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Farm Radio Weekly is a news and information service for rural radio broadcasters in sub-Saharan Africa. It is published by Farm Radio International.

Issue #208

Husbands may represent worse threat to women than gunmen

This week we focus on health issues, starting with a story on violence against women. A new report maintains that, in parts of West Africa that are recovering from recent conflict, husbands present more of a threat to women than armed assailants. Violence against women increases during conflicts, and may persist when conflicts end. Violence against women is a global issue, fed by discrimination against women which is enshrined in law, societies and cultures.

Our second story explores the treatment of disabled children in Togo, but is applicable to all of Africa. When children with various kinds of disabilities are given the opportunity to take part in normal life, rather than being subjected to discrimination fed by fear, shame, and traditional beliefs, they are able to take an active part in society.

In Uganda, cervical cancer, though little-known, is proving deadly. Twice as many Ugandan women die from cervical cancer than from breast cancer.  Health workers worry that, due to lack of knowledge, cervical cancer will continue to go undiagnosed and untreated.

Our final story comes from Rwanda, where a government-operated health insurance scheme is proving challenging for the poor. Not only have annual premiums been raised over the last year, but patients are being asked to pay 10% of the cost of transportation and medical care. One health activist says that increased costs are forcing the poor to turn to traditional healers or self-medication.

This week’s Event section highlights a competition for journalists. Journalists are invited to submit an original piece which investigates the challenges and opportunities for small-scale farmers in value chains, and to showcase success stories and best practices. The top six finalists will be supported to attend an international conference on value chain development in November.

Happy reading!

-The Farm Radio Weekly team

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West Africa: Husbands worse threat to women than gunmen (IRIN)

A recent report from the International Rescue Committee says that in conflict-ridden West African countries, husbands often pose a greater threat to women’s lives than armed assailants.

Even in more stable countries, violence against women has been hard to eradicate.

Mariam Kamara is a mobilization officer at the UN Women-West Africa Sub-Regional office. She says, “Domestic violence is like diabetes. It is a disease that kills and causes damage, but which has not been very well documented.”

The 2012 report found that women suffer cruelty with “shocking frequency” in post-conflict Côte d’Ivoire, Liberia and Sierra Leone,

The report says that “though the focus of the humanitarian community has often been on armed groups, the primary threat to women in West Africa is not a man with a gun or a stranger − it is their husbands.”

The three West African countries are emerging from conflicts that killed thousands of people, displaced hundreds of thousands more, and unleashed widespread lawlessness. Violence against women worsens in times of war and often persists after conflict has subsided.

In Côte d’Ivoire, reported cases of violence against women increased by 40 per cent during the 2010 unrest that followed the disputed presidential elections.

The author of the report, Elisabeth Roesch, says domestic violence is not unique to a particular region or country, and its causes are varied and complex. She continues, “Across the globe, women face violence from their partners because they have lower status, and because they face really widespread discrimination enshrined in law, society and cultures.”

Senegal enacted a law against domestic violence in 1999, but only a handful of offenders have been brought to court. Experts say this is due to the difficulty of obtaining evidence, the expense of medical reports, and the prejudice against women that pressures them not to report abuse.

Benjamin Ndeye is a Senegalese conflict mediator. He says, “In the Senegalese society, it is very important for a woman to be married. If a woman takes her husband to court, it is said that she is not a good wife.” Women often face judges who tend to favour family unity. Mr. Ndeye said he has never seen an abusive husband receive more than a two-month sentence.

Elisabeth Sidibè volunteers for the Committee to Combat Violence against Women and Children in Senegal. She says there have been improvements in recent years: “The police have made a lot of progress − they now tend to refer women to NGOs.”

Fatou Bintou Thioune is the Committee’s coordinator. She says, “We cannot say the issue is not taboo anymore … more and more women are daring to look for help.”

Some NGOs have stepped up the fight against domestic violence by conducting radio and TV talk shows, public debates and legal training. The Association of Senegalese Women Jurists offers legal help to women and has launched a hotline for reporting domestic violence.

But there has been less progress in Sierra Leone, Liberia or Côte d’Ivoire. The IRC report quoted a woman who complained of police complacence about domestic violence. The women said, “Some of the police officers say, ‘It’s because of your ways that your husband beats you.’ ”

Fanta Coulibaly is head of the National Commission against Domestic Violence on Women and Children in Côte d’Ivoire. She says that domestic abuse continues despite the law against it.  She states, “The law alone is not enough. The whole community needs to get involved in the issue.”

