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South African Strike Puts Thousands of HIV-Infected Patients at Risk

Health experts in South Africa say many HIV-positive people in the country could get very sick and even die as a result of the strike by 500,000 to one million public service workers, including state nurses and pharmacists. The workers are demanding higher wages and improved benefits.

The protest action has shut down government clinics and hospitals, which usually dispense life-prolonging antiretroviral drugs (ARVs) to more than a million HIV-infected South Africans.

A spokesman for South Africa’s national health department, Fidel Hadebe, acknowledged the “gravity” of the situation but added that there is “little” it can do in the face of “massive” staff shortages.

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A fieldworker for South Africa’s Treatment Action Campaign (TAC) health activist group in the Free State, Sello Mokaliphi, said some people have already died in the province because they weren’t able to access ARVs.

“Unfortunately, if you do not belong (to) a medical aid or you can access (medicine) in a private health care facility, the reality for many people now is they will go without the treatment,” said TAC chairperson Nonkosi Khumalo.

Francois Venter, the president of the South African HIV Clinicians Society, said those “most in danger” are HIV-positive people with serious tuberculosis (TB) or very low CD4 (immune cell) counts, who need to start ARV therapy “immediately,” A delay of only a few days in giving them medicine means “they could die,” he said.

A CD4 count is a measure of the strength or weakness of a person’s immune system.

Venter said, “Pregnant women who need ARVs to prevent HIV from being passed on to their babies are also at serious risk. If these mothers can’t access the drugs, their children could get HIV.”

Ill patients face ‘lock outs’

In the Free State capital of Bloemfontein, David Mokoen, who’s infected with HIV, is a “worried” man. I don’t have drugs, I don’t have drugs…. Many of us here on ARVs will die in the future,” he said. “Government nurses have been chasing me away from the clinics since last week. When they see us waiting outside, they just lock the doors,” Mokoena said.

Khumalo added that this scenario is being repeated “across South Africa” and is set to get “much worse” as the strike intensified this week, as analysts expect it to.

Another particularly badly hit province is Gauteng, where HIV-positive Fundiswa Pasmeni usually received ARV drugs from state nurses at a clinic in Daveyton in East Rand district. She spoke with VOA by cell phone while traveling many miles away from her home in a minibus taxi, desperately trying to find a clinic that would provide ARVs.

“We waited at the (Daveyton) clinic from quarter to five in the morning, until past 11. Then some nurses came out and shouted at us, ‘Go home!’ Then they just went back inside the clinic and closed the doors. They said we can’t get the tablets; there’s nobody there to give us tablets,” Pasmeni said.

She added that she was beginning to feel extremely ill, with a bad headache and pains across her chest, because she hadn’t taken her ARVs “for days now…. I haven’t got anyone to help me. I don’t know what will happen to me,” she said, weeping.

Potentially fatal drug interruptions

HIV/AIDS experts say interrupting ARV treatment is very dangerous. In order for the medicine to work effectively, it has to be taken consistently. Mokaliphi said, “When treatment’s interrupted, patients will probably develop resistance to the drugs. The medicine will stop working properly which means they’ll get very sick and will eventually die.”

TAC said that because of the ARV interruptions caused by the strike, the resulting drug resistant patients will in the near future have to be placed on “completely new” drug regimens if their lives are to be saved.

Mokaliphi stated, “This would be at great cost to the government and the South African taxpayer, not to mention being a further burden on the health system, which is already stressed and may not be able to handle further complicated ARV procedures.”

Khumalo agreed, saying, “That new regime would be very expensive for government to treat. So my advice to the state now is to rather satisfy the strikers’ demands than deal with the costs of more expensive HIV treatment.”

Mokaliphi said those most at risk at the moment are HIV-infected people who are on the last regimen of ARV drugs currently available in South Africa. If they develop resistance to this regimen, he emphasized, their lives will be in “bitter danger.”

“When they default on this (present regimen), there is nothing that can be done. So it means they are going to lose their lives because there is nothing that they can use to suppress the virus,” Mokaliphi said.

‘Government to blame’

He expressed sadness over the strike and its consequences for all South Africans. But he blamed the government, and not the trade unions, for the situation. Mokaliphi added that while the state “haggled with the unions over peanuts” many South Africans, including those who weren’t infected with HIV, were dying for lack of health care.

