Uganda tests out rubber band circumcision

With trousers around his ankles, Justin Igalla awaits a tight rubber band for his foreskin, an innovative non-surgical technique rolling out in several African nations to encourage circumcision and cut HIV infection rates.

The simple device – two plastic rings and an elastic band – cuts off blood supply to the foreskin, which then shrivels and is removed with the band after a week.

“I felt nothing, not even a little discomfort,” Igalla said after a procedure taking just minutes, noting there was no blood – unlike traditional circumcision where the foreskin is sliced off by knife – thus reducing the risk of infection.

Igalla, a father of two, said he opted to have his foreskin taken off for “health reasons”.

Scientists have found that male circumcision can significantly reduce the chances of HIV infection because the foreskin has a higher concentration of HIV-receptors than the rest of the penis and is prone to tears during intercourse, providing HIV an entry point.

As well as Uganda, the device is being used in Botswana, Kenya, Mozambique, South Africa, Zambia, Zimbabwe and other sub-Saharan countries. All have been identified by the World Health Organisation (WHO) as “priority” states where the risk of acquiring HIV is high and male circumcision, and access to conventional surgical procedures, is low.

Uganda hopes the device, called PrePex, will convince adult men to be circumcised as part of the battle against Aids, now resurgent in the East African nation after years of decline, with as many as 80 000 people dying of the disease every year.

PrePex, a non-surgical circumcision device. (Pic: AFP)
PrePex, a non-surgical circumcision device. (Pic: AFP)

From a peak of 18% infected in 1992, Uganda’s “ABC” strategy – Abstinence, Be faithful, Condomise – helped slash rates to 6.4% in 2005.

But rates have crept back up, to 7.2%  in 2012. As many as 1.8 million people in the country now live with HIV, and a million children have been orphaned after their parents died of Aids.

The makers of PrePex boast that a man “can resume work and almost all daily activities shortly after the procedure,” with the device “designed to be placed, worn, and removed with minimal disruption”, although they should abstain from sex for six weeks afterwards.

Doctor Barbara Nanteza, male circumcision project manager at Uganda’s Aids Control Programme, said that trials had shown that circumcision reduced risk of transmission from a woman to a man by as much as 60 percent.

Although some contest the validity of these studies, WHO and the United Nations Aids programme push circumcision as an additional prevention measure in high-prevalence countries where HIV transmission is predominantly heterosexual.

The WHO says there is “compelling evidence” circumcision reduces risk of heterosexually acquired HIV infection in men. The organisation has “prequalified” PrePex, meaning the device has been assessed and meets international standards for efficacy and safety.

And with health budgets already overstretched, the device offers a cheaper way to tackle the problem, Nanteza said.

“If circumcision can help reduce the cost, that could very good for the country,” she told AFP.

Uganda, long praised for its efforts in the fight against Aids, launched a general circumcision programme in 2010, when some 9 000 had the conventional treatment.

Since then 1.2 million men have been circumcised – or 13% of men over 15, including 800 000 last year alone, the health ministry said.

The introduction of the PrePex device is expected to boost numbers even further – but it’s still not enough, according to Nanteza.

Though the device greatly reduces the pain of traditional circumcision, she conceded the issue remained an awkward one for married men.

“It is difficult for them to explain to their wife that they want to get a circumcision to prevent HIV infection when they are supposed to be faithful to them,” Nanteza said.

Despite massive health awareness campaigns, problems remain.

James Brian, a counsellor with the Walter Reid Project, a US-based medical organisation supporting the programme, said it was essential to emphasise that while circumcision reduces the risk of infection, it does not prevent it.

“After circumcision someone should not think that they are immune against HIV,” Brian said, who works with patients to highlight the continuing need to practise safe sex.

Emmanuel Leroux-Nega for AFP

Malawi’s prized chambo fish faces extinction

In the decade that fisherman Edward Njeleza has been trawling the deep, clear waters of Lake Malawi in Africa’s Great Rift Valley, he has seen his once abundant catch shrink by 90 percent.

Now he spends most days on the shore searching for pods and a special type of grass he uses to make necklaces, key rings and bracelets to supplement his income.

In the past, he and his nine fishing mates would on average catch roughly 300 kilograms (650 pounds) of fish a day, but that haul has dropped to no more than 25 kilograms, he told AFP.

“We go fishing but never come back with much,” said Njeleza, waiting by the lake with a bag full of homemade jewellery slung over his shoulder.

“And we don’t catch big fish.”

Malawian fishermen pulling up fish in their nets on the shores of Lake Malawi. (Pic: AFP)
Malawian fishermen pulling up fish in their nets on the shores of Lake Malawi. (Pic: AFP)

Lake Malawi, one of the deepest in the world, is estimated to have the largest concentration of freshwater fish species – up to 1 000, according to the UN Scientific and Cultural Organisation (Unesco).

