The International Community for relief of starvation and suffering works with tribal groups to find long term solutions to poverty and disease.
Our teams and planners are from the communities. Our public health research has made a contribution to International health for thirty years. ICROSS strives to constantly improve its programmes and the way in which we work. We are constantly improving our operations and management.
ICROSS is an International development organization that was founded to bring about lasting changes in health. We work closely with communities, civil society and partners in building long term health care. We are establishing new support groups in other countries as part of our International strategy.
While our Strategic plan details our corporate governance there are key areas of governance that we are prioritising in 2011-2016.
Vision
Our long term strategy as outlined in our five year plan embrace the vision and aspirations of the Millennium development goals building on the values, leadership and cultural structures of African people. The vision of ICROSS places emphasis on the National development framework developed in Africa by Africans.
Africanisation
We are proud that since 2001 all ICROSS programmes were completely managed by Africans. All project managers, supervisors, trainers, field teams and community staff are African. While these teams provide learning opportunities for Intern and volunteer partnerships, the Africanisation of all projects has been a vital component of the success and continuity of the programmes.
Gender
ICROSS is an equal opportunities NGO. As part of our Gender policy, we have actively recruited women into senior management positions. The majority of Project managers and field co ordinators are women, the great majority of field staff are women. ICROSS focuses all its core programme development on gender.
Ownership
Programmes are not owned or driven by donors but by local communities.
Whose Reality
As part of corporate accountability ICROSS places the beliefs, values, cultural structures and hopes of the local people at the centre of planning, decision making and planning. With a strong inclusion policy and partnership in local language we work towards programmes that have their roots in local communities.
Transparency
As part of our policy of accountability to our donors ICROSS continually strives to improve its financial systems and procedures.
With rural projects scattered across geographical areas larger than Ireland there are challenges to ensure best practices and accountability of resources in Africa. ICROSS and our donors undertake frequent internal and external audits with Annual external audits or all programmes.
As part of continual improvements and strengthening of the organization, we conducted external organization and management reviews and have recently commissioned a comprehensive financial review of all financial systems, structures procedures and operations.
Our commitment is to best practices of transparency and collective accountability. ICROSS insists on the highest standards from its entire staff as well as ensuring due diligence and the highest work ethics. Our code of conduct is based upon international gold standards and ensures not only equality and ethics but transparency and integrity.
External audits and comprehensive financial records are available to partners including Governments through our national offices.
Management
Apart of corporate governance ICROSS continues to profesionalise and strengthen its management teams. All management of field programmes is executed by senior staff with at least ten years operational field experience. We are in the process of reviewing management structures in the face of recent expansion of all programmes.
Staff
We have a staff policy based upon the local regulations, laws and norms. ICROSS is an equal opportunities employer and does not discriminate on any grounds.
Advice & Consultation
ICROSS has a team of advisors and skilled specialists that it regularly consults on specific areas of International development. All advisors have at least a decade of experience working in underdeveloped countries while most are currently in operational settings. All ICROSS advisors are highly qualified specialists in their field of expertise with the latest knowledge and information.
This helps ICROSS in its strategic planning and evidence based strategic development.
As part of its international collaboration and team , work ICROSS designs all its international research in close partnership with peer review collaborators.
More Information is Available Concerning Our Corporate Governance
In developing our corporate policies we seek to create a dynamic forward-looking organisation that will be able to respond to emerging challenges and needs in a rapidly changing world. Together with our partners, we are moving forward embracing new ideas and innovative approaches, learning from the wisdom and experience of the past. We are building on evidence and introducing fresh, exciting ideas and directions. Our vision of a better world inspires us, our mission focuses us, and our shared goals unite us. With effective planning, transparency, and clear direction, we will be able to really create lasting change. As part of this process our international advisory board is made up of a wide range of professionals across many disciplines.
http://icrossinternational.org/
www.icross-africa.net
http://icrosskenya.org/
http://icrossprojects.blogspot.com/
http://twitter.com/#!/ICROSSprojects
Philip Sironka
Head Communication ICROSS
We are a small international organisation working to fight poverty and disease in the poorest parts of the world. For over 25 years we have worked with tribes in East Africa fighting disease. Health professionals work with local communities in long term development and health programmes.
ICROSS works with the resources, capabilities and capacities of poor marginalised communities seeking to strengthen their capacity to improve their own health and livelihoods through the rights based approaches of participation, inclusion and community empowerment processes. ICROSS has fully documented its vast experience in disease prevention and control amongst these disadvantaged communities. This experience is informing national and international best practice on critical areas such as HIV/AIDS prevention, home-based care for those infected with HIV/AIDS and succession planning for orphans and vulnerable children.
Our values include living as equals among those we work with and for, learning their languages and culture, inculcating a respect for diversity of beliefs and dedicating ourselves to long-term commitment to the poor, those who are socially excluded and those who are victims of social injustice.
People in the communities are empowered to take full responsibility for the changes and developments that drive the development of ICROSS. Community participation starts right from needs identification through implementation, monitoring and evaluation. Communities, families and individuals are involved in all decisions that impact, however remotely, upon their lives.
ICROSS believes that the most effective vehicle for development work is the communities' own belief systems and traditions. People have the right to choose and the right to plan their own future, consequently, anthropological research is a key part of our work.
ICROSS Concept
ICROSS is much more than just an organisation working in Africa. ICROSS is a concept, an idea, a set of values, which is shared and advocated by a large and evolving international community. The three decades ICROSS has operated in Africa has taught us the importance of these values and in a world where political, religious and socio-economic agendas play an ever more important role in the aid industry, ICROSS has uniquely, and with instinct, refrained from giving up its values and beliefs.
The values of ICROSS derive from something as simple as caring for our brothers and sisters; assist them out of and prevent them from suffering, without an agenda other than genuinely wanting to assist. We assist them through their own people, their languages, their traditions and existing political and belief systems with a sincere admiration and respect for their cultures.
By listening to the people whom we assist and develop programmes according to their needs and in their presence, rather than our wishes in an office far from their reality, the communities we serve, gain a sense of ownership. This is a real ownership not a donor driven or foreign idea. The feeling of ownership is crucial in any development work; it reduces possible constraints and limitations of a programme and ensures success, cost effectiveness and more importantly sustainability. ICROSS assists communities to facilitate themselves out of affliction.
ICROSS has over the years, scientifically shown, that what we do works. Our values and evidence based approach has ensured that even as a small, bottom-up, grass-root operating organisation, we have gained international respect among politicians, religious leaders, and academics around the world, who among thousands of others, make up the international community of ICROSS. ICROSS actually has the poor, donors and Government represented on our board of Directors, it is transparent and shares new ideas.
This international community is the driving force behind ICROSS as an idea. The humanitarian work of ICROSS stretches far beyond our programmes in Africa. ICROSS is within anyone who genuinely wants to care and assist others with love, respect and understanding. ICROSS as an idea is growing dynamically and with your help could reach more people.
Disclaimer
This is the official web site of the International Community for Relief of Starvation and Suffering. ICROSS is a Kenyan based International NGO founded by Dr Michael Meegan. The projects, research, initiatives and work are operated, managed and run by ICROSS Kenya.
This web site, its contents, programmes and images are the sole property of ICROSS Kenya and no other entity by the same name has any involvement or ownership of these programmes or this web site.
.
Please note that all partners, stakeholders and International Advisory board as well as the co-founder Dr. J Barnes working with ICROSS Kenya have no association with any other entity in regard to our programmes or this web site. All reports, research, publications, information and data available are the sole property of and represents ICROSS Kenya and no other entity. No other person or persons may present or claim any of this material or data.
Contact Us
Address
ICROSS International Head Office
ICROSS, PO 507 Ngong Hills, Kenya
Sunday, July 31, 2011
Friday, July 29, 2011
Extending safe motherhood programmes ICROSS August 2011
As we extend our Rural health programmes ICROSS extends all its
clinics. Inyonyori has served the communities in Maasailand for 25
years This picture shows the new wing which will be used as part of
the Mother and child care and the child survival programmes. As we
develop the primary health interventions and disease control we are
increasing the numbers of health personnel at all ICROSS clinics. In
this, the largest expansion on health services since 1997 we hope to
double our field capacity by 2014.
At the centre of the ICROSS strategic plan is Mother and child health,
reproductive health, comprehensive safe motherhood and long term
changes in malnutrition and water resources. Together with all our
friends, colleagues and partners we are building a long term health
programme that will make a lasting impact in the lives of the
communities we serve.
ICROSS Nurses and womens group leaders joined other organisations and
community groups yesterday at the District health planning forum. As
ICROSS prepares for the challenges of the drought , we are working
closely with Government and tribal leaders to put support systems in
place. Our partners in Kenya and Europe are working hard to put in
place the resources needed to reach those most in need.
The Entasat said "We need women around the World to share our journey
and work with us to help in these times of such suffering for our
mothers and children" Field project leader OleMakeseer added that "
It is hard for people to understand the extreme poverty endured in
this time, without food and water, many of our people enduring
unimagined hardship and poverty".
Speaking from Inyonyori the International Director said " the future
remains community owned planning, locally driven priorities, our great
success over the last thirty years is working through the culture and
values of the communities, that how we have survived over the decades,
by living among th communities as part of them. We are proud that long
before community participation became a fad in the mid 1990s, we were
implementing local ownership and decision making" Michael Meegan went
on to say that " We are not passing through, our teams , managers,
nurses are from the communities, this is the only way that will work
long term" More on http://icrossprojects.blogspot.com/ and
http://twitter.com/#!/ICROSSprojects
clinics. Inyonyori has served the communities in Maasailand for 25
years This picture shows the new wing which will be used as part of
the Mother and child care and the child survival programmes. As we
develop the primary health interventions and disease control we are
increasing the numbers of health personnel at all ICROSS clinics. In
this, the largest expansion on health services since 1997 we hope to
double our field capacity by 2014.
At the centre of the ICROSS strategic plan is Mother and child health,
reproductive health, comprehensive safe motherhood and long term
changes in malnutrition and water resources. Together with all our
friends, colleagues and partners we are building a long term health
programme that will make a lasting impact in the lives of the
communities we serve.
ICROSS Nurses and womens group leaders joined other organisations and
community groups yesterday at the District health planning forum. As
ICROSS prepares for the challenges of the drought , we are working
closely with Government and tribal leaders to put support systems in
place. Our partners in Kenya and Europe are working hard to put in
place the resources needed to reach those most in need.
The Entasat said "We need women around the World to share our journey
and work with us to help in these times of such suffering for our
mothers and children" Field project leader OleMakeseer added that "
It is hard for people to understand the extreme poverty endured in
this time, without food and water, many of our people enduring
unimagined hardship and poverty".
Speaking from Inyonyori the International Director said " the future
remains community owned planning, locally driven priorities, our great
success over the last thirty years is working through the culture and
values of the communities, that how we have survived over the decades,
by living among th communities as part of them. We are proud that long
before community participation became a fad in the mid 1990s, we were
implementing local ownership and decision making" Michael Meegan went
on to say that " We are not passing through, our teams , managers,
nurses are from the communities, this is the only way that will work
long term" More on http://icrossprojects.blogspot.com/ and
http://twitter.com/#!/ICROSSprojects
ICROSS health teams awarded at Kajiado District health forum July 28 2011
Today ICROSS Kenya was awarded the "Best Nurse award" and the "Most dedicated Nurse"award. These were both awarded to Rose Gitau who is the nurse in charge at the Ronan Conroy clinic in Sinkiraine. Despite multiple challenges ICROSS is extending its community and primary health services in 2011-2012. The Dr Joe Barnes Clinic at Longosua was also recognised at the District conference. ICROSS is working throughout all its health programmes to increase immunisation and child survival. As famine spreads children under five are increasingly vulnerable to diarrhoeal infection, dehydration and severe malnutrition.
Wednesday, July 27, 2011
Emergency Famine Appeal August 2011
ICROSS Emergency Famine Appeal August 2011
Worsening drought, spreading poverty and growing unrest have added to failure of rains in East Africa. This has led to worsening famine in much of East Africa. This famine is deteriorating. ICROSS has been fighting famine and poverty for thirty years in East Africa., Our first famine was in 1983-85.
But this is the worst drought in 60 years in many parts of Africa with more than 10 million people in Ethiopia, Kenya, Somalia, and the newly-formed Republic of South Sudan face starvation, desperately needing water and emergency healthcare.
The International Director Dr Michael Meegan said today “ Our project teams and health staff are committed in the long term to follow-up and ongoing primary care as well as this crisis. “ He added “ the rise of serious cases of malnutrition, diarrhoeal infections and deteriorating health of whole communities is an urgent concern for us all”.
Head of programmes Sarune OleLengeny said today “We were here through many dissaters and problems, we will continue serving the communities hit by these tragedies in the long term. All of us will be here God willing for the next thirty years” POleLasoi added “ ICROSS is made up of the local communities, we are the people affected, we live in the drought areas , in the middle of the increasing humanitarian crisis . We have been working here for decades. As always, we at ICROSS have been here long before the crisis started and still here long after the media leave.”
Please help by :-
Contacting us directly or by donating on line , no matter how small , every cent counts . Please donate by clicking on
A. http://www.icross-africa.net/ or
B. https://www.paypal.com/uk/cgi-bin/webscr?cmd=_flow&SESSION=y0ApSsBgpgauToQxhN0CklatV6LsV9mlTL_tIvw27Srlg9tpeRF5xXnQP3y&dispatch=5885d80a13c0db1f8e263663d3faee8d1e83f46a36995b3856cef1e18897ad75
C. Visiting our online store http://www.icross-africa.net/#!__store
Worsening drought, spreading poverty and growing unrest have added to failure of rains in East Africa. This has led to worsening famine in much of East Africa. This famine is deteriorating. ICROSS has been fighting famine and poverty for thirty years in East Africa., Our first famine was in 1983-85.
But this is the worst drought in 60 years in many parts of Africa with more than 10 million people in Ethiopia, Kenya, Somalia, and the newly-formed Republic of South Sudan face starvation, desperately needing water and emergency healthcare.
The International Director Dr Michael Meegan said today “ Our project teams and health staff are committed in the long term to follow-up and ongoing primary care as well as this crisis. “ He added “ the rise of serious cases of malnutrition, diarrhoeal infections and deteriorating health of whole communities is an urgent concern for us all”.
Head of programmes Sarune OleLengeny said today “We were here through many dissaters and problems, we will continue serving the communities hit by these tragedies in the long term. All of us will be here God willing for the next thirty years” POleLasoi added “ ICROSS is made up of the local communities, we are the people affected, we live in the drought areas , in the middle of the increasing humanitarian crisis . We have been working here for decades. As always, we at ICROSS have been here long before the crisis started and still here long after the media leave.”
Please help by :-
Contacting us directly or by donating on line , no matter how small , every cent counts . Please donate by clicking on
A. http://www.icross-africa.net/ or
B. https://www.paypal.com/uk/cgi-bin/webscr?cmd=_flow&SESSION=y0ApSsBgpgauToQxhN0CklatV6LsV9mlTL_tIvw27Srlg9tpeRF5xXnQP3y&dispatch=5885d80a13c0db1f8e263663d3faee8d1e83f46a36995b3856cef1e18897ad75
C. Visiting our online store http://www.icross-africa.net/#!__store
Monday, July 25, 2011
Reflections Michael Meegan
"Everything changes when you wake up in the morning and decide to own today. It will not be taken from you by anyone else, it will be yours"
Michael Meegan, Changing the World
www.michaelmeegan.net
www.eye-books.com
"When we feel overwhelmed by all the suffering in the world, or just drained by the stress of the day, do this. Close your eyes, breathe deeply, and know that the very breath you are taking is the same miracle of life that pervades all creation. He who gives you this breath, despite your anxieties, fears and pain, knows you. He knows you better than you will ever understand yourself. Breathe in, breathe out. You are experiencing the miracle. The most amazing miracle of all. The gift of life. All things will find harmony in this knowing, in this, is the whisper of not only all creation, but of the Creator"
Michael Meegan
"Your energy is powered by your thoughts, negative thoughts drain you, loving thoughts fill you with love"
Michael Meegan, The Tribe of one
www.eye-books.com
" when we really know ourselves, we forgive always"
Michael Meegan
ALL WILL BE WELL
www.eye-books.com
" If you really want to know who your friends are, see you stands by you in a storm"
Mike Meegan
" Remind yourself of your vision, keep your hopes close yo your heart, be passionate about them and alwaus, always always be true to them"
Michael Meegan
Changing the World
" The most important language of personal joy is the often complex linguistics of silence"
Michael Meegan
ALL WILL BE WELL
www.eye-books.com
Michael Meegan, Changing the World
www.michaelmeegan.net
www.eye-books.com
"When we feel overwhelmed by all the suffering in the world, or just drained by the stress of the day, do this. Close your eyes, breathe deeply, and know that the very breath you are taking is the same miracle of life that pervades all creation. He who gives you this breath, despite your anxieties, fears and pain, knows you. He knows you better than you will ever understand yourself. Breathe in, breathe out. You are experiencing the miracle. The most amazing miracle of all. The gift of life. All things will find harmony in this knowing, in this, is the whisper of not only all creation, but of the Creator"
Michael Meegan
"Your energy is powered by your thoughts, negative thoughts drain you, loving thoughts fill you with love"
Michael Meegan, The Tribe of one
www.eye-books.com
" when we really know ourselves, we forgive always"
Michael Meegan
ALL WILL BE WELL
www.eye-books.com
" If you really want to know who your friends are, see you stands by you in a storm"
Mike Meegan
" Remind yourself of your vision, keep your hopes close yo your heart, be passionate about them and alwaus, always always be true to them"
Michael Meegan
Changing the World
" The most important language of personal joy is the often complex linguistics of silence"
Michael Meegan
ALL WILL BE WELL
www.eye-books.com
Sunday, July 24, 2011
Culturally-based health promotion programmes Ronán M Conroy a Corresponding AuthorEmail Address, Michael Elmore-Meegan a
Culturally-based health promotion programmes
Ronán M Conroy a Corresponding AuthorEmail Address, Michael Elmore-Meegan a
Authors' reply
Sir—Our research was not run as a prospective study. Mortality data for the control areas were extracted from records by the Kenyan Ministry of Health at our request in 1999, when we were collating and analysing the records of the ICROSS traditional birth attendant programme. The control areas were not left without a traditional birth attendant programme as part of a controlled experiment. Rather, they had no programme because the Ministry of Health had neither the resources nor the expertise to launch and maintain such programmes.
