USAID launches latest clean-up for Vietnam War-era Agent Orange site

Yahoo – AFP, April 20, 2019

A Vietnamese soldier stands next to a sign warning of toxic hazard at Bien Hoa
air base, on the outskirts of Ho Chi Minh City (AFP Photo/Thomas WATKINS)

Hanoi (AFP) - The US launched on Saturday a $183 million clean-up at a former Vietnam storage site for Agent Orange, a toxic defoliant used in their bitter war which years later is still blamed for severe birth defects, cancers and disabilities.

Located outside Ho Chi Minh City, Bien Hoa airbase -- the latest site scheduled for rehabilitation after Danang airbase's clean-up last year -- was one of the main storage grounds for Agent Orange and only hastily cleared by soldiers near the war's end more than four decades ago.

US forces sprayed 80 million litres (21 million gallons) of Agent Orange over South Vietnam between 1962 and 1971 in a desperate bid to flush out Viet Cong communist guerrillas by depriving them of tree cover and food.

The spillover from the clearing operation is believed to have seeped beyond the base and into ground water and rivers, and is linked to severe mental and physical disabilities across generations of Vietnamese -- from enlarged heads to deformed limbs.

At Bien Hoa, more than 500,000 cubic metres of dioxin had contaminated the soil and sediment, making it the "largest remaining hotspot" in Vietnam, said a statement from the US development agency USAID, which kicked off a 10-year remediation effort on Saturday.

The dioxin amounts in Bien Hoa are four times more than the volume cleaned up at Danang airport, a six-year $110 million effort which was completed in November.

"The fact that two former foes are now partnering on such a complex task is nothing short of historic," said the US ambassador to Vietnam, Daniel Kritenbrink, at Saturday morning's launch attended by Vietnamese military officials and US senators.

Hanoi says up to three million Vietnamese people were exposed to Agent Orange, and that one million suffer grave health repercussions today -- including at least 150,000 children with birth defects.

An attempt by Vietnamese victims to obtain compensation from the United States has met with little success. The US Supreme Court in 2009 declined to take up the case while neither the US government nor the manufacturers of the chemical have ever admitted liability.

While US officials have never admitted direct links between Agent Orange and birth defects, USAID on Saturday also issued a "memorandum of intent" to work with government agencies to improve the lives of people with disabilities in seven Vietnamese provinces.

American Red Cross squandered aid after Haiti earthquake, report alleges

Despite raising nearly half a billion dollars and allocating $170m to ‘shelter relief’, the aid organization built only six permanent homes, an investigation has found

The Guardian, Alan Yuhus, 4 June 2015

An undated American Red Cross handout photo of the aftermath of the earthquake
shows the devastation to homes in Haiti. Photograph: Matt Marek/American
Red Cross/PA

Despite collecting nearly half a billion dollars for Haiti earthquake relief, the American Red Cross has built only six permanent homes and seemingly squandered millions in the country, according to a new report.

A joint investigation by ProPublica and NPR uncovered rampant mismanagement, high overhead costs and deeply rooted acrimony from Haitians toward the aid organization. Among the investigation’s findings was that although the Red Cross apportioned about $170m to the category of “shelter” relief, and although it at first planned to build some 700 houses, it only constructed six permanent homes.

The report charges the Red Cross with consistent misrepresentation of its projects, especially in housing. The authors cite promotional materials that say the Red Cross provided more than 130,000 people with homes, and then note that that total includes people in “transitional shelters”, recipients of short-term rent assistance, and people who had been “trained in proper construction techniques”.

The Red Cross disputes the report and asserts it has “helped build and operate eight hospitals and clinics” and “move more than 100,000 people out of make-shift tents into safe and improved housing”. In a statement, the organization said it is “disappointed” by the “lack of balance, context and accuracy” on the part of ProPublica and NPR.

A major problem for the organization was leadership and staffing, according to the report. Integral positions, including experts for health and shelter, were left vacant for months and sometimes years. The positions that were staffed were predominantly held by expats or by people flown in from the United States, many of whom could not speak French or Creole.

In one 2011 document, Red Cross official Judith St Ford notes that there are “serious program delays caused by internal issues that go unaddressed”, including for cholera relief.

“There is a clear lack of foresight and planning,” she wrote, and “the lack of leadership ability has contributed to poor morale in the field.”

She also urged her superiors to hire more Haitians: “the implication that talented, smart, competent Haitians cannot be found in Haiti has to be dispelled.”

In its statement the Red Cross says 90% of its current staff are Haitians; the organization did not break down the hierarchy or positions of its staff.

“If they were an organization that had a real history in Haiti I think this would’ve gone a lot better,” said Justin Elliott, one of the journalists who co-wrote the report. “The entire Haiti reconstruction effort has been really problematic, but the outside groups that have done better have roots there, have Haitian people working at high levels, have people who speak the language.”

In one 2013 email published by ProPublica, CEO Gail McGovern admitted a project had failed and that she did not know what to do with a $20m remainder. “Now that the Northern project is going bust and we are still holding $20 million of contingency, any ideas on how to spend the rest of this?” she asked, before mentioning a mysterious “wonderful helicopter idea”.

