MONDE: IRIN Service français - Bulletin hebdomadaire n°497 du 28 décembre 2009 au 1 janvier 2010

	nouvelles et analyses humanitaires ONU - Bureau pour la coordination des affaires humanitaires

Table des matières 1. R?PUBLIQUE CENTRAFRICAINE: Des travailleurs humanitaires ?vacu?s du nord 2. TCHAD: Combattre le banditisme dans l?est 3. MAURITANIE: Ne laisser aucun enfant sur le bord de la piste 4. S?N?GAL: Casamance ? l??ducation des enfants r?ussie malgr? tout 5. MALI: Le paradoxe de l?abondance R?PUBLIQUE CENTRAFRICAINE: Des travailleurs humanitaires ?vacu?s du nord BANGUI, 29 d?cembre 2009 (IRIN) - International Medical Corps (IMC), une organisation non gouvernementale (ONG) bas?e aux ?tats-Unis, a ?vacu? treize de ses employ?s du nord-est de la R?publique centrafricaine (RCA) suite ? deux incidents au cours desquels un groupe arm? s?est empar? de trois de ses v?hicules. full report TCHAD: Combattre le banditisme dans l?est GOZ BEIDA, 29 d?cembre 2009 (IRIN) - Quelques jours apr?s l?attaque d?un convoi des Nations Unies dans l?est du Tchad, les travailleurs humanitaires et les responsables de la s?curit? discutent des moyens de pr?venir les enl?vements et les vols de voiture qui persistent malgr? la pr?sence d?une force de maintien de la paix des Nations Unies qui repr?sente un investissement de plusieurs millions de dollars. full report MAURITANIE: Ne laisser aucun enfant sur le bord de la piste KAEDI, 30 d?cembre 2009 (IRIN) - Arriv?s d?s les premi?res heures du jour en charrette tir?e par des ?nes dans le village de Nima, ? plusieurs heures de piste de Ka?di, dans le sud de la Mauritanie, le long du fleuve S?n?gal, quelques volontaires du Croissant-Rouge mauritanien frappent ? toutes les portes du village pour inviter les familles ? faire d?pister leurs enfants pour la malnutrition. full report S?N?GAL: Casamance ? l??ducation des enfants r?ussie malgr? tout NARANG, 30 d?cembre 2009 (IRIN) - Dans certaines parties de la Casamance, r?gion du sud du S?n?gal touch?e par les conflits, les familles et les enseignants sont confront?s ? un certain nombre de probl?mes, dont le manque de salles de classe pour les enfants en primaire, ont dit des experts et des habitants. full report MALI: Le paradoxe de l?abondance SIKASSO, 31 d?cembre 2009 (IRIN) - Sikasso est l?une des r?gions les plus fertiles du Mali, mais le taux de malnutrition chez les enfants de moins de cinq ans y est aussi ?lev? que dans les r?gions d?sertiques du nord, selon des donn?es du gouvernement sur la situation sanitaire. full report

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MeeHive - Your Top Stories - December 31, 2009

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SOMALIA: School enrolment up in Somaliland

SOMALIA: School enrolment up in Somaliland

HARGEISA, 31 December 2009 (IRIN) - School enrolment has risen sharply in Somalia's self-declared independent region of Somaliland since 1991, raising the literacy rate from 20 percent to 45 percent, education officials have said.

"School enrolment [in primary and secondary schools] has increased dramatically. In 1991, we had only 1,019 students enrolled in schools but by the year 2009 some 45,223 students were in school," Abdi Abdillahi Mohamed, the director of planning in Somaliland's ministry of education, told IRIN.

Somaliland declared unilateral independence from the rest of Somalia in 1991.

Ali Abdi Odowa, director-general in the education ministry, attributed the increase to rising awareness and the construction of many primary schools.

"Hundreds of schools have been built both in urban and rural areas and adult education has also started," he said.

Somaliland, he said, plans to ensure that at least 75 percent of the population is able to read and write by 2015.