The ICROSS programme, which is run in partnership with the Kenyan Ministry of Health, is supported by the Irish and Danish Governments. ICROSS has made several attempts to secure funding to extend the traditional birth attendant programme to other areas in Kenya, but to date these have been unsuccessful. Many bilateral donors have shifted funds away from supporting primary healthcare, perhaps partly because of lack of evidence that such support really improves community health. We hope that our results will help to highlight the untapped potential that is represented by the traditional healers and birth attendants in communities in less-developed countries. Rather than simply attempting to provide such communities with health services along more-developed-world lines, we should, in parallel, be developing and supporting the communities' indigenous health services.
a Department of Biostatistics, Royal College of Surgeons, Dublin 2, Ireland; and ICROSS Kenya, PO Box 506, Ngong, Kenya
Corresponding Author Information Department of Biostatistics, Royal College of Surgeons, Dublin 2, Ireland
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News Women's groups in Kenya win small victory against female circumcision more information
Mechanisms of Disease A new NOS2 promoter polymorphism associated with increased nitric oxide production and protection from severe malaria in Tanzanian and Kenyan children more information
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Ronán M Conroy a Corresponding AuthorEmail Address, Michael Elmore-Meegan a
Authors' reply
Sir—Our research was not run as a prospective study. Mortality data for the control areas were extracted from records by the Kenyan Ministry of Health at our request in 1999, when we were collating and analysing the records of the ICROSS traditional birth attendant programme. The control areas were not left without a traditional birth attendant programme as part of a controlled experiment. Rather, they had no programme because the Ministry of Health had neither the resources nor the expertise to launch and maintain such programmes.
The ICROSS programme, which is run in partnership with the Kenyan Ministry of Health, is supported by the Irish and Danish Governments. ICROSS has made several attempts to secure funding to extend the traditional birth attendant programme to other areas in Kenya, but to date these have been unsuccessful. Many bilateral donors have shifted funds away from supporting primary healthcare, perhaps partly because of lack of evidence that such support really improves community health. We hope that our results will help to highlight the untapped potential that is represented by the traditional healers and birth attendants in communities in less-developed countries. Rather than simply attempting to provide such communities with health services along more-developed-world lines, we should, in parallel, be developing and supporting the communities' indigenous health services.
a Department of Biostatistics, Royal College of Surgeons, Dublin 2, Ireland; and ICROSS Kenya, PO Box 506, Ngong, Kenya
Corresponding Author Information Department of Biostatistics, Royal College of Surgeons, Dublin 2, Ireland
Access this article on SciVerse ScienceDirect
Article Options
Full Text
PDF (66 KB)
Printer Friendly Version
Request permission
Export Citation
Create Citation Alert
Linked Articles
Correspondence Culturally-based health promotion programmes more information
Other Articles of Interest
Newsdesk President of Kenya proposes sex ban more information
News Tobacco sponsored Kenyan media awards provokes anger more information
News Kenya's government tackles influx of sub-standard drugs more information
News Women's groups in Kenya win small victory against female circumcision more information
Mechanisms of Disease A new NOS2 promoter polymorphism associated with increased nitric oxide production and protection from severe malaria in Tanzanian and Kenyan children more information
Bookmark
Delicious
Digg
StumbleUpon
Clearing the Fields: Solutions to the Global Land Mines Crisis
Clearing the Fields: Solutions to the Global Land Mines Crisis
edited by Kevin M. Cahill, 237 pp, paper, $25, ISBN 0-465-01177-2, New York, NY, BasicBooks, 1995.
Michael K. Elmore-Meegan, BPhEccl, MSc, TCD, PhD
[+] Author Affiliations
International Community for the Relief of Starvation and Suffering (ICROSS) Nyoonyorrie Mobile Unit Base Mbagathi, Kenya
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
The use of land mines has evolved from a predominantly defensive battlefield tactic designed to impede the movement of enemy artillery to an offensive weapon that terrorizes entire civilian populations. Clearing the Fields is the first serious attempt at exploring solutions and answers to a problem that kills hundreds of civilians every week around the world. Here is a book that should be read by every political and military decision maker.
Clearing the Fields is a rich source of up-to-date information. More than 100 million mines have been deployed in over 60 countries. In the former Yugoslavia an estimated 3 million mines have been planted without maps during the past four years, with 50 000 more hidden each week. In Cambodia one of every 253 people is an amputee. On average, antipersonnel mines can be bought for $10 to $20, with many available for less than $3. In contrast, it ...
edited by Kevin M. Cahill, 237 pp, paper, $25, ISBN 0-465-01177-2, New York, NY, BasicBooks, 1995.
Michael K. Elmore-Meegan, BPhEccl, MSc, TCD, PhD
[+] Author Affiliations
International Community for the Relief of Starvation and Suffering (ICROSS) Nyoonyorrie Mobile Unit Base Mbagathi, Kenya
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
The use of land mines has evolved from a predominantly defensive battlefield tactic designed to impede the movement of enemy artillery to an offensive weapon that terrorizes entire civilian populations. Clearing the Fields is the first serious attempt at exploring solutions and answers to a problem that kills hundreds of civilians every week around the world. Here is a book that should be read by every political and military decision maker.
Clearing the Fields is a rich source of up-to-date information. More than 100 million mines have been deployed in over 60 countries. In the former Yugoslavia an estimated 3 million mines have been planted without maps during the past four years, with 50 000 more hidden each week. In Cambodia one of every 253 people is an amputee. On average, antipersonnel mines can be bought for $10 to $20, with many available for less than $3. In contrast, it ...
Michael Meegan fly traps trachoma
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The Lancet, Volume 349, Issue 9055, Page 886, 22 March 1997
doi:10.1016/S0140-6736(05)61803-XCite or Link Using DOI
Fly traps
Mike Meegan a, David Morley a Corresponding Author, Desmond Chavasse a
Sir
Conroy and colleagues report (Dec 21/28, p 1695)1 suggests the value of plastic bottles in the disinfection of drinking water by sunlight to reduce the frequency of diarrhoea. We investigated the possibility of using these bottles to construct a simple fly trap
Flies are a major risk to health in many countries, but in some populations the use of pesticides is too expensive. Fly traps have been developed in Israel where traps are made commercially in Kibbutzim.2, 3 We suggest an alternative fly trap that can be made from used plastic drinking bottles in less than 1 h. Currently, 45 are in use among groups of Maasai who catch about 255 flies daily. We do not claim that this method of catching flies makes a substantial difference because of the large population of flies, but hope that other fieldworkers can improve on the design and find more effective but readily available baits.
The fly trap is shown in the figure. Slightly diluted paint is poured into the bait bottle and rolled around the lower two-thirds of the bottle. When the paint is dry, fly ports are cut in the bottle. A plastic tube is made from another bottle and fixed to the neck of the bait bottle. The upper end of the tube is narrowed so that flies can just squeeze through the hole. The lower end of the trap bottle is cut off and slits are cut so that it fits firmly onto the bait bottle. The trap is hung just off the ground in the semi-shade. In Israel, yeast with a small quantity of ammonium carbonate is used as the bait but the Maasai use goats' droppings together with cows' urine.
|
Journals
The Lancet
The Lancet Infectious Diseases
The Lancet Neurology
The Lancet Oncology
|
Specialties
|
Audio
|
Conferences
The Lancet Conferences
Conference Collaborations
Meet the Editors at Conferences
|
Education
At the Limits
The Lancet Seminars
The Lancet Core Clinical Collection
The Lancet Student
|
The Lancet Series
|
Information for
Authors
Advertisers
Press
|
Careers
The Lancet, Volume 349, Issue 9055, Page 886, 22 March 1997
doi:10.1016/S0140-6736(05)61803-XCite or Link Using DOI
Fly traps
Mike Meegan a, David Morley a Corresponding Author, Desmond Chavasse a
Sir
Conroy and colleagues report (Dec 21/28, p 1695)1 suggests the value of plastic bottles in the disinfection of drinking water by sunlight to reduce the frequency of diarrhoea. We investigated the possibility of using these bottles to construct a simple fly trap
Flies are a major risk to health in many countries, but in some populations the use of pesticides is too expensive. Fly traps have been developed in Israel where traps are made commercially in Kibbutzim.2, 3 We suggest an alternative fly trap that can be made from used plastic drinking bottles in less than 1 h. Currently, 45 are in use among groups of Maasai who catch about 255 flies daily. We do not claim that this method of catching flies makes a substantial difference because of the large population of flies, but hope that other fieldworkers can improve on the design and find more effective but readily available baits.
The fly trap is shown in the figure. Slightly diluted paint is poured into the bait bottle and rolled around the lower two-thirds of the bottle. When the paint is dry, fly ports are cut in the bottle. A plastic tube is made from another bottle and fixed to the neck of the bait bottle. The upper end of the tube is narrowed so that flies can just squeeze through the hole. The lower end of the trap bottle is cut off and slits are cut so that it fits firmly onto the bait bottle. The trap is hung just off the ground in the semi-shade. In Israel, yeast with a small quantity of ammonium carbonate is used as the bait but the Maasai use goats' droppings together with cows' urine.
Meegan Culturally-based health promotion programmes
Culturally-based health promotion programmes
J Jaime Miranda aEmail Address, Rosa Malca a, Eduardo Bedriñana a, Efraín Loayza a
Sir
Michael Elmore Meegan and colleagues (Aug 25, p 640)1 report a decrease in mortality rates due to neonatal tetanus in five Massai areas (sub-Saharan Africa) after introduction of a culturally-based health promotion approach.
Promotion activities were done by local community actors in the intervention areas, whereas in control areas, such activities were done by local Ministry of Health staff.
Although the study period was almost 20 years, the death rates in children younger than 6 weeks fell sharply after the first year of intervention and has not risen again in the past 11 years.
In view of such spectacular change, we wonder whether Meegan and colleagues promoted this approach to other communities, rather than just continuing with the analysis for such a long time. Moreover, we would like to know if they transferred this knowledge to local sustainable actors such as Ministry of Health bodies.
We disagree with the long observation period because the study control areas could have benefited from this culturally based approach for at least 11, if not 18, years.
Culturally-adequate approaches result in wider local acceptance and higher compromise with local actors, thereby providing greater chances of sustainability. Our experience with culturally adequate delivery services implemented on rural health facilities from the Peruvian Andes reflects this outcome. In Peru there is a high maternal mortality rate (around 215 per 100 000 by 2000). More than 80% of mothers die at home despite an adequate number of antenatal care visits.2 Women in the Andes generally delivered their babies at home because of fear and shame from using modern delivery methods that do not accord with local cultural beliefs.3 We took into account the requirements of rural people and negotiated with local Ministry of Health staff. So far, after 9 months of implementation, the number of institutional deliveries is rising, and is contributing to lower maternal mortality.
References
1 Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect on neonatal tetanus mortality after a culturally-based health promotion programme. Lancet 2001; 358: 640-641. Summary | Full Text | PDF(59KB) | CrossRef | PubMed
2 Guerra V. Lucha contra la muerte materna, Ayacucho. Salud Para Todos 2001; 1: 6. PubMed
3 Investigation report: provision of culturally adequate sexual and reproductive health services in rural communities affected by violence. Ayacucho, Peru: Health Unlimited, Peruvian Programme, 2000.
J Jaime Miranda aEmail Address, Rosa Malca a, Eduardo Bedriñana a, Efraín Loayza a
Sir
Michael Elmore Meegan and colleagues (Aug 25, p 640)1 report a decrease in mortality rates due to neonatal tetanus in five Massai areas (sub-Saharan Africa) after introduction of a culturally-based health promotion approach.
Promotion activities were done by local community actors in the intervention areas, whereas in control areas, such activities were done by local Ministry of Health staff.
Although the study period was almost 20 years, the death rates in children younger than 6 weeks fell sharply after the first year of intervention and has not risen again in the past 11 years.
In view of such spectacular change, we wonder whether Meegan and colleagues promoted this approach to other communities, rather than just continuing with the analysis for such a long time. Moreover, we would like to know if they transferred this knowledge to local sustainable actors such as Ministry of Health bodies.
We disagree with the long observation period because the study control areas could have benefited from this culturally based approach for at least 11, if not 18, years.
Culturally-adequate approaches result in wider local acceptance and higher compromise with local actors, thereby providing greater chances of sustainability. Our experience with culturally adequate delivery services implemented on rural health facilities from the Peruvian Andes reflects this outcome. In Peru there is a high maternal mortality rate (around 215 per 100 000 by 2000). More than 80% of mothers die at home despite an adequate number of antenatal care visits.2 Women in the Andes generally delivered their babies at home because of fear and shame from using modern delivery methods that do not accord with local cultural beliefs.3 We took into account the requirements of rural people and negotiated with local Ministry of Health staff. So far, after 9 months of implementation, the number of institutional deliveries is rising, and is contributing to lower maternal mortality.
References
1 Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect on neonatal tetanus mortality after a culturally-based health promotion programme. Lancet 2001; 358: 640-641. Summary | Full Text | PDF(59KB) | CrossRef | PubMed
2 Guerra V. Lucha contra la muerte materna, Ayacucho. Salud Para Todos 2001; 1: 6. PubMed
3 Investigation report: provision of culturally adequate sexual and reproductive health services in rural communities affected by violence. Ayacucho, Peru: Health Unlimited, Peruvian Programme, 2000.
Meegan Sex Workers in Kenya, Numbers of Clients and Associated Risks: An Exploratory Survey
Sex Workers in Kenya, Numbers of Clients and Associated Risks: An Exploratory Survey
Purchase
$ 31.50
Michael Elmore-Meegana, Ronán M ConroyE-mail The Corresponding Author, b and C Bernard Agalac
a Director, ICROSS, Ngong Hills, Kenya
b Lecturer in Biostatistics, Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
c Research Assistant, ICROSS, Ngong Hills, Kenya
Available online 18 May 2004.
Abstract
In Kenya in 1999, an estimated 6.9% of women nationally said they had exchanged sex for money, gifts or favours in the previous year. In 2000 and 2001, in collaboration with sex workers who had formed a network of self-help groups, we conducted an exploratory survey among 475 sex workers in four rural towns and three Nairobi townships, regarding where they worked, the number of clients they had and the risks they were exposed to. Participants were identified by a network of social contacts in the seven centres. Most of the women (88%) worked from bars, hotels, bus stages and discos; 57% lived with a stable partner and almost 90% had dependent children. In the previous month, 17% had been assaulted and 35% raped by clients. Unwanted pregnancy was common; 86% had had at least one abortion. Compared with women in rural towns, township sex workers were younger (median age 22 vs. 26), saw more clients (median 9 vs. 4 per week) and earned more from sex work (up to €63–90 vs. €12 per week). Issues of alternative sources of income, safety for sex workers and the conditions which create the necessity for sex work are vital to address. The question of number of clients and the nature of sex work have obvious implications for HIV/STI prevention policy.
Résumé
Au Kenya en 1999, on estimait que 6,9% des femmes avaient eu des relations sexuelles contre de l'argent, des cadeaux ou des faveurs pendant l'année précédente. En 2000 et 2001, en collaboration avec des prostituées qui avaient formé un réseau de groupes d'auto-assistance, nous avons mené une enquête auprès de 475 prostituées dans quatre villes rurales et trois bidonvilles de Nairobi, afin de déterminer pourquoi elles se prostituaient, le nombre de leurs clients et les risques auxquels elles étaient exposées. Les participantes ont été identifiées par un réseau de contacts sociaux dans les sept centres. La plupart des femmes (88%) travaillaient dans des bars, des hôtels, des gares d'autobus et des discothèques ; 57% vivaient avec un partenaire stable et presque 90% avaient des enfants à charge. Le mois précédant l'enquête, 17% avaient été battues et 35% violées par des clients. Les grossesses non désirées étaient fréquentes ; 86% avaient avorté au moins une fois. Comparées avec les prostituées rurales, celles des bidonvilles étaient plus jeunes (âge médian 22 contre 26), voyaient davantage de clients (valeur médiane 9 contre 4 par semaine) et leur activité rapportait davantage (jusqu'à 63-90€ contre 12€ par semaine). Il est vital d'étudier des questions comme les sources alternatives de revenus, la sécurité des prostituées et les conditions qui rendent la prostitution nécessaire. Le nombre de clients et la nature du travail sexuel ont des conséquences évidentes sur la politique de prévention du VIH/SIDA.
Extracto
En 1999, aproximadamente el 6.9% de las mujeres en Kenia informaron de haber intercambiado sexo por dinero, regalos o favores durante el año anterior. En 2000 y 2001, en colaboración con trabajadoras sexuales que habían formado una red de grupos de autoayuda, realizamos una encuesta exploratoria entre 475 trabajadoras sexuales en cuatro pueblos rurales y tres municipios de Nairobi, respecto al lugar donde trabajaban, el número de clientes que tenían y los riesgos a los que se exponían. Las participantes fueron seleccionadas por una red de contactos sociales en los siete centros. La mayoría de las mujeres (el 88%) trabajaban en bares, hoteles, estaciones de autobús y discotecas; el 57% vivía con una pareja estable y casi un 90% tenía hijos dependientes. En el mes anterior, el 17% había sido asaltada y el 35% violada por sus clientes. El embarazo no deseado era común; el 86% había tenido por lo menos un aborto. Comparadas con las mujeres en los pueblos rurales, las trabajadoras sexuales de los municipios eran más jóvenes (edad promedio de 22 frente a 26), veían más clientes (promedio de 9 frente a 4 por semana) y ganaban más dinero realizando trabajo sexual (hasta €63–90 frente a €12 por semana). Es vital abordar las cuestiones relacionadas con otras fuentes de ingreso, la seguridad de las trabajadoras sexuales y las condiciones que crean la necesidad de realizar trabajo sexual. La interrogante del número de clientes y la naturaleza del trabajo sexual tienen obvias implicaciones para las políticas de prevención de las ITS/VIH.
Author Keywords: sex work; sexual violence; sexually transmitted infections; HIV; Kenya
Purchase
$ 31.50
Michael Elmore-Meegana, Ronán M ConroyE-mail The Corresponding Author, b and C Bernard Agalac
a Director, ICROSS, Ngong Hills, Kenya
b Lecturer in Biostatistics, Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
c Research Assistant, ICROSS, Ngong Hills, Kenya
Available online 18 May 2004.
Abstract
In Kenya in 1999, an estimated 6.9% of women nationally said they had exchanged sex for money, gifts or favours in the previous year. In 2000 and 2001, in collaboration with sex workers who had formed a network of self-help groups, we conducted an exploratory survey among 475 sex workers in four rural towns and three Nairobi townships, regarding where they worked, the number of clients they had and the risks they were exposed to. Participants were identified by a network of social contacts in the seven centres. Most of the women (88%) worked from bars, hotels, bus stages and discos; 57% lived with a stable partner and almost 90% had dependent children. In the previous month, 17% had been assaulted and 35% raped by clients. Unwanted pregnancy was common; 86% had had at least one abortion. Compared with women in rural towns, township sex workers were younger (median age 22 vs. 26), saw more clients (median 9 vs. 4 per week) and earned more from sex work (up to €63–90 vs. €12 per week). Issues of alternative sources of income, safety for sex workers and the conditions which create the necessity for sex work are vital to address. The question of number of clients and the nature of sex work have obvious implications for HIV/STI prevention policy.