Without Haitians in leadership positions, the Red Cross was particularly ill-prepared to deal with Haiti’s land tenure rules, a system so tangled and unforgiving that it has intimidated USAid and Vatican relief efforts.

Residents of the Jean-Marie Vincent camp for people displaced by the 2010
earthquake, wait for customers outside their tent where they have set up a
stand to sell rice, oil and canned goods in Port-au-Prince on 9 January 2013.
Photograph: Dieu Nalio Chery/AP

“Land tenure is probably the biggest stumbling block,” said Jonathan M Katz, a freelance journalist and author of a book about the earthquake, The Big Truck That Went By. The system has stymied aid organizations for years, and Katz said that for years aid organizations have “thrown up their collective hands and said ‘we don’t really want to deal with this.’”

The Red Cross entangled itself in a web of other organizations, often paying them to do relief work, themselves struggling in Haiti. This outsourcing is commonplace in the international aid industry, Katz said, and leads to inevitable but not necessarily unreasonable overhead costs. But eager to better solicit donations, organizations often try to downplay these costs.

The report notes that overhead charges by the Red Cross and its contractors undermine McGovern’s claim that “minus the nine cents overhead, 91 cents on the dollar will be going to Haiti.”

In one case, Elliott and his co-author, NPR’S Laura Sullivan, found that the International Federation of the Red Cross (IFRC) exacted $1.56m in overhead from the American Red Cross’s payment of $6m, all to help give Haitians rental subsidies so they could leave tent camps. The IFRC said the costs were related to “administration, finance, human resources”.

In another case, the Red Cross commissioned Swiss and Spanish Red Cross societies to upgrade shelters, but still took 24% of the money for the project in additional overhead costs, according to the report.

Where exactly the $488m of the American Red Cross’s Haiti budget has gone is unclear, Elliott said, since “the whole international aid sector is pretty opaque in general. And the spending of the American Red Cross is incredible opaque. You can tell hardly anything from their disclosures.”

He said that the issue of money was particularly sensitive to Haitians who had coordinated with the Red Cross.

“They were furious basically over broken promises,” Elliott said. “About three years ago, the Red Cross told people they were going to build hundreds of new homes in this very hard-hit area, and this thing was just stalled. Over the next two years they had meetings with the community, handed out juice boxes and so on, and nothing happened for a long time.”

The Red Cross is now helping build a road and install solar lights in the area.

Katz said that the problems of the American Red Cross are “typical of the aid industry in general. The Red Cross is sort of the biggest kid on the block. Because they make way more money than anybody else, what they do is magnified.”

The interconnected NGOs and aid organizations of the world, ranging from the many satellites of the Red Cross to Doctors Without Borders to the Clinton Foundation, Katz said, should deserve more skepticism from the public. Reports have traced the 2011 cholera epidemic to United Nations relief efforts, he noted, adding that many organizations operate more like businesses than anything else.

“Even when an aid group is pulling off a project well,” he said, “if it isn’t going to be there forever, if it isn’t going to be accountable for successes and failures, if it isn’t leaving something behind that’s permanent, then it’s still capable of doing damage.”

Last year the Red Cross similarly took issue with another ProPublica report that said the organization had disastrously mismanaged aid relief after hurricane Sandy.

Aids breakthrough as study says treatment should cost less

Clinton Foundation delivers report showing cost of treating people with HIV is four times less than previously thought

guardian.co.uk, Sarah Boseley, health editor, Friday 20 July 2012

Bill Clinton with school pupils in Matugga, Uganda. The former US president

 has hailed the results of the Clinton Foundation study. Photograph: 

Kasamani Isaac/AFP

Lack of money can no longer be considered a reason – or an excuse – for failing to treat all those with HIV who need drugs to stay alive, following game-changing work about to be published by the Clinton Foundation that shows the real cost is four times less than previously thought.

The striking findings of a substantial study carried out in five countries of sub-Saharan Africa are hugely important and will set a new hopeful tone for the International Aids Conference in Washington DC, which opens on Sunday. It will help make the argument for President Obama and other international donors to dig deeper into their pockets – because the cost of saving lives, slowing the spread of HIV and achieving the ambition of an Aids-free world is lower than anyone assumed.

The work by the Clinton Health Access Initiative (CHAI) shows that the total cost of treatment in health facilities – including drugs, lab tests, health workers' salaries and other overheads – comes to an average of $200 a patient a year across Ethiopia, Malawi, Rwanda and Zambia – four of the Aids-hit African nations studied. That rises to $682 in South Africa, which has higher salaries and lab costs.

Until now the generally accepted total cost of treating a patient for a year was an average of $880 – based on a study by the US president's emergency plan for Aids relief (Pepfar) released at the last International Aids Conference two years ago in Vienna.

Bernhard Schwartländer, director of strategy at UNAIDS, believes the CHAI work should lead to new optimism. "I think the cost argument is just a false argument and it has been used as an escape. We do need more money but it is not at a level that will be impossible," he said.

The costings are particularly important in the wake of recent scientific findings that show putting people on antiretroviral drugs makes them far less likely to infect others – helping to stop the spread of HIV as well as keeping people alive. CHAI will also announce that it has negotiated down the prices of some of the newer and most important drugs needed for treatment by around a third.

