Ebola epidemic has exposed Africa’s disaster unpreparedness

The World Health Organization (WHO) has now declared the killer Ebola epidemic ravaging parts of West Africa an international health emergency and appealed for global aid to help the afflicted countries. This comes after the epidemic continued to spread, affecting more countries, the latest being Nigeria, and humanitarian agencies responding to it admitted that they were over-stretched and there were few resources to respond to the disaster. The latest reported cases bring the total number up to 1,711 across the four countries, with 932 deaths-the worst Ebola outbreak in history.

One outstanding face of the efforts to save lives in this has been the profound Western response to it, as though it were the hardest hit. Just to mention, the US CDC has sent its 60 best scientists to West Africa, the World Bank has pledged USDs. 150 Million, and the British Parliament spared time to debate the crisis. With her better science and technology, the west has always been there to bring us up in our lowest moments of need.

Urbanization, travel and the personal connections that come with economic development and weaker and/or unadhered-to policies appear to have helped the virus spread. At the same time, a more formidable health-care infrastructure that could go a long way to stopping Ebola before it reaches outbreak status has not kept pace, and in some countries were just too weak. More health workers have been in demand, and in some cases, the few available have been demotivated to serve their people. Right through the disaster, Nigerian doctors have been on strike over poor pay and Liberian nurses have been on strike over lack of basic protection while handling the Ebola patients; cultural beliefs related to hygiene and sanitation habits have exposed weaker health education systems and admissions of failure by West African governments have confirmed our fears of vulnerability in times of disaster.

The African Union has ubiquitously remained silent and disinterested in mobilizing African resources to complement the efforts by others. This is the time for the Africa Union to develop a response plan unique to the African factors contributing to the spread of the disease. It would be better if even indigenous organizations were largely involved in using the USDs. 60 Million contributed by the African Development Bank (AfDB) towards containing the scourge.

It has also pointed to our weak disaster response plans. This Ebola has caught everyone by surprise because most Ebola outbreaks occur in Central Africa, where it originated. A 2012 World Risk Report notes that 13 out of the 15 most vulnerable countries globally are African, solely because of their low coping and adaptive ability in the event of disasters. Though early warning systems in the continent are lacking and need improvement, there is also a need to fill the void between the dissemination of this information and the ability to act on it. Only 25 African countries have established national policies and strategies for risk reduction and worse, only 13 have set aside funds from their national budget towards this cause.

These said, Africa MUST learn and (collectively) document quick lessons from this, so that the next epidemic disaster (God forbid) does not happen on our land again. One most important one: let us invest in more and diverse health human resources, effectively train and properly motivate them better for stronger disease control and emergency surveillance and response systems.

The Writer is a Kenyan Public Health Expert on Community Mobilization based in South Sudan (chrispory.juma@gmail.com)

Climate change is the biggest threat to public health, GCHA urges action

International Health experts, the Global Climate and Health Alliance (GCHA), have added their voice to the climate action movement, arguing that the health risks posed by a global temperature rise are too grave to ignore. The health professionals are basing their argument on the UN’s Intergovernmental Panel on Climate Change's (IPCC) Fifth Assessment Report on climate change, which was released on Monday to intense global interest. 

The IPCC's ‘Climate Change 2014: Impacts, Adaptation, and Vulnerability’, affirms that humans are responsible for the earth’s warming which is having a devastating impact on communities globally. According to the United Nations’ World Meteorological Organization (WMO) the period from 2001-2010 was found to be the hottest decade on record.

People in the developing world are disproportionately affected by this rise in world temperature, with lower crop yields resulting in rising levels of under nutrition. This climate induced problem stunts child growth and inhibits full development. Similarly, weather disasters such as last year’s Typhoon Haiyan have had a severe and resoundingly negative impact on local communities, with significant numbers of casualties left in their wake.

Drawing on the IPCC’s data, the Global Climate and Health Alliance (GCHA) has developed a briefing report to highlight the precise health implications of climate change. Sue Atkinson, Co-Chair of the Climate and Health Council describes the rise in temperatures as the “biggest threat to public health” and notes that without “urgent action to curb emissions, both by individuals and organisations, the impact on the health of many will continue to increase”.

The GCHA believes the UNFCCC conference in Paris 2015 presents a key opportunity for tackling this alarming problem, and urges political leaders worldwide to commit to a binding and ambitious climate treaty. However, the health coalition also emphasize that small-scale actions such as increased use of bicycles can tackle greenhouse gas emissions effectively while also having a significant health benefit for individual cyclists.

Gary Cohen, President, Health Care Without Harm, has stressed that those in the medical profession must demonstrate climate leadership by “by anchoring the community response to extreme weather events, leading by examples in mitigating its own climate footprint and becoming powerful messengers for climate policies that will improve the health of our communities and the planet.”