Résumé
Au Kenya en 1999, on estimait que 6,9% des femmes avaient eu des relations sexuelles contre de l'argent, des cadeaux ou des faveurs pendant l'année précédente. En 2000 et 2001, en collaboration avec des prostituées qui avaient formé un réseau de groupes d'auto-assistance, nous avons mené une enquête auprès de 475 prostituées dans quatre villes rurales et trois bidonvilles de Nairobi, afin de déterminer pourquoi elles se prostituaient, le nombre de leurs clients et les risques auxquels elles étaient exposées. Les participantes ont été identifiées par un réseau de contacts sociaux dans les sept centres. La plupart des femmes (88%) travaillaient dans des bars, des hôtels, des gares d'autobus et des discothèques ; 57% vivaient avec un partenaire stable et presque 90% avaient des enfants à charge. Le mois précédant l'enquête, 17% avaient été battues et 35% violées par des clients. Les grossesses non désirées étaient fréquentes ; 86% avaient avorté au moins une fois. Comparées avec les prostituées rurales, celles des bidonvilles étaient plus jeunes (âge médian 22 contre 26), voyaient davantage de clients (valeur médiane 9 contre 4 par semaine) et leur activité rapportait davantage (jusqu'à 63-90€ contre 12€ par semaine). Il est vital d'étudier des questions comme les sources alternatives de revenus, la sécurité des prostituées et les conditions qui rendent la prostitution nécessaire. Le nombre de clients et la nature du travail sexuel ont des conséquences évidentes sur la politique de prévention du VIH/SIDA.
Extracto
En 1999, aproximadamente el 6.9% de las mujeres en Kenia informaron de haber intercambiado sexo por dinero, regalos o favores durante el año anterior. En 2000 y 2001, en colaboración con trabajadoras sexuales que habían formado una red de grupos de autoayuda, realizamos una encuesta exploratoria entre 475 trabajadoras sexuales en cuatro pueblos rurales y tres municipios de Nairobi, respecto al lugar donde trabajaban, el número de clientes que tenían y los riesgos a los que se exponían. Las participantes fueron seleccionadas por una red de contactos sociales en los siete centros. La mayoría de las mujeres (el 88%) trabajaban en bares, hoteles, estaciones de autobús y discotecas; el 57% vivía con una pareja estable y casi un 90% tenía hijos dependientes. En el mes anterior, el 17% había sido asaltada y el 35% violada por sus clientes. El embarazo no deseado era común; el 86% había tenido por lo menos un aborto. Comparadas con las mujeres en los pueblos rurales, las trabajadoras sexuales de los municipios eran más jóvenes (edad promedio de 22 frente a 26), veían más clientes (promedio de 9 frente a 4 por semana) y ganaban más dinero realizando trabajo sexual (hasta €63–90 frente a €12 por semana). Es vital abordar las cuestiones relacionadas con otras fuentes de ingreso, la seguridad de las trabajadoras sexuales y las condiciones que crean la necesidad de realizar trabajo sexual. La interrogante del número de clientes y la naturaleza del trabajo sexual tienen obvias implicaciones para las políticas de prevención de las ITS/VIH.
Author Keywords: sex work; sexual violence; sexually transmitted infections; HIV; Kenya
Africa on the Precipice: Perspective From South Africa-Reply Michael Elmore-Meegan, BPh, MSc [+] Author Affiliations International Community for the Relief of Starvation and Suffering Mbagathi, Kenya Since this article does not have an abstract, we have provided the first 150 words of the full text. Excerpt In Reply. —Walker et al make some very helpful points. There are complex differences between evolving African countries. South Africa's mortality rate for children under 5 years of age is 72 per 1000 live births compared with 180 in least-developed countries and a mean of 101 in developing countries.1 Forty-nine percent of South Africa's population is urbanized compared with a mean of 28% in sub-Saharan Africa,1 while the maternal mortality rate stands at 83% in South Africa and 600 for sub-Saharan Africa. In most of Africa, 80% of the population remains rural. It is a tribute to the great advances in South Africa that it is so nonrepresentative of most of the continent. Walker et al are, of course, correct that there must be a strengthening of health facilities and infrastructure; nor must we forget referral mechanisms and secondary care. A great failing of many donors and funding ...
Africa on the Precipice: Perspective From South Africa-Reply
Michael Elmore-Meegan, BPh, MSc
[+] Author Affiliations
International Community for the Relief of Starvation and Suffering Mbagathi, Kenya
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
In Reply. —Walker et al make some very helpful points. There are complex differences between evolving African countries. South Africa's mortality rate for children under 5 years of age is 72 per 1000 live births compared with 180 in least-developed countries and a mean of 101 in developing countries.1 Forty-nine percent of South Africa's population is urbanized compared with a mean of 28% in sub-Saharan Africa,1 while the maternal mortality rate stands at 83% in South Africa and 600 for sub-Saharan Africa. In most of Africa, 80% of the population remains rural. It is a tribute to the great advances in South Africa that it is so nonrepresentative of most of the continent.
Walker et al are, of course, correct that there must be a strengthening of health facilities and infrastructure; nor must we forget referral mechanisms and secondary care. A great failing of many donors and funding ...
Michael Elmore-Meegan, BPh, MSc
[+] Author Affiliations
International Community for the Relief of Starvation and Suffering Mbagathi, Kenya
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
In Reply. —Walker et al make some very helpful points. There are complex differences between evolving African countries. South Africa's mortality rate for children under 5 years of age is 72 per 1000 live births compared with 180 in least-developed countries and a mean of 101 in developing countries.1 Forty-nine percent of South Africa's population is urbanized compared with a mean of 28% in sub-Saharan Africa,1 while the maternal mortality rate stands at 83% in South Africa and 600 for sub-Saharan Africa. In most of Africa, 80% of the population remains rural. It is a tribute to the great advances in South Africa that it is so nonrepresentative of most of the continent.
Walker et al are, of course, correct that there must be a strengthening of health facilities and infrastructure; nor must we forget referral mechanisms and secondary care. A great failing of many donors and funding ...
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The psychological well-being of children orphaned by AIDS in Cape Town, South Africa
The psychological well-being of children orphaned by AIDS in Cape Town, South Africa
A year before his death, 17-year-old Atria weighs 7 stone. He has left his village. He is afraid and he is ashamed. He is embarrassed to be here. He is sweating, he fights. His hands tremble. His pulse is rapid. He tries to smile. His problems aren't only the rashes and the intestinal worms. These are easily cleared up. But you can't "clear up" anger and fear, or sleepless nights and panic attacks, or how long a few minutes can seem . . . or the sense of powerlessness watching your own body fall away, the humiliation of disintegration. Some infections are harder to deal with: a mouth filled with ulcers, an inflamed penis. As the disease progresses so do the nausea, the back pain, the headaches. Muscle cramps always hurt, especially when one has very little muscle. Atria has severe diarrhea and the dull aches in his stomach become …
http://jama.ama-assn.org/content/284/2/152.short
A year before his death, 17-year-old Atria weighs 7 stone. He has left his village. He is afraid and he is ashamed. He is embarrassed to be here. He is sweating, he fights. His hands tremble. His pulse is rapid. He tries to smile.
His problems aren't only the rashes and the intestinal worms. These are easily cleared up. But you can't "clear up" anger and fear, or sleepless nights and panic attacks, or how long a few minutes can seem . . . or the sense of powerlessness watching your own body fall away, the humiliation of disintegration.
Some infections are harder to deal with: a mouth filled with ulcers, an inflamed penis. As the disease progresses so do the nausea, the back pain, the headaches. Muscle cramps always hurt, especially when one has very little muscle. Atria has severe diarrhea and the dull aches in his stomach become …
A year before his death, 17-year-old Atria weighs 7 stone. He has left his village. He is afraid and he is ashamed. He is embarrassed to be here. He is sweating, he fights. His hands tremble. His pulse is rapid. He tries to smile.
His problems aren't only the rashes and the intestinal worms. These are easily cleared up. But you can't "clear up" anger and fear, or sleepless nights and panic attacks, or how long a few minutes can seem . . . or the sense of powerlessness watching your own body fall away, the humiliation of disintegration.
Some infections are harder to deal with: a mouth filled with ulcers, an inflamed penis. As the disease progresses so do the nausea, the back pain, the headaches. Muscle cramps always hurt, especially when one has very little muscle. Atria has severe diarrhea and the dull aches in his stomach become …
Meegan Maasai diet
Titre du document / Document title
MAASAI DIET
Auteur(s) / Author(s)
MCCORMICK J. ; ELMORE-MEEGAN M. ;
Revue / Journal Title
Lancet ISSN 0140-6736 CODEN LANCAO
Source / Source
1992, vol. 340, no8826, pp. 1042-1043 [2 page(s) (article)]
Langue / Language
Anglais
Editeur / Publisher
Elsevier, Kidlington, ROYAUME-UNI (1823) (Revue)
Localisation / Location
INIST-CNRS, Cote INIST : 5004, 35400003201820.0330
MAASAI DIET
Auteur(s) / Author(s)
MCCORMICK J. ; ELMORE-MEEGAN M. ;
Revue / Journal Title
Lancet ISSN 0140-6736 CODEN LANCAO
Source / Source
1992, vol. 340, no8826, pp. 1042-1043 [2 page(s) (article)]
Langue / Language
Anglais
Editeur / Publisher
Elsevier, Kidlington, ROYAUME-UNI (1823) (Revue)
Localisation / Location
INIST-CNRS, Cote INIST : 5004, 35400003201820.0330
Meegan Maasai diet
Titre du document / Document title
MAASAI DIET
Auteur(s) / Author(s)
MCCORMICK J. ; ELMORE-MEEGAN M. ;
Revue / Journal Title
Lancet ISSN 0140-6736 CODEN LANCAO
Source / Source
1992, vol. 340, no8826, pp. 1042-1043 [2 page(s) (article)]
Langue / Language
Anglais
Editeur / Publisher
Elsevier, Kidlington, ROYAUME-UNI (1823) (Revue)
Localisation / Location
INIST-CNRS, Cote INIST : 5004, 35400003201820.0330
MAASAI DIET
Auteur(s) / Author(s)
MCCORMICK J. ; ELMORE-MEEGAN M. ;
Revue / Journal Title
Lancet ISSN 0140-6736 CODEN LANCAO
Source / Source
1992, vol. 340, no8826, pp. 1042-1043 [2 page(s) (article)]
Langue / Language
Anglais
Editeur / Publisher
Elsevier, Kidlington, ROYAUME-UNI (1823) (Revue)
Localisation / Location
INIST-CNRS, Cote INIST : 5004, 35400003201820.0330
Meegan Batch process solar disinfection is an efficient means of disinfecting drinking water contaminated with Shigella dysenteriae
ims: The mortality and morbidity rate caused by Shigella dysenteriae type I infection is increasing in the developing world each year. In this paper, the possibility of using batch process solar disinfection (SODIS) as an effective means of disinfecting drinking water contaminated with Sh. dysenteriae type I is investigated.
Methods: Phosphate-buffered saline contaminated with Sh. dysenteriae type I was exposed to simulated solar conditions and the inactivation kinetics of this organism was compared with that of Sh. flexneri, Vibrio cholerae and Salmonella typhimurium.
Significance: Recovery of injured Sh. dysenteriae type I may be improved by plating on medium supplemented with catalase or pyruvate. Sh. dysenteriae type I is very sensitive to batch process SODIS and is easily inactivated even during overcast conditions. Batch process SODIS is an appropriate intervention for use in developing countries during Sh. dysenteriae type I epidemics.
Introduction
After virtually disappearing at the beginning of the 20th century, epidemic Shigella dysenteriae type I reappeared in 1968 in Central America and later in Asia and Africa (Mata et al. 1970; World Health Organisation 1988; Tuttle et al. 1995). Today, bacillary dysentery is endemic throughout the world with 150 million cases and almost 600 000 deaths occurring annually (Sansonetti 1999). About 95% of these cases occur in developing countries where water quality and sanitation is less than adequate. The low infective dose (thought to be as little as 10 cells; Sansonetti 1999) together with the emergence of antimicrobial resistant strains has made it increasingly difficult to control both the spread and treatment of this organism. In 1987, Sh. dysenteriae type I strains resistant to all commonly available anti-microbial agents were isolated in Bangladesh (Munshi et al. 1987). Strains resistant to trimethorprim–sulphamethoxazole and ampicillin were isolated in both Africa and Asia (Frost et al. 1981; Central Statistics Office 1991).
Small improvements in water supply and sanitation facilities in poor communities have a lower impact on diarrhoea caused by pathogens of low infective dose such as Sh. dysenteriae type I compared with pathogens of high infective dose, e.g. Vibrio cholerae (Esrey et al. 1985). Zeng-sui et al. (1989) reported that provision of good quality drinking water supplies reduces the transmission of viral hepatitis A, cholera and acute watery diarrhoea but does not influence the incidence of bacillary dysentery. It is clearly desirable to control all potential routes of transmission of Sh. dysenteriae type I. Batch process solar disinfection (SODIS), which takes advantage of the most abundant source of energy in many of these regions, natural sunlight, may provide additional possibilities for control of bacillary dysentery.
The SODIS technique consists of filling transparent bottles with drinking water and exposing them to full sunlight for up to 8 h with the subsequent inactivation of microbial and viral pathogens (Acra et al. 1989; Sommer et al. 1997; Kehoe et al. 2001). The bactericidal effect of sunlight is due to optical and thermal processes and a strong synergistic effect occurs at temperatures exceeding 45°C (McGuigan et al. 1998). In addition to direct u.v. killing, sunlight is absorbed by endogenous (e.g. cytochromes) and exogenous (e.g. humic substances) photosensitizers that then react with oxygen producing highly reactive oxygen molecules such as hydrogen peroxide (H2O2), singlet oxygen and superoxides which exert a bactericidal effect (Whitelam and Codd 1986; Farr and Kogoma 1991). As a result, oxygen levels within the container should be at a maximum (Reed et al. 2000; Kehoe et al. 2001). Most bacterial strains produce catalase in response to hydrogen peroxide. However, Sh. dysenteriae type I does not produce a catalase that is detected by standard methods and thus may be more sensitive to batch process SODIS. Bogosian et al. (2000) noted that H2O2-sensitive cells of V. vulnificus produced during starvation were recovered by growth on medium supplemented with catalase or pyruvate but not by growth on standard medium. We supplemented medium with catalase or pyruvate to achieve maximum plating efficiency.
We show that sublethally solar injured Sh. dysenteriae type I may be recovered on medium supplemented with either catalase or pyruvate but not on standard medium. Sh. dysenteriae type I is extremely sensitive to SODIS with inactivation occurring even during overcast conditions.
Materials and methods
The following bacterial strains were used in this experiment: Sh. dysenteriae type I ATCC 13313, V. cholerae 8021 serovar 01, classical biotype, Ogawa serotype purchased from the NCTC Collection, Colindale, London, UK, Salmonella typhimurium C5Nxr as described by Smith et al. (2000). Sh. flexneri (M90 T; Franzon et al. 1990) was kindly donated by P.J. Sansonetti, Institut Pasteur, Paris, France. All experiments involving Sh. dysenteriae type I were performed in a class 3 containment laboratory in correspondence with EU regulations.
All bacterial strains were inoculated (single colony) in 100 ml of sterile nutrient broth (Oxoid CM67) and incubated at 37°C for 18 h to obtain a stationary phase culture. Cells were harvested by centrifugation at 855 g for 10 min and washed three times with HPLC analytical reagent sterile water to completely remove the nutrients. Finally, the pellet was resuspended in sterile phosphate-buffered saline (PBS), pH 7·3 (Oxoid; BR14) to a final concentration of 106 CFU ml−1. These organisms were found to be more unstable when maintained in water than PBS (Kehoe 2001). By resuspending these cells in PBS we aimed to expose them to solar irradiation in their most stable environment. The solar simulation apparatus described by McGuigan et al. (1998) was used. The irradiating light source was a 150 W Xenon arc lamp (model 66057/68806 Oriel Ltd., Stratford, CT, USA) fitted with a rear reflector and u.v. collecting optics. The light from the lamp was passed through an Air Mass 1.0 heat-absorbing solar filter (model KG2, Melles-Griot, Cambridge, UK), which closely approximates the incident solar irradiation expected at sea level on the equator. The complete continuous output spectrum of this system is given in McGuigan et al. (1998). A low optical irradiance of 42 mW cm−2, corresponding to an overcast day in Kenya (Joyce et al. 1996) was simulated and the water temperature was maintained at 42°C for Sh. dysenteriae type I and Sh. flexneri while Salm. typhimurium and V. cholerae were exposed to higher levels of irradiation in order to obtain inactivation within 8 h (42 and 45°C respectively and 87 mW cm−2). Sh. dysenteriae type I and Sh. flexneri inactivation occurred at such a high rate under these high optical irradiances that it was necessary to reduce the optical irradiance to 42 mW cm−2 for calculation of inactivation kinetics.
In the field trials of the SODIS technique described by Conroy et al. (2001) test subjects placed their SODIS bottles on the roof of their dwelling or kept them inside their dwelling in a darkened area, at room temperature. Bottles were exposed on the roof of Maasai huts and reached water temperatures of between 40 and 55°C or were kept indoors in the shade where water temperatures were similar to room temperature. Consequently, in our experiments a control solution was left in the dark at room temperature throughout the procedure. Test samples were maintained at the intermediate water temperature of 42°C to ensure that thermal inactivation processes did not predominate. Volumes of 100 μl were taken from each bottle of the control and irradiated groups at the beginning of each experiment and at each sampling interval. These volumes were diluted in a series of 10-fold dilutions and plated in triplicate on either standard plate count agar (SPCA; Oxoid CM 463) or agar supplemented with either catalase or pyruvate (see below) and the CFU/ml were calculated by the method of Hoben and Somasegeram (1982) following incubation at 37°C for 18 h. First-order solar decay constants (kJ−1) were calculated from the slope of the regression line Ln(Nt/N0) vs cumulative dose in kJ, where N0 is the number of viable bacteria in CFU/ml at time zero and Nt is the number of viable bacteria in CFU/ml at time, t. Plotting values as a function of cumulative dose as opposed to time allowed comparison between all four organisms studied taking into consideration the differing optical intensity and temperature. This measurement also takes into account, water volume and dimensions of solar reactors. Each experiment was repeated at least three times. Exact statistical tests were implemented in StatXact 5 (STATCON, Witzenhausen, Germany). First-order decay constants were compared using analysis of variance with general scores. Catalase (EC 1.11.1.6, from bovine liver; Sigma, C-9322) solutions were prepared by dilution in ice-cold phosphate buffer (10 mm, pH 7). Solutions were immediately filter sterilized with 0·2 μm membrane filters (Sarstedt, Nümbrecht, Germany, 83.1826.001) and 0·5 ml aliquots aseptically transferred to the surface of a standard agar plate. Quantities of 406, 812, 1700, 2445, 3260 units catalase were applied to plates and that concentration which gave optimum plating efficiency was determined. Catalase plates were prepared approx. 1 h prior to sampling. A solution of catalase, which had been boiled for 10 mins, acted as a control.
Pyruvate plates were prepared by addition of sodium pyruvate (Sigma, p-8574) directly to the medium before autoclaving. The following concentrations were examined for plating efficiency and the optimum determined; 0·03, 0·05, 0·07, 0·1 and 0·25%. Glacial acetic acid (0·03%), a by-product of H2O2 degradation by pyruvic acid acted as a control (Zelitch 1972; Elstner and Heupel 1976).
