Polio Eradication Efforts: Militant or Ineffective?

Follow the Polio outbreak in real time with HealthMap

Smallpox has been globally eradicated since 1980, so why is the eradication of Polio so much more difficult? The World Health Organization (WHO) recently released that the Global Polio Eradication Initiative (GPEI) would be conducting a new targeted 15 country effort to vaccinate 72 million children in Africa. The new campaign follows numerous failed efforts of the past and reemerging outbreaks. Why does the African continent remain prone to Polio outbreaks that spread rapidly? Why did the organized campaign to eradicate Smallpox take only 21 years while Polio is going on almost 40 years?

Since 1796, when cowpox was used to protect humans from Smallpox, eradication efforts have taken place. It wasn’t until the WHO intensified the eradication of smallpox in 1967 that efforts were coordinated around the world. The Smallpox Eradication Program (SEP) was jointly run by the WHO, CDC, and National Ministries of Health in various countries. Doctors and epidemiologists from the US volunteered to help with the efforts. In many instances US volunteers were overbearing and controlling of their local counterparts. A report by Paul Greenough documented the use of intimidation and coercion in the final stages of the SEP. Foreign volunteers were sent to kick down doors (literally), force vaccination of those who refused, and fix the mistakes of local staff members (1995). These coercive tactics evoked resistance from local communities, but the SEP prevailed. The SEP was run in a structured, militant fashion, where individual human rights were overridden for the global public good. Similar issues with resistance have been seen in Polio eradication efforts, but responses to resistance have not been as militant. Could this be why Polio has continued to resurface?

The earliest documented case of Polio in Africa is traced back to 1580 B.C. in Egypt and still the virus continues to spread across the continent. The eradication of Polio relies heavily on National Immunization Days (NIDs), but these events are ineffective because they aren’t comprehensive vaccination efforts, positive cases are missed and some children aren’t vaccinated causing continued Polio outbreaks. Organized Polio eradication efforts began when the World Health Assembly launched the Expanded Programme on Immunization (EPI) in 1974, a program implemented through the NIDs . In 1988, the World Health Assembly said that by the year 2000 Polio would be eradicated and they launched the Global Polio Eradication Initiative (GPEI) to make it happen. Many prominent people and organizations put their support behind the program including Rotary International and Nelson Mandela, who in 1996 launched the “Kick Polio Out of Africa” campaign which vaccinated 420 million children. In the 90s, the UN Secretary General negotiated peace treaties to vaccinate in war-torn Liberia and Sierra Leone. Most recently in 2004, 23 African countries coordinated NIDs focused on Polio vaccination.

After all these efforts, Africa remains the only continent where Polio remains alive and well in multiple countries. A series of studies completed across West Africa showed that due to misconceptions about the vaccine, lack of adequate funding and corruption at the local level, and ineffective immunization campaigns, Polio has persisted on the African continent (Melissa Leach & James Fairhead, 2007). The year 2007 marked an outbreak of 25 cases in Angola which spread to 28 cases in the Democratic Republic of the Congo (DRC). In 2008, after an outbreak in northern Nigeria, where there have been vaccination conspiracy theories, spread to a dozen other countries, the WHO made Polio eradication their “top operational priority.”

Armed with a “more effective” version of the oral vaccine, the new GPEI organized effort across 15 countries hopes to eradicate Polio for good. However, just yesterday the New York Times wrote that the WHO reported 104 deaths and 201 cases of paralysis from Polio in the DRC. Is the renewed GPEI effort, launched Oct. 28, 2010, even working? Is eradication even a desirable goal at all, if past experience with Smallpox Eradication Program requires militancy?

Originally written for Americans for Informed Democracy (Dec. 4, 2010), where I wrote as a Global Health Analyst.

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Blue Helmets ineffective compared to US troops in Central Africa?

After operations in Somalia ended badly in 1993, the US seemed to have full blown “Black Hawk Down” syndrome when it came to military intervention on the African continent. Many have cited the Somalia event among other reasons for the Clinton Administration’s failure to act during the Rwandan genocide of 1994. However, the US has been involved in militarizing the African continent since the Cold War: propping up warlords, funding resistance movements, and even assassinating the newly (democratically) elected head of state of modern day Democratic Republic of Congo (DRC), Patrice Lumumba. Currently, the Obama Administration has shown no reason for restraint in sending troops to engage in African conflicts.

The UN has had a high degree of failure when it comes to peacekeeping missions in Africa. Largely due to limited mandates, UN troops in Rwanda, Darfur, and the DRC have been ineffective. The UN has had 15 deployments related to African conflicts, 8 of which are ongoing. The critical question is are UN peacekeepers more effective than US military interventions?