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TOGO: Freeing disabled children from damaging customs (IRIN)

Disabled children in Togo are often ridiculed, hidden indoors for years, neglected, and cut off from normal life. This is done out of fear, shame and strong traditional beliefs.

For example, eighteen-year-old Sofia Adama was left disabled by a botched injection when she was a baby. She remembers, “I was told I was good for nothing. Even my brothers and sisters said I was inferior to them, and they mocked me.”

Afi Ouro is another teen, a thirteen-year-old who lives in a small village outside Sokodé. She has epilepsy and often hides in a dark room in her family home. She takes refuge there after being humiliated by villagers, who publicly mock her club feet and ostracize her entire family.

There is no universally agreed definition of “disability.” But disabilities are generally considered to include various long-term physical, mental, intellectual or sensory impairments which interact with barriers in the environment to hinder full and effective participation in society.

Naka Abalo is coordinator of the Community Based Rehabilitation Project, operated by the NGO Plan International in Sokodé, Togo’s second largest city. He says, “Disability is considered a form of sorcery or the result of a demon in the family.”

Neighbours believed that throwing stones at Ouro when she had an epileptic seizure would prevent her from spreading epilepsy. But her parents were convinced she had not been cursed and relentlessly sought medical help.

Ouro’s mother Fatima says, “People told me I was wasting my time and that nothing would change. But then people saw the changes.” After five months in a hospital in neighbouring Benin, Ouro can now walk to school by herself without fear of having a seizure on the way. Fatima says that, though people with epilepsy or disabilities  were once thought of as useless, things are changing and they can integrate into society.

There are an estimated 378,000 children with disabilities in Togo’s population of six million. The UN’s Children’s Fund, or UNICEF, estimates that between five and 10 per cent of African children have disabilities. They are mainly caused by genetic and birth complications, by diseases such as poliomyelitis, measles, meningitis and cerebral malaria, and by poor health and diet.

While marking the Day of the African Child on June 16, UNICEF called for an end to neglecting children with disabilities, and to discrimination and violence against them.  Rosangela Berman Bieler is head of UNICEF’s Disability Unit. She published a statement which stated: “Children living with disabilities continue to be the most excluded among all groups of children in Africa. Only a small portion of them are in school and far fewer receive the adequate inclusive education they need.”

Changing long-held traditional beliefs in Togo will be difficult, but families whose disabled children have received help know that excluding them from daily life is not the answer.

Laure Akofa Tay is the coordinator of Christian Blind Mission in Togo and Benin. She says, “Progressively, when the mentality has changed, we will overcome this. Then we can move disabled children from the shadows into a society that knows how to treat them.”

The Togolese government ratified the UN Convention on the Rights of Persons with Disabilities in 2011, and is aware of the added difficulties the disabled must deal with. But the government has not yet established clear measures to help them, or to counter damaging beliefs.

Ms. Tay says, “The government acknowledges that it is an important issue, but they don’t know how to go about it. We need to work closely with the government institutions like the Ministry of Health and the Ministry of Education to… [help formulate] their early protection and rehabilitation programmes.”

She adds, “[Disabled children’s rights are] no different from the rights of all children. We already have human rights, but we need to work on the rights of children with disabilities in Africa. Their rights still need to be communicated.”

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Uganda: Cervical cancer: Little-known but deadly (IRIN)

In the obstetrics and gynecology ward of St. Mary’s Hospital Lacor in northern Uganda’s Gulu District, Apilli Kilara lies on the floor under a blood-stained sheet, staring at the ceiling.

The 43-year-old mother of seven is in the advanced stages of cervical cancer.

She noticed an unusual itching after her fifth delivery in 2007. Then in 2011, after her seventh child, she had sharp pains in her pelvis and irregular bleeding. She remembers, “The pain and bleeding didn’t stop. That’s when I started imagining something was wrong with me.”

Mrs. Kilara could have been treated successfully if the disease was caught early, but she knew nothing of cervical cancer at the time. Now, doctors fear she may not live much longer.

Lying next to her is another patient diagnosed with cervical cancer. Akello (not her real name) is 39. When her symptoms began, Akello thought witchcraft was responsible, and sought treatment from a local healer.