And a local favourite, the Oreochromis lidole or “chambo” as it is known in this landlocked southeast Africa state where it is a vital source of protein for millions of poor, is among the hardest hit.

In its last study on chambo, the International Union for the Conservation of Nature estimated in 2004 that the population had declined 70 percent over the previous 10 years, William Darwall, head of the IUCN’s freshwater biodiversity unit, told AFP.

Overfishing is the main cause, and scientists blame both a lack of government muscle to enforce seasonal fishing bans as well as environmental degradation.

“The primary reasons why the fish stocks, specifically chambo, are going down is overfishing, (and) degradation issues because of factors related to the effects of climate change,” said William Chadza, director of the Centre for Environmental Policy and Advocacy in Blantyre, the country’s finance and commerce hub.

Climate change is said to have affected rainfall patterns and caused a drop in the lake’s water levels, also hit by the effects of deforestation on tributaries feeding the lake.

‘Going towards a disaster’
In Makawa fishing village near Mangochi town in the country’s southeast, Njeleza has no choice but to diversify.

Apart from making jewellery, he hopes to bait the odd tourist visiting the lake into a ride in his blue and white boat, which he has named Wanangachi, meaning “What is the problem with us?”

At night he returns to fishing, but stays much longer than in previous years.

“We used to spend just about two hours out on the lake and come back with a boatload of fish – now we need about 12 hours, and bring back less than before,” Njeleza said.

Some officials fear chambo could face extinction in Lake Malawi.

“It’s a very big issue, and I think if we don’t do something … we could be in a dire state shortly,” Chadza told AFP.

But rangers say the fight to save the fish is a losing battle.

“We are not winning,” said Gervaz Thamala, chief of the Wildlife and Environmental Society of Malawi.

Laws to protect the chambo exist, but “the major problem which we have is governance,” Thamala said.

“It seems we are going towards a disaster, which is quite critical,” he warned. “Extinction is also a possibility because we have not fully developed the aquaculture sector, which could act as a buffer.”

Back at the lake, Dogo Morris leads a team of 10 fishermen pulling in their nets, cast six hours earlier, but their haul is only about 10 kilograms of fingerlings.

“I have nothing to sell today,” he tells more than a dozen would-be customers, who walk away dejectedly clutching their empty bowls.

Fishmonger Raymond Johnson, who supplies hotels and restaurants in Blantyre, Malawi’s largest city, has waited three days to purchase chambo, which he buys in bulk – hundreds of kilograms per trip to the lake.

“My business is not doing well. It has gone down by 40 to 45 percent,” said Johnson.

Back in Blantyre, restaurant owners share his despair, saying diners complain that the fish on their plates are getting smaller all the time.

Susan Njanji for AFP

Nigeria shuts sports bars in bid to stop World Cup attacks

Soldiers in a Nigerian state at the heart of an Islamist revolt shut down all venues preparing to screen live World Cup matches on Wednesday, hoping to stave off the kind of attacks that have killed more than 20 people in the past two weeks.

The Nigerian government also advised residents of Abuja to avoid public viewing centres as the 2014 World Cup kicks off in Brazil in case of attacks.

Nigeria has seen an increasingly bold series of assaults over the past five years by the Islamist militant group Boko Haram, including the kidnapping of more than 200 schoolgirls in April.

Since then, militants have set off a car bomb that killed 18 people watching a game on television at a centre in the settlement of Gavan, in the northeastern state of Adamawa, on June 1.

A week before, a suicide bomber set out for an open-air screening of a match in Nigeria’s central city of Jos. His car blew up on the way, killing three people.

Such assaults on often-ramshackle television viewing centres across Africa have raised fears militant groups will target supporters gathering to cheer on the global soccer contest.

“Our action is not to stop Nigerians … watching the World Cup. It is to protect their lives,” Brigadier-General Nicholas Rogers said on Wednesday in Yola, the capital of Adamawa state, which has been hit regularly by Boko Haram raids.

Many fans had been relying on the viewing centres – often open-sided structures with televisions set up in shops and side streets – to watch live coverage of their national squad, the “Super Eagles” – seen by many as Africa’s main champion in the contest.

The Nigeria team ahead of their international friendly soccer match against Scotland at Craven Cottage in London on May 28 2014. (Pic: Reuters)
The Nigerian team ahead of their international friendly soccer match against Scotland at Craven Cottage in London on May 28 2014. (Pic: Reuters)

Minister Bala Mohamed issued a directive for Abuju ordering high vigilance in places such as motor parks, restaurants, markets, supermarkets, shopping malls, banks, churches, mosques, hotels, viewing centres and hospitals.

“Apart from installing separate close circuit televisions (CCTVs), they are required to liaise with appropriate security agencies and engage well trained uniformed security personnel who shall be equipped with bomb detectors,” the minister said.