Darfur/ South Kordofan/ South Sudan

Sudan has presented a host of conflicts that seem to have baffled US and UN diplomats alike. Some have called for greater military intervention, but the US has focused on non-military negotiations and peace deals. The conflicts in the Sudanese region are largely based on the Sudanese government attacking other ethnic groups and attempting to maintain control of the remaining regions under their jurisdiction. The SPLA has become the main military of South Sudan and has an affiliate in Sudan (North) SPLM-N.

US

During the 2008 US Presidential race, on the campaign trail in 2007, Joe Biden called for a force of 2,500 US troops to end the genocide in Darfur. Hillary Clinton and John Edwards supported a plan for a peacekeeping force. Barack Obama called for a no-fly zone in Darfur and divestment from corporations supporting the Sudanese regime. Bill Richardson personally met with the Sudanese president to push for a peacekeeping force.

It is a little known fact that the Sudan People’s Liberation Army (SPLA) leader, John Garang, was trained at Fort Benning and that,

“The US government decided, in 1996, to send nearly $20 million of military equipment through the ‘front-line’ states of Ethiopia, Eritrea and Uganda to help the Sudanese opposition overthrow the Khartoum regime.” (Source)

President Bush was lauded for his role in the Comprehensive Peace Agreement (CPA) that ended the North-South civil war in 2005 which led to the popular vote dividing Sudan and South Sudan. However, there is no mention of the US’s military role in fueling the conflict.

The US has played a significant diplomatic role in the Sudanese region. There has been a lot of talk and agreements and support for peacekeepers, but there has been little accomplished in the way of ending the long running conflict between various groups. Could George Clooney get the US to send troops into Sudan?

UN

The UN has four current missions in the Sudanese region: UNAMID, UNMIS, UNISFA, UNMISS. The first of which, UNAMID, began operating in Darfur in 2007. Since, then 51 peacekeepers have been killed. Reports continue that the Sudanese government is targeting civilians.

Following the creation of South Sudan, a conflict arose over the area of South Kordofan in Abeyi. The  UN added missions in Abeyi to mitigate conflict in South Kordofan (UNIFSA) as well as a mission for South Sudan in general (UNMISS). By all accounts Darfur was a major failure of UN action and South Kordofan represented an equally prominent failure. Reports noted that UN troops stood by while Sudanese troops killed unarmed civilians.

In the Sudanese region, the UN has failed to end the killing of hundreds of thousands of people more than once and has suffered casualties of its own forces since becoming involved in the region. It is easy to quickly say that UN peacekeepers in the Sudanese region have failed, but would Joe Biden’s 2,500 US troops have done any better instead of the UN-AU peacekeeping force?

Actors:

  • Sudanese government troops
  • UNMIS (UN mission, 2005)
  • UNAMID with AU forces (UN-AU mission in Darfur, 2007)
  • SPLA (Sudan People’s Liberation Army)
  • SPLM-N (Sudan People’s Liberation Movement – North)
  • SLM/A – Sudan Liberation Movement/Army
  • JEM – Justice and Equality Movement
  • UNMISS (South Sudan, 2011)
  • UNIFSA (S. Kordofan, Abeyi, 2011)

Uganda/ Democratic Republic of Congo

The DRC has seen a high degree of conflict, which increased following the CIA assassination of Patrice Lumumba in 1961 and the US backed Mobutu coming to power for the next 32 years. Mobutu supported the Hutu militia (FDLR) responsible for the 1994 Rwandan genocide. The FDLR has been given refuge by the political establishment in DRC first with Mobutu and later with current President Joseph Kabila utilizing the FDLR to combat intervening forces (i.e. Rwanda & Uganda in 1996, 1998).

US

Since 2008, US military advisors have been on the ground in DRC helping to train the Congolese army (FARDC) to better maintain control of various regions of the vast country. It is unclear why military advisors were sent in the first place. Potentially it was a move by the US to counteract Chinese development programs targeting natural resources extraction.

The US has largely been absent from the conflicts of the DRC until recently. In 2011, President Obama announced that 100 US troops would be headed to Uganda to act as military advisors in the campaign to flush out the LRA leader, Joseph Kony. However, Kony and the LRA aren’t in Uganda anymore, they have been hiding out and operating from the DRC since 2006. New reports have come out saying that US troops are operating from bases in 4 countries are tracking down the LRA from bases in Uganda, South Sudan, DRC, and the Central African Republic.

