COVID-19: What will Africa look like in 2030 and 2063?

Banji Oyelaran-Oyeyinka Opinion

African leaders need to look in the mirror and ask where this continent will be in 2030 and 2063

[ABIDJAN, Ivory Coast] The COVID-19 pandemic, one of the world’s most significant events, has resulted in cessation of economic activities that will lead to a significant decline in GDP, an unprecedented social disruption, and the loss of millions of jobs. According to estimates by the African Development Bank, the contraction of the region’s economies will cost Sub-Saharan Africa between $35 billion and $100 billion due to an output decline and a steep fall in commodity prices, especially the crash of oil prices. More fundamentally, the pandemic has brutally exposed the hollowness of African economies on two fronts: the fragility and weakness of Africa’s health and pharmaceutical sectors and the lack of industrial capabilities. The two are complementary. This is because Africa is almost 100 percent dependent on imports for the supply of medicines. According to a recent McKinsey (2019) study, China and India supply 70 percent of Sub-Saharan Africa’s demand for medicine, worth $14 billion. China’s and India’s markets are worth $120 billion and $33 billion respectively. Consider a hypothetic situation where both India and China are unable or unwilling to supply the African market? Africa surely faces a health hazard. The root of Africa’s underdeveloped industrial and health sectors can be encapsulated in three ways. First, some African policy makers simply think that poor countries do not need to industrialize. This group believes the “no-industrial policy” advocates who engage in rhetoric that does not fit the facts. The histories of both Western societies, and contemporary lessons from East Asia, run contrary to that stance. Clearly, governments have an important role to play in the nature and direction of industrialization. Progressive governments throughout history understand that the faster the rate of growth in manufacturing, the faster the growth of Gross Domestic Product (GDP). From the Economist magazine five years ago: “BY MAKING things and selling them to foreigners, China has transformed itself—and the world economy with it. In 1990 it produced less than 3% of global manufacturing output by value; its share now is nearly a quarter. China produces about 80% of the world’s air-conditioners, 70% of its mobile phones and 60% of its shoes. Today, China is the world’s leader in manufacturing and produces almost half of the world’s steel.” The keyword is “making”. Two, rich countries therefore became rich by manufacturing and exporting to others, including high-quality goods and services. Poor African countries remain poor because they continue to produce raw materials for rich countries. For example, 70% of global trade in agriculture is in semi-processed and processed products. Africa is largely absent in this market while the region remains an exporter of raw materials to Asia and the West. Lastly, African countries are repeatedly told that they cannot compete based on scale economy, and as well, price and quality competitiveness because China will outcompete them. For this reason, they should jettison the idea of local production of drugs, food and the most basic things. The question is: How did Vietnam, with a population of 95 million, emerge from a brutal 20-year war and lift more than 45 million people out of poverty between 2002 and 2018 and develop a manufacturing base that spans textiles, agriculture, furniture, plastics, paper, tourism and telecommunications? It has emerged as a manufacturing powerhouse, becoming the world’s third-largest exporter of textiles and garments (after China and Bangladesh). Vietnam currently exports over 10 million tonnes of rice, coming third after India and China. How is it that Bangladesh, a country far poorer than many African countries, is able to manufacture 97% of all its drugs demand, yet it is next door to India, a powerhouse of drug manufacturing? The COVID-19 pandemic has exposed Africa. African leaders need to look in the mirror and ask where this continent will be in 2030 and 2063. Africa must adopt progressive industrial policies that create inclusive, prosperous and sustainable societies. What then should be done? A three-pronged approached is urgently needed. First, Africa needs a strong regional coordination mechanism to consolidate small uncompetitive firms operating in small atomistic market structures. With a consumer base of 1.3 billion and $3.3 trillion market under the African Continental Free Trade Area (AfCFTA), the continent has no choice but to bring together its fragmented markets. Second, Africa needs to build better institutions, strengthen weak ones and introduce the ones missing. No better wake-up call is required than the present pandemic. Third, one important institution that has been abruptly disrupted is the supply chain for medicines and food, for example. Logistics for transporting capital and consumer goods across the region need predictable structures. Building or strengthening supply chains involve fostering and providing regulations for long-term agreements and competences that leverage both private and public institutional challenges such as customs regulations. Finally, development finance institutions (DFIs) such as the African Development Bank are mandated to, and are currently, trying to fill the gaps left by private financial institutions. There is an opportunity to Africa to rethink and reengineer its future. The Africa of tomorrow must look inwards for its solutions. - whether in feeding its own people, build industrial powerhouses led by African champions. The African Development Bank stands ready to help target and push for deeper economic transformation. Africa needs to execute structurally transformative projects that generate positive externalities and social returns. Keep our eyes on the days after. Professor Banji Oyelaran-Oyeyinka, is the Senior Special Adviser on Industrialization to the President of the African Development Bank. He is a fellow of the Nigerian Academy of Engineering and Professorial Fellow, United Nations University. His recent book is “Resurgent Africa: Structural Transformation and Sustainable Development”, UK: Anthem Press, 2020.