She says, “I had been visiting a traditional herbalist for treatment in vain; that is what women suffering similar ailments in my village do.”

Cervical cancer is the most common form of cancer affecting Ugandan women. Every year, over 3,500 women are diagnosed with cervical cancer, and nearly 2,500 die. In comparison, 1,100 women die of breast cancer every year.

It is estimated that about a third of Ugandan women harbour cervical human papillomavirus − the main cause of cervical cancer − at any given time.

A study from the University of Washington in the US found that three-quarters of all reported cases of cervical cancer now occur in developing countries. Almost half are in women under 50.

Pontius Bayo is head of obstetrics and gynaecology at St. Mary’s Hospital Lacor. He says the hospital has a limited ability to treat women with cervical cancer. Eleven per cent of deaths in the maternity ward result from the disease.

Health workers worry that, due to lack of knowledge, cervical cancer will continue to go undiagnosed and untreated. Mr. Bayo adds, “It’s a concern in a situation where there is no adequate outreach program for screening and treating the disease in its early stages.” In addition, many women diagnosed with cervical cancer cannot afford treatment. Many cannot even afford the fare to the hospital.

The Ugandan Women’s Health Initiative, or UWHI, is a collaborative effort between universities and hospitals to address women’s health issues. UWHI, which conducts cervical cancer screening around Uganda, says even major referral hospitals do not offer regular screening. UWHI’s Tom Otim says, “There is very high need for women and their husbands to be sensitized so that they know the symptoms of cervical cancer.” He emphasizes, “It’s a neglected area that requires attention.”

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Rwanda: Despite health insurance, many Rwandans cannot afford medical treatment (Syfia Grands Lacs)

In Rwanda, having health insurance is no guarantee of receiving medical treatment. Rwandans are required to pay 10% of the cost of medical care. Those who cannot afford modern treatment are turning to traditional healers or self-medication.

Patients are not as keen as earlier to phone 912, the toll-free number for Service d’aide Médicale d’Urgence, or SAMU. SAMU was launched in 2009 to provide emergency support for accident victims and the seriously ill. But since early 2011, SAMU has required that people demonstrate an ability to pay for transportation and medical aid before an ambulance is dispatched.

Patients must pay 10% of the cost of travel — the equivalent of 40 Rwandan francs per kilometre — plus the cost of care during the trip. A villager in Kabuga, 20 kilometres from the capital city of Kigali, says, “When I called the ambulance to rescue my son who had just burned his whole body, I was told that I must first pay FRW 2600 (US $4.30), of which FRW 800 were for the ambulance and the remainder for first aid.” The villager chose not to go to the hospital, knowing that the same amount would need to be paid before his son received any treatment.

At the hospital, the patient must pay 10% of the cost of all materials needed for examinations, treatments, and operations, including syringes, gloves, gauze, disinfectant, serum and even scalpels.  A nurse at the University Hospital of Kigali said, “Even in the case of an operation, all equipment must be provided by the patient. If he is not able to buy it, he cannot have medical examinations, let alone medication.” The nurse explained that patients must go back and forth between health insurance and pharmacies to find the necessary papers and medications.

Since mid-2011, Rwandans have been paying more for health insurance. Annual premiums rose from FRW 1000 per person to FRW 7000, FRW 3000 or FRW 2000, depending on income. This is in addition to the 10% user fees. A nurse in Bugesera in eastern Rwanda says, “A family of six persons in the second category makes annual payments of 18,000 FRW ($30). It is almost impossible for them to pay extra user fees.”

Health insurance covers treatment in public facilities only, not in private establishments. But there are often drug shortages in public pharmacies, and patients must cover the cost of purchasing these medications themselves.

Those in rural areas must pay for transport to hospitals – which are usually in towns – plus lodging. Kantarama lives in Rwamagana, a village in eastern Rwanda. When his son suffered an eye injury, he was transferred to Kabayi in the south of the country. Kantarama says that, because he knew no-one in the region, he had to sell the entire year’s harvest to pay for the cost of transport and lodging.

In 2010, hospitals lost huge sums because many people received medical care but were unable to pay. To limit their losses, the authorities decided that all services must be prepaid. Some institutions will even return an injured person who is unable to pay on arrival. A Kigali-based human rights activist says, “This requirement discourages people and pushes them to go to traditional healers or practice self-medication.” He thinks it would be better to raise premiums than demand money from villagers with little cash to spare.