The fact that the US is willing to devote military assets to routing a single militant group is extremely significant especially since there have been numerous bad actors operating in the region for decades and US actions in African conflicts haven’t been forthcoming. Since Ugandan president Yoweri Museveni took power and ensured that he kept getting elected, there have been 22 armed groups that have been formed to combat the government. Museveni has perpetuated the North-South ethnic divide held over from British colonial rule. As much as the LRA needs to be routed, Museveni needs to be engaged by the US to step down and allow real democracy to occur.

UN

UN troops have been operating in the DRC since 2008, but have often had to bend to the will of area militias. What real power does the MONUSCO have in the DRC? More recently, in 2009 and 2012, MONUSCO has been cooperating with FARDC (the Congolese army) on joint missions to take down the FDLR and other militant groups, including the LRA. On March 14th, a senior officer of the FDLR surrendered to the UN forces.

The UN mission in DRC has the largest budget of any peacekeeping mission, but is notably underfunded and ill-equipped. The main problem is the vastness of the mountainous region and the multiple militant groups that need to be negotiated with or militarily engaged. It just can’t manage all the space with the man power that it has, therefore it is unable to protect the population because it is just unable.

Some have credited MONUSCO with ending the violence in some of the regions of DRC as well as organizing successful country-wide elections. Potentially the UN missions is gaining ground in the conflict?

Support from both the UN mission and US military advisors is somewhat concerning since FARDC has been involved in some of the worst human rights violations in the conflict.

Actors:

  • FARDC (Congolese army)
  • MONUSCO (UN mission, 2010)
  • General Nkundu – split from Congolese army to lead Tutsi forces against FDLR
  • FDLR – former Interhamwe responsible for Rwandan genocide
  • Rally for Congolese Democracy (RCD) – backed by Rwanda
  • LRA (Lord’s Resistance Army) – from N. Uganda
  • UPDF (Uganda People’s Defense Force)


Will  the US replace the UN as primary peacekeepers in Africa? 

UN peacekeeping forces have tried to take on the Sudanese government and militias in the DRC, but have failed to keep peace or intervene in the killing of civilians. The UN almost always comes out with a statement condemning the killing of civilians by this or that group. Many peacekeepers have been killed in the various missions and there are only a few positive impacts noted from those missions. UN missions are notoriously plagued by underfunding, under-trained troops and a lack of adequate equipment.

In the past year the US has militarily intervened in 7 African countries with and without mandates or international support. They have trained the FARDC forces, which are now completing joint missions with MONUSCO to route militant groups. It seems as if Obama has taken up the Bush Doctrine to militarily intervene whenever he feels like it. Contrary to the UN missions, US military actions are rarely under-funded, troops are highly trained, and there is no lack of equipment.

On a side note, how can both the US and the UN overlook the atrocities committed by national armies (Sudanese government, FARDC, UPDF)? In these conflicts the UN/US create the narrative for who is the good guy and who is the bad guy, but there is a need for nuance. I understand that it isn’t possible to engage all sides and I can only hope that the UN/US missions are working to end atrocities committed by national armies, since those atrocities have often fueled conflicts further.

The UN is stretched and the US has the ability to send elite troops into conflict zones to rescue its citizens (Somalia). Can the US’s quick military interventions, anti-terrorism trainings, and military advisors create a more effective peace than the UN? After the LRA is eliminated will the US pick the next militant group to hunt down? Too many questions arise when analyzing military interventions. There is always cause for concern when conflict regions see an influx of militarization from the UN, US, and other countries with foreign policy interests.

Obama’s Africa Policy is Military Policy

Oil and US Military Activities in Africa

Many people had high hopes for Obama’s presidency having a serious focus and positive impact on the African continent (including myself). The policies of past presidents relegated Africa to a single, monolithic policy for a continent of 55 countries. Under Bush, AFRICOM launched and a renewed focus on military engagement became the norm for US Africa Policy with the US military providing anti-terrorism training and the military implementing humanitarian aid projects typically conducted by USAID.

As Obama was campaigning as a Senator, I thought he had great potential to make changes in US Africa Policy. In 2007, I wrote:

Just last year the Illinois Senator went on an African tour visiting South Africa, Kenya, Ethiopia, and Chad – discussing the issues of the HIV/AIDS epidemic, the growing violence in Darfur, refugees from the Sudan conflict, the Kibera slums, and Africa becoming a new haven for terrorists. I wonder if he is in favor of the Africa Command? Obama presents a great hope for American political reform and rebirth, but also Obama presents a great hope for Africa and bringing about a more focused and effective and involved US African Policy that is not afraid to invest in the continent. (Written 01/06/2007)

President Obama began his presidency repairing the world’s view of the US after the extremely negative view the world population held of Bush and his wars in the Middle East. In 2009, Obama gave compelling speeches in Ghana and Egypt. To me, these speeches seemed to signify that the Obama Administration was going to engage countries in Africa as individual actors and place engagement in Africa as a higher priority.