“We are talking about people who are diabetic here; we are talking about people who are defaulting TB treatment,” Mokaliphi said. “What about those with pulmonary TB, what’s going to happen to them? When the strike goes on and on and it gets worse, that means people going on and on to die as they are dying right now.”

Mokoena also appealed to the government to “respond (positively) to the demands of the public servants.” He remains convinced that this is “the only way” to save lives, so that nurses can return “immediately” to their posts and begin dispensing ARVs.

But Pasmeni said “no matter” whether the nurses had legitimate grievances or not, it is “inexcusable” for these “essential” workers to abandon their posts.

“People who are working with (other) people’s lives, they must think about that; they must think about it. It’s really bad. People are dying out there,” Pasmeni said.

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Mortar Kills AU Peacekeepers in Somalia

A mortar attack on the presidential palace in the Somali capital has killed at least four African Union peacekeepers and critically wounded nine others. For the past week, the peacekeeping force, protecting the country's U.N.-backed government in Mogadishu, has been battling a new round of attacks by al-Qaida-linked al-Shabab militants.

Failed attack

According to the spokesman of the African Union peacekeeping mission in Somalia, Barigye Ba-Hoku, a mortar round fired from an al-Shabab position near the presidential palace exploded near a contingent of Ugandan peacekeepers guarding the palace compound, also known as Villa Somalia.

Ba-Hoku called the mortar strike a "lucky hit" for the al-Qaida-linked militants, who are battling to overthrow Somalia's weak, U.N.-backed government and to force the withdrawal of the peacekeeping force.

Uganda and Burundi are the only countries contributing troops to the 6,000-member African Union peacekeeping mission in Somalia. Uganda was the target of twin suicide bombings last month in Kampala, which al-Shabab said it carried out in retaliation for Uganda's participation in the peacekeeping mission.

al-Shabab renews efforts

Vowing last week to wage a massive, final war against the government and the African Union troops, al-Shabab has renewed its efforts to seize power in the Somali capital.

Last Tuesday, two al-Shabab suicide bombers, disguised as government security forces, killed more than 30 people, including parliament members and civil servants at a Mogadishu hotel. As the fighting in the capital escalated, killing and wounding dozens more, reports suggested that hundreds of al-Shabab reinforcements had arrived from other parts of Somalia.

On Friday, al-Shabab's self-styled mayor, Ali Mohamed Hussein, said al-Shabab had captured government military bases and the Mogadishu base of pro-government Sufi Muslim militia, Ahlu-Sunna Wal-Jama'a.

Declaring al-Shabab victory in Friday's battle, Hussein said the extremist group was getting closer to its goal of throwing out the government. An Ahlu-Sunna official subsequently denied that the Sufi militia had been defeated and said the militia had only made a tactical retreat.  

Some of the worst fighting in the Somali capital occurred the following day, as al-Shabab fighters pressed their way into Muka al-Mukarama Road, a vital thoroughfare that connects the presidential palace and government ministries to the airport.

Questions raised

Government soldiers, backed up by African Union firepower, beat back the al-Shabab advance. But the incident raised further questions about the government, which has not been able to stand up a security force of its own.

In the past two years, thousands of Somalis have been given police and military training by various countries, including Ethiopia, Kenya, and European Union member states, to keep al-Shabab at bay while the government demonstrated that it could govern and provide basic services to the people. But the majority of the recruits are believed to have defected to al-Shabab or have sold their uniform and arms and disappeared after the government failed to pay their salaries.

In a press release, Somali President Sharif Sheik Ahmed said the government is committed to re-establishing law and order in Mogadishu and elsewhere in Somalia. But he said it needed far more attention and financial help from the international community.

President Sharif noted that Somalia does not receive the kind of international assistance given to other countries suffering terrorist-related violence, such as Pakistan, Afghanistan, and Iraq, even though Somalia is facing a similar, if not more potent, enemy.

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Senegal Religious Leaders Respond to Crackdown on Begging

Religious leaders in Senegal object to a government crack down on begging because the prime minister told people to go to churches and mosques instead of begging in the streets.