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Notes to broadcasters on domestic abuse in Africa

Domestic abuse is an issue all over the world. But a recent study from the International Rescue Committee reported that in conflict-hit West African countries, violent husbands often pose a greater threat to women’s lives than armed assailants.

For a link to the IRC report, visit: http://www.rescue.org/sites/default/files/resource-file/IRC_Report_DomVioWAfrica.pdf

Domestic violence is a global problem. According to estimates from the World Health Organization (WHO), violence in the home is the primary cause of injury and death for women aged 16–44 in Europe, more lethal than road accidents or cancer. Indeed, “Violence against women,” said then-UN Secretary-General Kofi Annan in 1999, “knows no boundaries of geography, culture or wealth. It is perhaps the most shameful human rights violation.”

According to WHO, violence affects millions of women in Africa. In a 2005 study on women’s health and domestic violence, the WHO found that 50 per cent of women in Tanzania and 71 per cent of women in Ethiopia’s rural areas reported beatings or other forms of violence by husbands or other intimate partners.

Africa Renewal’s take on gender-based violence: http://www.un.org/en/africarenewal/vol21no2/212-violence-aganist-women.html

For statistics about violence against women in Africa, visit the UN’s UNITE to End Violence against Women’s stats site: http://www.africaunitecampaign.org/wp-content/uploads/2012/06/africaunitefactsheets.pdf

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Notes to broadcasters on children with disabilities

Farm Radio Weekly published the following stories which touch on the issue of persons with disabilities:

Congo-Brazzaville: Growing cassava is not just for the sighted (FRW 135, November 2010) http://weekly.farmradio.org/2010/11/15/congo-brazzaville-growing-cassava-is-not-just-for-the-sighted-spore-syfia-international/

Niger: Woman with disability proves her productivity through gardening (FRW #36, September 2008)

http://weekly.farmradio.org/2008/09/15/niger-woman-with-disability-proves-her-productivity-through-gardening-un-integrated-regional-information-networks/

The same issue of FRW highlighted a resource called Key principles for the disability conscious journalist. See:

http://weekly.farmradio.org/2008/09/15/key-principles-for-the-disability-conscious-journalist/

There are many international statements and declarations which validate the human rights of persons with disabilities. For example, the United Nations’ 1948 Universal Declaration of Human Rights Article 25(1) states: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

The UN has designated December 3 as the annual International Day of Persons with Disabilities. See the website of UN Enable for more on the UN’s work with persons with disabilities: http://www.un.org/disabilities/default.asp?id=17

Farm Radio International’s broadcasting partner agreement form states that, to be a partner, a station must oppose and not condone using radio to promote or spread hate or intolerance based on “ethnicity,  race, language, gender, religion, political affiliation, disability, or other general characteristic or attribute.” http://farmradio.org/english/partners/corner/join_e.doc

Disabilities can be an emotionally charged issue, and there may be strong and differing opinions. If you want to do programming on this issue, one option is to start by giving a general overview of the conditions in which disabled people live. You could also invite a knowledgeable person from government or an NGO who advocates for the rights of disabled people to the studio. Be sure that you and your guests use appropriate language when discussing this topic.

Does your national or regional government have policies on the rights and the treatment of disabled people? If so, ask government spokespeople whether these policies are being honoured. If not, what are the barriers and how can they be overcome? What are the traditional beliefs in your region about people – including children – with disabilities?

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Notes to broadcasters on cervical cancer

Cervical cancer is usually caused by the human papillomavirus, a sexually transmitted virus. It can be treated if identified early. It shows few symptoms, and is usually detected by screening tests. However, many African women do not have access to these tests or the medical facilities that provide them. This is an issue of increasing importance for women’s health in Africa.

For more information of cervical cancer prevention in Africa, visit: http://www.africa-health.com/articles/november_2009/Cervical%20cancer%20prevention%20in%20Africa.pdf

For information on cervical cancer screening in Africa: http://cancercareafrica.org/cervical_cancer.html

For the World Health Organization’s information about cervical cancer in Africa, visit: http://www.afro.who.int/index.php?option=com_content&view=article&id=2810:cervical-cancer&catid=1999&Itemid=2793

and: http://apps.who.int/hpvcentre/statistics/dynamic/ico/country_pdf/XFX.pdf?CFID=444177&CFTOKEN=58630489

You may want to raise awareness of this issue in your communities. It can be a difficult topic to discuss, and it is important that you and your listeners understand the facts about the disease.  Try to find statistics on cervical cancer from your local hospital;  ask a doctor or nurse to explain the symptoms and the availability of screening and treatment.

