un retrait progressif d'ici la fin de l'année, pour arriver à 2.000 soldats à l'été et à un millier en décembre qui auront vocation à rester aux côtés d'une force de l'ONU de quelque 11.000 hommes en préparation.
Alliés à l'armée malienne et d'autres armées africaines, les soldats français ont à ce jour réussi à chasser en partie les jihadistes du nord du pays, mais des poches de résistance demeurent, en particulier dans la région de Gao, la plus grande ville de la région, située à près de 1.200 km de Bamako.
Au lendemain de vives critiques américaines contre les troupes africaines jugées "incapables", la France leur a rendu hommage jeudi en soulignant qu'elles "ont pris une part active aux opérations contre les groupes terroristes présents dans le nord du Mali".
Un millier de soldats français mènent depuis dimanche une opération dans une vallée au nord de Gao, considérée comme la principale base d'un des groupes islamistes armés ayant occupé le Nord, le Mouvement pour l'unicité et le jihad en Afrique de l'Ouest (Mujao).
Réconciliation et élections
En février, les jihadistes avaient réussi à s'infilter dans Gao où ils avaient commis les premiers attentats-suicides de l'histoire du Mali. De violents combats les avaient opposés aux soldats français et maliens dans le centre-ville.
Parallèlement à la poursuite des opérations militaires dans le Nord, le processus de réconciliation entre les différentes communautés du Mali et de préparation d'élections prévues en juillet se poursuit.
Un décret du président par intérim Dioncounda Traoré rendu public mercredi soir désigne les trente membres de la Commission dialogue et réconciliation (CDR), parmi lesquels trois touareg et cinq arabes, représentants de communautés souvent assimilées aux islamistes.
En mars, le gouvernement avait annoncé la création de cette commission et nommé à sa tête Mohamed Salia Sokona, ex-ministre et ex-ambassadeur à la retraite.
Les signes d'une volonté de réconciliation sont une exigence de la communauté internationale avant la tenue d'élections générales - dont une présidentielle - que les autorités de transition à Bamako se sont engagées à organiser en juillet, à une date qui n'a pas encore été fixée.
Le principal parti politique malien, l'Alliance pour la démocratie au Mali (Adéma), a désigné son candidat à la présidentielle, en la personne de Dramane Dembélé, un ingénieur des mines de 46 ans, considéré comme un proche du président Dioncounda Traoré dont il fut étudiant.
De nombreuses interrogations demeurent sur la possibilité de tenir des élections dans un délai aussi serré, en raison de l'instabilité persistante dans le Nord où quelque 400.000 déplacés et réfugiés ayant fui la guerre ne sont toujours pas retournés.
Et les accusations d'exactions contre les minorités du pays se poursuivent: deux Touareg, soupçonnés d'avoir soutenu les jihadistes, arrêtés dans le Nord par l'armée en février, sont morts en détention à Bamako après avoir été "torturés", selon l'organisation de défense des droits de l'homme Human Rights Watch (HRW).
04/11/2013 14:50 GMT
by Serge Daniel
GAO, Mali, April 11, 2013 (AFP) - Mali's prime minister on Thursday urged France to maintain a military presence in its former colony, as troops began an early withdrawal three months after ousting armed Islamists from the country's north.
Diango Cissoko made the plea on a tour of Gao, the first visit to the battle-scarred northern city by a head of government since it was overrun by Al Qaeda-linked militants more than a year ago.
The premier, who was welcomed by locals and military personnel, paid tribute to the French troops who intervened to liberate northern Mali from the armed militias in January.
"The Malian nation will be eternally grateful," he said.
But he urged the French army to "continue on this path" and stay in Mali, despite Paris pulling out 100 soldiers ahead of schedule this week as part of a phased withdrawal of the majority of its 4,000 troops.
France has said it will leave 2,000 soldiers on the ground throughout the summer, reducing its presence by the end of the year to a "support force" of 1,000 fighting alongside a UN-mandated army of some 11,000 troops.
The cities of Gao, Timbuktu and Kidal fell in March last year to Tuareg rebels who declared independence of the entire desert north before losing control to armed Islamists.
French warplanes bombed parts of Gao in January to drive out fighters from the Movement for Oneness and Jihad in West Africa (MUJAO), and the city was recaptured for the Bamako government by French and Malian forces on January 26.
Just days later, jihadists managed to infiltrate the city, where they staged the first suicide bombing in Mali's history.
France honoured its African partners, deemed incapable by US critics of containing the insurgency in Mali, in a statement from the foreign ministry stressing that they "took an active part in operations against terrorist groups in northern Mali".
French troops fighting alongside the Malian army and other African soldiers have largely succeeded in driving Islamist insurgents from the north but pockets of resistance remain, particularly in the Gao region.
One thousand French soldiers have been conducting an operation to destroy MUJAO's logistics infrastructure in a valley north of Gao since Sunday.
Parallel to the ongoing military operations, the international community is pushing for a formal process of reconciliation between the deeply divided nation's diverse ethnic communities ahead of presidential elections scheduled for July.