My hopes aren’t as strong as Obama begins his campaign for a second term. It is no mystery that Obama’s focus has been on domestic issues during the last 4 years. Beyond the far reaching impacts of political unrest and change across North Africa and the Middle East, Obama’s Africa Policy has been kept at an arms length. Hillary Clinton has done a commendable job of managing the US’s image abroad, but Obama’s Administration has not engaged the continent the same way he has spoken to and about Africa.

How has Obama fared since his Africa Tour of 2006? What advances have been made in US Africa Policy? Here are the issues since 2006:

HIV/AIDS

Arguably the most prominent accomplishment of Obama’s term was passing Healthcare Reform. Much of his time and effort was focused on fighting, compromising, and pushing for this legislation. The strong domestic focus is expected, but its seems Obama only mentions HIV/AIDS on World AIDS Day. This past year (2011) Obama had a strong story and spoke of a growing commitment to “The End of AIDS.” However, we have also seen Congress push to slash our humanitarian aid budget to even less than 1% while at the same time the Global Fund is in a funding crisis. Bush often mention PEPFAR in his State of the Union speeches, but Obama never has. This may have just been political, Bush needed to deflect attention from his unpopular war-mongering and Obama needed to draw in his base of supporters for the upcoming election. Obama has said publicly that he will defend the US funding for PEPFAR and the Global Fund. Many people note that if Obama is elected to a second term he will likely be involved in more international issues. This seems to be one on Obama’s radar for future involvement.

Darfur, Sudan

While serving in the Senate, Obama was a staunch advocate for ending genocide in Darfur. After elected, he appointed strong anti-genocide advocates to key posts: Susan Rice, UN Representative for the US, and Hillary Clinton, Secretary of State. During Obama’s term, the world’s newest country was formed: South Sudan. Both Obama and Clinton have made statements affirming US support for the new country of South Sudan. Obama has made strong statements that South Sudan and Sudan need to move past long standing differences if they are to both prosper, but the reality on the ground is another story. The violence and bloodshed has not ended. Rhetorically I ask, why have no troops been sent to Darfur or South Sudan?

Slums

During his Africa Tour, Senator Obama visited the Kibera slum in Kenya. The AFRICOM 2011 statement of purpose notes the great need for increased economic support in Africa to bring stability and growth. This past year has seen revolutions and uprisings against governments across Africa, from human rights protests in Uganda, to full revolution in Egypt, armed conflict in Libya, land protests in South Africa, to #OccupyNigeria decrying the oil industry’s grip on the country. The slums in full view of skyscrapers are a common sight in many of the developing world’s major cities. Global inequality is not being ignored any longer and populations are taking things into their own hands. Obama has been known to be in close personal contact with African heads of state. US investment in Africa has not been as well publicized.

In 2011, Ambassador Demetrios Marantis spoke about the US’s Africa trade and investment policy. Marantis highlighted the small-scale, project by project, country by country investment related to the African Growth and Opportunity Act (AGOA) as well as the Millennium Challenge Corporation (MCC), but it seems that the glaring issues with these programs raised during the Bush administration have not been addressed. Marantis also spoke of the US’s efforts to sign bi-lateral trade agreements, 7 total, which will increase private investments. If you ask me this is a poor response and demonstrates a lack of imagination and innovation towards African engagement.

Terrorism

This has been by far the most prominent area of the Obama Administraion’s Africa Policy. Out of all issues focused on in Africa, the military intervention and on the ground action seems to be the “go to move” for African engagement. Since 2003, the US military has been conducting anti-terrorism trainings with many African militaries in the West African Sahel region, working to mitigate Al-Qaeda in the Islamic Magreb (AQIM). The US military has also been involved in the Somali conflict, helping Kenyan troops to protect their border and engaging Al-Shabab, these efforts have not been without civilian casualties. Recently, US special forces went into Somalia to rescue aid workers held by a Somali pirate group.

Obama authorized the US military to run support missions in Libya, carrying out the majority of flight missions attacking Libyan military installations. The US military presence was significant even though the UK and France were leading the mission. More recently in October 2011, Obama announced he would be sending around 100 troops to Uganda to assist in fighting the Lord’s Resistance Army (LRA) responsible for a long running conflict affecting Northern Uganda and neighboring regions.