The pandemic is no time for fiscal distancing

Opinion

Akinwumi A. Adesina

The African Development Bank estimates that Covid-19 could cost Africa a GDP loss between $22.1 billion and $88.3 billion in the worst case scenario

[ABIDJAN, Ivory Coast]  These are very difficult days, as the world faces one of its worst challenges ever: the novel coronavirus pandemic. And it seems almost no nation is spared. As infection rates rise, so does panic across financial markets, as economies drastically slow down and supply chains are severely disrupted.  Extraordinary times call for extraordinary measures. As such, it can no longer be business as usual.  Each day, the situation evolves and requires constant reviews of precautionary measures and strategies. In the midst of all this, we must all worry about the ability of every nation to respond to this crisis. And we must ensure that developing nations are prepared to navigate these uncharted waters fully.  Akinwumi Adesina Pic: AfDB That's why I support the UN Secretary-General Antonio Guterres' urgent call for special resources for the world's developing countries.  In the face of this pandemic, we must put lives above resources and health above debt. Why? Because developing economies are the most vulnerable at this time. Our remedies must go beyond simply lending more. We must go the extra mile and provide countries with much-needed and urgent financial relief -- and that includes developing countries under sanctions.  According to the independent, global think tank ODI in its report on the impact of economic sanctions, for decades, sanctions have decimated investments in public health care systems in quite a number of countries. Today, the already stretched systems as noted in the 2019 Global Health Security Index will find it difficult to face up to a clear and present danger that now threatens our collective existence. Only those that are alive can pay back debts.   Sanctions work against economies but not against the virus. If countries that are under sanctions are unable to respond and provide critical care for their citizens or protect them, then the virus will soon "sanction" the world. In my Yoruba language, there is a saying. "Be careful when you throw stones in the open market. It may hit a member of your family."   That's why I also strongly support the call by the UN Secretary-General that debts of low-income countries be suspended in these fast-moving and uncertain times.  But I call for even bolder actions, and there are several reasons for doing so.  First, the economies of developing countries, despite years of great progress, remain extremely fragile and ill equipped to deal with this pandemic. They are more likely to be buried with the heavy fiscal pressure they now face with the coronavirus.  Second, many of the countries in Africa depend on commodities for export earnings. The collapse of oil prices has thrown African economies into distress. According the AFDB's 2020 Africa Economic Outlook, they simply are not able to meet budgets as planned under pre-coronavirus oil price benchmarks. The impact has been immediate in the oil and gas sector, as noted in a recent CNN news analysis. In the current environment, we can anticipate an acute shortage of buyers who, for understandable reasons, will reallocate resources to addressing the Covid-19 pandemic. African countries that depend on tourism receipts as a key source of revenue are also in a straightjacket.  Third, while rich countries have resources to spare, evidenced by trillions of dollars in fiscal stimulus, developing countries are hampered with bare-bones resources.  The fact is, if we do not collectively defeat the coronavirus in Africa, we will not defeat it anywhere else in the world. This is an existential challenge that requires all hands to be on deck. Today, more than ever, we must be our brothers and sisters' keepers.   Around the world, countries at more advanced stages in the outbreak are announcing liquidity relief, debt restructuring, forbearance on loan repayments, relaxation of standard regulations and initiatives. In the United States, packages of more than $2 trillion have already been announced, in addition to a reduction in Federal Reserve lending rates and liquidity support to keep markets operating. In Europe, the larger economies have announced stimulus measures in excess of 1 trillion Euros. Additionally, even larger packages are expected.  