Results
The solar inactivation behaviour of the four bacteria differed considerably (Fig. 1; Table 1). Sh. dysenteriae type I is significantly more sensitive to SODIS than either Sh. flexneri, V. cholerae or Salm. typhimurium (P = 0·015). No change in culturability was noted in the dark control microcosms over the course of exposure. A 6-log reduction in CFUs of Sh. dysenteriae type I was observed after just 1·5-h exposure to simulated overcast conditions at equatorial latitudes (Fig. 2). Six-hour exposure is required to inactivate a similar concentration of Sh. flexneri. The order of sensitivity to batch process SODIS is: Sh. dysenteriae type I > Sh. flexneri > Salm. typhimurium > V. cholerae. An optical dose of approx. 6 kJ is required to inactivate 106Sh. dysenteriae type I/ml while approx. 24 and >60 kJ is required to inactivate 106Salm. typhimurium/ml and 106V. cholerae/ml respectively. To put these figures in perspective, an optical dose of 60 kJ would be achieved in approx. 100 min under a standard equatorial solar irradiance of 100 mW cm−2.
Figure 1. Solar inactivation of Sh. dysenteriae type I, Shigella flexneri, Salmonella typhimurium and Vibrio cholerae plated on standard plate count agar (SPCA) expressed in terms of cumulative u.v. dose received (300–400 nm)
image
Table 1. Representative decay constants (kJ−1), in terms of cumulative u.v. dose received (300–400 nm), for solar disinfected Sh. dysenteriae type I, Sh. flexneri, V. cholerae 01 and Salm. typhimurium plated on standard plate count agar (SPCA), medium supplemented with pyruvate or medium supplemented with catalase. R2 values in parentheses Decay constants (kJ−1)
SPCA Pyruvate Catalase
Sh. dysenteriae type I 3·055 (0·942) 1·61 (0·900) 1·191 (0·987)
Sh. flexneri 0·462 (0·895) 0·435 (0·913) 0·314 (0·997)
Salm. typhimurium 0·168 (0·952) 0·171 (0·969) 0·171 (0·986)
V. cholerae 0·076 (0·917) 0·074 (0·910) –
Figure 2. Solar inactivation of Sh. dysenteriae type I, exposed to a solar irradiance of 42 mW cm−2 and a water temperature of 42°C plated on standard plate count agar (SPCA) (•) or medium supplemented with catalase (406 units/plate) (○) or pyruvate (0·05%) (bsl00072)
image
The optimum concentration of catalase and pyruvate is 406 units per plate and 0·05% respectively (data not shown). The inactivation of Sh. dysenteriae type I on SPCA and plates supplemented with 0·05% pyruvate and 406 units catalase are presented in Fig. 2 and Table 1. These results show that when grown on standard plates, 6 log units of Sh. dysenteriae type I appear to be completely inactivated after 1·5-h exposure. However, when this sample was plated on medium supplemented with pyruvate or catalase, almost 104 CFU ml−1 were culturable.
Comparisons of decay constants for Sh. flexneri, Salm. typhimurium and V. cholerae when plated on standard agar and supplemented plates are presented in Table 1 and supplementation of medium with either catalase or pyruvate had little effect on the culturability of these organisms.
Discussion
Shigella dysenteriae type I is sensitive to batch process SODIS. When plated on SPCA 106Sh. dysenteriae type I/ml are inactivated after 1·5-h exposure to simulated equatorial overcast conditions. As shown in Table 1, Salm. typhimurium and V. cholerae have significantly lower decay constants. MacKenzie et al. 1992 reported that solar treatment of drinking water to prevent and control the spread of cholera is effective only under selected conditions, possibly related to altitude and intensity of ultraviolet radiation. However, children under 6 years of age drinking solar disinfected water were protected from V. cholerae infection during an outbreak in rural Kenya (Odds Ratio, 0·12; 95% CI, 0·02–0·65) (Conroy et al. 2001). This suggests that drinking solar disinfected water during a Sh. dysenteriae type I outbreak would protect against infection transmitted by that route.
When grown on supplemented medium it takes almost three times longer for Sh. dysenteriae type I to become nonculturable (see Fig. 2 and Table 1) but inactivation is still occurring at a much higher rate when compared with Salm. typhimurium and V. cholerae although Sh. dysenteriae type I is only exposed to overcast conditions. Pyruvate neutralizes peroxides by a direct nonenzymatic decarboxylation reaction (Mallet et al. 2002). However, it is also thought to act as an important metabolic fuel. Therefore, the improved plating efficiency observed when irradiated Sh. dysenteriae type I is plated on supplemented medium may be due to either or a combination of these factors. However, similar increases in plating efficiencies were noted when catalase was added to the medium. Catalase enzymatically decomposes hydrogen peroxide and is not thought to act as an energy reserve. Supplementation of the medium with boiled catalase had no effect on the plating efficiency of irradiated Sh. dysenteriae type I also suggesting that catalase does not act as an energy reserve. Since catalase and pyruvate have a similar effect on the plating efficiency of Sh. dysenteriae type I and catalase appears to exert its effect by enzymatic decomposition of peroxide then pyruvate is likely to act through neutralization of peroxides rather than acting as an energy reserve. We recommend the supplementation of recovery medium with pyruvate as it may be added to the agar prior to autoclaving and is thus evenly distributed throughout the medium. Catalase, on the other hand, is very unstable at room temperature and it is therefore difficult to predict the shelf life of the plates.
Although supplementation of medium seems to have the greatest impact on the plating efficiency of Sh. dysenteriae type I, such cells are also more susceptible to SODIS and therefore will be inactivated at a faster rate than other species. In addition, we have previously shown that viable bacterial cells (Salm. typhimurium) which were exposed to solar conditions but still culturable on standard plates are less infective than nonexposed viable cells when administered via the intraperitoneal route (Smith et al. 2000). Subsequent studies showed that such culturable but irradiated bacteria were also less infective when administered via the oral route (Kehoe 2001).
Shigella dysenteriae type I is inactivated by batch process SODIS even during equatorial overcast conditions. Batch process SODIS is therefore an appropriate intervention for developing countries during Sh. dysenteriae type I endemics even where adequate sanitation is provided as improvements in water quality and sanitation have little impact on the epidemiology of this organism because of the low infective dose. Studies testing the efficacy of solar/u.v. disinfection should incorporate pyruvate into bacteriological medium.
Acknowledgements
Sincere thanks to P.J. Sansonetti, Institut Pasteur, Paris, France for providing the Sh. flexneri strain used in this project. We thank Ronán Conroy for assistance with the statistical analysis. This project was funded by Royal College of Surgeons in Ireland Research Committee and Enterprise Ireland/British Research Council Research Travel Scheme.
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Methods: Phosphate-buffered saline contaminated with Sh. dysenteriae type I was exposed to simulated solar conditions and the inactivation kinetics of this organism was compared with that of Sh. flexneri, Vibrio cholerae and Salmonella typhimurium.
Significance: Recovery of injured Sh. dysenteriae type I may be improved by plating on medium supplemented with catalase or pyruvate. Sh. dysenteriae type I is very sensitive to batch process SODIS and is easily inactivated even during overcast conditions. Batch process SODIS is an appropriate intervention for use in developing countries during Sh. dysenteriae type I epidemics.
Introduction
After virtually disappearing at the beginning of the 20th century, epidemic Shigella dysenteriae type I reappeared in 1968 in Central America and later in Asia and Africa (Mata et al. 1970; World Health Organisation 1988; Tuttle et al. 1995). Today, bacillary dysentery is endemic throughout the world with 150 million cases and almost 600 000 deaths occurring annually (Sansonetti 1999). About 95% of these cases occur in developing countries where water quality and sanitation is less than adequate. The low infective dose (thought to be as little as 10 cells; Sansonetti 1999) together with the emergence of antimicrobial resistant strains has made it increasingly difficult to control both the spread and treatment of this organism. In 1987, Sh. dysenteriae type I strains resistant to all commonly available anti-microbial agents were isolated in Bangladesh (Munshi et al. 1987). Strains resistant to trimethorprim–sulphamethoxazole and ampicillin were isolated in both Africa and Asia (Frost et al. 1981; Central Statistics Office 1991).
Small improvements in water supply and sanitation facilities in poor communities have a lower impact on diarrhoea caused by pathogens of low infective dose such as Sh. dysenteriae type I compared with pathogens of high infective dose, e.g. Vibrio cholerae (Esrey et al. 1985). Zeng-sui et al. (1989) reported that provision of good quality drinking water supplies reduces the transmission of viral hepatitis A, cholera and acute watery diarrhoea but does not influence the incidence of bacillary dysentery. It is clearly desirable to control all potential routes of transmission of Sh. dysenteriae type I. Batch process solar disinfection (SODIS), which takes advantage of the most abundant source of energy in many of these regions, natural sunlight, may provide additional possibilities for control of bacillary dysentery.
The SODIS technique consists of filling transparent bottles with drinking water and exposing them to full sunlight for up to 8 h with the subsequent inactivation of microbial and viral pathogens (Acra et al. 1989; Sommer et al. 1997; Kehoe et al. 2001). The bactericidal effect of sunlight is due to optical and thermal processes and a strong synergistic effect occurs at temperatures exceeding 45°C (McGuigan et al. 1998). In addition to direct u.v. killing, sunlight is absorbed by endogenous (e.g. cytochromes) and exogenous (e.g. humic substances) photosensitizers that then react with oxygen producing highly reactive oxygen molecules such as hydrogen peroxide (H2O2), singlet oxygen and superoxides which exert a bactericidal effect (Whitelam and Codd 1986; Farr and Kogoma 1991). As a result, oxygen levels within the container should be at a maximum (Reed et al. 2000; Kehoe et al. 2001). Most bacterial strains produce catalase in response to hydrogen peroxide. However, Sh. dysenteriae type I does not produce a catalase that is detected by standard methods and thus may be more sensitive to batch process SODIS. Bogosian et al. (2000) noted that H2O2-sensitive cells of V. vulnificus produced during starvation were recovered by growth on medium supplemented with catalase or pyruvate but not by growth on standard medium. We supplemented medium with catalase or pyruvate to achieve maximum plating efficiency.
We show that sublethally solar injured Sh. dysenteriae type I may be recovered on medium supplemented with either catalase or pyruvate but not on standard medium. Sh. dysenteriae type I is extremely sensitive to SODIS with inactivation occurring even during overcast conditions.
Materials and methods
The following bacterial strains were used in this experiment: Sh. dysenteriae type I ATCC 13313, V. cholerae 8021 serovar 01, classical biotype, Ogawa serotype purchased from the NCTC Collection, Colindale, London, UK, Salmonella typhimurium C5Nxr as described by Smith et al. (2000). Sh. flexneri (M90 T; Franzon et al. 1990) was kindly donated by P.J. Sansonetti, Institut Pasteur, Paris, France. All experiments involving Sh. dysenteriae type I were performed in a class 3 containment laboratory in correspondence with EU regulations.
All bacterial strains were inoculated (single colony) in 100 ml of sterile nutrient broth (Oxoid CM67) and incubated at 37°C for 18 h to obtain a stationary phase culture. Cells were harvested by centrifugation at 855 g for 10 min and washed three times with HPLC analytical reagent sterile water to completely remove the nutrients. Finally, the pellet was resuspended in sterile phosphate-buffered saline (PBS), pH 7·3 (Oxoid; BR14) to a final concentration of 106 CFU ml−1. These organisms were found to be more unstable when maintained in water than PBS (Kehoe 2001). By resuspending these cells in PBS we aimed to expose them to solar irradiation in their most stable environment. The solar simulation apparatus described by McGuigan et al. (1998) was used. The irradiating light source was a 150 W Xenon arc lamp (model 66057/68806 Oriel Ltd., Stratford, CT, USA) fitted with a rear reflector and u.v. collecting optics. The light from the lamp was passed through an Air Mass 1.0 heat-absorbing solar filter (model KG2, Melles-Griot, Cambridge, UK), which closely approximates the incident solar irradiation expected at sea level on the equator. The complete continuous output spectrum of this system is given in McGuigan et al. (1998). A low optical irradiance of 42 mW cm−2, corresponding to an overcast day in Kenya (Joyce et al. 1996) was simulated and the water temperature was maintained at 42°C for Sh. dysenteriae type I and Sh. flexneri while Salm. typhimurium and V. cholerae were exposed to higher levels of irradiation in order to obtain inactivation within 8 h (42 and 45°C respectively and 87 mW cm−2). Sh. dysenteriae type I and Sh. flexneri inactivation occurred at such a high rate under these high optical irradiances that it was necessary to reduce the optical irradiance to 42 mW cm−2 for calculation of inactivation kinetics.
In the field trials of the SODIS technique described by Conroy et al. (2001) test subjects placed their SODIS bottles on the roof of their dwelling or kept them inside their dwelling in a darkened area, at room temperature. Bottles were exposed on the roof of Maasai huts and reached water temperatures of between 40 and 55°C or were kept indoors in the shade where water temperatures were similar to room temperature. Consequently, in our experiments a control solution was left in the dark at room temperature throughout the procedure. Test samples were maintained at the intermediate water temperature of 42°C to ensure that thermal inactivation processes did not predominate. Volumes of 100 μl were taken from each bottle of the control and irradiated groups at the beginning of each experiment and at each sampling interval. These volumes were diluted in a series of 10-fold dilutions and plated in triplicate on either standard plate count agar (SPCA; Oxoid CM 463) or agar supplemented with either catalase or pyruvate (see below) and the CFU/ml were calculated by the method of Hoben and Somasegeram (1982) following incubation at 37°C for 18 h. First-order solar decay constants (kJ−1) were calculated from the slope of the regression line Ln(Nt/N0) vs cumulative dose in kJ, where N0 is the number of viable bacteria in CFU/ml at time zero and Nt is the number of viable bacteria in CFU/ml at time, t. Plotting values as a function of cumulative dose as opposed to time allowed comparison between all four organisms studied taking into consideration the differing optical intensity and temperature. This measurement also takes into account, water volume and dimensions of solar reactors. Each experiment was repeated at least three times. Exact statistical tests were implemented in StatXact 5 (STATCON, Witzenhausen, Germany). First-order decay constants were compared using analysis of variance with general scores. Catalase (EC 1.11.1.6, from bovine liver; Sigma, C-9322) solutions were prepared by dilution in ice-cold phosphate buffer (10 mm, pH 7). Solutions were immediately filter sterilized with 0·2 μm membrane filters (Sarstedt, Nümbrecht, Germany, 83.1826.001) and 0·5 ml aliquots aseptically transferred to the surface of a standard agar plate. Quantities of 406, 812, 1700, 2445, 3260 units catalase were applied to plates and that concentration which gave optimum plating efficiency was determined. Catalase plates were prepared approx. 1 h prior to sampling. A solution of catalase, which had been boiled for 10 mins, acted as a control.
Pyruvate plates were prepared by addition of sodium pyruvate (Sigma, p-8574) directly to the medium before autoclaving. The following concentrations were examined for plating efficiency and the optimum determined; 0·03, 0·05, 0·07, 0·1 and 0·25%. Glacial acetic acid (0·03%), a by-product of H2O2 degradation by pyruvic acid acted as a control (Zelitch 1972; Elstner and Heupel 1976).
Results
The solar inactivation behaviour of the four bacteria differed considerably (Fig. 1; Table 1). Sh. dysenteriae type I is significantly more sensitive to SODIS than either Sh. flexneri, V. cholerae or Salm. typhimurium (P = 0·015). No change in culturability was noted in the dark control microcosms over the course of exposure. A 6-log reduction in CFUs of Sh. dysenteriae type I was observed after just 1·5-h exposure to simulated overcast conditions at equatorial latitudes (Fig. 2). Six-hour exposure is required to inactivate a similar concentration of Sh. flexneri. The order of sensitivity to batch process SODIS is: Sh. dysenteriae type I > Sh. flexneri > Salm. typhimurium > V. cholerae. An optical dose of approx. 6 kJ is required to inactivate 106Sh. dysenteriae type I/ml while approx. 24 and >60 kJ is required to inactivate 106Salm. typhimurium/ml and 106V. cholerae/ml respectively. To put these figures in perspective, an optical dose of 60 kJ would be achieved in approx. 100 min under a standard equatorial solar irradiance of 100 mW cm−2.
Figure 1. Solar inactivation of Sh. dysenteriae type I, Shigella flexneri, Salmonella typhimurium and Vibrio cholerae plated on standard plate count agar (SPCA) expressed in terms of cumulative u.v. dose received (300–400 nm)
image
Table 1. Representative decay constants (kJ−1), in terms of cumulative u.v. dose received (300–400 nm), for solar disinfected Sh. dysenteriae type I, Sh. flexneri, V. cholerae 01 and Salm. typhimurium plated on standard plate count agar (SPCA), medium supplemented with pyruvate or medium supplemented with catalase. R2 values in parentheses Decay constants (kJ−1)
SPCA Pyruvate Catalase
Sh. dysenteriae type I 3·055 (0·942) 1·61 (0·900) 1·191 (0·987)
Sh. flexneri 0·462 (0·895) 0·435 (0·913) 0·314 (0·997)
Salm. typhimurium 0·168 (0·952) 0·171 (0·969) 0·171 (0·986)
V. cholerae 0·076 (0·917) 0·074 (0·910) –
Figure 2. Solar inactivation of Sh. dysenteriae type I, exposed to a solar irradiance of 42 mW cm−2 and a water temperature of 42°C plated on standard plate count agar (SPCA) (•) or medium supplemented with catalase (406 units/plate) (○) or pyruvate (0·05%) (bsl00072)
image
The optimum concentration of catalase and pyruvate is 406 units per plate and 0·05% respectively (data not shown). The inactivation of Sh. dysenteriae type I on SPCA and plates supplemented with 0·05% pyruvate and 406 units catalase are presented in Fig. 2 and Table 1. These results show that when grown on standard plates, 6 log units of Sh. dysenteriae type I appear to be completely inactivated after 1·5-h exposure. However, when this sample was plated on medium supplemented with pyruvate or catalase, almost 104 CFU ml−1 were culturable.
Comparisons of decay constants for Sh. flexneri, Salm. typhimurium and V. cholerae when plated on standard agar and supplemented plates are presented in Table 1 and supplementation of medium with either catalase or pyruvate had little effect on the culturability of these organisms.
Discussion
Shigella dysenteriae type I is sensitive to batch process SODIS. When plated on SPCA 106Sh. dysenteriae type I/ml are inactivated after 1·5-h exposure to simulated equatorial overcast conditions. As shown in Table 1, Salm. typhimurium and V. cholerae have significantly lower decay constants. MacKenzie et al. 1992 reported that solar treatment of drinking water to prevent and control the spread of cholera is effective only under selected conditions, possibly related to altitude and intensity of ultraviolet radiation. However, children under 6 years of age drinking solar disinfected water were protected from V. cholerae infection during an outbreak in rural Kenya (Odds Ratio, 0·12; 95% CI, 0·02–0·65) (Conroy et al. 2001). This suggests that drinking solar disinfected water during a Sh. dysenteriae type I outbreak would protect against infection transmitted by that route.