This year, the bombing skills of Boko Haram have improved quickly and the Nigerian and US militaries believe AQIM is teaching militants in Nigeria to make better bombs. The attack on the US Embassy has lead the US to commit military efforts to helping the Nigerian government fight Boko Haram.

What will 2012 Bring?

Some have called these various efforts the “Pentagon’s shadow war in Africa,” however nothing has been veiled in shadows. The US holds nothing back to show it is there to militarily support African countries. The US Africa Policy has been revealed to be a focus on mitigation of terrorist groups that seem to be gaining ground and ensuring regional security before other economic or humanitarian efforts are increased.

“Africa is not big in Washington, there is no constituency that cares about Africa that much,” said Kwaku Nuamah, a Ghanaian professor at American University in Washington.  “I did not think the traditional contours of American foreign policy were going to change because there was somebody in the White House with ties to Africa, but of course a lot of people expected that.”

Like all presidents, Obama has many words and equally many unfulfilled commitments. As Obama is focused domestically, it has been the US military that has demonstrated his Africa Policy. Obama has chosen the sword over the pen in implementing policy across the continent and I can only continue to hope, like others, that a second term for Obama will mean more non-military engagement in Africa. This all goes without noting the US’s competition with China in Africa. . .

HIV solution: decentralizing treatment & patient empowerment

At the core of successful health programs are powerful community systems. Whether they are strong local governments, community-based organizations, or just informal groups of individuals – these types of community centered systems keep health programs focused on serving people and meeting needs in ways that will be most effective for the community.

In what has been called a model for Africa and US health programs by CDC Dr. Kebba Jobarteh, Mozambique is leading the way in restructuring how HIV treatment and support is delivered. Most countries in southern Africa have very high HIV prevalence rates as well as difficulties in providing treatment to those who need it. While there are many people in need of HIV treatment, there is a critical lack of adequate health infrastructure, clinics, hospitals, and health workers, to deliver the necessary services.

Providing treatment is just the beginning of the battle. Once an individual starts treatment with antiretrovirals (ARVs) they need to continue to adhere to a regular regimen of ARVs. Access to the medications and clinics along with regularly taking ARVs present a two-fold problem in areas where health services have long been weakened by a plethora of misfortunes: apartheid, structural adjustment programs, lack of development, under-investment, etc.

The new model developed by Doctors without Borders (MSF) puts communities at the forefront. By creating “patient groups,” treatment is decentralized to small health clinics in communities. This model spreads the responsibility to communities where there is the greatest need. The patient groups act as both a delivery system for ARV drugs as well as a support network for those with HIV. In many rural areas, people don’t have the time to travel long distances for extended periods of time to get their ARV drugs. The members of a patient group take turns traveling the distance to the health clinic. Likewise, members record whether each member of their group has taken their ARVs regularly and on time, which is then reported to the health clinic.

The model is very similar to that of “community health workers” (CHWs), who are members of the community that share knowledge and provide services when health systems can’t. As a solution to the inadequate health systems seen around the world, the “patient group” model puts those who need health services in control of their own treatment with the backing of a support network from their community. This may be a more effective model than CHWs since those who need treatment are providing the treatment. What better way to understand patient needs than to listen to the patients?

The CHW model has been popularized by organizations such as Partners in Health working in communities in developing countries. The model has now spread to urban areas and “developed” countries around the world. The patient model is yet another example of rural solutions from developing countries setting the bar for gaps in health care treatment in developed countries. A patient-centered/ people-centered approach to health delivery will make health systems more effective and successful around the world.

Featured on the Americans for Informed Democracy Blog, where I’m writing as a Global Health Analyst and reposted by Partners in Health.

carrenhos de chocque em mocambique (required to fight aid worker burn-out)

During my three-month long internship with a small-scale HIV/AIDS non-profit in South Africa, I visited a friend working in Mozambique with an HIV/AIDS activism organization as part of her Peace Corps placement. Beyond the entirely new experience of traveling to Mozambique, I met a very interesting crew of international development/ aid workers who gave me some great insights into who I might want to become if I entered the international development/aid arena. From working on a small operation in East Darfur, Sudan with a religious relief agency, to a technology focused firm constructing health curriculums funded by PEPFAR, to those doing backend all office-based, administrative work for USAID and the Clinton Foundation,  they were all at various stages in their lives and working in very different aspects of  development/ aid work. Some of the volunteers were in their 40s, others just out of college in Peace Corps, some had just come from extremely stressful environments where “guns were like sticks,” while others had just come to complete an internship for their Princeton graduate degree, all in all it was a motley group that gave a compelling snapshot of aid workers and the many directions they can come from and be headed towards.