As developed countries put in place programs to compensate workers for lost wages for staying at home for social distancing, another problem has emerged -- fiscal distancing. Think for a moment what this means for Africa.  The African Development Bank estimates that Covid-19 could cost Africa a GDP loss between $22.1 billion, in the base case scenario, and $88.3 billion in the worst case scenario. This is equivalent to a projected GDP growth contraction of between 0.7 and 2.8 percentage points in 2020. It is even likely that Africa might fall into recession this year if the current situation persists. The Covid-19 shock will further squeeze fiscal space in the continent as deficits are estimated to widen by 3.5 to 4.9 percentage points, increasing Africa's financing gap by an additional $110 to $154 billion in 2020.  Our estimates indicate that Africa's total public debt could increase, under the base case scenario, from $1.86 trillion at the end of 2019 to over $2 trillion in 2020, compared to $1.9 trillion projected in a 'no pandemic' scenario. According to a March 2020 Bank report, these figures could reach $2.1 trillion in 2020 under the worst case scenario. This, therefore, is a time for bold actions. We should temporarily defer the debt owed to multilateral development banks and international financial institutions. This can be done by re-profiling loans to create fiscal space for countries to deal with this crisis.   That means that loan principals due to international financial institutions in 2020 could be deferred. I am calling for temporary forbearance, not forgiveness. What's good for bilateral and commercial debt must be good for multilateral debt. That way, we will avoid moral hazards, and rating agencies will be less inclined to penalize any institution on the potential risk to their Preferred Creditor Status.  The focus of the world should now be on helping everyone, as a risk to one is a risk to all. There is no coronavirus for developed countries and a coronavirus for developing and debt-stressed countries. We are all in this together.   Multilateral and bilateral financial institutions must work together with commercial creditors in Africa, especially to defer loan payments and give Africa the fiscal space it needs. We stand ready to support Africa in the short term and for the long haul. We are ready to deploy up to $50 billion over five years in projects to help with adjustment costs that Africa will face as it deals with the knock-on effects of Covid-19, long after the current storm subsides.  But more support will be needed. Let's lift all sanctions, for now. Even in wartime, ceasefires are called for humanitarian reasons. In such situations, there is a time to pause for relief materials to reach affected populations. The novel coronavirus is a war against all of us. All lives matter. For this reason, we must avoid fiscal distancing at this time. A stitch in time will save nine.   Social distancing is imperative now. Fiscal distancing is not.  *Akinwumi A. Adesina is President of the African Development Bank Group

To Silence the Guns, Restore Nature

Opinion

H.E. Hailemariam Desalegn

In the span of a human life, Mozambique’s majestic Gorongosa National Park has flipped: from wildlife haven to killing ground to sacred ground of peacemaking and recovery. This past week, as African Heads of State gathered in Addis Ababa to evaluate progress toward “silencing the guns” and creating an environment conducive to development, Gorongosa stands as both a warning sign and a symbol of hope. 

Battles waged in Gorongosa during Mozambique’s 1977-1992 civil war left millions of people dead or wounded. It also ruined the ecosystem and killed 90 percent of elephants, buffalo, zebra, and wildebeest as soldiers poached them for money or slaughtered them for meat.  At the war’s end, just 15 buffalo and 100 hippo survived.  Few lions remained.

But with peace came opportunities to rebuild communities for 100,000 local people and to restore the environment. By 2018, grasslands, shrublands and forests were recovering. Some 1,000 buffalo roamed the area and the hippo population had increased five-fold. When Cyclone Idai struck last year, healthy ecosystems absorbed tens of millions of gallons of water, saving nearby villages from floods. Meanwhile, through programs of the Gorongosa Restoration Project, families have improved their agriculture and health, and the education of their children. Today, ecotourism adds local jobs, as the area reclaims an essential balance between nature and human development.