The Senegalese government recently announced it would crackdown on people begging in the streets of the West African country. Begging has been illegal since 2005, but the law is rarely enforced.

The announcement brought the ire of some of Senegal's religious leaders, after Prime Minister Souleymane Ndene Ndiaye urged the country's churches and mosques to take in the beggars.

Priest Emiliano Martinez, who serves as the head of a cathedral in Tambacounda, Senegal, says churches and mosques are places of prayer, not begging.  He says he thinks there are other routes for helping the poor population.

An imam in the same region, Samba Sarr, said the government should take responsibility of the country's poor, too.

Sarr said the government should create centers for the poor before they send them to mosques and churches. He added authorities should reduce the salaries of the ministers, senators and members of parliament and use that money to help the beggars.

The prime minster said those beggars leaving the streets would be given a place to stay.

Earlier this year, New York-based Human Rights Watch published a report describing how thousands of children are forced to beg in the streets by religious leaders, known as marabouts.

The author of the report, Human Rights Watch Researcher Matt Wells, said the government's renewed commitment to monitor begging is a positive step, but it does not address the underlying issues of child trafficking and forced begging.

"It demonstrates, on some level, a commitment or an engagement of the Senegalese government, which is positive," said Wells. "But sustainable solutions to problems of forced begging involve the prosecution of those that are trafficking these kids, as well as regulation of these schools-not just mass roundups of kids and other beggars."

According to the Human Rights Watch report, some of the marabouts who send children to beg in the streets take in thousands of dollars in profit every year.

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Guinea Coup Leader Stays Out of Presidential Run-Off

The leader of Guinea's military coup, Captain Moussa Dadis Camara, has said he is staying away from the country so as not to disrupt an electoral process that is set to conclude with next month's second round of presidential voting.  

Captain Camara, who has refused to endorse any candidate, said he did not return to Guinea this month for the funeral of his son, Moriba, because he does not want to impact the upcoming vote.

After taking power in a December 2008 coup, Captain Camara ruled Guinea for nearly all of 2009, until he was shot in the head by the former chief of the presidential guard.

While he still remains the country's official military leader, Captain Camara has been replaced in the country by his former defense minister, General Sekouba Konate, who has helped organize elections to return Guinea to civilian rule.

He said chose to stay in neighboring Burkina Faso out of respect for the democratic process during an interview with VOA's French to Africa service.  Camara said he has faith in the political maturity of Guinea's leaders.  And he expressed his hope that the election is conducted in the best possible conditions, saying Guineans will not get anywhere if they fight among themselves.

For the moment, Captain Camara said he must be neutral in the run-off between first place finisher Cellou Diallo and second-place finisher Alpha Conde, explaining that if he favors one candidate over another, he would  violate the principles of democracy.

Before he was shot, Captain Camara appeared to be preparing to run for president, despite earlier promises not to do so.  When civilians demonstrated against his expected candidacy last September, they were attacked by soldiers who killed at least 150 people and raped dozens of women.

The soldier who shot Captain Camara last December says the captain was trying to blame him for that September violence.  Many of Mr. Camara's political opponents feared he would return to Guinea after receiving treatment in a Moroccan hospital for the gunshot wounds, but he went to the Burkinabe capital, Ouagadougou, instead.

Captain Camara said he went to Ouagadougou freely at the recommendation of General Konate because he did he believes in the electoral process and loves his country.

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Kenya’s Prime Minister Calls Bashir Participation Ill-Advised

Kenya’s Prime Minister Raila Odinga said it was ill-advised that Sudan’s embattled President Omar Hassan Al-Bashir was invited to participate in the promulgation of Kenya’s constitution last Friday.

In an exclusive interview with VOA, Prime Minister Odinga said that the Sudanese leader should be held accountable for the crimes committed under his rule.

“You know, I’m on record as having said that President Bashir needs to answer for the crimes that were committed under his charge and, if only he has been cleared by the ICC (International Criminal Court), that he should be allowed to attend any, or other, meetings of heads of state. So, my position has not changed at all,” he said.

U.S President Barack Obama expressed disappointment that Kenya hosted Mr. Bashir in defiance of the International Criminal Court arrest warrants issued against him alleging war crimes, crimes against humanity, and genocide.