According to Mohamed, 225,853 students attended primary school and 21,331 attended secondary school in 2008/2009, while 26,156 were in adult education.

Some 6,820 students are currently enrolled in technical colleges and vocational schools.

"We have also added two social science subjects in high school - business and agriculture - which we hope will encourage high school leavers to be self-employed," Mohammed said.

Pastoralists complain

However, the ministry had received complaints from displaced persons and pastoralists about school fees and the lack of access by their children to schools.

"Somaliland's constitution stipulates that all elementary and secondary education is free; there are no fees paid by students but of course there is what we call contributions paid by parents to support voluntary teachers and teachers' salaries," he said.

In remote areas, the ministry has established a pilot project where teachers follow pastoralists and teach in mobile schools.

"This project is in Togdheer region... Teachers and the school follow the pastoralists wherever they go, and we pay such teachers more than the others," Mohamed said.

"We have also started school feeding centres: Pastoralists' children are fed in boarding schools in villages when their families are on the move in search of pasture."

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BANGLADESH: Ever so vulnerable to storms, floods and sea level rises

BANGLADESH: Ever so vulnerable to storms, floods and sea level rises

DHAKA, 31 December 2009 (IRIN) - Low-lying Bangladesh with its 230 rivers and dense population of over 150 million has long been prone to flooding, soil erosion and saltwater intrusion, but climate change could aggravate the situation, experts and government officials warn.

In a report entitled A Global Report: Reducing Disaster Risk: A Challenge for Development, the UN Development Programme (UNDP) has identified Bangladesh as the country most vulnerable to tropical cyclones and sixth most vulnerable to floods.

According to data from the government's Centre for Environmental and Geographic Information Systems (CEGIS), two-thirds of the country is only five metres above sea level, rendering it particularly vulnerable to sea level rises and tidal waves.

Melting Himalayan glaciers and an encroaching Bay of Bengal in the south, further increase the risk of flooding, experts say.

The fourth assessment report by the Intergovernmental Panel on Climate Change (IPCC) predicts that an increase in monsoon rainfall across South East Asia and melting Himalayan glaciers will result in increased water volumes in rivers that flow into Bangladesh from India, Nepal, Bhutan and China.

Damaged embankments

Low-lying southern coastal regions are the most vulnerable, despite being protected by a 5,107km-long network of flood embankments.

Almost half of this embankment network was damaged by recent cyclones (Sidr and Aila), leaving the whole region vulnerable to the tides, according to Bangladesh's Comprehensive Disaster Management Programme.

High population density means many Bangladeshis are forced to live on and cultivate flood-prone land.

"Our fields are dying because of the salty water. It is impossible to grow anything in them any more," lamented Abbasuddin Mollah, a 60-year-old farmer from the coastal district of Bagerhat.

"Without the dykes to protect us, the tides rush in twice daily and swamp the croplands," he told IRIN.

"This is the sort of effect rising sea levels will have on Bangladesh. We are fighting climate change on the front line," said Ainun Nishat, one of the country's leading environmentalists.

Government response

But according to Hasan Mahmud, state minister of environment and forestry, the government is working to address the issue.

A massive river dredging project at an estimated cost of US$2 billion has already been undertaken by the government in order to conserve water, increase the capacity of the rivers, and channel more fresh water into them to decrease their salinity.

"There are four indicators to measure the extent of damage that a country will have to face due to global climate change: the direct harmful impact of climate change; increasing natural disasters; the number of people facing these dangers; and the measures already undertaken by that country to reduce the negative impacts of climate change. Bangladesh is eligible on all counts," Mahmud said.

The 2009 Bangladesh Climate Change Strategy and Action Plan published by the Ministry of Environment predicts that within the next 50 years, over 20 million people could be displaced and become "climate change refugees", if sea and salinity levels rise.

The Plan recommends combating the effects of climate change by focusing on social security, disaster management, infrastructure development, research and knowledge management, low carbon development options and institutional capacity development.

Meanwhile experts warn of the increasing frequency and/or intensity of tropical storms in the Bay of Bengal.