Former US president Bill Clinton hailed the findings as evidence that all 15 million people with HIV in need of treatment could affordably get it — the target for 2015. At the moment, 8 million are being treated. "We now have compelling evidence that universal access to high-quality HIV treatment is achievable, sustainable, and within our means," said Clinton.

"Together, the costing study and price reductions open the door to scaling up and sustaining services for the 7 million people who currently lack access to HIV treatment. Providing treatment will save lives and help prevent the spread of HIV."

CHAI worked with the Centre for Global Development and the governments of those African countries involved to collect data from 161 health facilities for the last financial year on record – mostly 2010.

The original aim of the study was to find out whether there was any potential to reduce waste, cut costs and save money, but researchers found salaries and other costs were already so low that this was unlikely, except possibly in South Africa.

Average costs per patient were lowest in Malawi, at $136 a year. That rose to $186 in Ethiopia, $232 in Rwanda and $278 in Zambia. Nearly half the cost, on average, was the price of drugs – which will increase slightly as countries begin to use more effective and more expensive drugs now recommended by the World Health Organisation. CHAI, however, is about to announce a deal with generic drug companies, which will reduce tenofovir-based regimens, which are the "gold-standard" in the USA and recommended by the World Health Organisation, to $125 from $409. CHAI says this will save countries over $500 million between now and 2015.

Kate Condliffe, executive vice-president for health programmes at CHAI, said finances were thought to be a bottleneck to expanding the numbers of drugs in many countries. "The perception that treatment costs are higher is casting a cloud over conversations on how to accelerate treatments," she said.

"You sit through conversations on treatment and prevention where there should be incredible optimism, given the science, and yet there is concern about feasibility and cost that lead to an incremental approach."

But while there are not huge opportunities to save money on treatment in the clinics, there is a disparity between the costs at health facilities and the costs at government level. That was illustrated this week in the major UNAIDS report, which referred to national costs in Zambia – around a third higher than costs in the clinic.

Schwartländer said that even if one assumed a cost of $300 a patient a year, the bill to put 20 million people on HIV treatment would be $6bn a year. "It is not outrageous. It can really be handled," he said.

"Look at the amount of money moving around in low-income countries. $6bn should not shock us – it is not impossible. We need a different view from that of the 'treatment timebomb'."

An Aids treatment clinic in South Africa – a study says the average cost
 of treatment in Africa should be $200. Photograph: Stephane De Sakutin/
AFP/Getty Images

Related Articles:

Tutu calls for end to gay stigma to help tackle HIV

India to give free medicine to hundreds of millions


AIDS Was a Man-Made Pandemic

The perfect drug? Monsanto hooks Nepal on GMO corn

RT.com, 15 April, 2012

Anti-GMO activists rip open bags containing "MON 810", a variety of

 genetically modified maize (corn) developed by Monsanto Company after

 entering a Monsanto storehouse on January 23, 2012 in Trebes near

Carcassonne, southern France. (AFP Photo / Eric Cabanis)

The Nepalese government has teamed up with notorious agricultural giant Monsanto to force farmers use its GMO seeds. The strain, banned in several EU countries, will be used to substitute imports and boost the starving nation’s maize production.

Corn is one of Nepal’s biggest crops but the country produces only about half of what it needs for its feed industry, and imports some 130,000 tons annually to cover the deficit. Still, over 40 per cent of the Nepalese population is malnourished.

The United States Agency for International Development (USAID) is lending the starving country a helping hand. More specifically the hand of Monsanto, an agricultural goliath which reaps as much controversy as it does seed.

USAID announced last September that it wants to create a partnership with Monsanto and the Nepalese government to boost maize production.

“We have been trying to help the Nepalese farmer to increase his total production of the food crops,” making him “a little bit more competitive by bringing his costs down,” said USAID Economic Growth Advisor Rave Aulakh.

Soon after the initiative was introduced, public anger spilled onto both social media and the streets. Hundreds of protesters gathered in front of the US embassy in Katmandu to speak out against Monsanto.

“You start buying seeds from them,” explained protester Sabin Ninglekhu. “Year one: it can produce a bit of yield. Year two: yield starts going down. And then it means you have to increase inputs. You have to annually buy seeds from this company because seed fertility keeps going down.”

While most agree that Nepal must urgently address its food and security problems, critics say that the solution to Nepal’s agricultural problems should come from within the country, not from abroad.

The ultimate goal of the protests was to put pressure on the government of Nepal to cancel its agreement with USAID and Monsanto before the consequences hit. They say the partnership will shift the country's dependence from imported maize to genetically modified seeds from abroad.

Monsanto’s history is not exactly branded in glory. Allegations of monopolization of local markets follow the corporation, as it has been sued by hundreds of thousands of farmers around the globe.

The latest lawsuit against Monsanto was filed last week in New Castle, Delaware. The suit claims that the corporation, "motivated by a desire for unwarranted economic gain,” knowingly poisoned Argentinian farmers that were pressured to use the company’s pesticides. The farmers insist that exposure to Monsanto’s chemicals caused an array of defects in local children.