As in Gorongosa, the protection of nature everywhere is central to sustainable development, to the mitigation of climate change, and to secure and peaceful societies.  Yet nature is being lost is being lost at a frightening rate.

Habitat conversion, the unsustainable use of natural resources, urbanization, and climate change all undermine the foundations of the natural world. The earth has lost 60% of terrestrial wildlife and 90% of the big ocean fish.  One million plant and animal species are threatened with extinction. We are clear cutting rainforests at a rate of four football fields per minute.

                 H.E. Hailemariam Desalegn  Photo Credit: Tigrai online

The impacts of land and ecosystem degradation on biodiversity, land productivity, and human well-being in Africa has affected over 485 million people and costs an estimated US$9.3 billion annually. 

That which has been destroyed in centuries, we must act to restore in the next decade in order to avert even greater natural, climate and human catastrophes. 

Roadmap to Action

There is a roadmap to action.  The Campaign for Nature offers a science-driven, ambitious new deal for nature that calls on world leaders to protect at least 30 percent of the planet—its land and water—by 2030. This rallying cry of “30X30” fuels the Campaign, which is a partnership of the Wyss Campaign for Nature, National Geographic Society, and a growing coalition of more than 100 conservation and indigenous peoples’ organizations around the world. The Campaign has also launched a High Ambition Coalition (HAC) for Nature and People composed of government leaders to drive high-level action on 30X30.

The Campaign calls on world leaders help mobilize financial resources to properly manage protected areas, and to fully integrate and respect indigenous leadership and rights in the work of conservation.  We know from experience that local communities have to own the protected areas as their own and benefit from their protection. Only in this way will conservation succeed and promote inclusive economic and social development.

The Campaign’s main measures are crucial to Africa’s peaceful development.  Africa generates 62 percent of its GDP through industries that are highly or moderately dependent on nature, most especially agriculture. One of the major risks business faces from the loss of nature is increased conflict.  The protection of nature is paramount.

Africa can and should take the lead in driving action toward 30X30. A crucial opportunity to do so will be at the meeting of the 15^th Conference of the Parties to the Convention on Biological Diversity in Kunming, China, later this year. There, Convention targets will be updated to reflect the full extent of our planetary crisis.

                                        H.E. Hailemariam Desalegn Photo credit: AGRA

Many African countries have already committed to conserving their natural heritage as integral to sustainable development. The governments of both Rwanda and Uganda have resolved to protect 30 percent of their natural lands by 2030. Ethiopia has written environmental protection into its Constitution so that every political party that comes into power must act accordingly.  Namibia has designated its entire coastline as a national park.

Gorongosa National Park has shown us that nature recovers if given a chance. And like streams across a watershed, the benefits flow from there.

By investing in national parks, natural reserves, sustainable tourism, and community-led conservation areas, and by partnering with indigenous and local people, by building a global consensus for 30X30, we can not only save biodiversity but also generate jobs and income, significantly mitigate climate change, and silence the guns.

H.E. Hailemariam Desalegn is the former Prime Minister of Ethiopia.

Scratching the bare earth for food

A major UN report warns that Africa faces the greatest immediate dangers of climate change. Tens of millions of poor rural Africans are experiencing the grim realities of global warming first hand.


Ochieng' Ogodo

Journalist-Kenya

[NAIROBI] With equal measures of hope and despair, over 70 years old Syombua Munyao stoops wearily to sprinkle a handful of seeds into the dry, hardened earth, almost certain they will never grow into food.

“We are only trying. It is not like the old days when you would be sure of a harvest after the rains,” she sighs, shuffling back to one of a clutch of rounded huts of mud and thatched leaves where she lives in the poor Kiongwe region of eastern Kenya.

For decades, life has been a struggle in this harsh environment, but Munyao says things were never as bad as they are now.

“There are no good rains anymore,” she complains. “The sun was always hot, but these days it feels like it’s moved closer. We are being baked,” she exclaims, wiping sweat from her brow under a sun still uncomfortably hot in October.