4 August 2008

After walking from our hotel, my friend and I stopped at a “local” bar named Pirata (Pirate) to meet up with the motley crew of aid workers. We then headed into downtown Maputo for dinner at a restaurant recommended by one of the aid workers who had spent the longest time in and around Maputo (he had serious Mozambique cred). I had a supposedly traditional Mozambican dish of beans, rice, and shrimp which was very delicious or I was just supremely hungry from the day’s 8 hour bus ride from Johannesburg.

The Maputo based aid worker then took us to an odd sort of carnival hidden in what seemed like the middle of Maputo. It was randomly placed and not very large, but took me back to days of my earlier youth when we would visit the noise, lights, and crowds of the church carnival. We all were initially a bit shy about expressing our joy at the sight of children’s carnival games, but soon we were all reveling in the freedom from our assigned professional roles.

As we were the only ones at the carnival late in the evening, we had the whole place to ourselves. We all lined up and filled the bumper cars (carrenhos de chocque). The crackle of the electric wires, childish shouts of aid workers, and huge grins of pure joy made me realize that this should be a required exercise for all aid workers no matter if they are in the USA or based in a foreign country. We all need to take a step back every once in a while and just let ourselves enjoy being uninhibited by things as unimportant as bumper cars so that we can focus on important work.

A note for the future:

We all have to find what it is that helps us keep sharp and focused while also reducing stress, physical and emotional. The best thing to do is to schedule time when you can be unfocused, let loose, and enjoy time unencumbered by tasks, to-do lists, or responsibilities. My current job has a lot of frustrating client cancellations (currently the reason that I can sit and write this), long commutes with driving stress, and odd hours. As individuals who work in the field of aid, global health, and community development, we all want to love what we do, but the reality is that it is often a grind with harsh and far reaching social consequences that can cause us to resent a job. We all need to find those coping mechanisms that allow us to vent and rejuvenate our passions.

 

 

congo is not a country

Recent research and commentary on atrocities in the Democratic Republic of the Congo (DRC) have fueled reference to a “Congo” that seems to include only one country, but “the Congo” is a large, resource rich region made up of many countries.

Traditionally “the Congo” refers to the region of Middle Africa (referred to as “Central Africa” by the UN) comprised of parts of ten (10) different countries, including: Angola, Cameroon, Central African Republic, Democratic Republic of the Congo, Republic of the Congo, Equatorial Guinea, Gabon, Sao Tome and Principe, Burundi and Rwanda.

The Congo is best understood as a geographic region, with lush tropical rainforests and a wealth of mineral deposits, that benefits from the drainage of the Congo River. As a result, interest in the Congo region has caused violence and atrocities arguably since its “discovery” by Henry Morton Stanley in the name of King Leopold II of Belgium. The King wanted to spread Western civilization and religion to the region, which has led to continually destabilization and conflict.

The geographic region known to us as “the Congo” was home to one of the advanced African civilizations as well as the Baka people (often referred to as pygmies). The Kingdom of the Kongo included parts of the DRC, Republic of Congo and Angola. As recorded by Europeans the Kingdom of Kongo was highly developed with a extensive trading network. As “explorers” and colonizers penetrated further into the interior of the African continent, the Kingdom of Kongo became a major source of slaves. As a result of political in-fighting, resource grabbing, and European invasion, the Congo region’s factions remained in civil war for almost forty years (1700).

Since European arrival, the Congo region has been in a regular flux of conflict either between political factions, against colonizers, or now among local militias fighting for control of areas of resource wealth.

Much like our misunderstandings of various aspects of the African continent, its history, and people fuel monolithic interpretations of Africa, so too do our misunderstandings of the Congo region’s governments, resources, and cultures.

Maybe our misunderstandings and myths of “the Congo” are driven by the Heart of Darkness (supposedly inspired by Henry Morton Stanley) narrative set on the Congo River that details atrocities committed against native peoples? Maybe history shows Western violence has created a culture of violence in the quest for control and resources? Either way Congo is not a country, but a vast region with deep history and amazing possibilities.

middles classes & the globalization of #winning

News agencies and development pundits have been hailing the news that one-third of all Africans are now categorized as middle class and can be compared/ compete with China and India’s middles classes. I see a number of problems with this news, the criteria used to define middle class, and the comparison between an entire continent of people and those of two large countries (both of which are increasingly involved in development in Africa). The recent report from the Africa Development Bank (PDF) says that:

34%, or 313 million Africans are now middle class (living on $2-$20 a day), after several decades without any change, a jump from 27% in 2000.