Some European countries also strongly oppose using Monsanto’s genetically modified seeds. Last month, the MON 810 strain of maize was temporarily banned in France“to protect the environment.” Poland also stated it will move to ban the strain completely. And last week, the European Commission failed to gather enough support to approve cultivation of three corn varieties developed by Monsanto.

Related Articles:


Farm group seeks U.S. halt on "dangerous" crop chemicals

Monsanto and Genetically Modified Crops - Is there a cover-up?

$500m of US food aid lost to waste and company profit, says Oxfam

More than 17 million more hungry people could have been reached by US-funded programmes in 2010 if 'tied aid' restrictions were lifted, according to report

guardian.co.uk, Claire Provost, Friday 30 March 2012

World Food Programme wheat is unloaded from a US navy helicopter in
Pakistan. Photograph: Paula Bronstein/Getty Images

Nearly $500m of US food aid is lost to waste, inefficiency and the profit margins of big American agribusiness, according to a report by aid groups urging reforms on how US food aid is sourced and delivered.

Oxfam America and the American Jewish World Service (AJWS), which published the report on Thursday, estimate more than 17 million more hungry people could have been reached by US-funded programmes in 2010 if "anachronistic" restrictions contained in the US farm bill had been lifted.

The US provides roughly 50% of food aid globally at an estimated annual cost of $2bn. But unlike many other major donors, virtually all American food aid is "tied" and must be bought from US suppliers and transported on US ships – even if there are cheaper alternatives.

The report urges Congress to relax these restrictions and curtail "monetisation" schemes, where aid agencies are given US food to sell off in developing countries to finance their projects. Such reforms to the farm bill, which covers the bulk of US food aid programmes and is up for reauthorisation this year, could pay "enormous anti-hunger dividends" for those most in need, says the report, while saving millions in taxpayers' money.

"Food aid is a vital part of US foreign policy, but we are shortchanging millions of hungry people with unnecessary red tape," said the AJWS director of advocacy, Timi Gerson, in a statement. "US policies are ripe for reforms that will save lives now and reduce the need for aid later by enabling local farmers to thrive."

A January 2012 study by agricultural economists at Cornell University found that buying food products locally leads to average cost-savings of more than 50% for cereals like wheat, and almost 25% for pulses like peas and lentils. However, it found that some processed foods like vegetable oil are potentially cheaper to buy and ship from the US.

The study also estimated that procuring food locally, or distributing cash or vouchers, results in an average time-saving of nearly 14 weeks. It suggested a more flexible approach to food aid programmes, with aid agencies allowed to choose between food aid shipped from the US, locally or regionally purchased supplies, vouchers and cash transfers, depending on the situation and specific objectives.

The Oxfam/AJWS report acknowledged there may be limits to the amount of food aid that should be bought locally. In some cases, such as food aid destined for nearby Latin American countries, shipping costs could be relatively low, and some products might actually be cheaper to buy in the US. It also warned that in certain situations the stress placed on local markets by food aid procurement "could drive food price inflation, pushing the costs of food beyond the reach of local consumers".

Congress should, however, put an immediate end to the monetisation of food aid, it said. In 2010, aid agencies received more than $300m in US food to sell off in developing countries to finance their projects. The report estimates that just over $90m was lost in the process, as aid agencies often have to, or choose to, sell supplies below cost.

Lawmakers should cut this "circuitous, inefficient route" to funding development projects and hand cash directly to aid agencies rather than via US agribusiness, said the report, arguing that such schemes not only reduce the effectiveness of US aid programmes but can also undercut developing country farmers by flooding markets with US commodities.

Eric Munoz, senior policy advisor at Oxfam America, said while there is a growing body of evidence that US food aid policies carry significant financial and human costs, pushing through reforms means competing with powerful business and political interests "who all benefit from the current system and support the status quo".

In 2010 about 40% of US-funded food aid was purchased from just three companies, he said. Meanwhile, as current regulations require at least 75% of American food aid to be shipped on US-flagged vessels, "this is essentially a subsidy to the [shipping] industry and so they also have a very strong interest to maintain the current system", Munoz added.

Earlier this year, the US agency for international development (USAid) revised its procurement regulations to allow the agency to buy most goods and services from developing countries. But US-funded food aid – along with motor vehicles and US-patented pharmaceuticals – was not covered by these changes.

Munoz hopes the current financial climate might help push congressional officials to also reconsider long-standing food aid policies. "There is a growing recognition that we need to make the best uses of the resources available," he said. "And business as usual will certainly not make a difference in the lives of hungry people."

Related Article:

One third of world's food is wasted, says UN study

USNS Mercy arrival a blessing for Ambon’s neediest residents

M. Azis Tunny, The Jakarta Post, Ambon | Thu, 07/29/2010 9:47 AM |

Nurjanah could not be happier. Her three-year-old daughter, Cici Mahdani, just received corrective surgery to a cleft palate she was born with aboard the 273-meter floating hospital US Navy hospital ship, USNS Mercy.

The 24-year-old mother said she could not have afforded the surgery otherwise.