Late on Wednesday interim President Dioncounda Traore designated 30 members of a Dialogue and Reconciliation Commission, including eight representatives of the Tuareg and Arab communities, which have complained about rights abuses by Malian security forces who often equate them with Islamists.
New York-based Human Rights Watch said Thursday two Tuaregs suspected of supporting armed Islamists in northern Mali had died after being tortured in custody in Bamako.
Meanwhile the country's main political party, the Alliance for Democracy in Mali, has announced that its candidate for the election will be Dramane Dembele, 46, a mining engineer and former student of Traore, regarded as a close ally.
Dembele was arrested in April last year and held for a number of weeks after a military coup that overthrew the regime of president Amadou Toumani Toure and precipitated the fall of the north to Islamists.
Many questions remain about the possibility of holding elections within such a tight timescale due to continued instability in the north, which has still not seen the return of some 400,000 displaced people and refugees who fled the war.
The International Committee of the Red Cross said on Wednesday it needed an additional 33 million euros ($43.3 million) to help hundreds of thousands of victims of the conflict.
· Tchad : plus de 10 000 réfugiés à Tissi en quelques jours (MSF, 10 avril)
· Coopération : Le Tchad et le système des Nations-Unies regardent dans la même direction (Primature, 9 avril)
· Using tree food recipes to fight off malnutrition (BBC, 6 April)
· Emergency British food aid for those hit by hunger crisis in West Africa (DFID, 8 April)
· Famine forecasting systems still failing to spur action (AlertNet, 10 April)
· Santé: 15 milliards de dollars nécessaires pour lutter contre le Sida, la Tuberculose et le paludisme (Xinhua, 8 avril)
· Faux médicaments : commerce de la mort en Afrique (Afrik.com, 9 avril)
· At least 18 dead in Darfur tribal dispute (The Australian, 10 April)
Africa Report N°201
11 Apr 2013
EXECUTIVE SUMMARY AND RECOMMENDATIONS
For the population of northern Mali, the feeling of being “liberated” by the French military intervention launched on 11 January 2013 is real. The sudden, but clearly well-prepared intervention, which received widespread support in Mali, West Africa and beyond, ended the offensive by jihadi groups that the Malian army had been unable to repel. France also took the opportunity to try and destroy al-Qaeda in the Islamic Maghreb (AQIM) forces. Although Mali is in a better place than a few months back, sporadic fighting in the north continues and formidable threats to security, stability and the coexistence of the country’s various communities remain. The authorities in Bamako, regional organisations and the UN, which is preparing to deploy a stabilisation mission, must quickly agree on a strategy for the resolution of the crisis that provides security, protects civilians, promotes an inclusive inter-Malian dialogue, reestablishes state authority in the north and sees peaceful, credible elections.
Mali descended into turmoil at the beginning of 2012 when the National Movement for the Liberation of Azawad (MNLA) chased the Malian army out of the north and demanded independence for this vast part of the country. With its roots in the Algerian civil war , AQIM has established itself in northern Mali over the last decade, building local alliances that allowed it to significantly weaken both the state and the MNLA and resulted in armed jihadi groups – Ansar Dine and the Movement for Oneness and Jihad in West Africa (MUJAO) – taking control of the north in June 2012. This and the coup in Bamako on 21 March 2012 brought the country to its knees. A laboriously prepared Economic Community of West African States (ECOWAS) plan to deploy an African force was finally, though reluctantly, endorsed by UN Security Council Resolution 2085 on 20 December 2012.
The sudden jihadi offensive towards the centre of the country in January 2013 proved suicidal. The jihadi groups did not anticipate France’s strong military response, following a request from interim President Dioncounda Traoré. The Malian army itself did nothing more than accompany the French forces that took the three most important towns in the north, Gao, Timbuktu and Kidal. French and Chadian troops entered the northern-most Kidal region without the Malians, less to reconquer it for the Malian state than to pursue AQIM combatants into their sanctuaries, destroy stocks of arms, ammunition, fuel and food supplies, and “finish the job” in the context of a declared war against terrorism. Whether or at what point it will be possible to declare the capacities of jihadi groups sufficiently reduced to avoid exposing the civilian population and the forces of the African-led International Support Mission to Mali (AFISMA) to terrorist reprisal attacks is unclear.
Now as much as before the French intervention, a solution to the crisis will only be sustainable if it combines political and military measures. The north remains very insecure and the state is absent from the Kidal region, where the MNLA claims control. Mali’s army is fragmented and incapable of preventing its soldiers from committing atrocities against civilians, notably Tuaregs and Arabs who are indiscriminately accused of collusion with the enemy. The military action in the north has strengthened the president's authority, but the ex-junta retains influence and civilian political actors look incapable of mobilising citizens to take the country’s destiny into their hands. The government has announced that presidential election will be held in July, although conditions – technical, political, security and psychological – for a genuine vote look unlikely to be met.