The Asia Development Bank published a similar report last year saying that 56% of the Asian population is living on $2 – $20 a day (PDF). This calls into question the definition of middle class. I consider myself middle class in the United States of America and my family has been characterized as middle class ever since I can remember. However, my family and I definitely live on more than $20 per day and I would never imagine being able to call myself middle class based on how much money I spend in a day. Its all about location. Here in the US, the term middle class is synonymous with the “American Dream.” It is not so much a hard and fast economic development term that we can use to compare ourselves with other countries, but rather a socio-cultural term that is used to compare ourselves to each other in our attainment of the “American Dream” (Western notions of success).

The Guardian cites MIT economists, Abhijit Banerjee and Esther Duflo, who point out that:

the middle classes are: likely to be less connected to agriculture; more likely to be engaged in small business activities; and benefit from formal sector employment, with a weekly or monthly salary, which enables them to adopt a longer-term perspective towards their finances.

Even with a more economic definition, nothing about the term middle class is set in stone and it varies widely between communities and countries (more economic definitions of middle class). The Guardian continued to note that $2 is the poverty line for most countries, so if you live on more than that you are middle class, but there is no in-between. This only continues to prove that “middle class” cannot be defined by economists or development pundits. If we look closer at the term in the United States, it has always been a fluid and flexible term that a wide range of the population wanted to use. The majority of Americans call themselves “middle class” even when many fall into “working” or “upper” class categories based on their income levels.

Middle class often means achieving higher education, holding a professional job position, owning a home, and having a well established lifestyle that is socially acceptable. All of these status symbols mean something different across culture and country of origin. Populations bend and shape their definition of being “in-between” poor and more well off by different standards that are generally unwritten. If we use the United States as an example again, the Pew Research Center conducted a study on social and demographic trends to find that there isn’t just one middle class in America, but four! The study found that people often held onto definitions of middle class that defied traditional stereotypes.

In conclusion, we are all middle class. Whether we want to call ourselves middle class or we truly fit the economic definition, the majority of individuals around the globe identify themselves in the middle class. There is a global middle class that has no financial boundaries, but rather includes all individuals who seek advancement, education, and something more than what they currently have. Economists and development pundits cannot create a definition of middle class for a continent let alone a country, nor can they compare the middle class of the USA to that of another country or especially a continent.

If we want to truly understand if 1 in 3 Africans are middle class, then there needs to be some serious work that includes understandings of success in various countries and asks a large segment of a country’s population how they identify their socio-economic status based on their cultural norms. Why tell someone that their success isn’t as important as another’s?

Photo credit: BBC News

More “African middle class” pictures from BBC News

when conflict health becomes military tactic?

From refugee situations to border disputes, health crises that arise as a result of conflict are unfortunately quite common. Conflict health disrupts the ways that people access resources like food, water, and medicine. On the other hand, conflict health creates the circumstances where diseases spread, people are needlessly killed, and others are critically injured. These horrible results of conflict health are compounded by the destruction of infrastructure: roads, hospitals, etc.

What happens when conflict health becomes a military tactic? Since Medieval times (and before) armies attacking opposing castles would launch disease infested animal carcasses over the walls. In the 1800s, the US military gave smallpox blankets to indigenous North American groups in order to destroy their health and kill their populations. During apartheid in southern Africa, South African forces supporting RENAMO in Mozambique targeted health clinics and hospitals to cripple the health and infrastructure of the population.

During the World Wars, medics and vehicles with a red cross weren’t supposed to be targeted because they weren’t carrying out military actions. I had thought this idea was fairly widespread and that mercy was shown to health providers in times of conflict.

Recently, we have seen the complete opposite during the Libyan conflict. Libya’s pro-Gadhafi forces have targeted those attempting to provide health services to protestors and the population. In the early days of the protests it was reported that the military was entering the hospital to dump out blood supplies so that injured protestors could not be saved. In similar actions, Red Crescent medics and ambulances have been shot at, Colm O’Gorman, executive director of Amnesty International Ireland, said:

“This was a deliberate attack on medical professionals, who were wearing full medical uniform and arrived in two clearly marked Red Crescent ambulances.”

Ambulances have been bombed, The rebel spokesman confirmed that

“Gaddafi’s forces shoot three ambulances, killing two drivers.”

The Misrata hospital has been a flash point of intense shelling and fighting by Libyan forces. The hospital has been bombed from the air, shelled by tanks, and overrun by pro-Gadhafi troops.One person inside said,

“heavy tanks for Gadhafi troops start attacking the hospital – the bombs falling here 20 meters (66 feet) around us.”