When grown on supplemented medium it takes almost three times longer for Sh. dysenteriae type I to become nonculturable (see Fig. 2 and Table 1) but inactivation is still occurring at a much higher rate when compared with Salm. typhimurium and V. cholerae although Sh. dysenteriae type I is only exposed to overcast conditions. Pyruvate neutralizes peroxides by a direct nonenzymatic decarboxylation reaction (Mallet et al. 2002). However, it is also thought to act as an important metabolic fuel. Therefore, the improved plating efficiency observed when irradiated Sh. dysenteriae type I is plated on supplemented medium may be due to either or a combination of these factors. However, similar increases in plating efficiencies were noted when catalase was added to the medium. Catalase enzymatically decomposes hydrogen peroxide and is not thought to act as an energy reserve. Supplementation of the medium with boiled catalase had no effect on the plating efficiency of irradiated Sh. dysenteriae type I also suggesting that catalase does not act as an energy reserve. Since catalase and pyruvate have a similar effect on the plating efficiency of Sh. dysenteriae type I and catalase appears to exert its effect by enzymatic decomposition of peroxide then pyruvate is likely to act through neutralization of peroxides rather than acting as an energy reserve. We recommend the supplementation of recovery medium with pyruvate as it may be added to the agar prior to autoclaving and is thus evenly distributed throughout the medium. Catalase, on the other hand, is very unstable at room temperature and it is therefore difficult to predict the shelf life of the plates.
Although supplementation of medium seems to have the greatest impact on the plating efficiency of Sh. dysenteriae type I, such cells are also more susceptible to SODIS and therefore will be inactivated at a faster rate than other species. In addition, we have previously shown that viable bacterial cells (Salm. typhimurium) which were exposed to solar conditions but still culturable on standard plates are less infective than nonexposed viable cells when administered via the intraperitoneal route (Smith et al. 2000). Subsequent studies showed that such culturable but irradiated bacteria were also less infective when administered via the oral route (Kehoe 2001).
Shigella dysenteriae type I is inactivated by batch process SODIS even during equatorial overcast conditions. Batch process SODIS is therefore an appropriate intervention for developing countries during Sh. dysenteriae type I endemics even where adequate sanitation is provided as improvements in water quality and sanitation have little impact on the epidemiology of this organism because of the low infective dose. Studies testing the efficacy of solar/u.v. disinfection should incorporate pyruvate into bacteriological medium.
Acknowledgements
Sincere thanks to P.J. Sansonetti, Institut Pasteur, Paris, France for providing the Sh. flexneri strain used in this project. We thank Ronán Conroy for assistance with the statistical analysis. This project was funded by Royal College of Surgeons in Ireland Research Committee and Enterprise Ireland/British Research Council Research Travel Scheme.
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Elmore-Meegan Effect of agitation, turbidity, aluminium foil reflectors and container volume on the inactivation efficiency of batch-process solar disinfectors
Effect of agitation, turbidity, aluminium foil reflectors and container volume on the inactivation efficiency of batch-process solar disinfectors
Purchase
$ 31.50
S. C. Kehoe1, T. M. Joyce2, P. Ibrahim3, J. B. Gillespie4, R. A. Shahar1 and K. G. McGuiganCorresponding Author Contact Information, E-mail The Corresponding Author, 1
1 Department of Physics, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland
2 Tropical Medicine, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland
3 Department of Pharmacy, University of Science, Penang, Malaysia
4 Department of Industrial Microbiology, National University of Ireland, Dublin 4, Ireland
Received 4 October 1999;
accepted 28 June 2000.
Available online 22 December 2000.
Abstract
We report the results of experiments designed to improve the efficacy of the solar disinfection of drinking water, inactivation process. The effects of periodic agitation, covering the rear surface of the container with aluminium foil, container volume and turbidity on the solar inactivation kinetics of Escherichia coli (starting POPULATION=106 CFU ml−1) were investigated. It was shown that agitation promoted the release of dissolved oxygen from water with subsequent decrease in the inactivation rates of E. coli. In contrast, covering the rear surface of the solar disinfection container with aluminium foil improved the inactivation efficiency of the system. The mean decay constant for bacterial populations in foil-backed bottles was found to be a factor of 1.85 (std. dev.=0.43) higher than that of non-foil-backed bottles. Inactivation rates decrease as turbidity increases. However, total inactivation was achievable in 300 NTU samples within 8 h exposure to strong sunshine. Inactivation kinetics was not dependent on the volume of the water container for volumes in the range 500–1500 ml.
Author Keywords: solar disinfection, dissolved oxygen, agitation, water
Nomenclature
CFU
colony forming unit
HPLC
high-performance liquid chromatography
NTU
nephelometric turbidity unit
Article Outline
• Nomenclature
• Introduction
• Materials and methods
• Bacterial preparation and enumeration
• Optical irradiation measurements
• Laboratory simulations
• Results
• Agitation
• Foil-backing
• Turbidity
• Volume
• Discussion
• Acknowledgements
• References
Purchase
$ 31.50
S. C. Kehoe1, T. M. Joyce2, P. Ibrahim3, J. B. Gillespie4, R. A. Shahar1 and K. G. McGuiganCorresponding Author Contact Information, E-mail The Corresponding Author, 1
1 Department of Physics, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland
2 Tropical Medicine, Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, Ireland
3 Department of Pharmacy, University of Science, Penang, Malaysia
4 Department of Industrial Microbiology, National University of Ireland, Dublin 4, Ireland
Received 4 October 1999;
accepted 28 June 2000.
Available online 22 December 2000.
Abstract
We report the results of experiments designed to improve the efficacy of the solar disinfection of drinking water, inactivation process. The effects of periodic agitation, covering the rear surface of the container with aluminium foil, container volume and turbidity on the solar inactivation kinetics of Escherichia coli (starting POPULATION=106 CFU ml−1) were investigated. It was shown that agitation promoted the release of dissolved oxygen from water with subsequent decrease in the inactivation rates of E. coli. In contrast, covering the rear surface of the solar disinfection container with aluminium foil improved the inactivation efficiency of the system. The mean decay constant for bacterial populations in foil-backed bottles was found to be a factor of 1.85 (std. dev.=0.43) higher than that of non-foil-backed bottles. Inactivation rates decrease as turbidity increases. However, total inactivation was achievable in 300 NTU samples within 8 h exposure to strong sunshine. Inactivation kinetics was not dependent on the volume of the water container for volumes in the range 500–1500 ml.
Author Keywords: solar disinfection, dissolved oxygen, agitation, water
Nomenclature
CFU
colony forming unit
HPLC
high-performance liquid chromatography
NTU
nephelometric turbidity unit
Article Outline
• Nomenclature
• Introduction
• Materials and methods
• Bacterial preparation and enumeration
• Optical irradiation measurements
• Laboratory simulations
• Results
• Agitation
• Foil-backing
• Turbidity
• Volume
• Discussion
• Acknowledgements
• References
Michael Meegan Comparing liquid crystal thermometer readings and mercury thermometer reading of infants and children in a traditional African setting: implications for community-based health
Titre du document / Document title
Comparing liquid crystal thermometer readings and mercury thermometer reading of infants and children in a traditional African setting: implications for community-based health
Auteur(s) / Author(s)
VALADEZ J. J. (1) ; ELMORE-MEEGAN M. ; MORLEY D. ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Johns Hopkins school hyg. public health, Baltimore MD, ETATS-UNIS
Résumé / Abstract
Liquid crystal thermometer (LCT) readings of skin temperatures were compared with mercury thermometer (MT) rectal temperature readings to assess the reliability of LCTs. Temperatures of 498 children were measured at two points in time. LCT skin temperature readings of children 0 to 52 months were on average 0.50°C and 1.97°C lower than MT rectal temperature readings. A strong correlation between temperature differences and LCT readings indicated that the greatest differences occurred at the lower LCT readings. These conclusions indicate LCT skin readings undermeasure temperature. Some of these differences were due to MTs not measuring temperatures below 35°C. Children under 1 year of age had significantly greater differences than any other age group. Their LCT readings were, on average, 1.65°C lower than their MT readings. Using MTs as a standard, LCTs were 100% sensitive and 92% specific for detecting children with hypothermia. LCTs were 38.5% sensitive and 100% specific for detecting fevers. These results suggest that LCTs leave undetected a large proportion of children who have fevers. However, they are sensitive for identifying children with hypothermia. A knowledge, attitude and practice (KAP) study indicated that local mothers can be identified who understand principles and procedures of LCTs, and accept them for health care of their child.
Revue / Journal Title
Tropical and geographical medicine ISSN 0041-3232 CODEN TGMEAJ
Source / Source
1995, vol. 47, no3, pp. 130-133 (5 ref.)
Langue / Language
Anglais
Editeur / Publisher
Royal Tropical Institute, Amsterdam, PAYS-BAS (1958-1995) (Revue)
Mots-clés anglais / English Keywords
Thermometer
;
Mercury
;
Liquid crystals
;
Comparative study
;
Child
;
Infant
;
Kenya
;
Fever
;
Human
;
Africa
;
Mots-clés français / French Keywords
Thermomètre
;
Mercure
;
Cristal liquide
;
Etude comparative
;
Enfant
;
Nourrisson
;
Kenya
;
Fièvre
;
Homme
;
Afrique
;
Mots-clés espagnols / Spanish Keywords
Termómetro
;
Mercurio
;
Cristal líquido
;
Estudio comparativo
;
Niño
;
Lactante
;
Kenya
;
Fiebre
;
Hombre
;
Africa
;
Localisation / Location
INIST-CNRS, Cote INIST : 2191, 35400005168944.0080
Comparing liquid crystal thermometer readings and mercury thermometer reading of infants and children in a traditional African setting: implications for community-based health
Auteur(s) / Author(s)
VALADEZ J. J. (1) ; ELMORE-MEEGAN M. ; MORLEY D. ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Johns Hopkins school hyg. public health, Baltimore MD, ETATS-UNIS
Résumé / Abstract
Liquid crystal thermometer (LCT) readings of skin temperatures were compared with mercury thermometer (MT) rectal temperature readings to assess the reliability of LCTs. Temperatures of 498 children were measured at two points in time. LCT skin temperature readings of children 0 to 52 months were on average 0.50°C and 1.97°C lower than MT rectal temperature readings. A strong correlation between temperature differences and LCT readings indicated that the greatest differences occurred at the lower LCT readings. These conclusions indicate LCT skin readings undermeasure temperature. Some of these differences were due to MTs not measuring temperatures below 35°C. Children under 1 year of age had significantly greater differences than any other age group. Their LCT readings were, on average, 1.65°C lower than their MT readings. Using MTs as a standard, LCTs were 100% sensitive and 92% specific for detecting children with hypothermia. LCTs were 38.5% sensitive and 100% specific for detecting fevers. These results suggest that LCTs leave undetected a large proportion of children who have fevers. However, they are sensitive for identifying children with hypothermia. A knowledge, attitude and practice (KAP) study indicated that local mothers can be identified who understand principles and procedures of LCTs, and accept them for health care of their child.
Revue / Journal Title
Tropical and geographical medicine ISSN 0041-3232 CODEN TGMEAJ
Source / Source
1995, vol. 47, no3, pp. 130-133 (5 ref.)
Langue / Language
Anglais
Editeur / Publisher
Royal Tropical Institute, Amsterdam, PAYS-BAS (1958-1995) (Revue)
Mots-clés anglais / English Keywords
Thermometer
;
Mercury
;
Liquid crystals
;
Comparative study
;
Child
;
Infant
;
Kenya
;
Fever
;
Human
;
Africa
;
Mots-clés français / French Keywords
Thermomètre
;
Mercure
;
Cristal liquide
;
Etude comparative
;
Enfant
;
Nourrisson
;
Kenya
;
Fièvre
;
Homme
;
Afrique
;
Mots-clés espagnols / Spanish Keywords
Termómetro
;
Mercurio
;
Cristal líquido
;
Estudio comparativo
;
Niño
;
Lactante
;
Kenya
;
Fiebre
;
Hombre
;
Africa
;
Localisation / Location
INIST-CNRS, Cote INIST : 2191, 35400005168944.0080
Effect on neonatal tetanus mortality after a culturally-based health promotion programme
Effect on neonatal tetanus mortality after a culturally-based health promotion programme
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$ 31.50
Michael Elmore Meegan PhDa, Dr Ronán M Conroy MusBb, Corresponding Author Contact Information, E-mail The Corresponding Author, Sarune Ole Lengenya, Kate Renhaultc and J Nyangole MDd
aICROSS Kenya, PO Box 507, Ngong Hills, Kenya
bRoyal College of Surgeons in Ireland, Mercer Building, Dublin 2, Ireland
cFaculty of Medicine, McMaster University, Hamilton, Ontario L8S 4L8, Canada
dMinistry of Health, Kajiado District, Kenya
Available online 24 August 2001.
Summary
The Maasai have high rates of death from neonatal tetanus, partly due to their custom of packing the umbilical stump with cow dung. We report on the effect of a simple health promotion programme, designed in consultation with the local community and carried out by local women. After introduction of the programme in 1981, neonatal (<6 weeks of age) tetanus rates fell sharply, and by 1988 annual death rates had dropped to 0·75 (range 0–3) per 1000 births in the intervention areas compared with 82 (74–93) per 1000 in control areas.
Article Outline
References
Corresponding Author Contact InformationCorrespondence to: Dr Ronán M Conroy
Purchase
$ 31.50
Michael Elmore Meegan PhDa, Dr Ronán M Conroy MusBb, Corresponding Author Contact Information, E-mail The Corresponding Author, Sarune Ole Lengenya, Kate Renhaultc and J Nyangole MDd
aICROSS Kenya, PO Box 507, Ngong Hills, Kenya
bRoyal College of Surgeons in Ireland, Mercer Building, Dublin 2, Ireland
cFaculty of Medicine, McMaster University, Hamilton, Ontario L8S 4L8, Canada
dMinistry of Health, Kajiado District, Kenya
Available online 24 August 2001.
Summary
The Maasai have high rates of death from neonatal tetanus, partly due to their custom of packing the umbilical stump with cow dung. We report on the effect of a simple health promotion programme, designed in consultation with the local community and carried out by local women. After introduction of the programme in 1981, neonatal (<6 weeks of age) tetanus rates fell sharply, and by 1988 annual death rates had dropped to 0·75 (range 0–3) per 1000 births in the intervention areas compared with 82 (74–93) per 1000 in control areas.
Article Outline
References
Corresponding Author Contact InformationCorrespondence to: Dr Ronán M Conroy
http://jama.ama-assn.org/content/270/5/629.short
http://jama.ama-assn.org/content/270/5/629.short
Africa on the Precipice
An Ominous but Not Yet Hopeless Future
Michael Elmore-Meegan, BPh, MSc;
Thomas O'Riorden, MS, MRCP
[+] Author Affiliations
From the office of Rural Health Programs, International Community for the Relief of Starvation and Suffering, Mbagathi, Kenya (Mr Elmore-Meegan), and the Department of Medicine, Division of Pulmonary/Critical Care Medicine, State University of New York, Stony Brook (Dr O'Riordan).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
FOR SUB-SAHARAN Africa, the past 20 years have been disastrous. The region has been beset by famines, droughts, civil wars, political corruption, AIDS, a rapidly increasing population, decreased food production, environmental degradation, a fall in the value of exports, an increase in the costs of imports, and massive government indebtedness. In addition, Africa now faces increasingly intense competition from other regions for scarce international aid, most notably from Eastern Europe. Aid experts are unanimous in their prediction that further economic decline, poverty, and suffering are inevitable, at least in the short term.1-8 Despite ominous economic and demographic trends, there are indications that genuine political and economic reform may be about to take place. The opportunities for Western countries and institutions to contribute to the long-term humanitarian progress of the continent may be greater now than at at any time since the end of the colonial era.1-3 However, if
Footnotes
Reprint requests to the Director of Rural Health Programs, International Community for the Relief of Starvation and Suffering, PO Box 15619, Mbagathi, Via Nairobi, Kenya (Mr Elmore-Meegan). ...
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With recent changes in environmental factors among Africans in South Africa, how have cancer occurrences been affected? The Journal of the Royal Society for the Promotion of Health. 2002;122(3):148-155.
Abstract
Full Text (PDF)
Africa on the Precipice: Perspective From South Africa JAMA. 1994;271(10):744.
Abstract
Full Text (PDF)
Africa on the Precipice
An Ominous but Not Yet Hopeless Future
Michael Elmore-Meegan, BPh, MSc;
Thomas O'Riorden, MS, MRCP
[+] Author Affiliations
From the office of Rural Health Programs, International Community for the Relief of Starvation and Suffering, Mbagathi, Kenya (Mr Elmore-Meegan), and the Department of Medicine, Division of Pulmonary/Critical Care Medicine, State University of New York, Stony Brook (Dr O'Riordan).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
FOR SUB-SAHARAN Africa, the past 20 years have been disastrous. The region has been beset by famines, droughts, civil wars, political corruption, AIDS, a rapidly increasing population, decreased food production, environmental degradation, a fall in the value of exports, an increase in the costs of imports, and massive government indebtedness. In addition, Africa now faces increasingly intense competition from other regions for scarce international aid, most notably from Eastern Europe. Aid experts are unanimous in their prediction that further economic decline, poverty, and suffering are inevitable, at least in the short term.1-8 Despite ominous economic and demographic trends, there are indications that genuine political and economic reform may be about to take place. The opportunities for Western countries and institutions to contribute to the long-term humanitarian progress of the continent may be greater now than at at any time since the end of the colonial era.1-3 However, if
Footnotes
Reprint requests to the Director of Rural Health Programs, International Community for the Relief of Starvation and Suffering, PO Box 15619, Mbagathi, Via Nairobi, Kenya (Mr Elmore-Meegan). ...
Add to CiteULikeCiteULike
Add to ConnoteaConnotea
Add to DeliciousDelicious
Add to DiggDigg
Add to FacebookFacebook
Add to RedditReddit
Add to TechnoratiTechnorati
Add to TwitterTwitter
What's this?
Articles citing this article
With recent changes in environmental factors among Africans in South Africa, how have cancer occurrences been affected? The Journal of the Royal Society for the Promotion of Health. 2002;122(3):148-155.
Abstract
Full Text (PDF)
Africa on the Precipice: Perspective From South Africa JAMA. 1994;271(10):744.
Abstract
Full Text (PDF)
Prevalence of enteropathogens in stools of rural Maasai children under five years of age in the Maasail region of the Kenyan Rift Valley
Prevalence of enteropathogens in stools of rural Maasai children under five years of age in the Maasail region of the Kenyan Rift Valley
Auteur(s) / Author(s)
JOYCE T. (1) ; MCGUIGAN K. G. ; ELMORE-MEEGAN M. ; CONROY R. M. ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, IRLANDE
Résumé / Abstract
Stool samples were collected during August 1994 from seventy rural Maasai children under the age of five years who were living in the Maasailand region of the Kenyan Rift Valley. Microbiological analysis was carried out on these samples to identify which intestinal pathogens were present among the infant population of the Maasai. Of the samples studied 54% were pathogen positive. The most common pathogen isolated was Giardia lamblia which was detected in 31% of the samples. Other pathogens that were detected include : Entamoeba histolytica (23%), Enteropathogenic Eschericia coli (13%), Strongyloides stercoralis (4%), Blastacystis hominis (3%) and Cryptosporidium sp (3%). Although all samples were screened for Campylobacter and rotavirus, neither pathogen was detected. Water samples were taken from all the water sources in the study area and analysed microbiologically. Results showed that all the sources were contaminated with the faecal E. coli whose populations ranged from 14 CFU/ 100 ml to greater than 1800 CFU/ 100ml.