Although Munyao lives in Kenya, hers is a familiar story throughout Africa, which experts around the world agree is hardest hit by climate change.

The continent faces ominous environmental perils if current global warming trends continue, warned a new report released at the UN Climate Change Conference, underway in the Kenyan capital of Nairobi from 6 to 17 November.

In less than a generation, 40 per cent of Africa’s wildlife habitat could be lost, and cereal crops in the hungry continent of 900 million people could decline by five per cent, the authoritative UN report said.

It warned that a third of Africa’s coastal settlements could be wiped out this century by rising sea levels, and floods threaten as many as 70 million people, together with major cities such as Lagos in Nigeria and Cape Town in South Africa.

Munyao, who lives only about 200 kilometres from Nairobi, knows nothing about the report or its dire predictions. But tens of millions of poor rural Africans like her are already suffering under the grim impact of climate change on their lives.

A decade of drought

Ten years ago, dry spells and drought forced Munyao to move from the nearby lowlands to the higher grounds of Kiongwe, where there was more water. They had more to eat for a while, but without rainfall the earth dried up again.

She and many of the 3,000 people living in Kiongwe and around began cutting down trees on the higher ranges, clearing forested land to cultivate food and burning the wood for fuel.

Thick forests where elders once retreated for worship, or to gather vital medicinal plants to heal wounds and cure typhoid, diarrhoea, coughs and other ailments, have now become dry rocky ranges.

“When this place was forested it was an oasis, with water for our cattle, goats and sheep; there were wild animals like leopards and antelope,” Munyao recalls. “Now all we see are a few monkeys now and then,” she says.

The rainy seasons, once predictable, have become erratic and scarce. The Kiongwe River, which would flow strongly after rains in May and retain water for much of the year, is now nearly dry year round, people living there say.

“There are no rains anymore,” Munyao complains. “We no longer cultivate anything but maize and beans, because these ripen more quickly,” she says.

Sometimes, the people of Kiongwe say, they manage to stay alive only because of meagre food supplies from the UN’s World Food Programme.

Foods like cowpea, millet, sorghum and yam have become only memories from her younger days, Munyao says.

Deforestation, drought, loss of wildlife habitat and declining or disappearing crops are not future threats in the lives of most rural Africans. They are scourges of their daily lives.

Climate change, of the kind occurring in the Kitui district where Kiongwe is located, is associated with global warming, says Dr Buruhani Nyenzi, head of the UN’s World Climate Programme.

He says that the impact of climate change in Kitui was seen in long dry spells without rainfall, a rise in child mortality, and more cases of diseases like malaria.

The new UN climate change report noted that Africa had warmed 0.7 degrees centigrade in the previous century, and that 1995 and 1998 were the warmest years.

A changing landscape

In the Endau Hills area, about 300 kilometres east of Nairobi, Godfrey Wambua remembers the hot years of about a decade ago, noting that was when the weather became unpredictable and began to grow warmer.

“We had two seasons, the long rains from March to May and short ones running from October to November, but that is not the case anymore,” says Wambua, who is in his late 30s and is a council leader for his community of 30,000 people.

Only two decades ago a thick forest, home to birds, monkeys, gazelle and buffalo, covered the entire hilly area of Endau Hills, which spans 6,700 hectares. But the foothills have turned bare, with only the hilly peaks still green with trees. Most of the animals, the residents say, have disappeared.

Like in Kiongwe to the west, people in Endau have gradually moved up the highlands, cutting down trees to expand land for cultivation and grazing. But without trees to slow them down, winds sometimes blow so hard that they rip the thatched-leaf roofs from the huts.

Desertification is another scourge. Water, which was once plentiful from shallow springs, has become so scarce that women and girls sometimes walk more than 15 kilometres a day to fetch it, people in Endau say.

Scarcity throughout the region has led to tensions with herders in the next district, who have begun to bring their cattle, sheep, goats and donkeys in the hundreds of thousands to Endau for grazing and water.