The health of the Libyan people is under seige as much as the repressive dictatorship of Gadhafi. Many countries including Egypt, Morocco, and the UAE have established military field hospitals to be able to help the wounded who are leaving Libya. UNICEF is deeply concerned about the impact of the conflict on children and has distributed emergency health kits which contain enough drugs, medical supplies and basic medical equipment to cover the needs of 60,000 persons.

The conflict in Libya, through the blatant attacks on health providers and facilities, has demonstrated a new level of disregard for the basic health of a population. This is an obvious example that Gadhafi must be removed from power if the Libyan people are to regain their health and livelihoods.

Featured on the Americans for Informed Democracy Blog, where I’m writing as a Global Health Analyst.

Bringing African Perspectives into US Activism (#USSFafrica)

Thursday and Friday I attended many of the Africa focused workshops – most were very exciting and engaging. They really brought the African perspective into the ideas of the US Social Forum and made delegates think about the US role in issues affecting communities on the African continent.

24 Thursday 10am-12pm

African Unity Towards What? (Pan-Africanism & Nationalism is not enough!) by: University of Kmt

I still haven’t exactly figured out this group and what they do. They run the Kmt Press which publishes books and journals, but all of their sessions that I attended were focused on teaching with an African historical perspective. Their missions states that they are dedicated to educating the new generation of African leaders. Interesting that they are in Detroit and I wonder if they know of the Detroit Public School (DPS) Initiative starting in 1992 where Africa was integrated into school curriculums from math to literature. 

24 Thursday 1-3pm

Prioritizing Africa & the African Diaspora Agenda from Detroit to Dakar (D2D) by: Priority Africa Network (PAN)

This People’s Movement Assembly was geared towards bringing African perspectives into the US Social Forum and continue the discussion as preparations are made for the 2011 World Social Forum in Dakar, Senegal. The room was full of delegates from many African countries, Detroit, and US Africa Advocacy groups. 

Briggs Bomba, Director of Campaigns at Africa Action, spoke strongly about building solidarity with those most affected in Africa. He said, “corporate led globalization has harshest effects on those in the perifery, the underdeveloped.” He reminded us that all of us the privilege to attend conferences like these and make the policies need to prioritize the communities most affected.

A delegate from South Africa spoke eloquently about the social apartheid of displacement – ideologically, locations, in decision-making and governments; in voting process lack of people power and transformational action, and in the social mainstream. “We cover many issues, but it is the same struggle. We come from different areas, but share common experiences.” (i.e. colonialism)

Some top issues that came out of the PMA:

  • Militarization in the Congo (DRC)
  • HIV & STDs from Detroit to Africa
  • political economy – effects seen in everyday Africa
  • African defense (defend communities), liberation (not yet liberated), and autonomy

An exciting and dynamic session that really makes me excited for the World Social Forum in Dakar!

24 Thursday 3:30-5:30pm

The New Africa Command & U.S. Military Involvement in Africa by: African Security Research Project (aka: Daniel Volman)

This session was an interesting overview of AFRICOM by some leading scholars on the topic of US national security interests in Africa. The attendees were less diverse than the Detroit to Dakar session and most people came to learn more because it looked interesting and had studied Africa to some small degree in the past. 

Most interesting was when the discussion turned to private military contractors (PMCs) in Africa responsible for fighting wars in Libera, Southern Sudan, and Somalia. A Ugandan delegate actually talked about being trained by PMCs in Iraq to then return and fight the Lord’s Resistance Army in Northern Uganda. Great to hear the perspective of the Ugandan delegate and Dan Volman as well as to see so many people interested in learning more about African issues!

25 Friday 1-3pm

Power-sharing Deals in Africa: Implications for Democracy – The Case of Zimbabwe & Kenya by: Africa Action

This was by far the most organized session that I attended at the US Social Forum. The Africa Action team did an amazing job of gathering great speakers, formatting the session, and bringing people into the room for the discussion. Many African voices were heard from delegates representing Zimbabwe and Kenya. 

In both cases of power-sharing, the speakers agreed that the power-sharing deal was a sigh of relief that stopped the fighting and opened their doors to the international community and economy again. However, they also all recognized that power-sharing was a positive in the short-term, but can be positive as in the case of South Africa when Mandela and de Klerk signed a power sharing deal until the national democratic elections.

Here are some take-aways:

  • A weak state can and will be manipulated (i.e. Museveni in Uganda – waiting for a similar situation as Kenya and Zimbabwe soon, elections next year)
  • “The people” are separated from the power – people-centered in needed
  • Power-sharing allows for lessened tensions and time to create national unity towards something better
  • Coalition governments show defeat of “people power”

Crossposted from SCOUT BANANA