Revue / Journal Title
East African medical journal ISSN 0012-835X CODEN EAMJAV
Source / Source
1996, vol. 73, no 1 (88 p.) (13 ref.), pp. 59-62
Langue / Language
Anglais
Editeur / Publisher
Kenya Medical Association, Nairobi, KENYA (1932) (Revue)
Mots-clés anglais / English Keywords
Auteur(s) / Author(s)
JOYCE T. (1) ; MCGUIGAN K. G. ; ELMORE-MEEGAN M. ; CONROY R. M. ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, IRLANDE
Résumé / Abstract
Stool samples were collected during August 1994 from seventy rural Maasai children under the age of five years who were living in the Maasailand region of the Kenyan Rift Valley. Microbiological analysis was carried out on these samples to identify which intestinal pathogens were present among the infant population of the Maasai. Of the samples studied 54% were pathogen positive. The most common pathogen isolated was Giardia lamblia which was detected in 31% of the samples. Other pathogens that were detected include : Entamoeba histolytica (23%), Enteropathogenic Eschericia coli (13%), Strongyloides stercoralis (4%), Blastacystis hominis (3%) and Cryptosporidium sp (3%). Although all samples were screened for Campylobacter and rotavirus, neither pathogen was detected. Water samples were taken from all the water sources in the study area and analysed microbiologically. Results showed that all the sources were contaminated with the faecal E. coli whose populations ranged from 14 CFU/ 100 ml to greater than 1800 CFU/ 100ml.
Revue / Journal Title
East African medical journal ISSN 0012-835X CODEN EAMJAV
Source / Source
1996, vol. 73, no 1 (88 p.) (13 ref.), pp. 59-62
Langue / Language
Anglais
Editeur / Publisher
Kenya Medical Association, Nairobi, KENYA (1932) (Revue)
Mots-clés anglais / English Keywords
Saturday, July 23, 2011
Who are we : Bio Profile Dr Mike Meegan Founder ICROSS
Who is Michael Meegan 
Michael Kevin Elmore-Meegan
British
ICROSS Rural Health Programmes, P. O. Box 507, Ngong Hills, Rift Valley, Kenya
mikemeegan@gmail.com
www.icrossinternational.org http://www.icross-africa.net/ http://icrosskenya.org/
www.michaelmeegan.com www.michaelmeegan.net
+ 447525257413 (UK Mobile)
+ 254721737394 (Kenya Office)
Consultant International health, analysing health problems, belief systems, cultural public health processes. Community based health programmes . Creating effective long term health changes, design of research programmes Africa, Asia. Author, lecturer.
Doctorate in Medicine ( D.Med Hon, C) National University of Ireland 2006,
M.Sc (Community Health)1989, Trinity College Dublin, Ireland
B.Phil (Hons) 1979 Milltown Park, Holy See
Ongoing learning: Ph.D “The importance of local appropriateness in the development of health programmes in Africa” Global Health (Dept International Health, Faculty of Medicine, Tampere University, Finland ) 2009-2012
FRAMI Fellow of the Royal Academy of Medicine of Ireland
East African Association of Anthropology, co-founder
Senior Research fellow, Centre of Culture and Development Baroda, Gujarat
Melvin Jones Fellow
Trinity College Association, life member
Languages : English ,French, Samburu, Maasai, Swahili
Areas of Professional Experience:
Programme Management and Development
• Thirty years in strategic public health planning, project development and successful fundraising for community based health and development projects. Experienced in negotiating with donors and the government. Negotiated Global fund and multi/bi lateral grants of over $12 million.
• Designed and developed culturally appropriate health care based programmes for nomadic peoples in East Africa.Developed Strategic public health Plan 2011-2016.
• Established and designed numerous community based projects with emphasis on development of community systems, including women’s development and youth programmes
• Provided programmatic management and directed famine relief operations across 21,000 sq. miles reaching 32,700 including follow-up and rehabilitation of severely malnourished children 2009Programmatic management including human and financial resource management to ICROSS to achieve project goals, including personnel management and organisational restructuring for Kenyan and Tanzanian Programmes
• Provided monitoring and evaluation of internationally funded projects in the ICROSS programme including supervision of project feedback, development of proposal design and undertaking feasibility studies
• Pioneered the use of dialogic methodology for education and facilitation at community level.Pioneered the use of cultural linguistic ethnography and the application of epistemological and epidemiological disciplines to PLWA and programme development
• Designed, developed and monitored the implementation of competency based and problem oriented training system, for traditional birth attendants, in collaboration with Ministry of Health Tanzania (village and District level)
• Provided team leadership, drawing together multi disciplinary teams from widely differing ethnic, religious and cultural backgrounds into cohesive effective teams.
Research and Consultancy
Areas of specialization.
Anthropology
19 years living among Samburu and Maasai pastoral nomadic tribal communities in semi-arid rural areas. Cultural ethnography, applied medical anthropology, application of belief systems to public health policies, academic and ethnographic interpretation of data using cultural mechanisms.
The use of community concepts such as meaning, religion, symbol, value, systems and behavioral modeling, truth and acceptance in structuring development strategies.
International Health
Experienced in developing community centered evaluation systems through the use of epistemology (ethnic cognitional theories) and cultural epidemiology.
Key consultancies include:
• Principal Investigator Kenya, International Consortium ,Alternative methods for mass water protection , led by Royal College of Surgeons 2007-10
• Visiting Lecturer , Dept International Health, Faculty of Medicine Tampere University 2008-2011
• Principle investigator Kenya , International collaborative study on Solar disinfection of drinking water, EU funded multi country research, RCSI 2005-2010
• Visiting lecturer, Gujarat, Centre for Culture and Development Baroda Jan 2008
• Community based new born care, 2007, CARE International Cambodia
• Women’s health and Safe Motherhood Programme, Ministry of Health, Manila, Philippines June 2002 – December 2005. European Union.
• Development on extended medical anthropological studies and field research components for malaria control: Surat Malaria Control and Research Project. India (1999) (DFID funded project)
• Epidemiology advisor to the Rapid Response Mechanism component for malaria control; Surat Malaria Control and Research Project. India (1998) (DFID funded project)
• Social Development Advisor to Surat Malaria Control and Research Project. Development aspects of malaria control in Surat District, Gujarat State India 1997-98 (DFID funded project).
• Clinical epidemiological and statistical advisor, Central Leprosy Teaching and Research Institute, Tamil Nadu, India, Government of India, 1998 (DFID funded project). Clinical epidemiological and statistical Advisor, Central Leprosy Teaching and Research Institute, Tamil Nadu, India, Government of India, 1999 (DFID funded project)Project preparation, communications component Child-to-Child modules (1995) (Kenya).
• Project appraisal: community participation/education and communication components of regional health care programme (Population and Health Services, Kenya 1994)
Programme Experience:
2000- to date: Founder and International Director ICROSS, Head Public Health Research Programme. Based in Kenya. Overseeing the development of ICROSS as a local NGO in Kenya, and Tanzania, providing technical support to policy and planning.
• Founder , International Director ICROSS , established registered charities in 5 countries.
• Founder, New World International Kenya, NWI UK , an advocacy, awareness and action group for Global development 2008 / NWI Kenya 2008
• Designed participatory systems, models of impact analysis and mechanisms for evaluation surveillance for long-term programmes.
• Training Kenyan and Tanzanian programme managers in problem solving skills and developing line management systems
• Director of research ensuring ongoing analysis of development impact supervising 11 collaborative medical research programmes in East Africa.
• Production of project write-ups including financial profiles, cost benefits analysis and impact assessments totaling $4 million in 05-06
• Responsible for the Africanisation of all ICROSS programmes 2001-2009
• Advisor to numerous official bodies including; REHAB Ireland, Consultants in Public Affairs, Dublin, Japanese Embassy, Nairobi, DANIDA, Local NGOs, local grassroots development groups and the Centre for Social Studies Gujarat, India.
• Sourced over $28 million in grants for ICROSS health programmes in Kenya while International Director between 1997-2004
1987 –1999 Director of Rural Health Programmes, ICROSS
Based in Kenya; Responsible for establishing ICROSS Tanzania as an autonomous NGO, assisting local NGOs in the development of self-sustaining strategies.
• Ensured capacity building through human resource development. Responsible for 47 separate health project activities, through 36 local NGOs in Kenya.
• Advisory Board member for the Kenya Association of Professional Counselors Adolescent project.
• Initiated and ensured epidemiological and anthropological research to support the development of indicators for impact assessment.
1981-1986 Field Director
Based in Kenya. Responsible for implementation and coordination of multiple development activities in Kenya, Somalia and Uganda, including: -
• Evaluation of projects already in place, looking particularly at their impact on vulnerable local communities, including women and the internally displaced.
• Networking of NGOS and field supervision of famine relief logistics of supplementary feeding and emergency relief activities in three semi desert areas.
• Evaluation of micro-credit options available to disadvantaged groups in rural areas, research into options and secure, where appropriate, alternative micro-credit schemes to establish small scale enterprises. Recommend new avenues for continuing support between ICROSS international, and UK/USA solidarity groups and local initiatives.
• Research and implementation of multiple development projects in partnership with nomadic people, local NGOs and government departments, focus areas included health care interventions, water conservation and appropriate agricultural development planning for semi arid areas.
• Evaluation and assessment of field projects in Mogadishu, Somalia
Illustrative awards
2008
-Premio internazionale Exposcuola per l'impegno civile Italy, International Humanitarian award of the Exposcuola.
-International Angelo della Pace for 2008 The Rachel Foundation Italy
2006
Fellow of the Royal Academy of Medicine in Ireland 10 May 2006
Doctorate in Medicine D.Med (Honoris Causa) National University of Ireland 10 April 2006
2003
International Person of the year,
Irish National Awards , November 2003
1995
Melvin Jones Fellow
Humanitarian services
Lions Clubs International 1995
1988
Past Pupil of the Year
Terenure College 1988
Illustrative Research Articles and Publications
1. Elmore-Meegan M, Conroy RM, . Sex workers in Kenya,
numbers of clients and associated risks: an exploratory survey.
Reprod Health Matters 2004;12(23):50-7.
2. Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect
on neonatal tetanus mortality after a culturally-based health
promotion programme. Lancet 2001;358(9282):640-1.
3. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of drinking water protects against cholera in children
under 6 years of age. Arch Dis Child 2001;85(4):293-5.
4. Meegan M, Morley DC. Growth monitoring: family participation:
effective community development. Trop Doct 1999;29(1):23-7.
5. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of water reduces diarrhoeal disease: an update. Arch Dis
Child 1999;81(4):337-8.
6. Meegan M, Morley D, Chavasse D. Fly traps. Lancet 1997;349(9055):886.
7. Meegan M, Morley DC, Brown R. Child weighing by the unschooled: a
report of a controlled study of growth monitoring over 12 months of
Maasai children using direct recording scales. Trans R Soc Trop Med
Hyg 1994;88(6):635-7.
8. Conroy RM, Meegan ME. Dwindling donor aid for health programmes in
developing countries. Lancet 1994;343(8907):1228-9.
9. Meegan MK. Rethinking famine relief. Lancet 1992;340(8830):1293-4.
10. Konings E, Anderson RM, Morley D, O'Riordan T, Meegan M. Rates of
sexual partner change among two pastoralist southern Nilotic groups
in east Africa. Aids 1989;3(4):245-7.
11. Meegan M, McCormick J. Prevention of disease in the poor world.
Lancet 1988;2(8603):152-3.
12. Meegan M. Starvation and suffering. Lancet 1983;2(8365-66):1506.
13. Meegan M. The reality of starvation and disease. Lancet 1981;1
(8212):146.
Published Books
Changing the World
Feb 2009 256 pgs www.eye-books.com
Take my hand, a spiritual journey
With Sharon Wilkinson, Forward by T Hogan, 58 pgs www.michaelmeegan.com July 2008
Surprised by joy; a story of hope in the midst of tragedy ( forward by Stephen Sackur) 156 pgs
July 2006 www.maverickhouse.com
All Will be Well (Forward by John Hurt) Eye-Books, 149 pgs
May 2004.
ISBN 1903070279 www.eye-book.com
All Shall be Well, Forward by John Powell SJ, ISBN 000-627006-9, Collins. 146 pgs. First edition 1986, Reprint Jan 1999.
In preparation
The path of change
Meegan M ,Conroy R Scrima M
Eye Books May 2012 www.eye-books.com
The Tribe of One With Colin Meagle www.eye-books.com
May 2012
So you want o be a volunteer A guide for International volunteers
Journies in the underworld: a novel
With Thomas Ernst, Penelope Shales, Sharon Wilkinson, Allberto Bellu
Bright darkness Fortress monastery on Montpellier, guarding the secrets of the last king of Jerusalem 1200 pgs, historical Novel 2013
Illustrative general articles
AFRO Journal Italy, regular contributor on Global health, poverty and International health trends and patterning Oct 09 Feb 09 Dialogue on Diarrhoea , regular contributor
World Health Organsation (WHO ) guidelines Trachoma prevention, fly traps , M Elmore-Meegan Prof D Morely et al, Geneva, Switzerland. 2001
Peer Reviews for key publications & major conferences and journals incl Int AIDS Conference
Scientific conferences and presentations (illustrative)
Health care in regions of absolute Poverty
Seminar , Dept International health, Faculty of Medicine
University of Tampere, Finland 30th November 2009
SODIS in KENYA, 20 years of field implementaton
SODIS International Conference Phnom Phen Cambodia
International seminar of the impact of Solar disinfection
International Research Colloquium of the Network to promote
Household Water Treatment and Safe Storage (HWTS), Twenty years of SODIS in Kenya.
Royal College of Surgeons in Ireland, Dublin 21st - 23rd September 2009
Changing dynamics of Morbidity, Mortality and poverty of children in the Third World.
Senate Hearing, Italian Senate, Rome
Senatorial Commission on International Children’s Rights , At the request of Italian Senate Commission, Rome , 31st April 2009
Global health and interdependency,
The Royal College of Surgeons Charter day lecture 2009
Royal College of Surgeons,Dublin. 12th Feb 2009
Emerging mega-trends in Global health
Future shocks; disasters and relief in a changing world, RedR Conference, Royal College of nursing, London, 5th December, 2007
Locally appropriate technologies in low income settings, Dept International health, Tampere University, Finland. 29th Nov 2007
Applied operational study of pain determinants in terminally ill patients in Bondo, Kenya XVI International AIDS Conference,Toronto, August 06 Francis,P,Meegan,M
The 46th Robert Graves Lecture
Royal Academy of Medicine in Ireland
Creating long term change through culturally acceptable cost effective public health interventions.
Dublin 10 May 06
IFCW World Forum. “AIDS orphans & Vulnerable Children; an evidence-led response.” Cape Town, South Africa. 2003
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “An assessment of home-based care interventions among 2,116 terminally ill patients in Bondo and Siaya using clinically validated scales.
Interim results.” Nairobi, Kenya. 2003
"AIDS and the changing face of Africa: The impact on children, WUSC-Carleton, Médecins Sans Frontières, CARE Carlton University Canada, 25th Nov 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Modeling cultural determinants of sexual behavior” - A Pilot Study. Nairobi, Kenya. 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “AIDS, children and poverty, an alternative model to international Aid, ‘Love, evidence and common sense.” Nairobi, Kenya. 2002.
WHO Trachoma conference
. “Effect of fly control using sustainable interventions on the prevalence of Trachoma in five pastoral tribes in Kenya.” Geneva, Switzerland. 2001
Child Survival. Alternative strategies in reducing infant mortality” International Conference on Child survival. Nairobi, Kenya. 2001
Identifying emerging needs among AIDS orphans in Kenya. “Multicentre Matched Perspective Control Study of 2,786 Children Orphaned by AIDS, 2,420 other Orphans and 3,400”
Nairobi, Kenya. 2000
AIDS orphans. “An emerging crisis: a USAID sponsored conference.” Nanyuki. Kenya. 2000
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Multi centre Matched Perspective Control Study of 2,786 Children
Orphaned by AIDS, 2,420 other Orphans and 3,400.” Nairobi, Kenya. 2000
East African Association of Anthropologists inaugural Conference. “Anthropology and ethnography.” Nairobi, Kenya. 2000
Michael Kevin Elmore-Meegan
British
ICROSS Rural Health Programmes, P. O. Box 507, Ngong Hills, Rift Valley, Kenya
mikemeegan@gmail.com
www.icrossinternational.org http://www.icross-africa.net/ http://icrosskenya.org/
www.michaelmeegan.com www.michaelmeegan.net
+ 447525257413 (UK Mobile)
+ 254721737394 (Kenya Office)
Consultant International health, analysing health problems, belief systems, cultural public health processes. Community based health programmes . Creating effective long term health changes, design of research programmes Africa, Asia. Author, lecturer.
Doctorate in Medicine ( D.Med Hon, C) National University of Ireland 2006,
M.Sc (Community Health)1989, Trinity College Dublin, Ireland
B.Phil (Hons) 1979 Milltown Park, Holy See
Ongoing learning: Ph.D “The importance of local appropriateness in the development of health programmes in Africa” Global Health (Dept International Health, Faculty of Medicine, Tampere University, Finland ) 2009-2012
FRAMI Fellow of the Royal Academy of Medicine of Ireland
East African Association of Anthropology, co-founder
Senior Research fellow, Centre of Culture and Development Baroda, Gujarat
Melvin Jones Fellow
Trinity College Association, life member
Languages : English ,French, Samburu, Maasai, Swahili
Areas of Professional Experience:
Programme Management and Development
• Thirty years in strategic public health planning, project development and successful fundraising for community based health and development projects. Experienced in negotiating with donors and the government. Negotiated Global fund and multi/bi lateral grants of over $12 million.
• Designed and developed culturally appropriate health care based programmes for nomadic peoples in East Africa.Developed Strategic public health Plan 2011-2016.
• Established and designed numerous community based projects with emphasis on development of community systems, including women’s development and youth programmes
• Provided programmatic management and directed famine relief operations across 21,000 sq. miles reaching 32,700 including follow-up and rehabilitation of severely malnourished children 2009Programmatic management including human and financial resource management to ICROSS to achieve project goals, including personnel management and organisational restructuring for Kenyan and Tanzanian Programmes
• Provided monitoring and evaluation of internationally funded projects in the ICROSS programme including supervision of project feedback, development of proposal design and undertaking feasibility studies
• Pioneered the use of dialogic methodology for education and facilitation at community level.Pioneered the use of cultural linguistic ethnography and the application of epistemological and epidemiological disciplines to PLWA and programme development
• Designed, developed and monitored the implementation of competency based and problem oriented training system, for traditional birth attendants, in collaboration with Ministry of Health Tanzania (village and District level)
• Provided team leadership, drawing together multi disciplinary teams from widely differing ethnic, religious and cultural backgrounds into cohesive effective teams.