"For Bangladesh, effects of climate change are no longer a future threat. It is already a reality for us," State Minister Hasan Mahmud said.

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IRAQ: NGOs say ready for more responsibility

IRAQ: NGOs say ready for more responsibility

BAGHDAD, 31 December 2009 (IRIN) - The UN Refugee Agency (UNHCR) in Iraq wants closer ties with local NGOs in 2010, and the head of a leading NGO umbrella group believes more effective aid can be delivered to Iraqi returnees if cooperation between local NGOs and UN bodies is boosted. But there are a number of constraints.

First, the ongoing violence, especially in central Iraq, is not conducive to the smooth development of local NGOs and/or their relations with government or UN bodies, and providing any aid in these circumstances is fraught with problems.

On 11 December 2009 UNHCR reiterated its concern about involuntary returns amid ongoing violence: "UNHCR... advises against involuntary returns to Iraq of persons originating from Central Iraq until there is a substantial improvement in the security and human rights situation in the country."

"Many groups continue to face significant threats with UNHCR offices reporting that the numbers of Iraqi refugees returning are being offset by new arrivals," it said.

Second, establishing the bona fides of local NGOs in the current climate and ahead of elections scheduled for 7 March 2010 may be difficult for UN bodies, hence the lengthy vetting processes.

The UN already has a number of safeguards in place: UNHCR, for instance, has said local NGOs, to become eligible partners, need to be officially registered as NGOs; have a satisfactory track record; be able to set up their own bank account; and have satisfactory audit reports from previous years.

Third, in a society where government is weak, NGOs are relatively new and controls are lax, it may be difficult to boost cooperation between local NGOs and government, let alone between local NGOs and UN bodies, one analyst said.

"The Iraqi government is still building itself up and facing numerous challenges in many fields ranging from internal and external security to economic and public services. Cooperation with NGOs is still not one of its priorities," said Hamid Hassan Adul-Aziz, a lecturer in politics at Basra University.

"NGO culture is still a new phenomena. Most NGOs are either affiliated to political parties, under their control or at least sympathize with some of them," Abdul-Aziz said.

"Equal opportunities"

But Basil Abdul-Wahab al-Azawi, head of the Commission of Society Enterprises, an umbrella group of more than 1,000 NGOs inside and outside Iraq, called for a greater role for local NGOs. "Giving us equal opportunities with international NGOs and the Iraqi government will help achieve the necessary support, and rapid successful outcomes," he said.

"If the current mechanism for assisting IDPs [internally displaced persons], refugees and returnees is implemented next year then the outcomes will be as disappointing as they are now," said al-Azawi, adding that encouraging IDPs and refugees to return without ensuring decent housing, effective public services, jobs and financial assistance was a recipe for disaster.

"We have to make sure that the basics for return to their areas of origin are available. Only in this way will the results be good," he said.

Mizhar Abid Ahmed, a local government official in Iraq's western Anbar province, which has seen numerous bombings, said the security situation was hampering cooperation with NGOs: "We sometimes tell NGOs we are not ready to cooperate with them when we see the security situation in the area they want to visit is not good or we can't dispatch enough security forces to protect them."

The 2010 UNHCR Iraq operations profile says one of its key targets is the expansion of the "national NGO partnership programme" to broaden the agency's impact at the community level.

Maha Sidky, a spokesperson for UNHCR in Iraq, told IRIN by email that UNHCR had strengthened its links with local NGOs since the second half of 2008, and had switched from dealing almost exclusively with international NGOs as in previous years, something it had been forced to do for security reasons.

No large-scale returns yet

UNHCR said that although more IDPs and refugees are returning to their areas of origin, large-scale returns had not yet taken place. It put the number of IDPs who had returned in 2008-09 at about 300,000, and refugees at about 80,000.

Sidky said there was an average of 17,000 returnees (refugees and IDPs together) per month in 2009, but the rate of return would probably decrease around the time of the March 2010 elections.

According to Iraqi government figures from early this year, there are nearly 2.6 million IDPs in Iraq and about two million Iraqi refugees in neighbouring countries, mainly Syria and Jordan.