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Notes to broadcasters on health insurance

Rural workers (including farmers) and workers in the informal sector account for more than 90% of the workforce in Africa, and most have poor access to health care. In most African countries, health insurance is reserved for employees of the public and private sectors. There is no health insurance for the rest of the population.

Many different arrangements have been designed to address this situation.

Here’s a short piece about mutual health societies:  http://www.ilo.org/public/english/region/afpro/abidjan/publ/ilo8/social7.pdf

This website describes a Nigerian program which provides healthcare to low-income communities in two southern provinces for an annual fee:  http://hygeiagroup.com/hchp/

Here are two FRW stories about insurance for farmers:

Uganda: Microinsurance schemes to help farmers deal with unforeseen circumstances (FRW #56, February 2009.) http://weekly.farmradio.org/2009/02/23/1-uganda-microinsurance-schemes-to-help-farmers-deal-with-unforeseen-circumstances-written-by-joshua-kyalimpa-for-farm-radio-weekly-in-kampala-uganda/

Kenya: Livestock insurance will protect livelihoods from drought and floods (FRW #89, November 2009)

http://weekly.farmradio.org/2009/11/23/kenya-livestock-insurance-will-protect-livelihoods-from-drought-and-floods-associated-press-business-daily-ilri/

These Notes to broadcasters on microinsurance from FRW #56 may also be helpful:

http://weekly.farmradio.org/2009/02/23/notes-to-broadcasters-on-microinsurance/

Talk to farmers, extension workers, government workers, farmers groups, health NGOs and private or public insurance companies.  Find out what kinds of health or other insurance are available for farmers and other rural people. What do people do in the absence of health insurance? Do they have health insurance through farmers’ groups? Or perhaps they have home-grown solutions such as rotating savings and loans clubs, loans from relatives, etc.?

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Value chains competition

This competition is designed to encourage journalists from the African, Caribbean and Pacific Group of States (ACP) to investigate the challenges and opportunities for small-scale farmers in value chains, and to showcase success stories and best practices. Journalists are invited to submit one original print or audio-visual piece in English or French. Submission categories include: trends in value chain development, value chain innovations, enabling environments, and sustainability.

The top six finalists will be supported to attend the international conference on value chains development in Addis Ababa in November.

Send your entry to makingtheconnection@cta.int, copying Mikenga@cta.int, by  August 10, 2012.

For more information, visit: http://makingtheconnection.cta.int/awards

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Study of media coverage of women and agriculture

This report from the International Women’s Media Foundation, published in 2009, is still relevant. It examines how African media cover agricultural issues and analyzes whose voices are heard. Its aim is to improve media coverage of the role of African women in agriculture. The study finds that in the three countries addressed in the study, agricultural journalism is both urban and male-focused, while agriculture is often dominated by women in rural areas.

“Sowing the seeds: A Study of Media Coverage of Agriculture and Women in the Agricultural Sector in Three African Countries: Mali, Uganda and Zambia”

To read the report, visit: http://iwmf.org/docs/SowingTheSeeds_final.pdf

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Nigerian radio dramas seek to include community discussion

The African Radio Drama Association, one of Farm Radio International’s broadcasting partners, is using community discussion in conjunction with radio dramas. ARDA is currently producing a weekly drama called “Sweet Motherland.” It explores the challenges communities face in the Niger Delta region, including unemployment, environmental degradation and inter-communal clashes, and provides a forum for discussion. ARDA is a women-led non-profit organization that focuses on different aspects of the radio process, including creative development, production and broadcaster training. To learn more about ARDA or listen to the program, visit: http://ardaradio.org/modules/news/article.php?storyid=1.

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Nutrition – advice to an expectant mother

In keeping with this week’s focus on health issues, our script of the week focuses on nutrition and diet for expectant mothers and their children. A good diet – for example, breastfeeding and lots of fruits and vegetables – is essential for healthy children. This mini-drama explains why, and gives some suggestions for a nutritious diet.

http://www.farmradio.org/english/radio-scripts/70-3script_en.asp

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