The shutdown in the impoverished regional state bordering Cameroon came a day before the tournament’s opening ceremony and first match between Brazil and Croatia.

But vegetable-seller Mary Toba said she welcomed the decision, especially after the Gavan blast.

“I had told my husband and children they would have to kill me before I let them go out to watch football. I have dreams about the danger … I thank the military for their action,” she told Reuters.

Boko Haram has declared war on all signs of what it sees as corrupting Western influence.

Security experts have said the viewing centres’ combination of soccer and, sometimes, alcohol made them a target.

Authorities have issued warnings about going to the venues in Kenya, Nigeria, and in Uganda, where memories are still fresh of bomb attacks on two centres that killed at least 74 people watching the last World Cup final.

African Wikipedia aims to preserve traditions and languages

Offline, off road and off the power grid, the forest village of Ndjock-Nkong in Cameroon is not an obvious choice for an online venture seeking to emulate the giant online encyclopedia Wikipedia.

It is, however, a perfect place for an online African “ark” that will collect and preserve the continent’s endangered languages and traditions, says a local man with a mission.

Gaston Donnat Bappa embodies the combination of old and new: he inherited the title of clan chief from his great-grandfather, grandfather and father but has 34 years of experience in computer technology. He hopes to bring the two worlds together in the user-generated African Traditions Online Encyclopedia (Atoe).

Gaston Bappa is keen to preserve Africa's heritage. (Pic: Terry Morris)
Gaston Bappa is keen to preserve Africa’s heritage. (Pic: Terry Morris)

“People think traditions don’t belong with information and communications technology (ICT) because traditions are so far behind us and ICT is so far ahead of us,” Bappa said. “But if you don’t know who you are, you don’t know where you are going.”

Bappa (56) is creating a site that he hopes will become the first port of call for African arts and crafts, food, laws, medicine, music, oral storytelling, religion, science, sport – anything that can be defined as tradition, dating back millions of years. A prototype is open for contributions, with early entries including Myths and Legends of the Bantu, and Concepts of Social Justice in Traditional Africa .

The idea grew from Bappa’s passion for beliefs and customs from a young age in his village, Ndjock-Nkong, where he has been chief for 22 years, as well as his travels to more than 20 African countries as a senior IT engineer and consultant and bank executive. Most urgently, he found in the web a chance to rescue a precious legacy on the verge of extinction.

“I saw that even in my tribe traditions are beginning to disappear. When I was going to other countries in Africa I saw it was the same. It’s not because young people don’t want to learn about them but because they don’t have the access in urban areas.”

Languages are a prime example, said Bappa, president of an association of 42 traditional chiefs. “Every week we lose a language in the world. Africa has more languages than any other continent – more than 2 000 – and every one has 30 to 50 tribes. If you lose the language it’s very difficult to know the traditions of your area.”

But the Atoe will guard against forgetting, he hopes. “ICT is the only way to store traditions for the next generations. Between now and 2100 there will be 4 billion people in Africa; if we don’t know our traditions, we won’t be able to manage our economic development. They can also be available to the African diaspora in America, Europe or anywhere in the world.”

The success of Wikipedia, whose English edition has more than 4.5-million articles, is a natural model. Similarly, the Atoe will use wiki applications for volunteers to input, change or remove content in collaboration with others. Noting that there are already more than 1 000 websites on African traditions, Bappa is adamant that content will be referenced and verified for accuracy.

“The Wikipedia format remains the best international standard for online encyclopedias: the entire software is free of charge and provides the best and easiest technology. But we will improve the format of content, by integrating more multimedia. For example, we will illustrate African traditional medicine with pictures.”

But unlike Wikipedia, born in 2001 and hosted by the Wikimedia Foundation in the tech hub of San Francisco, the Atoe’s headquarters will be starting from scratch. Ndjock-Nkong is 93 miles from Cameroon’s capital, Yaoundé, and 19 miles from the main road in thick forest, Bappa says. “To get there you need a very strong car.” There is no access to a phone network, the internet or the electricity grid for the dwindling population of fewer than 300. “Even radio reception is very difficult.”

Yet Bappa has a vision. He hopes to fit solar panels to generate power and install servers that will eventually host the Atoe. “Little by little, the government is starting to repair the road. In less than three years, we’ll have TV and radio. We will bring satellite internet to the village so it is connected to the entire world. When we have our own servers, we’ll transfer all the data.”

Until then, Bappa is operating from Yaoundé and working to raise worldwide awareness of the project, which he will formally unveil at next year’s eLearning Africa conference. He plans to approach Microsoft and other potential sponsors in an attempt to raise €400 000 (£323 000) for the initial phase. He also hopes to incorporate content from Wikipedia.