In its 1 December Global Appeal for 2010-11, UNHCR said it would increase its 2010 budget for Iraq to US$264.29 million from $168 million in 2009.

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CAR: Clash in northern town of N'délé prompts security fears

CAR: Clash in northern town of N'délé prompts security fears

N'DELE, 31 December 2009 (IRIN) - Quartier Sultan in N'délé, a town in northern Central African Republic, was badly hit by fighting on 26 November when troops from the Central African Armed Forces (FACA) pushed back an incursion by rebel fighters from the Convention of Patriots for Justice and Peace (CPJP).

The CPJP announced the occupation of N'délé, the provincial capital of Bamingui-Bangoran, which lies 670km north of Bangui, but witnesses say the attack lasted a matter of hours and that only a few of the invading party had firearms, most carrying machetes or knives.

"This place had a problem, but it is now over", said a FACA sergeant, talking confidently, despite a warning glance from a nearby officer. "We have spoken to people and most have come back. Those who have not returned must have their reasons."

But that optimism is not widely shared. Well-armed troops are very visible around the town. There is no official curfew, but most residents are off the streets at dusk. The local market begins at around 9am, traders wary about the safety of their produce. The road north remains hazardous, with rumours of a strong rebel presence just a few kilometers out of town.

There is considerable confusion and anger about the events of 26 November, with strong criticism of rebels and government.

François Egue has been head of N'Délé's Quartier Artisanal, near the market, since 1957. He said the local authorities had been holding meetings, trying to re-establish calm and confidence, but was sceptical. "We do not know what is going on", said Egue. "All I can say is that myself and my community here are not at ease".

Egue's daughter, Lydie, who has a drinks business in town, said the CPJP attack came out of the blue. "These rebels could come back at any time", she warned. "We are living in a ghost town for now. Trade is really down. The depot where I buy beer has been closed down. The town is empty at night."

Lydie Egue said she knows little of the CPJP. "If the rebels have a problem with the government, they should go and negotiate, not take it out on civilians."

Who are the CPJP?

Emerging in late 2008 and not a signatory of the Comprehensive Peace Agreement (CPA) with the government, the CPJP remains an unknown quantity. Its regular bulletins, sent from an unknown location, denounce the government, play up military gains and call for the mediation of the Sultan of N'délé.

Lydie Egue, like others, says she has heard reports that the CPJP enjoys considerable support from the Runga, a long-established Muslim community with a strong presence in N'délé and the surrounding area.

Other residents go further, talking of fifth columnists and accomplices who facilitated the CPJP's entry on 26 November and whose subsequent flight from the town is evidence of their complicity.

But market trader Mohamed Ahmed said the Rungas now faced a campaign of hostile propaganda and stigmatization. "There are divisions here", he said. "After 26 November, you got people saying: "the Muslims were behind all that", and you even had kiosks being looted.

Security fears

There has been a serious rupture in supplies, because traders don't want to buy new merchandise for fear of being robbed." Suppliers from Bangui were staying away for now, waiting for security to return, he added.

Yusuf Hassan, a Runga small-holder was one of those who headed for the bush on 26 November. Returning to the Quartier Sultan for the first time in several weeks, he said he intended to stay, that he owed it to his family of 18 to move back into the house. "But I still do not feel fully safe here", he warned.

NGOs, including Solidarités, International Medical Corps (IMC) and the Danish Refugee Council (DRC) have a high profile in N'délé and the surrounding area. The events of 26 November led some to suspend their activities, while others remained in place.

UN Humanitarian Coordinator Bo Schack said the UN's decision to remain in N'délé was important in helping restore stability. "Within the UN system, all the UN staff remained in place", Schack told IRIN. "The authorities were deeply appreciative that we stayed throughout the events and this had a calming influence on what could have been an even bigger exodus from the town."

