Congo’s humanitarian crisis helped mpox spiral again into a global health emergency

Patients listen to a doctor outside the consultation room of the Mpox treatment centre at Nyiragongo General Referral Hospital, north of Goma on August 17, 2024. (AFP)
Patients listen to a doctor outside the consultation room of the Mpox treatment centre at Nyiragongo General Referral Hospital, north of Goma on August 17, 2024. (AFP)
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Updated 18 August 2024
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Congo’s humanitarian crisis helped mpox spiral again into a global health emergency

Congo’s humanitarian crisis helped mpox spiral again into a global health emergency
  • Millions are thought to be out of reach of medical help or advice in the conflict-torn east, where dozens of rebel groups have been fighting Congolese army forces for years over mineral-rich areas, causing a huge displacement crisis

GOMA, Congo: Sarah Bagheni had a headache, fever, and itchy and unusual skin lesions for days, but she had no inkling that her symptoms might have been caused by mpox and that she might be another case in a growing global health emergency.
She also has no idea where to go to get medical help.
She and her husband live in the Bulengo displacement camp in eastern Congo, a region that is effectively ground zero for a series of mpox outbreaks in Africa.
This year’s alarming rise in cases, including a new form of the virus identified by scientists in eastern Congo, led the World Health Organization to declare it a global health emergency on Wednesday. It said the new variant could spread beyond the five African countries where it had already been detected — a timely warning that came a day before Sweden reported its first case of the new strain.
In the vast central African nation of Congo, which has had more than 96 percent of the world’s roughly 17,000 recorded cases of mpox this year — and some 500 deaths from the disease — many of the most vulnerable seem unaware of its existence or the threat that it poses.
“We know nothing about this,” Bagheni’s husband, Habumuremyiza Hire, said Thursday about mpox. “I watch her condition helplessly because I don’t know what to do. We continue to share the same room.”
Millions are thought to be out of reach of medical help or advice in the conflict-torn east, where dozens of rebel groups have been fighting Congolese army forces for years over mineral-rich areas, causing a huge displacement crisis. Hundreds of thousands of people like Bagheni and her husband have been forced into overcrowded refugee camps around Goma, while more have taken refuge in the city.
Conditions in the camps are dire and medical facilities are almost nonexistent.
Mahoro Faustin, who runs the Bulengo camp, said that about three months ago, administrators first started noticing people in the camp exhibiting fever, body aches and chills — symptoms that could signal malaria, measles or mpox.
There is no way of knowing how many mpox cases there might be in Bulengo because of a lack of testing, he said. There haven’t been any recent health campaigns to educate the tens of thousands of people in the camp about mpox, and Faustin said he’s worried about how many people might be undiagnosed.
“Just look at the overcrowding here,” he said, pointing to a sea of ramshackle tents. “If nothing is done, we will all be infected here, or maybe we are already all infected.”
Around 70 percent of the new mpox cases in the Goma area in the last two months that were registered at a treatment center run by Medair were from displacement camps, said Dr. Pierre Olivier Ngadjole, the international aid group’s health adviser in Congo. The youngest of those cases was a month-old baby and the oldest a 90-year-old, he said.
In severe cases of mpox, people can develop lesions on the face, hands, arms, chest and genitals. While the disease originated in animals, the virus has in recent years been spreading between people via close physical contact, including sex.
Bagheni’s best hope of getting a diagnosis for her lesions is a government hospital that’s a two-hour drive away. That’s likely out of the question, given that she already struggles with mobility having previously had both her legs amputated.
Seven million people are internally displaced in Congo, with more than 5.5 million of them in the country’s east, according the UN refugee agency. Congo has the largest displacement camp population in Africa, and one of the largest in the world.
The humanitarian crisis in eastern Congo has almost every possible complication when it comes to stopping an mpox outbreak, said Dr. Chris Beyrer, director of Duke University’s Global Health Institute.
That includes war, illicit mining industries that attract sex workers, transient populations near border regions, and entrenched poverty. He also said the global community missed multiple warning signs.
“We’re paying attention to it now, but mpox has been spreading since 2017 in Congo and Nigeria,” Beyrer said, adding that experts have long been calling for vaccines to be shared with Africa, but to little effect. He said the WHO’s emergency declaration was “late in coming,” with more than a dozen countries already affected.
Beyrer said that unlike COVID-19 or HIV, there’s a good vaccine and good treatments and diagnostics for mpox, but “the access issues are worse than ever” in places like eastern Congo.
In 2022, there were outbreaks in more than 70 countries around the world, including the United States, which led the WHO to also declare an emergency that lasted until mid-2023. It was largely shut down in wealthy countries within months through the use of vaccines and treatments, but few doses have been made available in Africa.
The new and possibly more infectious strain of mpox was first detected this year in a mining town in eastern Congo, about 450 kilometers (280 miles) south of Goma. It’s unclear how much the new strain is to blame, but Congo is now enduring its worst outbreak yet and at least 13 African countries have recorded cases, four of them for the first time.
The outbreaks in those four countries — Burundi, Kenya, Rwanda and Uganda — have been linked to Congo’s, and Doctors Without Borders said Friday that Congo’s surge “threatens a major spread of the disease” to other countries.
Salim Abdool Karim, an infectious disease expert who chairs the Africa Centers for Disease Control and Prevention’s emergency committee, said the Congo outbreak has a particularly concerning change, in that it’s disproportionately affecting young people. Children under 15 account for 70 percent of cases and 85 percent of all deaths in the country, the Africa CDC reported.
Unlike the 2022 global outbreak, which predominantly affected gay and bisexual men, mpox now appears to be spreading in heterosexual populations.
All of Congo’s 26 provinces have recorded mpox cases, according to the state-run news agency. But Health Minister Samuel-Roger Kamba said Thursday that the country doesn’t have a single vaccine dose yet and he pleaded for “vigilance in all directions from all Congolese.”
Dr. Rachel Maguru, who heads the multi-epidemic center at Goma’s North Kivu provincial hospital, said they also don’t have drugs or any established treatments for mpox and are relying on other experts such as dermatologists to help where they can. A larger outbreak around the city and its numerous displacement camps already overburdened with an influx of people would be “terrible,” she said.
She also noted a pivotal problem: poor and displaced people have other priorities, like earning enough money to eat and survive. Aid agencies and stretched local authorities are already wrestling with providing food, shelter and basic health care to the millions displaced, while also dealing with outbreaks of other diseases like cholera.
 