“I’m so grateful that my daughter received free surgery here. She could not have the surgery before since we did not have the money to take her to the hospital,” she told The Jakarta Post in the ship’s waiting room on Wednesday.

The vessel, carrying 956 US Navy military and civilian personnel, docked in Ambon on Monday. It is on a mission to provide free medical services, including surgeries, as part of Operation Surya Baskara Jaya, which is part of the ongoing Sail Banda maritime event.

The free medical services was also hassle free, according to Nurjanah, who said she did not have to undergo any complicated administrative procedures.

Nurjanah said she was only required to submit a letter explaining where she lives and a letter on her daughter’s ailment. The next day, her daughter was on the surgery list.

“When I heard about the ship’s services from my cousin, who works at a community health clinic in Ambon, I was just submitted the letters and my daughter could come here for the surgery. The

arrangements took only one day,” Nurjanah said.

Despite her troubles in speaking English, she said the doctors and attendants made efforts to consult her condition and that of her daughter.

Nurjanah said she felt lucky to be able to board the world’s largest hospital ship. Out of the hundreds of patients who were offered treatment, only 83 had been referred for surgery aboard the sophisticated vessel.

USNS Mercy contingent commander Capt. Jeffery W. Paulson said more than 20 patients had undergone surgery aboard the vessel since Tuesday.

“We intend to operate on 83 patients on the ship. We have also opened a dental clinic and worked together with 50 health clinics in Ambon and the surrounding areas,” Paulson said.

“We estimate that 500 patients will receive treatment each day.

“The biggest surgery we’ve performed so far on our visit to Ambon was an orthopedic surgery. But we’ve also performed cataract and harelip surgeries,” said Paulson.

During its visit to Ambon, the USNS Mercy will provide free surgery, medical treatment and dental care at a number of locations in Ambon and the surrounding islands, including Seram and Haruku islands.

Currently on its 2010 Pacific Partnership mission, USNS Mercy is supported by 65 doctors and assisted by hundreds of medical attendants.

In the Pacific Partnership mission, the USNS Mercy is led by three captains — Capt. Lisa M. Franchetti (Pacific Partnership mission commander), Capt. Jeffery W. Paulson (medical contingent commander) and Capt. David C. Bradshaw (ship’s captain).

The 2010 Pacific Partnership is part of the fifth training exercise conducted in Indonesia aiming to help disaster victims and strengthen regional cooperation.

The humanitarian mission carried out by the US and a number of countries is currently taking place simultaneously with the Sail Banda event in Maluku.

Mission commander Capt. Franchetti said she was proud to be a part of the Sail Banda event.

“Our visit to Maluku has been very productive and full of memories,” said Franchetti.

Various teams participating in the mission in Indonesia are professionals in various fields, such as medical and machinery.

They come from Australia, Canada, Cambodia, Singapore, New Zealand, England, Indonesia and the US armed forces.

Volunteers from a number of NGOs are also involved in the mission.

The USNS Mercy has made three visits to Indonesia. The first was its involvement in humanitarian efforts after the 2004 boxing day tsunami that devastated Aceh. In 2006, it docked in Indonesia as part of its five-monthly program providing medical mitigation programs in Bangladesh, Timor Leste and the Philippines.

After setting sail from Ambon, the USNS Mercy will head to Timor Leste to complete the 2010 Pacific Partnership mission.

US, RI partnership to fight HIV/AIDS continues

Antara News, Monday, November 30, 2009 14:51 WIB

Jakarta (ANTARA News) - Under the international theme of "Universal Access and Human Rights," the U.S. Government is once again standing in partnership with the Indonesian Government in supporting World AIDS Day, which is observed on December 1, the US embassy said here Monday.

Indonesia`s theme this year is "Working together community/civil society and government can accelerate access for information, prevention, care and support for all", according to the US embassy in a press release.

World AIDS day provides us with the opportunity to recognize the significant strides we have made in the fight against HIV/AIDS over the last 25 years, and recommit ourselves to joint efforts to overcome the obstacles and challenges that remain, the embassy said.

This year, the governor of Jakarta, with the Minister of Health, the Minister for People`s Welfare and the Secretary of the National AIDS Commission in attendance will launch a program to provide universal access to HIV/AIDS services to most-at-risk populations: injecting drug users, commercial sex workers, clients of sex workers and men who have sex with men.

Other events include the public announcement of the National AIDS Strategy and Action Plan 2010-2014, teleconferences between the President of Indonesia and district governors on making political commitments to HIV/AIDS, and a press conference with HIV/AIDS experts, it said.

The United States supports Indonesia`s National AIDS Program with an annual $8 million HIV/AIDS program, the embassy added.

The U.S. program focuses on prevention efforts and technical assistance and capacity building with NGOs and district governments to expand services for most-at-risk populations in eight provinces where local epidemics are escalating, including; Papua, West Papua, North Sumatra, East Java, Jakarta, Riau Islands, West Java and Central Java.

According to 2008 estimates by UNAIDS, the HIV epidemic in Indonesia is among the fastest growing in Asia. The epidemic is concentrated primarily among injection drug users (IDUs) and their sexual partners, people engaged in commercial sex and their clients, and men who have sex with men. Across Indonesia, there are an estimated 270,000 people living with HIV/AIDS this year, it disclosed.