Research and Consultancy
Areas of specialization.
Anthropology
19 years living among Samburu and Maasai pastoral nomadic tribal communities in semi-arid rural areas. Cultural ethnography, applied medical anthropology, application of belief systems to public health policies, academic and ethnographic interpretation of data using cultural mechanisms.
The use of community concepts such as meaning, religion, symbol, value, systems and behavioral modeling, truth and acceptance in structuring development strategies.
International Health
Experienced in developing community centered evaluation systems through the use of epistemology (ethnic cognitional theories) and cultural epidemiology.
Key consultancies include:
• Principal Investigator Kenya, International Consortium ,Alternative methods for mass water protection , led by Royal College of Surgeons 2007-10
• Visiting Lecturer , Dept International Health, Faculty of Medicine Tampere University 2008-2011
• Principle investigator Kenya , International collaborative study on Solar disinfection of drinking water, EU funded multi country research, RCSI 2005-2010
• Visiting lecturer, Gujarat, Centre for Culture and Development Baroda Jan 2008
• Community based new born care, 2007, CARE International Cambodia
• Women’s health and Safe Motherhood Programme, Ministry of Health, Manila, Philippines June 2002 – December 2005. European Union.
• Development on extended medical anthropological studies and field research components for malaria control: Surat Malaria Control and Research Project. India (1999) (DFID funded project)
• Epidemiology advisor to the Rapid Response Mechanism component for malaria control; Surat Malaria Control and Research Project. India (1998) (DFID funded project)
• Social Development Advisor to Surat Malaria Control and Research Project. Development aspects of malaria control in Surat District, Gujarat State India 1997-98 (DFID funded project).
• Clinical epidemiological and statistical advisor, Central Leprosy Teaching and Research Institute, Tamil Nadu, India, Government of India, 1998 (DFID funded project). Clinical epidemiological and statistical Advisor, Central Leprosy Teaching and Research Institute, Tamil Nadu, India, Government of India, 1999 (DFID funded project)Project preparation, communications component Child-to-Child modules (1995) (Kenya).
• Project appraisal: community participation/education and communication components of regional health care programme (Population and Health Services, Kenya 1994)
Programme Experience:
2000- to date: Founder and International Director ICROSS, Head Public Health Research Programme. Based in Kenya. Overseeing the development of ICROSS as a local NGO in Kenya, and Tanzania, providing technical support to policy and planning.
• Founder , International Director ICROSS , established registered charities in 5 countries.
• Founder, New World International Kenya, NWI UK , an advocacy, awareness and action group for Global development 2008 / NWI Kenya 2008
• Designed participatory systems, models of impact analysis and mechanisms for evaluation surveillance for long-term programmes.
• Training Kenyan and Tanzanian programme managers in problem solving skills and developing line management systems
• Director of research ensuring ongoing analysis of development impact supervising 11 collaborative medical research programmes in East Africa.
• Production of project write-ups including financial profiles, cost benefits analysis and impact assessments totaling $4 million in 05-06
• Responsible for the Africanisation of all ICROSS programmes 2001-2009
• Advisor to numerous official bodies including; REHAB Ireland, Consultants in Public Affairs, Dublin, Japanese Embassy, Nairobi, DANIDA, Local NGOs, local grassroots development groups and the Centre for Social Studies Gujarat, India.
• Sourced over $28 million in grants for ICROSS health programmes in Kenya while International Director between 1997-2004
1987 –1999 Director of Rural Health Programmes, ICROSS
Based in Kenya; Responsible for establishing ICROSS Tanzania as an autonomous NGO, assisting local NGOs in the development of self-sustaining strategies.
• Ensured capacity building through human resource development. Responsible for 47 separate health project activities, through 36 local NGOs in Kenya.
• Advisory Board member for the Kenya Association of Professional Counselors Adolescent project.
• Initiated and ensured epidemiological and anthropological research to support the development of indicators for impact assessment.
1981-1986 Field Director
Based in Kenya. Responsible for implementation and coordination of multiple development activities in Kenya, Somalia and Uganda, including: -
• Evaluation of projects already in place, looking particularly at their impact on vulnerable local communities, including women and the internally displaced.
• Networking of NGOS and field supervision of famine relief logistics of supplementary feeding and emergency relief activities in three semi desert areas.
• Evaluation of micro-credit options available to disadvantaged groups in rural areas, research into options and secure, where appropriate, alternative micro-credit schemes to establish small scale enterprises. Recommend new avenues for continuing support between ICROSS international, and UK/USA solidarity groups and local initiatives.
• Research and implementation of multiple development projects in partnership with nomadic people, local NGOs and government departments, focus areas included health care interventions, water conservation and appropriate agricultural development planning for semi arid areas.
• Evaluation and assessment of field projects in Mogadishu, Somalia
Illustrative awards
2008
-Premio internazionale Exposcuola per l'impegno civile Italy, International Humanitarian award of the Exposcuola.
-International Angelo della Pace for 2008 The Rachel Foundation Italy
2006
Fellow of the Royal Academy of Medicine in Ireland 10 May 2006
Doctorate in Medicine D.Med (Honoris Causa) National University of Ireland 10 April 2006
2003
International Person of the year,
Irish National Awards , November 2003
1995
Melvin Jones Fellow
Humanitarian services
Lions Clubs International 1995
1988
Past Pupil of the Year
Terenure College 1988
Illustrative Research Articles and Publications
1. Elmore-Meegan M, Conroy RM, . Sex workers in Kenya,
numbers of clients and associated risks: an exploratory survey.
Reprod Health Matters 2004;12(23):50-7.
2. Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect
on neonatal tetanus mortality after a culturally-based health
promotion programme. Lancet 2001;358(9282):640-1.
3. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of drinking water protects against cholera in children
under 6 years of age. Arch Dis Child 2001;85(4):293-5.
4. Meegan M, Morley DC. Growth monitoring: family participation:
effective community development. Trop Doct 1999;29(1):23-7.
5. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of water reduces diarrhoeal disease: an update. Arch Dis
Child 1999;81(4):337-8.
6. Meegan M, Morley D, Chavasse D. Fly traps. Lancet 1997;349(9055):886.
7. Meegan M, Morley DC, Brown R. Child weighing by the unschooled: a
report of a controlled study of growth monitoring over 12 months of
Maasai children using direct recording scales. Trans R Soc Trop Med
Hyg 1994;88(6):635-7.
8. Conroy RM, Meegan ME. Dwindling donor aid for health programmes in
developing countries. Lancet 1994;343(8907):1228-9.
9. Meegan MK. Rethinking famine relief. Lancet 1992;340(8830):1293-4.
10. Konings E, Anderson RM, Morley D, O'Riordan T, Meegan M. Rates of
sexual partner change among two pastoralist southern Nilotic groups
in east Africa. Aids 1989;3(4):245-7.
11. Meegan M, McCormick J. Prevention of disease in the poor world.
Lancet 1988;2(8603):152-3.
12. Meegan M. Starvation and suffering. Lancet 1983;2(8365-66):1506.
13. Meegan M. The reality of starvation and disease. Lancet 1981;1
(8212):146.
Published Books
Changing the World
Feb 2009 256 pgs www.eye-books.com
Take my hand, a spiritual journey
With Sharon Wilkinson, Forward by T Hogan, 58 pgs www.michaelmeegan.com July 2008
Surprised by joy; a story of hope in the midst of tragedy ( forward by Stephen Sackur) 156 pgs
July 2006 www.maverickhouse.com
All Will be Well (Forward by John Hurt) Eye-Books, 149 pgs
May 2004.
ISBN 1903070279 www.eye-book.com
All Shall be Well, Forward by John Powell SJ, ISBN 000-627006-9, Collins. 146 pgs. First edition 1986, Reprint Jan 1999.
In preparation
The path of change
Meegan M ,Conroy R Scrima M
Eye Books May 2012 www.eye-books.com
The Tribe of One With Colin Meagle www.eye-books.com
May 2012
So you want o be a volunteer A guide for International volunteers
Journies in the underworld: a novel
With Thomas Ernst, Penelope Shales, Sharon Wilkinson, Allberto Bellu
Bright darkness Fortress monastery on Montpellier, guarding the secrets of the last king of Jerusalem 1200 pgs, historical Novel 2013
Illustrative general articles
AFRO Journal Italy, regular contributor on Global health, poverty and International health trends and patterning Oct 09 Feb 09 Dialogue on Diarrhoea , regular contributor
World Health Organsation (WHO ) guidelines Trachoma prevention, fly traps , M Elmore-Meegan Prof D Morely et al, Geneva, Switzerland. 2001
Peer Reviews for key publications & major conferences and journals incl Int AIDS Conference
Scientific conferences and presentations (illustrative)
Health care in regions of absolute Poverty
Seminar , Dept International health, Faculty of Medicine
University of Tampere, Finland 30th November 2009
SODIS in KENYA, 20 years of field implementaton
SODIS International Conference Phnom Phen Cambodia
International seminar of the impact of Solar disinfection
International Research Colloquium of the Network to promote
Household Water Treatment and Safe Storage (HWTS), Twenty years of SODIS in Kenya.
Royal College of Surgeons in Ireland, Dublin 21st - 23rd September 2009
Changing dynamics of Morbidity, Mortality and poverty of children in the Third World.
Senate Hearing, Italian Senate, Rome
Senatorial Commission on International Children’s Rights , At the request of Italian Senate Commission, Rome , 31st April 2009
Global health and interdependency,
The Royal College of Surgeons Charter day lecture 2009
Royal College of Surgeons,Dublin. 12th Feb 2009
Emerging mega-trends in Global health
Future shocks; disasters and relief in a changing world, RedR Conference, Royal College of nursing, London, 5th December, 2007
Locally appropriate technologies in low income settings, Dept International health, Tampere University, Finland. 29th Nov 2007
Applied operational study of pain determinants in terminally ill patients in Bondo, Kenya XVI International AIDS Conference,Toronto, August 06 Francis,P,Meegan,M
The 46th Robert Graves Lecture
Royal Academy of Medicine in Ireland
Creating long term change through culturally acceptable cost effective public health interventions.
Dublin 10 May 06
IFCW World Forum. “AIDS orphans & Vulnerable Children; an evidence-led response.” Cape Town, South Africa. 2003
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “An assessment of home-based care interventions among 2,116 terminally ill patients in Bondo and Siaya using clinically validated scales.
Interim results.” Nairobi, Kenya. 2003
"AIDS and the changing face of Africa: The impact on children, WUSC-Carleton, Médecins Sans Frontières, CARE Carlton University Canada, 25th Nov 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Modeling cultural determinants of sexual behavior” - A Pilot Study. Nairobi, Kenya. 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “AIDS, children and poverty, an alternative model to international Aid, ‘Love, evidence and common sense.” Nairobi, Kenya. 2002.
WHO Trachoma conference
. “Effect of fly control using sustainable interventions on the prevalence of Trachoma in five pastoral tribes in Kenya.” Geneva, Switzerland. 2001
Child Survival. Alternative strategies in reducing infant mortality” International Conference on Child survival. Nairobi, Kenya. 2001
Identifying emerging needs among AIDS orphans in Kenya. “Multicentre Matched Perspective Control Study of 2,786 Children Orphaned by AIDS, 2,420 other Orphans and 3,400”
Nairobi, Kenya. 2000
AIDS orphans. “An emerging crisis: a USAID sponsored conference.” Nanyuki. Kenya. 2000
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Multi centre Matched Perspective Control Study of 2,786 Children
Orphaned by AIDS, 2,420 other Orphans and 3,400.” Nairobi, Kenya. 2000
East African Association of Anthropologists inaugural Conference. “Anthropology and ethnography.” Nairobi, Kenya. 2000
The changing face of famine is a dynamic shifting paradigm. ICROSS has created a long term research programme constantly incorporating these rapid changes into our own intelligence and strategies.
Food Outlook
According to the latest Famine Early Warning Systems Network (FEWSNET) and WFP joint food security report, the cumulative effects of the failed October to December 2010 rains and the insignificant contribution of early 2011 rains means that food security in lowland and pastoral areas will be classified at emergency levels in the coming months until the next rainy season between October and December 2011. The report adds that significant reduction in herd size (60-80% for cattle, 25-35% for shoats, and 25-40% for camels) has been reported as a result of water and pasture shortages in the southern zones of Somali, lowland areas of Oromia Region (including Bale, Borena, and Guji zones) and in South Omo, SNNPR, in addition to significant reduction in productivity resulting in poor milk availability. Moreover, the purchasing capacity of pastoral and agro-pastoral communities is poor due to unfavorable livestock-to-cereal terms of trade caused by increases in food prices against low prices of livestock and reduced demand.
The below-average performance of the 2011 rains is also likely to result in poor belg harvests in parts of the eastern meher- producing areas, including parts of southern Tigray; Oromia and North Shewa zones of Amhara; and East and West Harerghe zones of Oromia regions. Furthermore, prospects for harvests of short- and long-cycle crops in July and December/January are low, as planting has been significantly affected by the late and insufficient rains. The June to December lean season, coupled with the upcoming dry weather conditions in many lowland/pastoral areas, is expected to exacerbate the food security situation. For more information, contact: ocha-eth@un.org & Ethiopia@fews.net
Market Watch
WFP's April Market Watch reports that the country-level consumer price index has increased by 34.7 per cent food, with the consumer food price index increasing by 40.7 percent and cereal price index by 27.5 percent, in May 2011 as compared to the same month last year. International maize, wheat and sorghum prices remained high in May 2011 and thus import parity prices stood above the 2008 and 2009 levels. In May 2011, the import parity prices at Addis Ababa stood at US$ 584 per MT for maize, at $562 per MT for wheat and at $450 per MT for sorghum. Wholesale prices of cereals have increased continuously for the last four months and currently the prices of maize and wheat stand above the same months from 2008 to 2010. Out of the 23 monitored markets, maize price climbed up in 20 markets. Contrary to seasonal trends, maize prices in most SNNPR markets are similar to those in deficit markets. Meanwhile, the Ethiopian Government has lifted the ceiling prices imposed on basic food and non-food commodities except for wheat flour, edible oil (palm oil) and sugar. The Ethiopian Grain Trade Enterprise has started the distribution of wheat at subsidized prices to millers so that bakeries can maintain an affordable selling price. For more information, contact: wfp.addisababa@wfp.org
WASH Update
Although the late gu/ganna rains temporarily relieved the severe water shortages and led to reduction in water trucking operations, some pocket areas continue to depend on water trucking for their supply of clean water. At present in Oromia region, 22 water trucks are required, out of which 18 are deployed and providing water trucking in West Arsi (2 trucks) and Borena (16 trucks) with the support of Government, UNICEF and NGOs (GOAL, AFD and CONCERN). The NGO Concern is preparing to deploy an additional truck in Dillo woreda (Borena zone). In Somali, where water trucking has been ongoing in pocket areas, Save the Children US undertook a rapid assessment with woreda officials in Moyale and Hudet woredas (Liben zone), the results of which showed a need to resume water trucking in those woredas. Save the Children US will resume water rationing with funding from the Humanitarian Response Fund (HRF). In Afar, water trucking continues in Bidu, Dupti, Elidar, Erebti Kurri, and Yalo woredas. In Amhara, water trucking is ongoing in Minjar Shenkora and East Belesa woredas. Ten water trucks are deployed in Tigray region, including in Ahferom, Geter Adwa, Raya Azebo, Shire and Tsegede woredas. For more information, contact: aayele@unicef.org
Health Update
According to the Ethiopian Health and Nutrition Institute (EHNRI), the number of new measles cases reported between 20 and 27 June decreased from 114 to 2 cases. The two cases were reported in Addis Ababa. However, the measles epidemic is ongoing in SNNPR, with outbreaks reported in Arba Minch (Gamo Gofa zone), Hadero Tunto (Kembata Tembaro), Hamer, Selamgo, and Bena Tsemay (South Omo) and in Halaba special woreda. EHNRI also received reports of a possible measles epidemic from Begi woreda (West Wollega zone) and sent a team to investigate. Over the past four weeks, total reported cases were nearly 270, with no deaths. Meanwhile,during the same week, 13 suspected cases of acute watery diarrhoea (AWD) were reported from Galadi woreda (Warder zone, Somali Region). Between 6 and 26 June, EHNRI received reports of nearly 200 cases of AWD from Somali region, including from parts of Fik, Shinile and Warder zones). UNICEF had pre- positonned case treatment center kits and sent emergency drug kits to support case management. In collaboration with the Regional Health Bureau (RHB), WHO and partners are strengthening disease surveillance and monitoring health-related emergencies in Amhara, Gambella, Oromia and SNNPR. In SNNPR, support has been provided for assessment of community-level surveillance in 34 woredas of eight zones (Gamo Gofa, Gurage, Hadiya, Kembata Tembaro, Segen Selti, Sidama and Wolayita). In Amhara, WHO supported the assessment of the current status in health emergency preparedness in North Shewa and Oromia zones in light of AWD outbreak risks. For more information, contact: who-wro@et.efro.who.int
Despite China’s rapid economic growth and India’s healthy democracy, you could say that there’s one area where Africa beats the Asian giants: in the famine stakes. Dr Stephen Devereux, editor of the book “The New Famines” (Routledge 2006) talks to WFP web writer Michelle Hough about why Africa is on the frontline of the chronic hunger battle.
Despite China’s rapid economic growth and India’s healthy democracy, you could say that there’s one area where Africa beats the Asian giants: in the famine stakes. Dr Stephen Devereux, editor of the book “The New Famines” (Routledge 2006) talks to WFP web writer Michelle Hough about why Africa is now on the frontline of the chronic hunger battle.
For many of us the face of famine is black, it’s poor and it is above all African.
Through the fuzzy focus of the international news machine chronic hunger seems to have a stranglehold on this vast continent, and most of us probably can’t remember a time when it was any different. However, do a bit of Googling and you’ll find that the top ten worst famines of the twentieth century all took place in Asia.
The media is a major famine prevention tool
Dr Stephen Devereux
In a presentation at WFP’s Rome headquarters for the book “The New Famines”, Dr Stephen Devereux lays it out clearly in a bar chart: over 30 million people dead China in 1958, 9 million dead in the Soviet Union in 1921 and over 7 million people killed by famine in the Soviet Union in 1932.
If you compare the estimated one million who died in the most recent African famine, Ethiopia in 1984, to the large numbers killed in the previous fifty years, there has been a positive change – even though 854 million people around the world are still desperately hungry.
Relative improvment
“There has been a relative improvement,” says Dr Devereux. “Nowadays there are less famines and they affect less people.”
Dr Devereux explains that Asia made the move away from famine through improved infrastructure, technology, agriculture and market access, all of which improved food availability.
Democracy also gave people a voice and the power to protect one of their most basic rights: access to food. In India, the post-independence government was made accountable through a social contract outlining the eradication of famine. The country hasn’t since experienced famine – although the same can’t be said for chronic under-nutrition, which is rife.