Sometimes fights erupt over water, and animals are killed in revenge, says Wambua, who owns cattle and sheep, and grows maize when seasons are good.

“Over the years the situation has gone from bad to worse,” Wambua says, squatting under a thin leafless tree with his chin rested in his palm.

Musyoka Kaleli, who has lived in Endau Hills and makes a living from cattle and subsistence farming, remembers a time when there was more than enough food and milk to go around.

“Thirty-six years ago there was rich grazing land, fertile soil and good harvests,” he recalls wistfully. “We had plenty of milk, and those who did not have could get generous rations from neighbours at no cost.”

“But life has changed; there is hunger all year long,” says Kaleli, 68. His greatest worry is for the future. “When you look at us today you see poverty. This is sad, because it is getting worse, and those who come after us will have the bare earth to scratch for food.”

This story was originally produced by  Panos London on 11/09/2006. Link: http://panoslondon.panosnetwork.org/features/scratching-the-bare-earth-for-food/

Second chance against FGM

Ochieng’ Ogodo

Journalist – Kenya 

[NAIROBI] There is something happening in Burkina Faso that other African nations could borrow a leaf from. Doctors are offering a second chance for women to repair the damage caused by Female Genital Mutilation (FGM). 

This is what Professor Michel Akotionga, a gynecologist and obstetrician teaching at Ouagadougou University in Burkina Faso, calls medical rehabilitation.

Medical rehabilitation is a series of processes that restore some of the damage caused by FGM. This enables women to attain a higher sense of sensation that will make sex as enjoyable to them as it is to women who are not circumcised.

“It is [a method] to give back a woman the possibility to use the functions of the genital organs for menstruation and sexuality,” Akotionga explained. 

Types and Severity

FGM is widely practiced in Africa and some Asian countries. Among the practicing communities, it is a highly valued ritual carried with a near religious enthusiasm. But beneath this enthusiasm and a firm commitment to FGM lie devastating health consequences.

The World Health Organization (WHO) has categorized FGM into four types:

Type I – excision of the prepuce (a fold of skin covering the clitoris), with or without excision of part or all of the clitoris. This is often called clitoridectomy.

Type II – excision of the clitoris and prepuce along with partial or total excision of the labia minora (the inner folds of skin of the external female genitalia). According to WHO, this type accounts for 80% of FGM cases in Africa.

Type III – excision of part or all of the external genitalia and stitching or narrowing of the vaginal opening. This is called infibulation. WHO estimates that 15 percent of women subjected to FGM have undergone this severe form.

Type IV – other practices including piercing, cauterizing, scraping, or using corrosive substances designed to scar and narrow the vagina.

The surgery, explained Akotionga, can be performed on all the different types of FGM. However, it is most constructive in cases of Type III. The stitched and narrowed vaginal orifice, characteristic of this type of FGM, causes major problems for women.

WHO estimates that between 100 and 140 million women in more than 28 African countries have undergone some type of female genital mutilation. Each year, three million girls are forced to undergo the practice.

In some practicing communities, such as among Somalis, the part remaining after circumcision is further sewn up, leaving only a very small opening for urination. This causes adverse health consequences during the menstrual cycle, sexual intercourse, and child delivery. These health hazards may include severe pain, hemorrhage, urine retention, ulceration of genital tissues, and injury to adjacent tissues.

Fetal distress during labor in circumcised women is another of the health consequences FGM poses. Dr. Jaldesa Guyo, an obstetrician and gynecologist at Kenyatta National Hospital, Kenya, explained that the stitching can inhibit the baby’s head from coming out. This leads to brain damage and can also cause problems in the automatic breathing system of the newborn. “There is increased death [of babies] at birth because of FGM,” he added. The risk of loss of a baby at birth is placed as high as 22 percent among circumcised women.

Medical Rehabilitation

According to Akotionga, for a woman to undertake the rehabilitation process, a doctor must first establish the need for the operation. He explained that there are two different types of interventions that may be performed.