Let me prove it all in my work: Endang

Adianto P. Simamora, The Jakarta Post, Jakarta | Thu, 10/29/2009 1:13 PM

The new commander of the health portfolio promises she will be competent in the role despite criticism following her appointment.

Endang Rahayu Sedyaningsih made her maiden public appearance at a health expo Wednesday after her installment last week.

The public did not know much about Endang, who abruptly replaced other Nila Juwita Anfasa Muluk just a day before the President announced his Cabinet lineup last Tuesday.

Hours after her selection, rumors arose, including from her predecessor, Siti Fadilah Supari who organized a press conference to respond to the President's decision.

Siti accused Endang of smuggling H5N1 bird flu virus samples overseas.

Officials at the ministry were also shocked by Endang's appointment.

"Many people phoned me minutes after asking who Endang was," an official who asked for anonymity told The Jakarta Post.

"But I could not answer because I didn't know Endang *at the time*."

Endang began her career at the Health Ministry in 1990, but she was demoted by Siti in 2008, an action many officials believed was her punishment for carrying virus specimens abroad without consulting the minister.

"The demotion was an ordinary thing and as staff, we must abide by orders," Endang said after her recent inauguration.

The mother of three holds a masters and PhD from the School of Public Health at the prestigious Harvard University in Boston, United States.

A graduate of the University of Indonesia in 1979, Endang joined the Pertamina Hospital in Jakarta as a clinician.

She then moved to the Waipare Health Center in East Nusa Tenggara as head of the community health center before joining the Jakarta Health agency in 1983.

In 2001, Endang moved to the World Health Organization (WHO) in Geneva, Switzerland, as a technical adviser at the Department of Communicable Disease Surveillance and Response.

Endang was named coordinator and researcher of the avian influenza program for the Health Ministry's Center for Biomedical and Pharmaceutical Research and Program Development in 2006, Jakarta.

In 2007, she was promoted to director of the center.

Additionally, she worked as part of an advisory team and as a country consultant for foreign agencies including WHO, the US Agency for International Development (USAID), the Australian government's overseas aid program (AusAID) and the World Bank.

She also wrote a series of articles for international journals, including "Epidemiology of cases of H5N1 virus infection in Indonesia" in 2007.

Responding to the accusation, she said "That's not true.

"I've never taken the virus overseas. I've never sold it.

"I only conducted research with my colleagues."

Endang also denied allegations her appointment was backed by foreign organizations and the local tobacco industry, saying it was only a rumor based on her frequent partnership with foreign researchers.

She said she would follow in the steps of her predecessor by maintaining the suspension of the US Navy's Naval Medical Research Unit No. 2 (Namru-2) laboratory in Jakarta.

"We had to close Namru-2 because it was a military unit," Endang said.

"But Indonesia's cooperation with the US will continue and covers a wide range of areas, including the operation of the biomedical lab.

"Details of this partnership will be provided soon," she said.

"The point is it aims to advance biomedical technology."

Namru-2 began operation in Indonesia in 1970 as a joint-research laboratory to study virus strains under a partnership between the US Navy and the Indonesian Health Ministry.

The laboratory is located in the ministry's research and development center.

But the two countries have agreed to form a center for medical research to forge cooperation in joint-research activities.

Related Articles:

Health Ministry to form commission on specimen transfer

New health minister denies virus-smuggling accusation

Sanitation becomes a must-learned topic

Tertiani ZB Simanjuntak, The Jakarta Post, Jakarta | Mon, 12/22/2008 11:05 AM  

Education officials in Batu municipality had had enough. The uncontrolled development of its water catchment area had reduced the Brantas River, the city's main water source, to a stream; weather in the resort town was growing warmer every day and sanitation-related diseases were on the rise. 

To encourage the involvement of local people, from a young age, in combating these sorts of problems, the city's education agency launched a sanitation and environmental curriculum in 2003. 

"At first the program was laughed at by others because it focused on what people often overlook, such as how to bathe, wash the hands...But later people took it seriously because the new curriculum made children aware of the environment and their personal hygiene," education agency head Mistin said. 

Visiting Jakarta for a discussion held by the Environmental Services Program (ESP), funded by the United States Agency for International Development, Mistin discussed the difficulties her office faced in implementing the curriculum with some school teachers in the capital. 

She said that schools usually choose teachers who worked the least, such as physical education teachers, to teach the environmental studies classes. The teachers were changed regularly because of scheduling issues and no standard teaching material was used. 

"As a local curriculum, meaning there is no national examination, the schools didn't pay due attention to it and some of them even integrated it as part of other subjects such as science," Mistin said. 

In 2005, the ESP introduced its Clean, Green and Hygiene program to Batu, in a bid to save the forest by encouraging locals to separate their organic and non-organic waste. 

After adopting ESP's fun teaching method, school students now learn about river ecosystems, forest conservation, waste management and hygiene. 

"There are special teachers handling the class and they have routine meetings to discuss the studies. Now we have standard teaching methods and modules," Mistin said. 