Even if French troops remain and AFISMA is rehatted as a UN stabilisation mission – which currently appear probable -- the interim authorities, political actors and civil society face an immense political challenge. Political dialogue in Bamako, zero tolerance for atrocities by members of security forces, intercommunal dialogue and the redeployment of the state in the north are essential. Elections must be held soon, but not at any cost. The work of reconciliation should begin immediately. So too should the provision of basic social and economic services in the north, so as to facilitate the gradual return of thousands of internally displaced and refugees. The radicalisation of public opinion is a major risk, especially during the election campaign, and firm action by Malian leaders and institutions should aim to prevent people lumping together rebels, terrorists and drug traffickers with all Tuaregs and Arabs.
A focus on terrorism alone also risks distracting from the north’s real problems. The roots of the crisis lie much more in corruption and bad governance than they do in the terrorist threat, the Tuareg issue or even the north-south divide. The international community must insist that Malian leaders assume responsibility for tackling these problems. The most reasonable and realistic way for the state to regain its presence across Mali and maintain lasting security is to find a compromise between the representatives of all communities, ensure even the most isolated populations feel included, and take into account the vulnerability of vast border areas to the flow of weapons and armed groups.
The most important and immediate challenge for regional organisations and the UN is to align their positions on the political process. First, they must convince the MNLA that its interests are best served by renouncing its armed struggle and discussing how its representatives and supporters can participate in a dialogue on the north’s real problems. Secondly, they should persuade Bamako that it should not impose so many pre-conditions on talks – such as, for instance, requiring the MNLA to immediately disarm – that it closes the door to dialogue, or even discrete contacts, with MNLA representatives. ECOWAS, the African Union (AU), the UN Security Council, Mauritania, Algeria, Niger, Burkina Faso and France must all send the same message to the authorities in Bamako and the leaders of those armed groups in the north. Even this would not resolve everything, however. Without new regional security mechanisms involving all the countries of North and West Africa, any victory over terrorism, extremism and drug trafficking in Mali will only be temporary.
To launch a political process to promote reconciliation and peace
To the government of Mali:
a) promoting inclusive dialogue at the national, regional and local levels, without monopolising such initiatives;
b) reestablishing state control of the north as soon as possible, prioritising public services and economic recovery in addition to reconstruction of the police forces and the gendarmerie;
c) preparing a special emergency plan for the north, making an explicit break with the past, notably by guaranteeing transparency in the use of funds and by consulting the population, whose relationship with the state has changed after several months of the state’s complete absence; and
d) supporting the Dialogue and Reconciliation Commission (CDR) so that it can prepare as soon as possible a work plan aimed at promoting intercommunal reconciliation before the elections.
a) ensuring security so that all voters as well as internally displaced people and refugees can vote;
b) seeking a political solution that will allow citizens in the Kidal region to participate;
c) asking candidates in the presidential election to make a solemn promise to accept the results or to contest them exclusively through legal means, to conduct an electoral campaign compatible with the objective of national reconciliation, to introduce policies seeking reconciliation if they win and organise legislative elections as soon as possible and, in any event, before the end of 2013.
To Malian political forces and civil society organisations:
To the UN Security Council:
a) requesting the future special representative of the UN Secretary-General to Mali to use their good offices to facilitate dialogue between Malian political actors and the transitional authorities to contribute towards a peaceful electoral campaign;
b) providing the mission with a precise mandate to support the electoral process by using UN assistance operations and deploying experts throughout the territory before the elections; and
c) authorising the mission to be ready to provide technical support to the CDR.
To regional and international actors involved in Mali, especially the AU special envoy, the ECOWAS mediator and the authorities of Mauritania, Algeria, Niger and France:
Adopt a clear joint position to facilitate inclusion of the MNLA in the inter-Malian dialogue provided it renounces its armed struggle. To ensure security across the territory and protect the population
To the government of Mali and its defence and security forces:
a) giving a public and firm indication that the protection of all sectors of the Malian population is a central concern;
b) strengthening the presence of the gendarmerie and police forces in the liberated territories;
c) showing extreme firmness towards violent acts including those committed by the Malian armed forces.
To the French authorities:
To the AFISMA, countries contributing troops and donors who have promised funding:
To the UN Security Council:
a) maintaining a clear distinction between on the one hand the UN-mandated mission to stabilise the political and security situation, and on the other the “parallel force” responsible for offensive operations, and clarify the legal basis and geographical extent of the latter’s mandate;
b) equipping the mission with specific means to collect and analyse information and allowing it to benefit from assistance from third countries, notably France and the U.S.;
c) including in the mission a strong civilian component dedicated to monitoring the human rights situation, especially the behaviour of Malian and foreign forces towards the population; and
d) providing the mission with a mandate to help mobilise and coordinate resources allocated to reform the defence and security forces.
To the AU Commission, the states of the Sahel, West Africa and North Africa, the UN special envoy to the Sahel and the European Union (EU) special envoy to the Sahel:
a) formulating new regional security mechanisms based on control of the transnational flow of people, arms and illegal products; or restructure existing mechanisms; and
b) seeking to boost the economy of the Sahel-Sahara region by implementing transnational development projects.