In a statement, Mr. Obama said Kenya’s government “has committed itself to full cooperation with the ICC, and we consider it important that Kenya honor its commitments to the ICC and to international justice, along with all nations that share those responsibilities. In Kenya, and beyond, justice is a critical ingredient for lasting peace.”

Former U.N Secretary General Kofi Annan expressed surprise and joined the international community in questioning President Bashir’s participation in the public celebration of Kenya’s new constitution.

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Some officials in Kenya’s coalition government also condemned the Sudanese leader’s participation after accusing some within the Kenyan administration of keeping his visit under tight wraps. A group of Kenyans also demonstrated demanding Mr. Bashir’s arrest.

Local media reported that some European Union envoys, as well as human rights activists, boycotted the state luncheon following the promulgation of the new constitution to protest President Bashir’s attendance.

Prime Minister Odinga said he was demanding answers from his party’s partner in the unity government adding that they were surprised when Mr. Bashir’s name was mentioned during the ceremony.

“I have said we want a proper explanation as to how this was done and why we were not informed that Mr. Bashir was going to come because we are a partner in a coalition and we had agreed on a list of guests who were supposed to be invited to the ceremony and (Mr.) Bashir was not one of them,” Prime Minister Odinga said.

But, Kenya’s Foreign Minister, Moses Wetang’ula, was quoted as saying President Bashir was invited alongside other heads of state from neighboring countries “because it was in Kenya’s best interests that Sudan gets lasting peace.”

Prime Minister Odinga said the country would have to apologize to the international community over Mr. Bashir’s invitation and participation.

“Over issues like this there must be proper and thorough consultation before anything like this happens. And, we also want an apology made to the international community, particularly ICC, because we are a signatory and party to the Rome Statute,” Prime Minister Odinga said.

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South Africa Public Services Strike Enters Second Week, May Expand

The spokesman for the Congress of South African Trade Unions (COSATU) told VOA public sector workers will continue to strike Monday to press their demand higher pay and housing allowance increases than the government has offered.

Patrick Craven said, despite promises, the government of President Jacob Zuma has done very little to begin another round of negotiations to resolve the dispute.

“We haven’t heard anything definite from the government. They say that they want to reach a settlement as quickly as possible, but they haven’t yet come forward with concrete proposals for meetings, for which (we) put in a new offer on the table.  And, on the contrary, unfortunately, they are making a lot of quite provocative remarks about trying to force people back to work, which is obviously not helpful at all,” he said.

Craven also said that there is need for the government to present an urgent new offer which he said could be negotiated to enable workers to get back to work.

Last Wednesday, an estimated one million public service workers went on a one-day strike to press their demand for a wage increase.

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The workers want an 8.6 percent pay rise, about double the current inflation rate of 4.2 per cent, as well as a 1,000 rand ($137.22) monthly housing allowance.

But, the South African government offered the workers a 7 percent increase and 630 rand ($86.44) monthly housing allowance.

Analysts say the government wants to avert a prolonged nationwide strike that could potentially impede South Africa’s burgeoning economy.

Observers say the ruling African National Congress Party (ANC), which draws considerable support from COSATU, will want to resolve the stalemate ahead of the party’s policy-setting meeting which is scheduled for next month.

Local media reports that one of the unions representing tire makers will also begin their strike Monday to demand higher wages.

Analysts say the strikes are putting pressure on President Zuma’s administration to deliver on promises of improved living conditions.

COSATU spokesman Craven the unions are open to positively engage the government to end the impasse over their pay increase demand.

“The unions have made it clear throughout this dispute that they are always ready to re-open negotiations and look at new proposals. But, this has not been yet forthcoming from the government, and so it is very frustrating for the union leaders. But, obviously, we will keep putting the pressure on behind the scenes to try to get some progress,” he said.

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UN: Floods in Niger Displace 200,000

The United Nations is appealing for help for Niger, where it says floods have displaced nearly 200,000 people in recent weeks.

The U.N. Office for the Coordination of Humanitarian Affairs says shelter materials and blankets are urgently needed.

Food and mosquito netting are also in short supply.

The floods are compounding the misery in Niger, which was already experiencing a severe drought and food shortages before the rains hit.

The floods washed away the few crops and vegetable gardens that were starting to sprout.