Mark Kenber, CEO, The Climate Group, responded to the GCHA's report by drawing attention to the threat climate changes poses to international water security: "It is very encouraging to see such eminent international health experts lend their voices to the campaign for action on climate change. Climate scientists have predicted that the rise in global temperature will have a significant impact on drinking water both in terms of quantity and quality."

Borrowed from http://www.theclimategroup.org/what-we-do/news-and-blogs/if-human-health-is-to-be-protected-climate-change-must-be-tackled-global-health-leaders-urge-leaders-to-act/

Water Bill 2014 will enhance Water Sector gains

The CoK 2010 provided for opportunities that were meant to equally distribute resources and make services more accessible to citizens. It created devolution which placed water services delivery and storm water management in the hands of County Governments, entrenched citizen participation and broadened the bill of rights to explicitly espouse the right of access to safe water in adequate quantities. There was therefore need to align the water sector to these realities. The ongoing alignment process therefore provided an opportunity for sector institutions, the public, CSOs and development partners to move to a more targeted and integrated sector governance approach.

The Water Act 2002 has made great gains: The water sector has attracted more resources which confirm commitment and confidence by government and development partners respectively to the reform, there has been socially responsible commercialization of water services sector which has been successful in urban areas, there is more stakeholder participation and gender mainstreaming, there is improved ring-fencing of revenues, water resources increasingly receiving the desired attention as their management is more delegated to the grassroots and the sector is nowadays receiving manpower of varied skills. The Water Bill 2013 upholds the basic tenets of the Water Act 2002 and if correctly implemented could preserve and extend these gains made since 2002 hence improved accountability and transparency in water governance.

The Bill establishes bodies to be in charge of water resources, services, financing and disputes resolution; Water Resources: Are national assets belonging to all Kenyans. The Cabinet Secretary in charge of water affairs sets policies. The Water Resource Regulatory Authority (WSRA) sets and monitors rules and regulations.  Basin Water Resource Boards (BWRB) prepares and implements strategic basin water resource plans. Counties are represented on the BWRB; possibly on a rotational basis in a situation where the number of counties concerned exceeds the available seats. Water Resource Users Associations (WRUAs) with their current functions are established at the level of sub-basins and catchment areas. The Bill establishes the National Water Storage Authority (NWSA) responsible for national water works.

Water Services: Is primarily the responsibility of the county and inter-county governments, with the latter handling water supply systems covering several counties. The Bill upholds ring-fencing and regulation, i.e, what is paid for the water is used for water. Water Service Providers (WSPs) are licensed by the Water Service Regulatory Commission (WSRC). County Governments can take up water service provision instead of contracting companies. On the other hand, Water Works Development Boards (WWDB) plan and develop national water service works in consultation with the counties concerned. There are also Water Consumer Groups (WCGs), which provide for citizen participation in water service delivery. Currently, there are eight Water Action Groups across the eight Water Service Boards in Kenya.

Financing: The mandate of the WSTF (Water Sector Trust Fund) would extend to community initiative for water conservation. Communities in hard it Counties such as Kitui, Marsabit and Garissa should now be able to initiate community owned water supply projects.

Dispute resolution: The Bill establishes the Water Tribunal as a sub-ordinate court within the judiciary along the Land & Environmental Court mandated by the CoK. This should handle water related issues like the cross-county conflicts that have surfaced between Nairobi and Murang’a Counties.

With Devolution now fully running and various County Governments rolling up their sleeves to fully serve citizens, it would be great to finalize the enactment of the Bill for smoother transition. The pressure is already building up on many of them to find both short and long-term solutions to insistent low water coverage. Counties like Homa Bay and Siaya continue to have acute water shortages inspite of being close to World’s second largest fresh-water lake and surrounded by many permanent rivers. Counties now need a national framework to guide their processes of formulating county-based water laws which would inform investments and budgetary priorities; of course water is top priority for many Counties.

With many unmet objectives under the millennium development goal on water, a new water law would create a good environment even as we begin discussions on the post-2015 goals on water. More than  40% of Kenyans still do not have water and sadly, some Water Companies like the Nairobi City Water and Sewerage Company (NCWSC) plan to make water more expensive inspite if its scarcity and quality questions. This in itself is not in line with the Jubilee Government’s manifesto on water which went ahead to promise Kenyans piped tap water at their doorsteps by 2020.

The Commission for the Implementation of the Constitution (CIC) has uploaded the Bill on its website and there is still window for sector players’ inputs. Non State Actors such as Kenya Water and Sanitation CSOs Network (KEWASNET) and Water and Livelihoods Network (WALINET) have since 2012 engaged partners in consolidating inputs through position papers and policy briefs to be presented to the CIC and The Directorate of Water Sector Reforms. The Bill has been officially gazetted and shall be presented to Parliament for debate.

The writer is a Kenyan Public Health Officer based in South Sudan (chrispory.juma@gmail.com).