Dakar/Brussels, 11 April 2013
This document provides complex coverage of global events from 02 – 08 April 2013 with hyper- links to source material highlighted in blue and underlined in the text. For more information on the topics below or other issues pertaining to events in the region, contact the members of the Complex Coverage Team or visit our website at www.cimicweb.org
INSIDE THIS ISSUE
Refugees stranded in Mauritanian desert with no hope of return
MSF report calls for urgent aid effort for 70,000 Malians
London/Nouakchott, 12 April 2013 – Some 70,000 refugees from Mali are living in difficult conditions in the middle of the Mauritanian desert, with ethnic tensions in northern Mali quashing any hopes of a swift return home. A report released today by Médecins Sans Frontières/Doctors Without Borders (MSF) entitled Stranded in the desert calls on aid organisations urgently to renew efforts to meet the refugees’ basic needs.
The report, based on testimonies collected from more than 100 refugees in Mbera refugee camp in Mauritania, examines the reasons for the refugees fleeing and reveals the underlying complexity of the crisis in neighbouring Mali. While the crisis could last for months or even years, the refugees face a future of isolation in the middle of the desert, totally dependent on outside assistance and humanitarian aid.
“More than 100,000 people from northern Mali are currently displaced within their country or have escaped abroad as refugees,” says Henry Gray, emergency coordinator for MSF. “Most of the refugees are from the Tuareg and Arab communities. They fled pre-emptively, often for fear of violence due to their presumed links with Islamist or separatist groups. Their home in northern Mali is still in the grip of fear and mistrust.”
MSF has been working in Mauritania since the arrival of the first refugees in early 2012, and has frequently warned of the alarming consequences to the refugees’ health as a result of the appalling living conditions in Mbera camp. In November 2012, MSF conducted a retrospective nutritional mortality survey that revealed a critical nutrition situation, with mortality rates above the emergency threshold for children under two years old.
The medical situation has further worsened following an influx of 15,000 new refugees in the aftermath of the January 2013 joint French and Malian military intervention. The number of consultations in MSF’s clinics in the Mbera camp has increased from 1,500 to 2,500 per week. The number of children admitted per week for severe malnutrition has more than doubled, from 42 to 106, despite the nutritional status of the new refugees being generally good when assessed on arrival in the camp. Eight-five percent of the children being treated arrived in the camp in January and February.
“These statistics show that the refugees have grown weaker whilst in the camp, the very place where they should have been receiving assistance, including correctly formulated food rations from aid organisations,” says Gray. “There has clearly been a lack of preparation for this new influx of refugees. The situation has improved in recent weeks, but it is still extremely precarious and aid organisations need to maintain their humanitarian response for as long as necessary. Shelter, clean water, latrines, hygiene and food must all reach those in need, and be sustained at the minimum humanitarian standards.”
MSF runs medical and humanitarian programmes in the Malian regions of Mopti, Gao, Sikasso and Timbuktu , as well as for Malian refugees in Burkina Faso, Mauritania and Niger. In Mauritania, MSF supports four primary healthcare centres in Mbera camp and at Fassala border crossing, and runs an operating theatre in the town of Bassikounou. Since starting to work in Mauritania in February 2012, MSF teams have provided 85,000 consultations, assisted 200 deliveries and treated nearly 1,000 children suffering from severe malnutrition.
For interviews or further information, please contact MSF UK Senior Press Officer Heather Pagano on firstname.lastname@example.org or +44 7770 235 740.
Raghu Venugopal is a Canadian doctor who serves as medical team leader for Doctors Without Borders/Médecins Sans Frontières (MSF)’s Am Timan project in southeastern Chad, coordinating and optimizing MSF's core activities including pediatrics, malnutrition, obstetrics, HIV, tuberculosis, and outpatient mobile clinics. Raghu’s goal is to support the entire medical team to deliver the most efficient, compassionate, and professional medical care possible.
The desperate man asked me in French, “Doctor, what about my brother?” In rooms full of bloodied bodies on the ground, somewhere was this man’s brother.
A mass casualty incident hit Am Timan hospital. This man was looking for his brother amongst the 50 or so victims. An open-ended truck, full of people, had turned over. That is all we knew. Trucks and cars were then loaded with injured patients and brought to the hospital.
It was Friday night and I was on-call after a grueling week. My energy level was low and I needed to sit down to think as I did my evening rounds in the intensive care unit. The nurses and I were preparing a blood transfusion for a severely anemic child when the hospital head nurse burst into the room. He told me to come to the triage, now. I said, “Now?” He said, “Yes, now, there has been a large accident.”
I ran to the triage. There, I found complete mayhem. Police, military, crowds, screaming. Headlights illuminated the dust in the hot night air. I followed the crush of people into the triage department. It was like a war-zone. There were injured and bloodied people everywhere. All I could see were injured victims on the floor. Families tried to find their loved ones.
Triage was needed. But first, I needed help. I ran out to the MSF Land Cruiser and used the VHF [very high frequency] radio to call the base. I yelled to the radio operator, “Get our hospital nurse Eve and get my ultrasound.” I knew the portable ultrasound I brought from Canada would be key to diagnose intra-abdominal injuries needing to immediately go to the operating room.