A representative of the British-based charity Oxfam in Niger told VOA last week that people there are "extremely desperate."

Some information for this report provided by AFP.

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Uganda's Museveni to Seek Fourth Term

Ugandan President Yoweri Museveni says he will run for a fourth term next year.

A statement from the president's office says Mr. Museveni announced his plans late Saturday at a conference of the ruling NRM party.

He said he has turned in his nomination papers to be the party's chairman and presidential flag-bearer.

Mr. Museveni has ruled Uganda since seizing power in 1986. Since the advent of elections in 1996, the president has won three five-year terms.

He won the most recent election in 2006 with 59 percent of the vote. The opposition, led by Kizza Besigye, accused the president of rigging that poll.

Uganda used to have presidential term limits but they were removed by parliament in 2005. The next elections are scheduled for February.

Some information for this report was provided by AP.

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Kenya Defends Bashir Visit as Necessary for Regional Peace

Kenya has rejected international criticism over the inclusion of Sudanese President Omar al-Bashir in Friday's Promulgation Day festivities.  The east African nation has defended its actions as necessary for regional stability and national security.  

At a news conference in Nairobi, members of the Kenyan government defended the decision to invite controversial Sudanese leader Omar al-Bashir to the Friday signing of the country's new constitution.  The International Criminal Court has issued two warrants for Mr. Bashir under allegations of war crimes, crimes against humanity and genocide in Darfur.

Kenya, a signatory to the court, was blasted by the international community for failing to arrest Mr. Bashir and present him to The Hague.  

The court's judges expressed even stronger disapproval Friday, saying Kenya has a clear obligation to enforce the warrant.  The court referred the matter to the U.N. Security Council, asking the body to take "any measure they may deem appropriate" to resolve the issue.     

But Transport Minister Amos Kimunya explained Kenya's obligations under the Court were not the only factors that influenced the country's policy regarding Sudan.

"National interests come first; regional interests come second in ranking," he said. "Regional interests include our membership in IGAD, COMESA - where we are members with Sudan - and African Union, where we are obligated as African Union by the decisions of the Union."

Kimunya was referring to a 2009 decision by the African Union to ignore Mr. Bashir's arrest warrants.  The decision was made after the U.N. Security Council ignored an AU request to defer the warrant for one year in the interest of peace.

According to Kenya's Ministry of Foreign Affairs, Mr. Bashir's invitation was also extended in the interest of regional stability.  Sudan is just months away from a January referendum that many expect will split the country in two.  The referendum is the final step of the Comprehensive Peace Agreement, which ended 20 years of civil war between the government in Khartoum and rebels in the south.

In a statement, the Ministry explained President Bashir and Southern Sudanese President Salva Kiir were invited to the ceremony and frequent interaction with both parties is necessary to push for the implementation of the peace agreement as well as the referendum.

But Mr. Bashir's presence at the Promulgation ceremony complicates Kenya's relationship with the international court.  ICC Prosecutor Luis Moreno-Ocampo is investigating alleged crimes against humanity committed after Kenya's disputed 2007 presidential election.

More than 1,000 people were killed in early 2008 after President Mwai Kibaki and Prime Minister Raila Odinga accused each other of rigging the vote.  It is believed that many prominent Kenyan businessmen and politicians played a role in funding and organizing the ethnic violence that rocked the country.

Kenya has promised to cooperate fully with Moreno-Ocampo, but recent events have cast doubts over the country's commitment to justice.  

Former U.N. Secretary General Kofi Annan said Sunday he was surprised by the presence of Mr. Bashir and urged Kenya to clarify its position and reaffirm its commitment to cooperate with the Court.  

Assistant Minister of Foreign Affairs Richard Onyonka said Mr. Bashir's visit had no bearing on the ICC investigation in Kenya.

"We will continue with the arrangements which we have with the International Criminal Court to make sure that any individuals who may have participated in committing crimes against humanity and other crimes during the post-election violence will be prosecuted," he said.  "We will take this to its logical conclusion.  As far as we are concerned, the two issues between what has happened in President al-Bashir coming to the country and us being a signatory to the International Criminal Court and having issues pertaining to the post-election violence are mutually exclusive."