The first medical intervention involves the widening of the vagina. This is done under the effects of a local anesthetic. The doctor slowly begins to undo the sewing done to the vagina during circumcision until it reaches the normal size. This is measured as the opening being wide enough to allow two fingers inside. Once this is done, the right and left sides are sewn and held separately so that the vagina stays open. This intervention allows women who have stitched and narrowed vaginal orifices to enjoy sexual intercourse normally.

The second level of intervention, Akotionga explained, is reconstruction of the clitoris after widening the vagina. This takes place by pulling out the inner parts of the clitoris that have not been cut during circumcision. These are then sewn and held to the upper part of the vaginal orifice.

“The FGM process entails the cutting of mostly the outer clitoris. This leaves inside tissues intact. It is this inside tissue that a doctor pulls out in the reconstruction exercise,” said Akotionga.

“FGM denies women the natural ability to enjoy sex which each and every human being is entitled to. The restored clitoris has high sensitivity making sex fulfilling for the woman,” explained Akotionga.

The choice of which type of operation a doctor performs depends on the type of FGM performed on the woman. If the vaginal orifice has been narrowed, then the first intervention is used. But if the clitoris was damaged, then a doctor may operate on the reconstruction of the clitoris.

The first operation Akotionga performed in 1999 was the first type of intervention that widens the vagina. The second type, which involves reconstruction of the clitoris, was only commissioned in 2006. He has started training other doctors in this technique as well. “We have 50 doctors in Burkina Faso trained and are now doing the same [operation]. Other African countries are free to get in touch with us about the expertise,” he said during an interview.

So far, 519 women have been treated by Akotionga by widening of the vaginal opening. He has also managed 50 successful operations involving the reconstruction of the clitoris. The doctor explained that the first medical intervention process was his own development after a thorough study of FGM. The second type of intervention, however, was inspired by Dr. Pierre Foldes who is renowned for having developed the technique which restores the clitoris, thus becoming a savior to thousands of women.

New Hope

Akotionga, who hails from Kasena in southern Burkina Faso, explains that in his community, women are almost always circumcised. Even if they are not circumcised while alive, they are circumcised when they die.

“It is the scope of the problem in my community that made me develop a strong sense against FGM. As a practitioner I have also seen what those who have been mutilated go through, especially what happens during delivery. There are terrible tears, bleeding, and even death can occur. Sometimes the babies die during the process because of complications arising from the mutilation,” he said.

It has been a tough experience for him. Due to the level of poverty among the majority of the Burkina Faso population, Akotionga performs the first type of intervention for free. For the second type, he charges KSh 10,950 ($150) if it is performed in the First Lady’s Clinic where he works. In private hospitals and clinics, the operation can cost up to KSh 29,200 ($400).

According to Akotionga, the response has been extremely good. Many Burkinabè women are now turning to reconstruction procedures to correct the damage committed to them by this harmful traditional practice. “The feedback has been that of tremendous appreciation and many children are now named after me,” he commented, obviously touched by the gesture.

But there has been vigorous opposition from traditionalists who see him as going against the grain. Although Burkina Faso has some very strong laws against female circumcision, they have not been very successful in deterring the practice. It has strong cultural roots and many people have refused to give it up. Akotionga explained that his detractors have been launching heavy media campaigns against his practices under the freedom-of-expression right to ban them.

Medicalisation

However, while surgical repair is now offering these women a chance at a better life, another emerging practice is rather disturbing. Certain medical professionals are resorting to the “medicalization” of FGM. They perform it illegally for monetary gains.

The interest in the medicalization of FGM is increasing, especially among the Somali population in Kenya. In a poll, 15 of the 26 health workers interviewed in Nairobi reported having been approached to perform female circumcision. Most of them even claimed having been asked more than once (USAID February 2005).

The increased interest is attributed to the increased awareness of the health complications of FGM. This has been facilitated among those living in Nairobi by the media and by interactions with other cultures.

“Medicalisation of FGM legitimizes a procedure that is harmful to the health and well-being of girls and women. Furthermore, it is a violation of the ethical code governing the professional conduct of nurses, midwives, and other healthcare workers,” said Dr. Guyo, obstetrician and gynecologist at Kenya’s biggest national hospital.

