South Africa burns ....

I've blogged before about the blatant and violent xenophobia that exists in South Africa against other black africans ..... resentment against malawians, mozambiqans and especially zimbabweans (not to mention congolese, nigerians, somalis etc) .... who are economic and political refugees in SA ...... who despite being from countries that sheltered and supported the ANC during the dark days of apartheid enduring bombs, assasinations and often full scale wars for their stance .... and despite the fact that most of South Africa's wealth is built on migrant labour in the mines etc .... are now not similarly welcomed .... resented for allegedly stealing jobs (foreigners do have a rather justified reputation for working harder) and ironically for crime (again see post in July for the ludicrousness of one of the world's most violent countries blaming crime issues on outsiders ....) .....

The images coming out of Jozi this past few days eerily mirror old pictures from the late 80s when the township battles raged and the struggle against apartheid was at its peak .... Panzers storming into the townships .... shacks torched .... policemen engaged in running gun battles with mobs .... and collaborators or members of opposition parties (except now its foreigners) necklaced and burnt to death ..... the only difference this time around is that more of the policemen are black ....

The dream of the Rainbow Nation appears to be in tatters .... in a great Comment is Free piece in the Guardian yesterday - Sean Jacobs lists the hard truths ..... South Africa remains the most unequal country in the world .... for an increasingly youthful population (78% black), only 42 of every 100 South Africans have a job ..... 49% are deemed poor (with monthly household income below R2,400 or £170) ..... approx 15% are HIV positive ..... and despite all the country's wealth and infrastructure - 24% of homes have no electricity, 32 % no tap water, 69% no hot water supply, and R21 (£1.40) of every R100 (£6.80) they earn, they spend on food ..... emanicipation from white rule has not brought with it emancipation from poverty ....

Of course - its no justification for the mindless and terrible violence and for the nasty racism underlying it .... many countries are poorer yet remain peaceful (e.g. Malawi) .... but it is true that in the 14-15 years since the ANC came to power .... only a small black elite has become incredibly rich and powerful ..... and although a black middle class is emerging .... the new regime has mostly failed to deliver for its own people and grassroots ....


Yet it is inconceivable that the south african people (well the blacks at any rate) will vote against the ANC .... Cosatu the labour union has always been critical of Mbeki ... and there are internal ANC rifts especially surrounding Zuma .... but the recent revolt by the Durban port workers aside ..... the poor and the desperate of South Africa won't revolt against its own party of revolution and independence .... and instead the anger is directed against foreigners .... and now we hear reports that Indians (brought to SA as indentured labourers generations ago) - are also being targetted .... a worrying sign and one we've seen with tragic consequences in other parts of Africa in the past ....

There is of course a progressive liberal South Africa - with a constitution based on UN Charter of Human Rights (including enshrining gay rights - the only African nation to do so) ..... but perhaps a society that was built on difference and brutalised for it will remain brutal for a long time yet to come ....

The Age of Terror

More of the beeb at its best. Incredible series on the evolution of terror ... this episode is particularly poignant on the Nairobi/Dar american embassy bombings ..... somewhat overshadowed at the time by the Lewinsky saga .... but now can clearly be seen as Bin Laden's declaration of war .... a fantastic piece of journalism.

http://www.bbc.co.uk/iplayer/page/item/b00b6wd4.shtml?q=terror&start=1&scope=iplayersearch&go=Find+Programmes&version_pid=b00bdrst

Win He Will ....

Britain's got talent ....

Zambia .... or the crazy world of NGOs

One of the things C & I really wanted to understand once on the ground in Zambia .... was quite how the seemingly simple intervention for PMTCT (at its most basic just one tablet for the mum at delivery .... to the WHO recommended treatment - which is still less mind you than the extended preventative treatment any of us would get in the west - of one or two anti-retroviral drugs from 28 weeks and then syrup to the baby for anything from 1 day to a week after delivery .... and exclusive breast feeding - meaning absolutely NOTHING but breastmilk not even water - for 6 months if you can't guarantee safe water or continuous supply for formula feed ... which is essentially the whole of sub-saharan africa) needed to be integrated into the whole system of ante-natal care as a whole .... especially in more rural areas ....

An African health minister once warned me of NGOs that often enter countries with promises of quick-fix interventions e.g. a programme of vitamin A supplementation which was feted to cure all children of blindness at a cost of just 7 million dollars ... which in order to be implemented actually put on the overstretched national health system a cost of 77 million ... which clearly the NGO didn't consider in its costs .... i think today - we've all learned our lesseons somewhat but trying to triangulate this whole new approach to addressing the health system's needs ... yet avoiding the temptation to try and fix everything .... and still show results in the short term to please your donors .... is a complicated politricky dance ....

We visited urban and rural clinics packed to the rafters with expectant mothers and children pressed against all the sick and the competing for the attention of the heroic clinical staff .... rudimentary government labs and sleek NGO funded training centres ... pharmacies ..... community groups .... government ministries (its amazing that you can just get appointments with health ministers - imagine doing that at home! see - that is the indignity of being poor and having to welcome every idiot with a cheque book) ..... and swish NGO offices (fully complete with fleets of white 4x4s with tall flagpoles that sweep imperiously over rural roads .... C&I had a tiny starlet which showed us up totally as a pimply teenager in this very grown-up world of NGO multinationals)

I developed a huge respect for poor african health ministeries who have to juggle the demands, (well and not so well intentioned) interventions and directives of local organisations, NGOs, donor agencies, private sector etc etc .... one visit to the central medical stores showed boxes piled up from all over the world - condoms from the US, China, Sweden etc etc .... drugs from India ... bicycles from Germany .... bed nets from Britain ... all heaped up .... and they have to make sure that the they all get out to the right clinics spread across the country (often taking upto a week to travel) and coordinate expiry dates plus the politricks of difference agencies only wanting the clinics they support to receive the drugs they donate (yes i'm outing the Japanese)

This NGO driven agenda was most evident when we visited a rural clinic about 2-3 hours outside Lusaka .... where an amazing young clinical officer (sort of more than a nurse but not quite a Dr) ran a clinic with one other nurse for a catchment area of more than 10,000 people .... he provided a full set of services for his patients .... including the dual-therapy PMTCT that we are struggling to implement even in rich South Africa .... he proudly showed us the computer and printer carefully covered in plastic sheeting on his desk donated by an NGO so that he could use a patient 'smart-card' system and electronic medical record system that's being rolled out through an american PEPFAR initiative as a health system improvement .... however he still draws graphs of his quarterly achievements by hand (displayed behind the desk) and the pharmacy stock room was down to its last bottle of AZT and other ARVs (not to mention non-HIV drugs...) .... because no one has ever really taught him how to use the machine except for the smartcard .... and he still relies on copying everything painstakingly by hand ... because electricity tends to only be on for a couple of hours a day ....

When we were about to leave .... he refused at first to shake my hand .... "i won't say goodbye to you my sister until you promise me a borehole for the clinic" .... i was flabbergasted .... a borehole! but he had a computer!! He emotionally admitted that they had no water at the clinic so one of the two of them had to spend two hours a day fetching water to keep on hand for deliveries at the clinic, plus their own needs ..... a borehole would cost 11,000 kwatcha .... probably the half the cost of the unused printer on his desk ..... this is Development gone Mad.