Moreno-Ocampo is expected to return to Kenya in October to continue his investigation into the post-election violence; the prosecutor has indicated he will bring charges against six suspects when he presents his case to The Hague at the end of the year.

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Libyan Leader Visits Italy to Mark Improved Relations

Libyan leader Colonel Moammar Gadhafi is on a three-day visit to the Italian capital to mark the second anniversary of a pact between the two countries that normalized relations and closed the painful chapter of Italian colonization.

Colonel Gaddafi has pitched a giant traditional Bedouin tent for his three-day visit to the Italian capital. The tent has been placed in the garden of the residence of the Libyan Ambassador to Italy, Abdulhafed Gaddur.

The Libyan leader's visit to Italy will mark the second anniversary of the signing of a $6 billion accord under which Rome agreed to pay reparations for its colonial rule of Libya between 1911 and 1943.

For the occasion, an equestrian show will be held, for which Libya has sent 30 Berber horses and riders. Traveling with Colonel Gadhafi are also 40 "Amazonian" bodyguards, a unique contingent made up of just women. A gala dinner for 800 guests is also planned for after the show.

But protests are planned in Rome, outside the Libyan embassy and elsewhere. There are many who oppose the Italian government's relationship with the Libyan leader.

The deal signed between Colonel Gadhafi and Prime Minister Silvio Berlusconi in August 2008 included an Italian commitment to build a 2,000-kilometer freeway along the Libyan coast. There is also a controversial agreement between the Libyan and Italian navies to stop African immigrants reaching Italy.

This initiative has been sharply criticized by human-rights groups, who say that after being forced back to Libya boat people are sent to squalid detention centers. But the Italian government has always maintained the immigration agreement is of utmost importance.

Speaking last year, Interior Minister Roberto Maroni said Italy "has the moral duty, before the right, to fight the traffic of human beings in every way in every form and with every measure."

The Italian government insists the immigration deal is a success, pointing to the significant drop in arrivals of immigrants on Italian shores.

Colonel Gadhafi and his entourage are also scheduled to meet with Italian business leaders in Rome. A separate agreement signed between Italy and Libya provides for Italian defense contracts in Libya and oil and gas concessions for Italian energy companies such as ENI and Enel.

Speaking at a conference in Italy last Thursday, ENI chief executive Paolo Scaroni confirmed his oil company's plan to invest $28 billion in Libya during the next 10 years.

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ICC Asks UN to Act Against Kenya

The International Criminal Court is asking the U.N. Security Council to take action against Kenya for hosting Sudan's president in defiance of international warrants for his arrest.

ICC judges in The Hague said Friday Kenya has a "clear obligation" as a member of the court to cooperate in enforcing its arrest warrants for Sudanese President Omar al-Bashir.

Mr. Bashir was one of several regional leaders who traveled to Nairobi for Friday's ceremonial signing of the new Kenyan constitution.  Kenyan Foreign Minister Moses Wetangula says Mr. Bashir was invited because he is the head of a friendly neighboring state.

Mr. Bashir is wanted by the ICC on charges of war crimes, crimes against humanity and genocide in Sudan's Darfur region, where the government has been been fighting rebels since 2003.  The United Nations estimates the conflict has killed 300,000 people.

The ICC said it is reporting Kenya to the U.N. Security Council in order for the Council to "take any measure it may deem appropriate."

U.S. President Barack Obama said Friday he is "disappointed" that Kenya hosted President Bashir, and he urged Nairobi to "honor its commitments to the ICC and to international justice."

The ICC issued its first arrest warrant against Mr. Bashir in 2009.  Since then, he has visited several regional states that are not full members of the court, including Egypt, Eritrea, Ethiopia, Libya, Qatar and Saudi Arabia.

Kenya is the second full ICC member to invite Mr. Bashir in defiance of the warrants.  Chad became the first when it hosted the Sudanese president earlier this year.

Rights activists say Kenya's hosting of Mr. Bashir raises questions about its commitment to cooperate with ICC investigations of the country's post-election violence of 2007 to 2008.

ICC prosecutor Luis Moreno Ocampo is investigating allegations of crimes against humanity committed during the unrest and expects to charge several suspects by the end of this year.

Some information for this report was provided by AP, AFP and Reuters.

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