“WHO has expressed its unequivocal opposition to the medicalization of female genital mutilation, advising that under no circumstances should it be performed by health professionals or in health institutions,” he told the journalists.

Meme Isaac, a Nigerian citizen, rounded up how she feels about the issue. “For me, [FGM] has meant excruciating pain, miscarriages, and other numerous health complications. For my sister, it meant death as a young child. For my aunt, it meant death from complications related to her mutilation during a pregnancy. For my cousin, it also meant death.”

---

Ochieng’ Ogodo is a Nairobi journalist whose works have been published in various parts of the world including Africa, the US and Europe. He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He is the chairman of Kenya Environment and Science Journalists Association (Kensja). His biography will be published in the 2009 Edition of the Marque’s Who’s Who in the World. He can be reached at ochiengogodo@yahoo.com or ochiengogodo@hotmail.com.

Groundwater in peril

COLOMBO, SRI LANKA – Mismanagement of groundwater threatens our drinking water, food production, and climate change adaptation prospects, warns a statement endorsed by the International Water Management Institute’s (IWMI) and signed by 700+ global experts.

The call to action highlighted in Nature this week cites recent scientific breakthroughs on groundwater’s vital role in supporting rivers globally. It supplies more than 40 percent of the water used for the world’s agricultural irrigation, drinking water to two billion people, and helps regions cope with worsening droughts. Millions of low income smallholder farmers, in particular, rely on groundwater in arid and semi-arid areas and during times of drought, making it one of nature’s best solutions to beat climate variability.

Groundwater makes up 99 percent of the Earth’s liquid freshwater. But in many places, warn the experts, groundwater is under threat from overexploitation and contamination, mostly due to poor understanding, land use planning, and management.

IWMI Director General Claudia Sadoff and groundwater lead researcher Karen Villholth, who coordinates GRIPP – the Groundwater Solutions Initiative for Policy and Practice – joined the 700+ signatories along with many individual experts and practitioners from IWMI’s partners. GRIPP is a key global partnership on groundwater science and policy, bringing together nearly 30 international institutes to strengthen groundwater initiatives and solutions.

“Groundwater is often out of sight, so we take it for granted, or misuse it in ways that impact the most vulnerable people and ecosystems.” says Sadoff. “IWMI is joining global experts, because if we allow groundwater to be further degraded or depleted, it threatens our ability to respond to increasing droughts and floods. And we’re closing in on real dangers to food and drinking water due to over-exploitation and mismanagement. The impacts could be global.”

The call to action comes as the world eyes the United Nations (UN) Climate Change Conference in Madrid (COP 25) and begins the Decade of Action on the UN Agenda 2030. Recent evidence points to the potential for groundwater as a major solution for helping the world – especially the Global South – adapt to droughts and climate extremes.

Over 700 scientists, practitioners and experts from over 75 countries around the world have now signed the call. The statement highlights the risks for 1.7 billion people who live above groundwater reserves that are stressed by overuse.

The statement calls for three actions:

1)      Put the spotlight on global groundwater sustainability through a UN World Water Development Report and a Global Groundwater Summit in 2022, the year when groundwater will be the UN World Water Day’s key focus.

2)      Commit to managing and governing groundwater sustainably from local to global scales by applying sustainability guiding principles locally, regionally and globally by 2030.

3)      Invest in groundwater governance and management by implementing groundwater sustainability plans for stressed aquifers by 2030. This means investing in nature-based solutions supporting groundwater, capacity building, awareness raising and developing better monitoring, reporting and management systems.

“Groundwater is so fundamental to our food and our drinking water, and critical to our ecosystems, but it’s still overlooked and mismanaged,” says Villholth, whose work is supported by the CGIAR Research Program on Water, Land and Ecosystems (WLE). “Our call to action will ensure groundwater stays on the radar following this week’s COP25 climate meetings. We’re stressing the critical importance of managing water properly for climate resilience, and under that the key role of groundwater. We are pushing hard now to get it on the global agenda to sustain these benefits and avoid widespread crises – in keeping with the Sustainable Development Goals horizon of 2030.”