“It is not only for Africa,” he said. “It will be open to all worldwide, Africans and non-Africans. It is for the whole of humankind because Africa is the cradle of humanity.”

Africa’s women entrepreneurs take the lead

Madinah Nalukenge recalls the day she set out to sell food on the filthy edges of a bus terminal in the Ugandan capital in 2004. She had just $10 left over from a failed attempt to sell bed sheets.

Now she runs a catering business that makes a monthly profit of up to $3 000, a source of pride for the 34-year-old single mother who spends her days offering plates of mashed plantain and greasy meats to transport operators in downtown Kampala.

“There is a lot of money to be made here,” she said recently, her apron bulging with cash. “I need to stay focused.”

Her competition: More than a dozen other women operating food stalls next to hers.

Madinah Nalukenge serves dishes to customers at her food stall, frequented by transport operators, that she owns on the edge of a bus terminal in Kampala. (Pic: AP Exchange)
Madinah Nalukenge serves dishes to customers at her food stall, frequented by transport operators, that she owns on the edge of a bus terminal in Kampala. (Pic: AP Exchange)

Nalukenge, who did not study beyond grade school, is part of a growing trend in Africa where more women are running businesses on a scale that was unthinkable a generation ago. Africa now has the highest growth rate of female-run enterprises across the world, according to the World Bank.

About 63% of women in the non-agricultural labor force are self-employed in the informal sector in Africa, more than twice the worldwide rate, according to World Bank data, which also shows that necessity – not opportunity – is the main driving force behind female entrepreneurship in poor countries. Women often start by running informal retail or service businesses, but those who are more ambitious have created thousands of jobs in projects that break stereotypes about what women can do, physically and socially, in societies that are still largely conservative.

“Traditionally women would sit at home and wait for the man to return home with a bag of groceries, but this has been changing over time as women’s dependence gradually reduces,” said Thomas Bwire, an economist with Uganda’s central bank. In a sign of the times, he said, Ugandan women now even work at road construction sites.

There are more women than men working in the informal sector in all of sub-Saharan Africa, according to the International Labor Organization. The UN agency’s most recent survey, released last year, noted that this is unlike other regions, including South and East Asia, where informal employment for women tends to be concentrated in home-based, domestic work.

Some of the food vendors in downtown Kampala have remarkably similar accounts of what sparked their entry into private business: Hungry children, unpaid rent and some violent partners. Most of them have long been single or were recently in failed relationships, an important detail because many insist their businesses are succeeding in part because of their independence on the home front. Many of the vendors have also enrolled their children in boarding school to make more time for work.

“They don’t help and they never want to help,” Nalukenge said of her former partners. “Yet even the little you get they want to take away from you. I was alone when I started this business.”

Force for economic growth
Development economists note that if more women are helped to join the labor force, especially through access to credit, they can be a powerful force for global economic growth.

A report released earlier this year by the investment bank Goldman Sachs urged what it called “giving credit where it is due,” noting that women’s “increased bargaining power has the potential to create a virtuous cycle as female spending supports the development of human capital, which in turn will fuel economic growth in the years ahead.”

An estimated $300-billion credit gap exists for female-owned enterprises, according to the International Finance Corp. of the World Bank, which in March launched a $600-million fund to finance women-owned businesses in the developing world. The venture – dubbed the Women Entrepreneurs Opportunity Facility – aims to work with local banks in sharing risks and extending credit to 100 000 women entrepreneurs.

Across sub-Saharan Africa, where poverty remains extreme in many parts, stories of successful women entrepreneurs are accumulating. A Kenyan woman, Mary Okello, is feted for starting, inside a three-bedroom house, what has since become a prestigious group of private schools. In Rwanda, Janet Nkubana has been recognised abroad for running a handicrafts company that employs more than 3 000 women whose baskets can be purchased at Macy’s. The Nigerian Adenike Ogunlesi is famous for her “Ruff ‘n’ Tumble” clothing line for children, a business that she first operated out of a car trunk.

In Uganda, where most of the food is grown locally, many women have been drawn to catering, and their food stalls are ubiquitous at transport terminals and open markets. Unable to get credit from banks, often the women start “cooperative” groups in which they pool savings. Then they take turns getting loans.

“The few who have ventured out have surprised themselves by succeeding,” said Ugandan economist Fred Muhumuza, who has been advising Uganda’s government on development policy. Rampant poverty, he said, is driving women to find ways of taking over “core family responsibilities” from men.

Nalukenge, the food vendor in downtown Kampala, said she has kept her children in school and now owns two small plots of land.

On a recent evening, as she prepared to clean up and pack her saucepans, she pondered her unlikely journey from failed hawker of bed sheets to successful caterer with a long line of loyal clients.

“We spend a lot of energy here,” she said. “There’s no resting. But at the end of the day we get our reward.” – Sapa-AP