 


G20 leaders gather for deadlocked talks on climate, Middle East, Ukraine wars

G20 leaders gather for deadlocked talks on climate, Middle East, Ukraine wars
Updated 18 November 2024
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G20 leaders gather for deadlocked talks on climate, Middle East, Ukraine wars

G20 leaders gather for deadlocked talks on climate, Middle East, Ukraine wars
  • Wars which have bitterly divided G20 members are set to feature prominently in discussions in Brazil
  • Biden will attend his last summit of world’s leading economies with China’s XI as the most influential leader

Rio de Janeiro: G20 leaders began arriving for a summit in Brazil on Monday to try reignite deadlocked climate talks and overcome their differences on the Middle East and Ukraine wars ahead of Donald Trump’s return to the White House.

US President Joe Biden will attend his last summit of the world’s leading economies, but as a lame duck leader eclipsed by Chinese President Xi Jinping, the most influential leader at this year’s meeting.

Brazil’s left-wing President Luiz Inacio Lula da Silva is using his hosting duties to promote issues close to his heart, including fighting hunger and climate change and taxing the super-rich.

But the wars which have bitterly divided G20 members are also set to feature prominently in the discussions.

A Brazilian foreign ministry source said Monday that some countries wanted to renegotiate a draft summit communique.

“For Brazil and other countries the text is already finalized, but some countries want to open up some points on wars and climate,” he told AFP.

Biden’s decision Sunday to allow Ukraine to use long-range US missiles to strike targets inside Russia — a major policy shift — could prompt European allies to also review their stance.

G20 leaders are also under pressure to try rescue UN climate talks in Azerbaijan, which have stalled on the issue of greater climate finance for developing countries.

UN Secretary-General Antonio Guterres has called for G20 members, who account for 80 percent of global emissions, to show “leadership” to facilitate a deal.