I ran back to the triage department. Then, systematically, I got on my knees and examined every patient. First, were they breathing? Second, could they talk to me? Third, how was their abdomen when I palpated it? My pants were red and I kept changing examining gloves.
Quickly, I knew there were four severely injured patients. Two adults had massive head injuries and would not talk. Next, a young boy also had a serious head injury but would talk. Also, another young boy had a very badly broken leg.
My phone rang. Sigrid, our German midwife, had caught wind something was wrong and called me to see if everything was OK. I yelled into my phone, “Come now. Bring everyone. I’m not kidding. Get the surgeon. Now. Now.”
Minutes later, Eve, our nurse from Canada; Andrea, our nurse from Germany; Cristina, our medical coordinator from Spain; and Sigrid, our midwife from Germany arrived.
I sent Cristina with the two children to the intensive care unit. Sigrid moved patients to the operating room. The two serious head injuries and other orthopedic injuries went to the operating room. These patients included a woman with both arms broken. Another was a woman with an open arm fracture. One by one, they were moved through the thick crowds on stretchers. We ran out of stretchers and so just carried people in our arms. I ran to the operating room to see if things were going OK. Our Nigerian surgeon and I shook hands as he headed in for the first cases. Things were working out. The team was getting the job done.
I went back to the triage. Nurses had come in voluntarily to the hospital to help out. The Ministry of Health and MSF worked side by side to aid the injured. A man with severe facial injuries was bleeding heavily from his nose. I used some tongue depressors and tape and we stopped the bleeding. Nurses and I examined patients, turned them over, and wound closure was happening everywhere.
I went to the intensive care unit. We anesthetized the boy with the femur fracture and when he was asleep we straightened out his leg. We moved stable patients to the wards and crammed extra beds into the ICU.
Back to the triage. A desperate man asked me in French, “Doctor, what about my brother?” I told him I did not know anything about his brother, but we could find him together. We went from room to room and found his bloodied brother on the floor, alone. I found a large injury on the back of the brother’s head. We gathered six men and we picked up the brother and put him on a bed. We examined the man and I got Isidro, a Spanish MSF nurse, to close the head wounds in the maternity ward. The patient was agitated and unable to cooperate. With the permission of the brother, we anesthetized the patient and completed the procedure. We then carried the man to the surgical ward for observation.
Again and again I went back to the triage. The situation was stabilizing. Victims were being triaged, treated, and admitted. Wounds were being closed and pain was being treated. Three doctors with the Ministry of Health worked in the operating room. The intensive care ward and other wards were filling with patients.
The triage was getting under control but we needed to get more patients off the floor, repair their injuries, and admit them to the wards. The nurses and I decided to share the load of remaining patients with all the adult wards. We asked men and women standing around to help us carry the injured to the wards.
Many hands made the work light. As we arrived in the wards with patients we carried in our arms or by stretcher, I gave a one-sentence summary to the attending nurse of the injuries and the medical care needed.
The rest of the team was working hard. Eve was making sure dressings and pain medication were available. Sigrid was keeping the operating room under control and supervising deliveries at the same time in the maternity ward. Johanna, our doctor from Sweden, was helping in the intensive care unit. Oliver, our German supply logistician, made sure there were extra blankets available.
In one return to the triage, I met the head nurse from the Ministry of Health. He thanked me like never before. It was just the way he said “thank you” that I know he’ll never forget this night when we all came together to deal with this mass casualty incident.
The night went on. Eventually things started calming down. I started to have difficulty standing up, I was so exhausted—emotionally, physically, and mentally.
I knew the next day would be difficult, so at some point in the night, Eve, Oliver, and myself left the hospital. I collapsed in a chair at the base. Amidst all the human suffering, the team had responded amazingly.
I went to bed with my three phones, still on-call for the hospital. I worried about what kind of delayed injuries might occur—ruptured spleens or slow-bleeding liver injuries.
My phones did not stop ringing in the night, but surprisingly, it was not for trauma victims, but for all the other types of emergencies that happen in the night at the hospital. The most heart-warming moment in the night was at about 5:00 AM when Hasan, our pediatrics supervisor, called me. He had come to the hospital on a volunteer basis to help out. He informed me on the progress of some patients that were now stabilized and asked me “permission” to go home. I told Hasan his dedication to patient care was a model for us. I asked him to go home and rest. I assured him we would pay him over-time hours for his work—but I think he just wanted to hear he could go home.
The next day, we went back to the hospital to identify those still remaining with untreated or newly discovered injuries. The surgeon, head nurse, and I did the rounds of the hospital. We identified the sickest victims that we could potentially evacuate to the trauma hospital of the International Committee of the Red Cross in Abeche—a town about two hours away by plane flight. I called the Red Cross surgeon, Dr. Igor, and we agreed on the transfers.
Among the transfers was the initially “lost” brother. After the dust had settled and I could examine him again, the brother had significant neck pain and what seemed like a broken arm. The team was not entirely sure if the arm was broken. When I examined his arm, there was definitely pain around the area above where a wristwatch usually is worn.