The town and surrounding villages live mainly off agriculture. The principal crops include beans and manioc. There is a diamond industry, with artisanal diggers working several sites outside town and a few diamond-buying houses in N'déle itself.

cs/cb[END]

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INDONESIA: Tsunami early warning system a work in progress

INDONESIA: Tsunami early warning system a work in progress

JAKARTA, 31 December 2009 (IRIN) - Five years after the Indian Ocean tsunami, Indonesia's early warning system remains a work in progress, officials and experts say.

Indonesia began setting up an early warning system in 2005, a year after a 9.2 Richter scale earthquake off Sumatra triggered a tsunami which left over 230,000 dead, 1.8 million displaced and 470,000 homes and buildings destroyed in 13 countries.

The Indonesian Tsunami Early Warning System has three levels: an earthquake monitoring system, a sea level monitoring system, and a computer modelling system able to generate different tsunami projections.

It collects data from seismometers, tide gauges, and GPS tracking units mounted on buoys to detect subtle changes in water pressure which could indicate an incoming tsunami, as well as ocean bottom satellite-linked sensors, allowing it theoretically to issue a tsunami warning at a regional level five minutes after an earthquake.

The warning would be relayed to the authorities, the media and communities likely to be affected.

"Right now we have in place what we call Service Level 1 [the earthquake monitoring system]. We use earthquake monitoring equipment to determine earthquake parameters and the potential for tsunami generation," Fauzi (like many Indonesians he goes by only one name), head of the Tsunami and Earthquake Centre in Jakarta, told IRIN.

Service Level 2 - the sea level monitoring system - is expected to be completed in April 2010, while Service Level 3 - tsunami modelling - should be in place by 2011, Fauzi said.

Under the system, a tsunami warning will be issued for any undersea earthquake with a Richter scale magnitude of 7.0 or higher and a depth of less than 70km.

When earthquake data indicate a potential tsunami, computer predictions of the tsunami's height, volume and impact will be generated, as well as its estimated arrival time at different points along the coast.

Fauzi said the sea level monitoring system was expected to be completed in 2010, along with the ability to produce predictive information about any tsunamis which might affect Java and Sumatra.

He said 50 tide gauges had been installed along the coasts of Java, Sumatra, Sulawesi and the Papua region and 20 more tsunami buoys would be installed across the country in 2010.

"We have been facing a lot of problems operating the buoys. They often break down" said Fauzi.

However, Fauzi said he was optimistic the entire system, supported by countries such as Germany, China, France and the USA as well as UN agencies, would be ready by 2011.

Culture of preparedness

Ardito Kodijat, programme officer for the UN Educational, Scientific and Cultural Organization (UNESCO)-sponsored Jakarta Tsunami Information Centre (JTIC), said regional capacity and instilling a culture of preparedness could prove greater challenges than putting in place the warning system.

"The regions [provincial level and lower] remain a weak link in the overall early warning system," he told IRIN, adding: "There's so much to do in terms of education and safety facilities. It's not an easy task and takes a long time."

Kodijat said UNESCO was working with the Indonesian Institute of Sciences to educate people in disaster-prone regions about disaster preparedness.

Fauzi agreed with Kodijat that educating the public was the harder part: "Developing a culture of preparedness is a long process. It involves education from the elementary level on up."

Dissemination of warnings

Danny Hilman Natawidjaja, a geology researcher at the Indonesian Institute of Sciences, said relaying a tsunami warning to communities could also be a problem.

"So far the dissemination of tsunami warnings has used telephone and SMS, and I don't know whether sirens are working," Natawidjaja said.

Sirens have been installed in coastal areas on Java, Sumatra and Bali and are tested every month, Fauzi said, adding that more sirens would be installed in Gorontalo, North Sulawesi and the Maluku islands next year.

Natawidjaja and several other scientists who have studied Sumatra's geological fault line predict major earthquake in the West Sumatra area in the next three decades, generating a tsunami equal to that which devastated hit Aceh Province five years ago.