ESP Health Communication coordinator Nona Utomo said the program had significantly reduced the number of diarrhea cases among children, the main target of the organization's work in Batu. 

"In three years, the number has plunged from nine to 10 cases per month on average to one or two," she said. 

Working together with ESP since 2006, Muslim organization Muhammadiyah had also adopted the Clean, Green and Hygiene program in swampy Paciran, Lamongan regency in East Java. 

"At first, many people resisted the involvement of a foreign country ... We used religious approach to make them accept the importance of clean and hygienic living," said Syafiq Mughni, chairman of Muhammadiyah in East Java. 

Muhammadiyah has 925 schools as well as 815 kindergartens in the province. Currently, 119 elementary schools and 330 Islamic boarding schools have applied the Clean, Green and Hygiene curriculum. 

"By May 2009 four model schools (based on the sanitation and environmental curriculum) will be launched in Paciran, Pare, Malang and Surabaya," Syafiq said. 

Noted environmentalist Emil Salim said that the Batu municipality and Muhammadiyah in East Java had succeeded in using a holistic approach to build the school curriculum. 

"We have to encourage the next generation to develop understanding on living in harmony with nature," he said. 

Winda, a teacher at Islamic private school Al-Kenaniyah in Pulomas, East Jakarta, said that the school was considering adopting the special curriculum. 

"We need this kind of local curriculum so children will understand why there is always flood and water-borne diseases in Jakarta. But we haven't got any response from the Jakarta administration about this matter," she said.

Indonesia, US discuss cooperation in bird flu management

Jakarta (ANTARA News) - Visiting US Health and Human Service Minister Michael O Leavitt and his Indonesian counterpart Siti Fadilah Supari met at the presidential office here on Monday to discuss the continuation of bilateral cooperation in bird flu management.

"We meet to follow up on talks on bird flu management that we held in Geneva ten days ago," Siti Fadilah Supari said after the meeting.

She said the follow-up talks with the US health and human services minister were held to find a solution to the Materal Transfer Agreement (MTA) on the shipment of bird flu virus samples to the United States.

According to the Indonesian health affairs minister, almost all of Indonesia`s proposals on MTA were approved at the Geneva meeting although their formats were simplified.

The minister said developing countries including Indonesia wanted MTA to ensure transparency in the use of bird flu virus specimens, transfer of technology to produce bird flu vaccine, and equality in the right to access vaccines.

US Health and Human Service Minister Michael Leavitt was on a two-day visit in Indonesia starting Monday (April 14) to strengthen bilateral cooperation in health affairs, a US Embassy Embassy staffer Kresna Soegio said.

He said there was close cooperation between Indonesia and the United States in health affairs, especially in bird flu management.

According to US Embassy data, the US was through the USAID implementing a program to support Indonesia`s national strategy to control and promote preparedness to deal with the bird flu pandemic for the 2006-2008 period. The strategy provides for enlightenment campaigns for the public and private sectors in every sub district in Java, Bali, West Sumatra and Lampung.

Since 2005, the United States had provided Indonesia with US$42.85 million to fund bird flu control and prevention programs.

Harm reduction -- Part I: Combating drug abuse

Jane Raniati, Contributor The Jakarta Post, Gianyar, Bali

While drug abuse is a broad problem encompassing many potential causes and consequences, both personal and societal, the problem of associated HIV infection is becoming one of the primary concerns due to the rapidly rising proportion of HIV/AIDS cases that are linked to injecting drug use.

According to a 2005 study by the National Narcotics Board (BNN) and the University of Indonesia, approximately 1.5 percent of Indonesia's population (3.2 million people) abuse drugs; 25 percent of them by injecting. Furthermore, 60 percent of these injecting drug users (IDUs) are estimated to be infected with HIV.

In the same study, the Communication and Information Technology Ministry estimated that 15,000 people die each year in Indonesia due to drug abuse, either from overdose or from AIDS. In addition, according to an article on the BNN website (www.bnn.go.id), 2006 saw more than 15,000 cases of secondary school students who were "victims of illegal drugs", with over 4,000 among junior hih school students and over 11,000 among senior high school students.

The first case of HIV due to injecting drug use (IDU) was reported in 1993. According to the Health Ministry, only 1.1 percent of all known HIV/AIDS cases by December 1995 were due to IDU, but by December 2000 this figure had risen to 6.4 percent; by December 2005, it reached 38.9 percent.

In 2006, IDU surpassed heterosexual transmission as the most common mode of transmission among all cumulative reported cases of HIV/AIDS in Indonesia. The latest data, compiled through September 2007, indicates that 49.5 percent of the 10,384 known AIDS cases in Indonesia (cumulative, not including HIV) are due to IDU.

Harm reduction

Harm reduction has become quite a global buzzword in recent years. It refers to interventions aimed at minimizing the medical and social problems associated with drug use, such as methadone maintenance and needle exchange programs. It is not exclusively concerned with IDUs or with HIV, but with all kinds of drug use and all kinds of harmful consequences.

In other parts of the world, HR has become a major thrust of government and community efforts to combat the problems of drug abuse, within the context of frustrated efforts at controlling drug trafficking and dissuading people from using drugs.