I pulled out my portable ultrasound, which I was carrying on the hospital rounds. Using a special probe I brought from Canada, I showed the assembled team the normal bone where the patient had no pain. Then, where he had pain on physical exam, the bone was obviously abnormal and broken. Everyone crowded around the machine could see the broken bone. The surgical team agreed to put a splint on the broken arm. With all the brother’s injuries, we would transfer the patient to the Red Cross in Abeche.
In the past day, MSF had responded to an unexpected emergency. It was amidst our usual priorities to our patients. With our partners in the Ministry of Health we dealt with each trauma victim one by one. There were no fatalities and the whole Ministry of Health and MSF team had surged in the night to deal with the emergency. The MSF team felt good about the way we had responded and the positive patient outcomes.
As a doctor, in MSF work and in Canada, family members tap me on the shoulder and ask for my attention all the time. It’s hard to know if it is an emergency or a less serious concern. The man who was looking for his brother was just one of these worried family members the night of this critical event. Everyone who has lost their brother or their sister deserves a helping hand. That is what we are here to do.
Farewell for now from the house-call . . . to Chad.
SUBMITTED BY MATT HOBSON ON THU, 2013-04-11 10:41
The following post is a part of a series that discusses 'managing risk for development,' the theme of the World Bank’s upcoming World Development Report 2014.
Despite more than 19 episodes of severe food shortage in Ethiopia since 1895, it was the dramatic images of famines in 1972 and 1984 which came to the world’s attention and (wrongly) made Ethiopia synonymous with drought and famine. Despite consistent food shortages in Ethiopia for decades, it only became clear in the run-up to the 2002/3 drought that, while the humanitarian system appeared to be saving lives, it was proving to be ineffective in saving livelihoods and managing risks effectively. In essence, rural Ethiopians had faced chronic food insecurity for decades, but were receiving ‘treatment’ for transitory food insecurity. In part as a result of this misdiagnosis, rural Ethiopians were becoming increasingly less resilient to drought and were unable to manage risks effectively. This realization prompted the birth of the Productive Safety Net Programme (PSNP).
The PSNP is the largest safety net in Africa, outside of South Africa. It is run by the Ethiopian Government with support by no less than ten development partners: Canada, Denmark, European Commission, Ireland, Netherlands, Sweden, UK, USA, the World Food Program, and the World Bank.
The PSNP provides cash or food to people who have predictable food needs in a way that enables them to improve their own livelihoods and manage risks today – and therefore become more resilient to the effects of shocks in the future. Independent studies have shown that the PSNP has reversed the pre-2005 trend of decade-on-decade deterioration in livelihoods. The PSNP has shown that providing timely and predictable assistance enables households to manage risk more effectively by preventing costly coping strategies such as sale of vital assets that worsens future food insecurity. The PSNP both protects households from food insecurity and allows them to use their resources more flexibly to smooth out consumption.
However, while the PSNP responds to the chronic food insecurity of households, there are times when a shock results in some households – whether within the PSNP or not - facing transitory food insecurity and requiring additional temporary support. In these instances, the PSNP has dedicated Contingency Budgets, designed to meet transitory needs. However, if a shock is too large, the PSNP’s contingency funds can be exhausted before all the transitory needs are met. When the contingency funds are exhausted, the Risk Financing Mechanism (RFM) is designed to address these needs. The RFM is an instrument that allows the PSNP to scale up in times of transitory crisis, in those districts where it is already operational. In particular, the RFM was designed to reduce the ‘typical’ humanitarian timeline for response, so that households would receive assistance before the crisis was felt.
In this way, the PNSP can expand and respond as the situation requires. The programme can address predictable food needs through usual PSNP operations, can address low-level transitory needs caused by moderate shocks through contingency funds and can address higher levels of transitory needs through the RFM.
In order for the RFM to function correctly, four conditions need to be fulfilled:
1 . Early Warning: Effective early warning systems need to be in place to indicate the need for a response as early as possible.
2 . Contingency Plans: Plans need to be put in place so that when a shock is indicated, key actors know how to respond.
3 . Contingency Financing: Resources need to be available to avoid the major time delays associated with the humanitarian appeal process.
4 . Institutions and Capacity: Institutional arrangements and capacity need to be in place to allow plans to be implemented.
By putting in place effective early warning systems, contingency financing, contingency plans and institutional capacity ahead of the crisis, the ‘typical’ timeline for humanitarian response can be significantly reduced, from 8-9 months to 2 months, as was the case in 2011, when the Horn of Africa was affected by the largest drought in 60 years. In August 2011, Ethiopia used RFM to address the transitory food needs of approx. 9.6 million drought-affected people.
Addressing transitory food insecurity in addition to chronic food insecurity is integral to the transition from relief to development in Ethiopia. With increased vulnerability as a result of climate change, the capacity of communities and Government to manage risks – already being built by the PSNP – is becoming increasingly important.