Security is tight for the gathering, which comes days after a failed bomb attack on Brazil’s Supreme Court in Brasilia by a suspected far-right extremist, who killed himself in the process.

The get-together will cap a farewell diplomatic tour by Biden which took him to Lima for a meeting of Asia-Pacific trading partners, and then to the Amazon in the first such visit for a sitting US president.

Biden, who has looked to burnish his legacy as time runs down on his presidency, insisted in the Amazon that his climate record would survive another Trump mandate.

All eyes at the stalled COP29 climate conference in Azerbaijan are on Rio to break an impasse over how to raise $1 trillion a year for developing countries to cope with global warming.

Rich countries want fast-developing economies like China and Gulf states to also put their hands in their pockets.

The meeting comes in a year marked by another grim litany of extreme weather events, including Brazil’s worst wildfire season in over a decade, fueled by a record drought blamed at least partly on climate change.

At the last G20 in India, leaders called for a tripling of renewable energy sources by the end of the decade, but without explicitly calling for an end to the use of fossil fuels.

Conspicuously absent from the summit is Russian President Vladimir Putin, whose arrest is sought by the International Criminal Court over the Ukraine war.

Lula, 79, told Brazil’s GloboNews channel on Sunday that he did not want the wars in Ukraine and the Middle East to take the focus off global poverty.

“Because if not, we will not discuss other things which are more important for people that are not at war, who are poor people and invisible to the world,” he said.

The summit opens on Monday with Lula, a former steelworker who grew up in poverty, launching a “Global Alliance against Hunger and Poverty.”

Brazil is also pushing for higher taxes on billionaires.

Lula had faced resistance to parts of his agenda from Argentinian President Javier Milei, a libertarian Trump uber-fan who met the Republican last week at his Mar-a-Lago resort.

The head of the Argentine delegation, Federico Pinedo, told AFP that Buenos Aires has raised some objections and would not “necessarily” sign the text, however. He did not elaborate.

But the Brazilian foreign ministry source on Monday downplayed the likelihood of Argentina blocking a consensus.


Why has ethnic violence escalated in India’s Manipur state again?

Why has ethnic violence escalated in India’s Manipur state again?
Updated 18 November 2024
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Why has ethnic violence escalated in India’s Manipur state again?

Why has ethnic violence escalated in India’s Manipur state again?
  • On May 3, 2023, members of the Kuki and Naga tribes launched protest against extension of benefits to dominant Meiteis
  • Latest violence flared this month after 31-year-old woman from Kuki tribe was found burned to death in a village in Jiribam district

Hundreds of people defied a curfew to stage demonstrations in India’s northeastern state of Manipur over the weekend and 23 were arrested for violence as tensions between two ethnic communities flared up again.
These are the reasons behind the violence in the border state.

HOW DID THE MANIPUR VIOLENCE BEGIN?

On May 3, 2023, members of the Kuki and Naga tribes, who inhabit Manipur’s hills and are regarded as Scheduled Tribes, or India’s most disadvantaged groups, launched a protest against the possible extension of their benefits to the dominant Meiteis.
The Meitei have sought special benefits for more than a decade, but received a fillip in April last year after the Manipur High Court recommended the state government should consider the demand and set a deadline of mid-May.
Meiteis account for half of Manipur’s population and extending limited affirmative action quotas to them would mean they would get a share of education and government jobs reserved for Kukis and Nagas.
Meiteis have traditionally lived in Manipur’s more prosperous valley region that makes up 10 percent of the state’s area.
They have also had better access to employment and economic opportunities. Nagas and Kukis live in the poorly developed hill regions.
The imbalance in development that has favored the valley over the hills has been a point of contention and rivalry between the ethnic groups.

WHAT WERE THE TRIGGERS?

The groups co-existed peacefully until unrelated events in 2023 exposed old faultlines.
Manipur shares a nearly 400-km (250-mile) border with Myanmar and the coup there in 2021 pushed thousands of refugees into the Indian state.
Kukis share ethnic lineage with Myanmar’s Chin tribe and Meiteis feared they would be outnumbered by the arrival of the refugees.

WHY IS PEACE YET TO RETURN?

