According to this book, food production, access to clean water and health in Africa may be affected by climate change. In eastern Africa, rainfall is expected to increase in some parts of the region. In southern Africa, rains will be disrupted, bringing a notable drop in maize production. In contrast, growing seasons may lengthen in parts of Southern Africa, for example Mozambique, owing to a combination of increased temperature and higher rainfall. Yet net revenues from crops could shrink by up to 90% by 2100. There is likely to be a greater number of people living with water stress by 2055 as rainfall becomes more erratic or declines. The previously malaria-free highland areas of Ethiopia, Kenya, Rwanda and Burundi could experience modest incursions of malaria by the 2050s, with conditions for transmission becoming highly suitable by 2080s. Rift Valley fever epidemics could become more frequent and widespread as El Niño events increase. In southern Africa, more areas are likely to become more suitable for malaria, with a southward expansion of the transmission zone into Zimbabwe and South Africa.
Equity in Health
The World Health Organization (WHO) says the full impact of the swine flu outbreak in Africa has yet to be seen. The African Region was the last to experience the pandemic amongst the six WHO regions, and concerns are mounting about its potential effect. ‘What is of particular concern to us as Africans is that, although the pandemic has spread to our continent last, we may be more severely affected by it,’ said South African health minister Dr Aaron Motsoaledi. The concern is exacerbated by Africa’s burden of disease. ‘It is well known that this continent has always been worst affected by any outbreak of communicable diseases – whether it is HIV, tuberculosis, malaria, one or more of the haemorrhagic fevers. It is, therefore, essential for all countries within the continent to ensure that we are adequately prepared for all of these, but in the present context prepared to deal with the influenza pandemic’, he added.
Africa’s informal sector is still largely unknown. Some reports have suggested that approximately 60% of those employed in the Southern African Development Community region may be in the informal sector, while others report that up to 20% of all African workers were employed in this sector in 1992. Provision for occupational health and safety (OHS) in the sector is generally scanty, and non-existent in some countries, even if policies exist. This brief recommends that a systematic regional approach is needed to protect the health of workers in the informal sector, including collect basic data on the state of the informal sector, state support for infrastructure in developing the informal sector and insist that health and safety issues form part of business plans that are submitted for funding. Governments must play an active lead role and take responsibility for the provision of health and safety support to this sector, as well as ensure that basic health and safety training for employers and workers is provided.
This article notes that almost 400 million of the world's indigenous people have low standards of health. This poor health is associated with poverty, malnutrition, overcrowding, poor hygiene, environmental contamination, and prevalent infections. The authors argue that this precarious situation is aggravated by inadequate clinical care and health promotion, and poor disease prevention services. As indigenous groups move from traditional to transitional and modern lifestyles, they are rapidly acquiring lifestyle diseases, such as obesity, cardiovascular disease, and type 2 diabetes, and physical, social, and mental disorders linked to misuse of alcohol and of other drugs. To correct these inequities, the authors recommend increased awareness, political commitment, and recognition rather than governmental denial and neglect of these serious and complex problems. Additionally, the authors recommend that indigenous people should be encouraged, trained, and enabled to become increasingly involved in overcoming these challenges.
This second article on the health of indigenous people delves into the underlying causes of health disparities between indigenous and non-indigenous people, providing an indigenous perspective to understanding these inequalities. The authors present a snapshot of the many research publications about indigenous health, with the aim to provide clinicians with a framework to better understand such matters. By applying this lens, placed in context for each patient, the authors argue that more culturally appropriate ways to interact with, to assess, and to treat indigenous peoples shall be promoted. The topics covered in this article include indigenous notions of health and identity; mental health and addictions; urbanisation and environmental stresses; whole health and healing; and reconciliation.
Occupational health and safety (OHS) provision for public servants is southern Africa is poor. Many factors may contribute to this grave situation. Managers of government departments often lack knowledge of their responsibilities regarding occupational health and safety. Training in health and safety for managers and workers is limited by inadequate budgets, bureaucratic obstacles to procuring the training and lack of available approved trainers. Resources to improve the working conditions in the public sector are scarce. What is needed to ensure the health and safety of the public sector in Southern Africa are adequate policy and legislation, enforcement and monitoring of compliance in public service departments, OSH programmes in public sector workplaces, access to adequate treatment and rehabilitation for those affected by workplace hazards, and adequate social security for those disabled and the survivors of those who die on the job. Even if they are motivated to act against unsafe conditions, many categories of worker are precluded from the right to strike as they are considered providers of ‘essential services’.
The aim of the research was to assess current and historical surveillance of the pneumoconioses in former miners, in particular silicosis, silico-tuberculosis and tuberculosis, and to assess the functioning of the Occupational Diseases in Mines and Works Act (ODMWA) surveillance and compensation system, which is a responsibility of the Department of Health. The research also aimed to assess the impact of the burden of lung disease and disability on the public health system and on the labour-sending communities from which the miners come and to which they return. The main objective was thus to investigate health systems surveillance of the pneumoconioses in former underground gold miners, and to assess diagnostic and compensation systems under the legal framework of the Occupational Diseases in Mines and Works Act 78 of 1973 as Amended (ODMWA). The main finding was that this is a historically neglected subject, under-researched and undocumented.
The Economic and Social Council (ECOSOC) has adopted a number of resolutions, including a resolution urging the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other relevant organisations and bodies of the United Nations system to intensify their support to governments in dealing with HIV and AIDS. It also reaffirmed its commitment to the implementation of the Programme of Action for the Least Developed Countries for the Decade 2001–2010, which calls on the UN Secretary-General to step up appropriate measures for effective and timely implementation of the Programme in coordination with all relevant stakeholders, and submit an analytical and results-oriented annual progress report on the further implementation. The Council also recommended mainstreaming information and communication technologies in the economy as a driver of growth and sustainable development and encouraged all stakeholders to continue engaging in people-centred partnerships as an effective way forward.
The International Federation of Red Cross and Red Crescent Societies (IFRC) has launched a US$ 8 million initiative to help build the disaster resilience of 600,000 people living along the Zambezi river in seven southern African countries. The Zambezi River Basin Initiative (ZRBI) is a response to ‘a dramatic increase in the numbers of floods along the river basin’, according to Farid Abdulkadir, IFRC disaster management coordinator for the southern Africa region. The focus of the ZRBI is on disaster preparedness rather than post emergency relief operations, as in the past. It is a joint programme between the Angolan, Botswana, Malawi, Mozambique, Namibia, Zambia and Zimbabwe Red Cross Societies, combining risk reduction efforts with food security, health, HIV prevention and capacity building activities. The US Agency for International Development (USAID) has already committed US$1 million to the project.
Zimbabwe and Botswana have reported their first suspected cases of swine flu as the H1N1 virus begins to establish a foothold in southern Africa. Neighbouring South Africa has reported 54 laboratory confirmed cases of swine flu so far, 32 of which have been linked to a squash tournament at a university in Johannesburg. No deaths have been reported in the region as yet. Dr Lucille Blumberg, head of epidemiology at South Africa's National Institute for Communicable Diseases, said that most cases of the illness were ‘mild’, and that it was too early to tell whether people living with HIV and AIDS (PLWHAs) would be affected to a greater degree by the flu. Most PLWHAs are in southern Africa, where most countries also have severely stretched health services, and the effects of the virus on their populations remain uncertain. Blumberg said in other parts of the world swine flu had killed healthy people, as well as those suffering from underlying illnesses.