"I don't think any region is ready for a tsunami. If a tsunami happened now, the number of casualties would still be high," he said.

atp/ds/cb[END]

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LIBERIA: More TB sufferers coming forward

LIBERIA: More TB sufferers coming forward

MONROVIA, 30 December 2009 (IRIN) - More tuberculosis sufferers in Liberia are seeking testing and treatment, which health officials say reflects increased awareness that the disease does not have to be a death sentence.

From January to September 2009, 4,401 tuberculosis (TB) patients were treated in government health centres country-wide, according to just-released government figures. Deddeh Bah Kesselly, head of the government's TB control programme, said the final tally for 2009 is certain to be higher than the 5,000 cases brought forward in 2008.

Government and NGO awareness campaigns have taken place in the capital Monrovia and surrounding counties, encouraging sufferers to come forward for treatment, health workers said.

The government set up what they called "TB hubs" throughout the capital to encourage people with consistent coughing to be tested, according to Kesselly.

The International Committee of the Red Cross also recently completed a TB awareness programme in Monrovia's nine neighbourhoods, with the message: "TB is curable, treatment is free and you can return to your family once cured," project coordinator Solomon Addison told IRIN.

"In the past, not much was heard about TB unless [one] visited a hospital," Addison said. "But if people remain unaware that treatment works, the stigma [surrounding TB] stops people from coming forward."

Many Liberians associate TB with HIV/AIDS and think both diseases are incurable and automatically kill, said Kesselly, whose team conducted surveys of attitudes about TB prior to their campaign.

Addison said many TB sufferers are ostracized from their communities, losing friends, family support and in some cases their jobs.

Joseph Wah, 33, lives in Paynesville on the outskirts of Monrovia. "I have been tested [for TB]," he said. "I do not have the disease - I was lucky. Many people here are stigmatized when they find out they have TB, which can cause them serious problems in their lives."

It is not only fear but false assumptions about the illness that prevent people from seeking treatment, said Addison.

John Doh, also from Paynesville, has had a consistent cough for several months. He told IRIN: "I have heard about TB but I have not been tested yet. I feel this is a curse from the sea spirit. If I am not a member of the marine spirit society, then I will not be affected by it."

Beyond the capital

The government and NGOs have made progress in the capital but stigma is high in other areas of Liberia and so testing rates there are low, Addison told IRIN.

"We are still seeing very low caseloads in smaller towns, which we do not think necessarily reflects the [real number of infections]. We need to expand our treatment and our [education campaigns] there." He said too few people know about existing testing and treatment facilities.

Treatment in small towns and villages has significantly improved since 2008, according to the national TB programme's Kesselly. Case detection rates have improved and some 236 health clinics across the country now have TB treatment facilities, while 25 laboratories are able to test the disease. The TB control project is supported by the Global Fund to fight AIDS, Tuberculosis and Malaria.

In 2009 the Global Fund provided the control programme with vehicles so drugs could be delivered more quickly to rural clinics, while the UN Development Programme helped the health authorities devise more efficient drug supply-chain systems, Kesselly said.

pc/aj/np[END]

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EGYPT: New report warns of HIV epidemic

EGYPT: New report warns of HIV epidemic

CAIRO, 30 December 2009 (IRIN) - A new report says Egypt is moving towards a "concentrated HIV epidemic", as an increasing number of HIV patients are being recorded.

The report by the Information and Decision Support Centre, the research arm of the Egyptian Cabinet, was published on 29 December, but is not yet available online.

It states that at the end of 2008 the number of people living with HIV in Egypt was 3,735, including 963 (25.8 percent) who had developed AIDS.

Local NGOs dealing with HIV/AIDS and the UN Joint Programme on HIV/AIDS (UNAIDS) say this figure could be far higher.

While the number of HIV/AIDS cases in Egypt is low compared to many other countries, the report's findings have come as a shock to many of those asked in this predominantly conservative Muslim society where extramarital sex is banned.

"Risky sexual activities can't be controlled," Magdy Badran, a leading Egyptian immunologist, told IRIN. "Also, there's a real expansion of drug addiction in this country. These are things that can spread the disease dramatically."