Both the Meiteis and Kukis are known to be flush with arms, including automatic weapons either stolen from the state police or sourced from Myanmar.
The Indian Army and federal paramilitary forces in the state cannot act independently and are legally bound to work with state police and authorities, who analysts say are also divided along ethnic lines.
Kukis also accuse Biren Singh, the chief minister of the Bharatiya Janata Party-ruled state and a Meitei, of complicity in violence against them and have sought his removal. Singh denies the accusations.

WHAT IS BEHIND THE LATEST SPIRAL OF VIOLENCE?

The latest violence flared this month after a 31-year-old Kuki woman was found burned to death in a village in Jiribam district, an area that was untouched by the conflict until June.
Kuki groups blamed Meitei militants for the act.
Kukis and Meiteis have moved to separate parts elsewhere in Manipur since the clashes last year but Jiribam still has a mixed population, leading to tensions and violence.
Days after the incident, 10 armed Kuki men were killed in a gunfight with security forces after they tried to attack a police station in Jiribam district, and security forces retaliated. During this gunfight, a Meitei family of six people went missing.
On Friday, bodies of three of the six were found floating in a river, triggering angry protests in the state capital Imphal. Police said on Sunday they had arrested 23 people for ransacking and setting fire to the homes of lawmakers and ministers, in a second straight day of unrest in the area.


Emergency declared as smog in New Delhi hits highest level this year

Emergency declared as smog in New Delhi hits highest level this year
Updated 18 November 2024
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Emergency declared as smog in New Delhi hits highest level this year

Emergency declared as smog in New Delhi hits highest level this year
  • New Delhi was the world’s most polluted city on Monday, according to IQAir
  • PM 2.5 concentration was 138.4 times higher than WHO’s recommended levels

NEW DELHI: New Delhi was in a medical emergency on Monday as toxic smog engulfing the Indian capital reached the highest level this year, prompting authorities to close schools and urge people to stay indoors.

Pollution in Delhi and the surrounding metropolitan area — home to around 55 million people — reached the “severe plus” category as some areas reached an Air Quality Index score of 484, this year’s highest, according to the Central Pollution Control Board.

On the AQI scale from 0 to 500, good air quality is represented by levels below 50, while levels above 300 are dangerous.

Delhi was ranked as the most polluted city in the world on Monday by Swiss group IQAir, with a concentration of PM 2.5, 138.4 times higher than the World Health Organization’s recommended levels.

“All of North India has been plunged into a medical emergency,” Delhi Chief Minister Atishi Marlena Singh said in a press conference, adding that many cities were “reeling under severe levels of pollution.”

She said farm fires, where stubble left after harvesting rice is burnt to clear fields, were causing the extreme levels of pollution.

“Why is the (central government) not taking action against these states and implementing concrete steps? People are unable to breathe. I am getting calls from people complaining about breathing and respiratory issues,” she said.

“All of North India is paying the price for this, especially children and elderly who are struggling to breathe.”

Authorities in Delhi have directed all schools to move classes online and tightened restrictions on construction activities and vehicle movements.

Mahesh Palawat, vice president of meteorology and climate change at forecast company Skymet Weather, said people in the capital region are faced with serious health risks.

“If they are non-smokers, then they will also inhale at least 30 to 40 cigarettes per day (at these pollution levels). So, you can imagine how bad it is for our health,” he told Arab News.

“PM 2.5 is a very minute particle (that can be inhaled). It is so minute that it can go into our blood vessels also, so it is very harmful and leads to various diseases, particularly for older people and infants who have breathing problems.”

Palawat is expecting the air quality to remain at this level for at least a few more days.

“It will remain in the very poor to serious category in coming days also,” he said.


Emergency declared in New Delhi as smog hits highest level this year

Emergency declared in New Delhi as smog hits highest level this year
Updated 18 November 2024
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Emergency declared in New Delhi as smog hits highest level this year

Emergency declared in New Delhi as smog hits highest level this year
  • New Delhi was the world’s most polluted city on Monday, according to IQAir
  • PM 2.5 concentration was 138.4 times higher than WHO’s recommended levels

New Delhi: New Delhi was in a state of ‘medical emergency’ on Monday as toxic smog engulfing the Indian capital reached the highest levels this year, prompting authorities to close schools and urge people to stay indoors.