The RFM is the largest current example of risk insurance in a humanitarian context in Africa - and the 2011 experience shows that it works. A clear precedent has been set. The RFM can of course be improved - but it can also be copied by other countries. Copying the model implies a paradigm shift for how the humanitarian community looks at slow-onset humanitarian crises. The key question then becomes: is the antiquated and under-performing humanitarian system ready and willing to reform?
The PSNP model (or parts of it) is being replicated in other countries in sub-Saharan Africa to great effect, including in Tanzania, Rwanda, Malawi, and others. Insofar as the author is aware, the RFM has not been rolled out to other countries yet, although discussions are taking place in a number of countries.
Une aide urgente doit être fournie aux 70 000 Maliens
Au milieu du désert mauritanien, 70 000 réfugiés continuent de survivre dans des conditions précaires, sans perspective de retour au pays en raison des tensions ethniques affectant le nord du Mali. C’est ce que décrit un rapport intitulé « Échoués dans le désert » et publié aujourd’hui par Médecins Sans Frontières (MSF), qui appelle les organisations humanitaires à se préparer à un effort continu à la hauteur des besoins.
À travers des témoignages recueillis auprès d’une centaine de réfugiés dans le camp de Mbéra, en Mauritanie, ce rapport revient sur les raisons qui ont forcé ces gens à fuir, et révèle ainsi la complexité de la crise au Mali voisin. Alors que cette crise risque de perdurer pendant des mois, voire des années, les réfugiés maliens risquent de rester isolés au milieu du désert, totalement dépendants de l’aide extérieure et humanitaire.
« Aujourd’hui, des pans entiers de la population du nord du Mali restent déplacés à l’intérieur du pays ou réfugiés dans les pays voisins », s’alarme Henry Gray, coordonnateur des opérations d’urgence de MSF. « La plupart des réfugiés appartiennent aux communautés touarègues et arabes. Ils ont fui de manière préventive, très souvent par peur de subir des violences à cause de leur lien présumé avec des groupes islamistes ou indépendantistes. Aujourd’hui, dans le nord du Mali, il règne un climat de méfiance et la peur persiste. »
Présente en Mauritanie depuis l’arrivée des premiers réfugiés début 2012, MSF a alerté à maintes reprises sur les conditions de vie déplorables dans le camp de Mbéra et leurs conséquences dramatiques sur la santé des réfugiés. En novembre 2012, une enquête nutritionnelle et de mortalité rétrospective de MSF révélait une situation nutritionnelle critique et des taux de mortalité dépassant les seuils d’urgence chez les enfants de moins de deux ans.
La situation médicale s’est encore aggravée avec l’arrivée d’environ 15 000 nouveaux réfugiés suite à l’intervention militaire franco-malienne, débutée le 13 janvier 2013. Dans le programme MSF, le nombre de consultations est passé de 1 500 à 2 500 par semaine. Le nombre d’enfants souffrant de malnutrition a, quant à lui, doublé, passant de 42 à 106 enfants malnutris, dont 85 pour cent sont arrivés dans le camp entre janvier et février. L’état nutritionnel de ces derniers était pourtant globalement bon lors de leur arrivée.
« Ces chiffres montrent que l’état des réfugiés s’est dégradé dans le camp, alors même qu’ils étaient censés recevoir une assistance, notamment une aide alimentaire adaptée, de la part des organisations d’aide », déplore Henry Gray. « Il y a clairement eu un manque de préparation à ce nouvel afflux de réfugiés. La situation qui s’est améliorée ces dernières semaines est encore extrêmement précaire, c’est pourquoi les organisations d’aide doivent maintenir leurs efforts aussi longtemps que nécessaire : abris, eau potable, latrines et nourriture doivent être fournis continuellement à hauteur des normes minimum de l’aide humanitaire. »
MSF mène des programmes d’aide médicale et humanitaire au Mali, dans les régions de Mopti, Gao, Sikasso et Tombouctou, ainsi qu’auprès des réfugiés maliens au Burkina Faso, en Mauritanie et au Niger. En Mauritanie, l’organisation appuie quatre structures de santé primaire, dans le camp de Mbéra et au poste frontière de Fassala, et gère un bloc opératoire dans la ville de Bassikounou. Depuis le début du programme en février 2012, les équipes de MSF en Mauritanie ont réalisé 85 000 consultations, réalisé 200 accouchements et pris en charge un millier d’enfants souffrant de malnutrition sévère.
Bamako/Sévaré, 12 April 2013 (IRIN) - Hunger in Mali has reached crisis levels in the northern Kidal Region and has reached critical levels in Gao and Timbuktu regions, according to food security agencies and the government’s early warning body.
One in five households in Gao and Timbuktu are facing severe food shortages, while in Kidal one in five households faces severe malnutrition and increasing mortality.
The situation is likely to worsen over the coming months as the lean season progresses, part of the usual seasonal deterioration in food security across the Sahel.
So far, 28 percent of the US$139 million appeal for food security and 17 percent of the $73 million appeal for nutrition have been committed by donors.