The report, the first of its kind to be produced by such a high-level body, said HIV cases had increased six-fold between 1994 and 2008. It said HIV cases could be found in all Egyptian governorates with the exception of northern and southern areas of the Sinai Peninsula. However, the country's two most populous cities, Cairo and Alexandria, had most cases.

The report said around 75 percent of Egyptians living with HIV were aged 25-49, the most productive segment of society.

Sex education

The authors of the report said one reason for the rise in cases might be the lack of sex education in schools.

"Our schools must offer proper health and sex education about HIV transmission," Badran said. "We must work hard to fight drug addiction, encourage marriage and put an end to the presence of children on the streets."

Some NGOs estimate the number of street children in Egypt to be more than three million, although the government disputes that number. The report said these children are the most vulnerable in terms of contracting HIV/AIDS.

It added that the steady increase in the number of detected HIV cases was a warning for the whole population.

ae/ed/cb[END]

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MeeHive - Your Top Stories - December 30, 2009

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KENYA: Call to protect human rights during HIV testing drive

KENYA: Call to protect human rights during HIV testing drive

NAIROBI, 30 December 2009 (PLUSNEWS) - An international rights group has called on the Kenyan government to ensure that human rights are protected during the country's national door-to-door voluntary HIV testing and counselling drive which began in February 2009.

"We... urge the inclusion of a strong human rights component into this ambitious testing programme," the New York-based Human Rights Watch (HRW) said in a recent letter http://www.hrw.org/en/news/2009/12/14/letter-kenyan-minister-public-health-and-sanitation-concerning-home-based-hiv-testin to Kenya's minister for public health. "In particular, we are calling for clear attention to principles of counselling, consent and confidentiality."

The programme aims to have 80 percent of eligible Kenyans tested by the end of 2010. A recent mini-drive which started in November 2009 to boost the initiative saw more than 1.5 million people tested in three weeks.

HRW noted that large-scale home-based testing would likely result in better access to testing and treatment and give a chance to those who could not afford the transport costs to health facilities or lacked information or the willingness to seek a test. But testing also reached into the family, where many abuses occurred, posing challenges for human rights protection, it said.

"Our research on access to testing and treatment in Kenya has shown that HIV-positive mothers and HIV-positive children frequently suffer stigma and abuse when their status becomes known," the letter said. "HIV-positive mothers - among them girls under the age of 18 - sometimes suffer violence, mistreatment, disinheritance, and discrimination from their husbands, families-in-law, or their own families."

According to Evelyn Amunga, a community health worker who has been involved in home-based counselling and testing programmes in Nairobi, many women agree to be tested at home in the presence of their husbands for fear of being accused of infidelity.

"If they decline, their husbands will accuse them of infidelity and say that is the reason they do not want to be tested," she told IRIN/PlusNews. "As much as we ensure confidentiality, we also counsel married people to reveal their status to each other, but it is a dilemma because the next day a woman you counselled with the husband calls to tell you she has been thrown out together with the children."

Damned if they do.

"The reality is, in home-based counselling and testing, many women are damned if they do and damned if they don't, especially in families where the man is present," she added.

Veronica Mwari, 34, lives with her husband in Gomongo, a Nairobi slum. They were recently visited by one of the government's home-based counselling and testing teams. After testing, her husband insisted on seeing her results.

"They just talked to us together but they told us they cannot show us our results together, so they sent my husband out and gave me mine and did the same for me when they wanted to show my husband his," she said.

"When they left us, he said he must know my status. It was negative so I just told him," she added. "He didn't tell me his results, but he warned me that if I had given him the HIV he would have killed me."

Nicholas Muraguri, the director of the National AIDS and Sexually Transmitted Infection Control Programme, says the government has put measures in place to ensure that those tested receive adequate medical and psychosocial support.

"Confidentiality and consent are the pillars of our counselling and testing programmes," he said. "Violence, discrimination and neglect are issues the government has been addressing together with partners and stakeholders but we can't say they do not happen."

"During testing, there is adequate counselling and those found to be positive are linked to health facilities through which they can receive medicine and further care," he added.

ko/kr/cb[END]

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