Pollution in Delhi and the surrounding metropolitan area — home to around 55 million people — reached the “severe plus” category as some areas reached an Air Quality Index score of 484, this year’s highest, according to the Central Pollution Control Board.

On the AQI scale from 0 to 500, good air quality is represented by levels below 50, while levels above 300 are dangerous.

Delhi was ranked as the most polluted city in the world on Monday by Swiss group IQAir, with a concentration of PM 2.5, 138.4 times higher than the World Health Organization’s recommended levels.

 “All of North India has been plunged into a medical emergency,” Delhi Chief Minister Atishi Marlena Singh said in a press conference, adding that many cities were “reeling under severe levels of pollution.”

She said farm fires, where stubble left after harvesting rice is burnt to clear fields, were causing extreme levels of pollution.

“Why is the (central government) not taking action against these states and implementing concrete steps? People are unable to breathe. I am getting calls from people complaining about breathing and respiratory issues,” she said.

“All of North India is paying the price for this, especially children and elderly who are struggling to breathe.”

Authorities in Delhi have directed all schools to move classes online and tightened restrictions on construction activities and vehicle movements.

Mahesh Palawat, vice president of meteorology and climate change at forecast company Skymet Weather, said people in the capital region are faced with serious health risks.

“If they are non-smokers, then they will also inhale at least 30 to 40 cigarettes per day (at these pollution levels). So, you can imagine how bad it is for our health,” he told Arab News.

“PM 2.5 is a very minute particle (that can be inhaled). It is so minute that it can go into our blood vessels also, so it is very harmful and leads to various diseases, particularly for older people and infants who have breathing problems.”

Palawat is expecting the air quality to remain at this level for at least a few more days.

“It will remain in the very poor to serious category in coming days also,” he said. 


Palestinian NGO to ask UK court to block F-35 parts to Israel over Gaza war

Palestinian NGO to ask UK court to block F-35 parts to Israel over Gaza war
Updated 18 November 2024
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Palestinian NGO to ask UK court to block F-35 parts to Israel over Gaza war

Palestinian NGO to ask UK court to block F-35 parts to Israel over Gaza war
  • West Bank-based Al-Haq is taking legal action against Britain’s Department for Business and Trade at London’s High Court

LONDON: Britain is allowing parts for F-35 fighter jets to be exported to Israel despite accepting they could be used in breach of international humanitarian law in Gaza, lawyers for a Palestinian rights group told a London court on Monday.
West Bank-based Al-Haq, which documents alleged rights violations by Israel and the Palestinian Authority, is taking legal action against Britain’s Department for Business and Trade at London’s High Court.
Israel has been accused of violations of international humanitarian law in the Gaza war, with the UN Human Rights Office saying nearly 70 percent of fatalities it has verified were women and children, a report Israel rejected.
Israel says it takes care to avoid harming civilians and denies committing abuses and war crimes in the conflicts with Hamas in Gaza and Hezbollah in Lebanon.
Al-Haq’s case comes after Britain in September suspended 30 of 350 arms export licenses, though it exempted the indirect export of F-35 parts, citing the impact on the global F-35 program.
Al-Haq argues that decision was unlawful as there is a clear risk F-35s could be used in breach of international humanitarian law.
British government lawyers said in documents for Monday’s hearing that ministers assessed Israel had committed possible breaches of international humanitarian law (IHL) in relation to humanitarian access and the treatment of detainees.
Britain also “accepts that there is clear risk that F-35 components might be used to commit or facilitate a serious violation of IHL,” its lawyer James Eadie said.
Eadie added that Britain had nonetheless decided that F-35 components should still be exported, quoting from advice to defense minister John Healey that suspending F-35 parts “would have a profound impact on international peace and security.”
A full hearing of Al-Haq’s legal challenge is likely to be heard early in 2025.
The Hamas-run Gaza health ministry says more than 43,800 people have been confirmed killed since the war erupted on Oct. 7, 2023.
Hamas militants killed around 1,200 people in attacks on communities in southern Israel that day, and hold dozens of some 250 hostages they took back to Gaza, according to Israeli tallies.