“The problem is that people are starting [the lean season] from an already highly deteriorated position. Assistance is not yet meeting needs, and even if security improves dramatically tomorrow it will take a long time for households to rebuild their livelihoods,” Cedric Charpentier, West Africa market specialist for the World Food Programme (WFP), told IRIN.
In January, donors pledged $455 million to the African-lead international force in Mali, leaving some to fear the situation in northern Mali could be seen through a politico-military lens that overlooks the chronic vulnerability of ordinary Malians.
“There is very strong political will to intervene in northern Mali,” said Frank Abeille, head of the NGO Solidarités Internationale in Mali, which is operating across the north. “What we need is to see a motivation that can also adapt to the reality on the ground: the real needs are humanitarian, not military.”
Markets are still near-empty in Gao town and surrounding villages, and cereal prices are up by between 30 and 70 percent, according to the Famine Early Warning Systems Network (FEWS NET). The closed Algeria border and the flight of the majority of Arab and Tuareg traders in both Gao and Timbuktu have made products like pasta, oil, rice and sugar scarce.
While large cereal markets continue to function, smaller village-level markets have shut down, leaving rural communities and small traders - many of them women - destitute, according to Sally Haydock, Mali’s WFP head. The availability of staple grains, sorghum, millet and corn is better than in February but still far from healthy, according to food aid analysts.
“We cannot say people are starving yet, but they are not eating as they should,” said Oumar Hama Sangho, a Gao resident who has just finished assessing food security in the area.
“You go to the market, there is no fruit, no vegetables, meat or fish… There is only rice, millet and corn - mainly donated by the government or internationals. Old and young are surviving on these cereals, but it is not enough.”
Mahamane Touré, coordinator of the German NGO Agro Action in Timbuktu, told IRIN insecurity prevented many women from planting their market gardens this year, so they have little to fall back on. “I have met many families who eat just one meal - of cereals - a day,” he told IRIN.
Banking systems in Gao and Timbuktu have also been largely shut down since mid-2012, making large-scale transactions impossible. This has led suppliers to refrain from large deals.
While security has improved in much of Gao and Timbuktu, widespread acts of criminality and banditry on transit roads and on the outskirts of towns are also disrupting food markets.
In Kidal Region, both food and non-food items are largely unavailable in markets or are for sale at prices out of reach for the poorest people, said several NGOs. Kidal residents are highly dependent on markets, as they do not produce much of their own grain.
“The region is already very fragile,” said Wolde Gabrielle Saugeron, spokesperson for the International Committee of the Red Cross (ICRC). “People lack seeds to plant this year, and planting will be even more difficult for the displaced, while for herders, the lack of livestock services will pose severe problems.”
“The situation changes daily and remains unstable across the north,” he added.
ICRC is providing food to 30,000 people in Kidal - about one-third of them displaced - and is providing water to people in Kidal town. Doctors of the World (MDM) is providing healthcare and nutrition assistance.
IDPs share rations
Many internally displaced people (IDPs) who spoke to IRIN in the central town of Sévaré said they were sending part of their monthly WFP food rations back home to family remaining in the north.
Ahmed Maiga, an IDP at the “La Maison des chauffeurs” makeshift camp in Sévaré, had recently returned from his home in Gao to check up on family members there. “I came back because life is too difficult there - the markets don’t exist. The shops are empty. Everything we had was looted… We send a large part of our monthly rations back home to the rest of our family,” he told IRIN.
WFP has delivered food to 90,000 Malians in the north so far this year, working through international NGO partners, and is looking to scale-up its deliveries, but access remains a concern.
“One of our top concerns is for humanitarian access to be re-established. This would allow WFP to reopen its offices in order to assist a larger caseload and for our partners to operate fully,” said Haydock.
A number of NGOs - Médecins sans Frontières, MDM, Action against Hunger (ACF) and Solidarités - have been running nutrition and other programmes in the north since 2012. They say gaining humanitarian access through negotiations with non-state armed groups was not too difficult in 2012, but access is now more problematic because of the absence of administrative authorities and the lack of a clear military chain of command.
ACF is helping moderately and severely malnourished children in Gao, Bourem and Ansongo, and plans to soon provide blanket feeding for up to 30,000 children under two years old. The agency is trying to figure out how to buy goods from local traders in order to support local businesses.
Countrywide, the number of Malians at risk of critical hunger this year is estimated to be 2 million, and 660,000 children under age five are at risk of severe malnutrition, though this latter estimate is based on figures from a 2011 survey.
ACF head Franck Vannetelle told IRIN its caseload of malnourished children has gone up in recent days, but this could also be linked to the fact that its mobile teams are again running, enabling the organization to identify more at-risk children.
WFP is scaling-up cash transfers for the south and is considering them for the north as well, but the pre-conditions - availability of food in markets, return of traders, re-opened trade routes, functional banks and better security - are not currently in place.
More detailed evaluations of food security in the north should take place soon. But obtaining information from health centres, families, market traders, officials, local NGOs, transporters and others and finding qualified staff who can undertake detailed, qualitative analyses of vulnerability and hunger remain challenging in the north.