Despite being recently embraced by the office of the Coordinating Minister for People's Welfare, HR remains somewhat controversial in Indonesia, mainly due to its different approach from the more popular demand reduction and supply reduction programs (see Part II-sidebar).

Octavery "Very" Kamil is head of the Injecting Drug Users Intervention Unit at the Aksi Stop AIDS! (ASA) project, run by the Jakarta-based Family Health International (FHI). He has worked for ASA since its inception in 2001.

ASA is funded mainly by the U.S. Agency for International Development (USAID), but also by The Global Fund to fight AIDS, Tuberculosis and Malaria and the HIV/AIDS Indonesian Partnership Fund (IPF) of the UK Department for International Development (DFID). The IDUs Intervention Unit was created in 2005, and it manages 22 non-governmental organizations (NGOs) and two Health Ministry programs in six provinces -- the latter covering 40 districts and cities.

"The goal of ASA's IDUs unit is to reduce the spread of HIV among IDUs," said Very, "thus all of the unit's work is concerned with harm reduction (HR)."

The organizations and programs supported by ASA's IDUs Intervention Unit work on preventing the spread of HIV and sexually transmitted infections, assisting with health issues related to HIV infection, and assisting on addiction problems through rehabilitation programs, counseling and family intervention.

HR programs include outreach work, needle and syringe programs (NSP), counseling and testing for HIV, case management and support groups.

Rise of heroin in Indonesia

Although Very's unit deals mainly with HR among people already injecting drugs, he and his team also make it their business, he said, to learn about the drug problem in Indonesia from every angle.

As Very explained, Indonesia's response to the spread of HIV began in 1991, when the reported cases of HIV or AIDS began reaching the double-digits, but before the emergence of cases linked to IDU.

"Around 1995 to 2000, the availability and use of heroin in Indonesia increased greatly," he said.

The monetary crisis in 1998, with its attendant lawlessness and loosening of social controls at the community level, exacerbated these already growing problems.

During this period, Very estimates that about 70 percent of high school students in major cities had access to heroin and other drugs, regardless of social or economic status; at the same time, the number of HIV/AIDS cases linked to IDU began to increase dramatically.

But by 2001, Very continued, the country saw a substantial restoration of law and order.

"The socio-economic profile of IDUs in Indonesia varies from city to city," noted Very, "and they come from widely varying backgrounds."

Initially, heroin users were from the upper classes, but during the heroin boom throughout the 1990s, its use spread toward greater variation among users.

According to Very, many users from affluent families were thrown out, and some middle-class families were cast into poverty due to the heroin addiction of a family member.

In major cities like Jakarta, Bandung and Surabaya, he said, many IDUs were youth from middle- and lower-class families. According to a survey in late 2006 among clients of the Kios Atmajaya IDU program in Jakarta, 20 percent of the sample group were below the age of 23, and 38 percent had never reached high school.IDUs who drop out of school due to drug use never complete their education," said Very.

US pledges US$8 million for AIDS in RI

The Jakarta Post

JAKARTA (Antara): The US government will allocate US$8 million dollars per year to help Indonesia deal with HIV/AIDS, a press statement from the US embassy said Friday.

The statement said that the money would be allocated for HIV/AIDS programs in 79 priority regencies in seven provinces -- Papua, North Sumatra, East Java, Jakarta, Riau Islands, West Java and Central Java.

According to the statement, the money is part of the president's emergency fund for dealing with AIDS both through preventive action, such as behavioral change, and providing medication and services to infected people.

Indonesia has around 210.000 HIV/AIDS cases, according to official figures, with 5,500 having died of AIDS so far.

US ambassador to RI promotes childhood immunization

Jakarta (ANTARA News) - United States Ambassador to Indonesia Cameron Hume emphasized the importance of childhood immunizations during the Ministry of Health`s National Child Immunization event at Menteng Park here on Monday, a US Embassy press release has said.

It said the U.S. Government`s Millennium Challenge Corporation (MCC) provided a US$20 million grant to the Indonesian Ministry of Health`s Expanded Program for Immunization (EPI).

The grant is an effort to help protect Indonesia`s children against vaccine-preventable diseases, such as diphtheria, tetanus, pertussis (whooping cough) and measles.

"Alleviating preventable childhood diseases is one of the most fundamental ways in which we can all be good ancestors. Every child has the right to proper and timely childhood immunization," the US envoy said at the National Child Immunization event.

"Today we celebrate the Government of Indonesia`s goal to immunize as many children as possible against the most deadly diseases of early childhood," Hume added.

The Ministry of Health`s EPI program aims to provide routine immunization services to protect Indonesia`s children against vaccine-preventable diseases.

Support for the EPI comes from the MCC`s Indonesia Immunization Project, which is administered by USAID. The two-year grant provides assistance at both the central level and to seven priority provinces in Indonesia, including 63 priority districts within these provinces.

The Millennium Challenge Corporation is assisting the Indonesian Ministry of Health in developing revised national immunization strategies for routine services and building capacity of the immunization health staff in both public and private sectors.

Among the goals of the Millennium Challenge Corporation Threshold Program is assistance to the Government of Indonesia to improve child immunization nationwide.