Reversal of fortunes
If you look at Africa, says Dr Devereux, not only have factors such as agriculture and democracy not improved, but in some cases there’s been a reversal.
For example, food production in Malawi is falling because families with more children have less land to farm. This is exacerbated by the fact that new generations still rely on farming for their livelihoods rather than moving towards new skills.
"Bread basket"
Zimbabwe used to be known as the “bread basket” of its region but now food shortages are frequent.
“In countries such as Zimbabwe and Somalia, poor governance and conflict increase poverty, which increases hunger,” says Dr Devereux.
“Meanwhile, in countries such as Ethiopia and Malawi, weak democracy has not strengthened citizens’ democratic voices and hunger remains an issue. In Africa, weak democratic processes often exist because minorities take over and exclude the majority,” he says.
Another major problem is the dominance of HIV/AIDS in some African countries. Dr Devereux says that AIDS has been a big factor in the resurgence of famine in Africa in the past twenty years because it depletes people’s resources and coping mechanisms.
Failure to respond
In the era of “The New Famines”, as our potential to eradicate famine increases, so does our potential to cause it, according to Dr Devereux. He thinks that now hunger crises are no longer caused by either food scarcity or market failure, a failure to respond is to blame.
Our biggest challenge is to move beyond emergencies and have a sustained attacked on hunger. We need to make ending global hunger a political priority
Dr Stephen Devereux
National governments may not be able to protect food security due to conflict or natural disasters. The international community, on the other hand, tends to prioritise some crises rather than others.
“Some famines get international attention, others don’t,” explains Dr Devereux. “There was a big reaction to the possibility of famine in the Balkans in the 1990s because famine in Europe would have been unacceptable. Iraq got action. Sudan hasn’t.”
Media old and new
In the “new famine” scenario, the heady mix of national governments, NGOs and the international community means it’s often difficult to lay accountability at the feet of one actor. And besides, no crisis should ever be allowed to get to the emergency stage when fingers are being pointed because it should have been spotted and dealt with earlier, says Dr Devereux.
“The media is a major famine prevention tool,” says Dr Devereux. “It highlights crises that have been concealed and forces people to respond, such as in Malawi in 2002.”
He goes one step further and suggests that victims of hunger can use new media such as the internet to raise awareness about their condition. I tell him that one refugee in a Kenyan camp did exactly that when he sent a text message to WFP in London to say the people in the camp didn’t have enough food.
Before hunger takes hold
Dr Devereux stresses that the media shouldn’t just focus on the powerful images created once famine has firmly taken hold eg. starving children and mass migration.
It should get in there earlier on in the process, when the situation is less “camera friendly” and highlight the numbers affected. It’s worth remembering that the effects of malnutrition kill many more people than famine.
WFP tackles hunger before it takes hold with projects such as school feeding and food-for-work which have the dual purpose of providing food assistance while promoting education and training - and in the long-run, providing a brighter future for beneficiaries.
Hopes for the future
Dr Devereux is hopeful for the future. He thinks the “Right to Food” campaign and other international initiatives will increase and there will be a concerted attempt to prevent famine.
He envisages democracy improving in countries wracked by food insecurity, and biotechnology may offer the potential to increase and stabilise food production. Nevertheless, AIDS will continue to be a big problem, in his opinion.
But, says Dr Devereux, wiping famine from the face of Africa will only be possible if the political will is behind it.
“Our biggest challenge is to move beyond emergencies and have a sustained attacked on hunger. We need to make ending global hunger a political priority,” says Dr Devereux.
Perspectives de l'alimentation
Selon les dernières Famine Early Warning Systems Network (FEWS NET) et le PAM rapport conjoint de la sécurité alimentaire, les effets cumulatifs de l'échec Octobre to Décembre 2010 pluies et de la contribution insignifiante des pluies au début de 2011 signifie que la sécurité alimentaire dans les plaines et les zones pastorales seront classés à des niveaux d'urgence dans les mois à venir jusqu'à la prochaine saison des pluies, entre Octobre et Décembre 2011. Le rapport ajoute que la réduction significative de la taille du troupeau (60-80% pour les bovins, 25-35% pour les gorets, et 25-40% pour les chameaux) a été signalé à la suite de pénuries d'eau et des pâturages dans les zones méridionales de la Somalie, les zones de plaine de la région d'Oromia (y compris Bale, Borena et Guji zones) et dans le Sud Omo, SNNPR, en plus de la réduction significative de la productivité résultant de la disponibilité de lait pauvre. Par ailleurs, la capacité d'achat des communautés pastorales et agro-pastorales est pauvre à cause de l'élevage défavorables à céréales termes de l'échange causée par l'augmentation des prix des denrées alimentaires contre les bas prix du bétail et de la demande réduite.
Les performances inférieures à la moyenne de 2011 pluies est également susceptible d'entraîner de mauvaises récoltes belg dans certaines parties de l'Est meher régions productrices, y compris les régions du sud du Tigré; Oromia et du Nord Shewa zones d'Amhara et les zones Est et Ouest Harerghe d'Oromia les régions. Par ailleurs, les perspectives de récoltes des cultures à court et cycle long en Juillet et Décembre / Janvier sont faibles, comme la plantation a été sensiblement affectée par les pluies tardives et insuffisantes. Le Juin to Décembre saison maigre, couplé avec les conditions à venir sécheresse dans de nombreuses plaines / les zones pastorales, on s'attend à aggraver la situation de sécurité alimentaire. Pour plus d'informations, contacter: ocha-eth@un.org & Ethiopia@fews.net
Market Watch
PAM rapports Avril Market Watch que l'indice au niveau des pays prix à la consommation a augmenté de 34,7 pour cent des aliments, l'indice des prix à la consommation alimentaire croissante de 40,7 pour cent et l'indice des prix des céréales de 27,5 pour cent, en mai 2011 par rapport au même mois l'année dernière . Prix internationaux du maïs, du blé et du sorgho est restée élevée en mai 2011 et donc importer des prix de parité était au-dessus des niveaux de 2008 et 2009. En mai 2011, le prix de parité à l'importation à Addis-Abeba s'élevait à US $ 584 par tonne pour le maïs, à 562 $ par tonne métrique pour le blé et à 450 $ par tonne métrique pour le sorgho. Les prix de gros de céréales ont augmenté continuellement au cours des quatre derniers mois et actuellement les prix du maïs et du blé sont au-dessus des mêmes mois de 2008 à 2010. Sur les 23 marchés étudiés, le prix du maïs a grimpé dans 20 marchés. Contrairement aux tendances saisonnières, les prix du maïs sur les marchés les plus SNNPR sont similaires à ceux des marchés déficit. En attendant, le gouvernement éthiopien a levé le prix plafond imposé sur les denrées alimentaires de base et des denrées non alimentaires, sauf pour la farine de blé, l'huile comestible (l'huile de palme) et le sucre. L'entreprise Ethiopian Grain Trade a commencé la distribution de blé à des prix subventionnés aux meuniers afin que les boulangeries peuvent maintenir un prix de vente abordable. Pour plus d'informations, contacter: wfp.addisababa @ wfp.org
WASH mise à jour
Bien que la fin des années gu / ganna pluies temporairement soulagé les graves pénuries d'eau et conduit à la réduction des activités de camionnage de l'eau, certaines zones de poche continuent de dépendre de camionnage de l'eau pour leur approvisionnement en eau propre. A l'heure actuelle dans la région d'Oromia, 22 camions d'eau sont nécessaires, dont 18 sont déployés et en fournissant de l'eau dans l'ouest de camionnage Arsi (2 camions) et Borena (16 camions) avec le soutien du Gouvernement, l'UNICEF et les ONG (BUT, l'AFD et PRÉOCCUPATION ). L'ONG Concern se prépare à déployer un camion supplémentaire dans Dillo woreda (Borena zone). En Somalie, où le camionnage de l'eau a été en cours dans les domaines de poche, Save the Children US a entrepris une évaluation rapide avec les responsables des woredas de Moyale et Hudet woredas (Liben zone), dont les résultats ont montré un besoin de reprendre de camionnage de l'eau dans les woredas. Save the Children US reprendra rationnement de l'eau avec un financement du Fonds d'intervention humanitaire (HRF). En Afar, le camionnage de l'eau continue de Bidu, Dupti, Elidar, Erebti Kurri et Yalo woredas. Dans l'Amhara, de camionnage de l'eau est en cours dans Minjar Shenkora et de l'Est Belesa woredas. Dix camions-citernes sont déployés dans la région de Tigray, y compris dans Ahferom, Geter Adwa, Raya Azebo, Shire et Tsegede woredas. Pour plus d'informations, contacter: aayele@unicef.org
Santé Mise à jour
Selon l'Ethiopian Health and Nutrition Institute (EHNRI), le nombre de nouveaux cas de rougeole signalés entre 20 et 27 Juin diminué de 114 à 2 cas. Les deux cas ont été signalés à Addis-Abeba. Toutefois, l'épidémie de rougeole est en cours dans la région SNNPR, avec des flambées signalées à Arba Minch (Gamo Gofa zone), Hadero Tunto (Kembata Tembaro), Hamer, Selamgo, et Bena Tsemay (Sud Omo) et dans Halaba spéciale woreda. EHNRI également reçu des rapports d'une éventuelle épidémie de rougeole à partir Begi woreda (Ouest Wollega zone) et a envoyé une équipe pour enquêter. Au cours des quatre dernières semaines, le total des cas signalés ont été près de 270, sans aucun décès. Pendant ce temps, durant la même semaine, 13 cas suspects de diarrhée aqueuse aiguë (AWD) ont été signalés dans Galadi woreda (Warder zone, la région Somali). Entre 6 et 26 Juin, EHNRI reçu des rapports de près de 200 cas de diarrhée aqueuse aiguë de la région Somali, y compris des parties de Fik, Warder Shinile et les zones). L'UNICEF avait pré-positonned kits cas du centre de traitement et envoyé des trousses de médicaments d'urgence pour soutenir la gestion des cas. En collaboration avec le Bureau régional de la santé (RHB), l'OMS et les partenaires sont le renforcement de la surveillance des maladies et la surveillance de la santé des urgences liées à Amhara, de Gambella, Oromia et SNNPR. En SNNPR, une aide a été fournie pour l'évaluation du niveau de la communauté de surveillance dans 34 woredas de huit zones (Gamo Gofa, Gurage, Hadiya, Kembata Tembaro, Segen Selti, Sidama et Wolayita). Dans l'Amhara, l'OMS a appuyé l'évaluation de l'état actuel de la préparation aux urgences de santé dans le Nord Shewa et les zones d'Oromia, à la lumière des risques épidémie AWD. Pour plus d'informations, contacter: who-wro@et.efro.who.int
Malgré la croissance économique chinoise rapide et saine démocratie de l'Inde, on pourrait dire qu'il ya bien un domaine où l'Afrique bat les géants asiatiques: dans les enjeux de la famine. Le Dr Stephen Devereux, l'éditeur du livre "Les famines Nouvelle" (2006 Routledge) parle au PAM web écrivain Michelle Hough pourquoi l'Afrique est sur le front de la bataille de faim chronique.
Malgré la croissance économique chinoise rapide et saine démocratie de l'Inde, on pourrait dire qu'il ya bien un domaine où l'Afrique bat les géants asiatiques: dans les enjeux de la famine. Le Dr Stephen Devereux, l'éditeur du livre "Les famines Nouvelle" (2006 Routledge) parle au PAM web écrivain Michelle Hough pourquoi l'Afrique est aujourd'hui sur le front de la bataille de faim chronique.
Pour beaucoup d'entre nous face à la famine est noir, il est pauvre et il est avant tout africaine.
Grâce à la mise au point floue de la faim internationales machines nouvelles chroniques semble avoir une mainmise sur ce vaste continent, et la plupart de nous ne peut probablement pas se rappeler un moment où il a été toute différente. Cependant, faire un peu de googling, et vous verrez que les dix premiers pires famines du XXe siècle ont tous eu lieu en Asie.
Les médias sont un outil de grande famine de prévention
Le Dr Stephen Devereux
Dans une présentation au siège du PAM à Rome pour le livre "Les famines Nouveau», le Dr Stephen Devereux qu'il énonce clairement dans un graphique à barres: plus de 30 millions de morts en Chine en 1958, 9 millions de morts en Union soviétique en 1921 et plus de 7 millions personnes tuées par la famine en Union soviétique en 1932.
Si vous comparez les environ un million qui sont morts dans la famine la plus récente en Afrique, en Ethiopie en 1984, au grand nombre de tués dans les cinquante années précédentes, il ya eu un changement positif - même si 854 millions de personnes dans le monde sont toujours désespérément faim .
Improvment relative
"Il ya eu une amélioration relative», explique le Dr Devereux. «Aujourd'hui, il ya moins de famines et ils affectent moins de personnes."
Dr Devereux explique que l'Asie a fait l'abandon de la famine grâce à une infrastructure, une technologie améliorée, l'agriculture et l'accès au marché, qui disponibilités alimentaires.
Démocratie a également donné aux gens une voix et le pouvoir de protéger un de leurs droits les plus élémentaires: accès à la nourriture. En Inde, le gouvernement post-indépendance a été rendu responsable par le biais d'un contrat social décrivant l'éradication de la famine. Le pays n'a pas depuis la famine expérimentés - bien que l'on ne peut pas en dire autant de sous-alimentation chronique, qui est omniprésente.
Renversement des fortunes
Si vous regardez l'Afrique, explique le Dr Devereux, ont non seulement des facteurs tels que l'agriculture et de la démocratie n'est pas améliorée, mais dans certains cas, il ya eu un renversement.
Par exemple, la production alimentaire au Malawi est en baisse parce que les familles avec plus d'enfants ont moins de terres à cultiver. Cette situation est aggravée par le fait que les nouvelles générations comptent toujours sur l'agriculture pour leur subsistance plutôt que de déplacer vers de nouvelles compétences.
"Corbeille à pain"
Le Zimbabwe était autrefois connu comme le «grenier» de sa région, mais maintenant les pénuries alimentaires sont fréquentes.
«Dans des pays comme le Zimbabwe et la Somalie, la mauvaise gouvernance et la pauvreté augmentent les conflits, ce qui augmente la faim», explique le Dr Devereux.
"Pendant ce temps, dans des pays comme l'Éthiopie et le Malawi, la démocratie n'a pas renforcé la faiblesse des voix démocratiques des citoyens et de la faim reste un problème. En Afrique, la faiblesse des processus démocratiques existent souvent parce que les minorités prennent le dessus et exclure la majorité », dit-il.
Un autre problème majeur est la domination du VIH / SIDA dans certains pays africains. Dr Devereux dit que le sida a été un grand facteur dans la résurgence de la famine en Afrique au cours des vingt dernières années, car il épuise les ressources des personnes et des mécanismes d'adaptation.
L'absence de réponse
Dans l'ère de la «Nouvelle famines», comme notre potentiel pour éradiquer la famine augmente, il en va de notre potentiel de le provoquer, selon le Dr Devereux. Il pense que maintenant crises alimentaires ne sont plus causés par la pénurie alimentaire ou une défaillance du marché, une absence de réponse est à blâmer.
Notre plus grand défi est d'aller au-delà des situations d'urgence et ont une attaque soutenue sur la faim. Nous avons besoin de faire éliminer la faim mondiale une priorité politique
Le Dr Stephen Devereux
Les gouvernements nationaux ne peuvent pas être en mesure de protéger la sécurité alimentaire en raison de conflits ou de catastrophes naturelles. La communauté internationale, d'autre part, tend à prioriser certaines crises plutôt que d'autres.
«Certaines famines attirer l'attention internationale, d'autres pas», explique le Dr Devereux. «Il y avait une réaction grande à la possibilité de la famine dans les Balkans dans les années 1990, car la famine en Europe aurait été inacceptable. L'Irak a obtenu l'action. Le Soudan n'a pas. "
Anciens et nouveaux médias
Dans la «nouvelle famine" scénario, le mélange capiteux des gouvernements nationaux, les ONG et la communauté internationale signifie qu'il est souvent difficile de jeter la responsabilité aux pieds d'un acteur. Et d'ailleurs, aucune crise ne devrait jamais être autorisé à accéder à la phase d'urgence lorsque les doigts sont fait parce qu'il aurait dû être repérés et traités plus tôt, explique le Dr Devereux.
«Les médias sont un outil de grande famine de prévention», explique le Dr Devereux. »Il souligne que les crises ont été dissimulés et force les gens à répondre, comme au Malawi en 2002."
Il va encore plus loin et suggère que les victimes de la faim peut utiliser les nouveaux médias comme l'Internet pour sensibiliser à leur condition. Je lui dis que un réfugié dans un camp au Kenya a fait exactement cela quand il a envoyé un message texte au PAM à Londres à-dire les gens dans le camp n'ont pas eu assez de nourriture.
Avant la faim s'empare
Dr Devereux souligne que les médias ne devraient pas se concentrer uniquement sur les images puissantes créé une fois que la famine a pris fermement par exemple tenir. enfants affamés et des migrations de masse.
Il devrait entrer là plus tôt dans le processus, lorsque la situation est moins "caméra amicale" et de souligner le nombre de personnes touchées. Il faut se rappeler que les effets de la malnutrition tuent beaucoup plus de gens que la famine.
Le PAM s'attaque à la faim avant qu'il s'empare avec des projets comme l'alimentation scolaire et de la nourriture contre travail, qui ont le double objectif de fournir une aide alimentaire tout en favorisant l'éducation et la formation - et dans le long terme-, offrant un meilleur avenir pour les bénéficiaires.
Espoirs pour l'avenir
Dr Devereux est optimiste pour l'avenir. Il pense que le "droit à l'alimentation" de campagne et d'autres initiatives internationales va augmenter et il y aura une tentative concertée pour prévenir la famine.
Il envisage la démocratie dans les pays en améliorant ravagé par l'insécurité alimentaire et la biotechnologie peut offrir la possibilité d'augmenter et de stabiliser la production alimentaire. Cependant, le SIDA continuera d'être un gros problème, à son avis.
Mais, explique le Dr Devereux, essuyant la famine de la face de l'Afrique ne sera possible que si la volonté politique est derrière elle.
«Notre plus grand défi est d'aller au-delà des situations d'urgence et ont une attaque soutenue sur la faim. Nous avons besoin de faire éliminer la faim une priorité politique globale ", déclare le Dr Devereux.
ICROSS Research has ben focused for three decades on these core areas.
among the wide ranging publications
1. Elmore-Meegan M, Conroy RM, Agala CB. Sex workers in Kenya,
numbers of clients and associated risks: an exploratory survey.
Reprod Health Matters 2004;12(23):50-7.
2. Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect
on neonatal tetanus mortality after a culturally-based health
promotion programme. Lancet 2001;358(9282):640-1.
3. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of drinking water protects against cholera in children
under 6 years of age. Arch Dis Child 2001;85(4):293-5.
4. Meegan M, Morley DC. Growth monitoring: family participation:
effective community development. Trop Doct 1999;29(1):23-7.
5. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of water reduces diarrhoeal disease: an update. Arch Dis
Child 1999;81(4):337-8.
6. Meegan M, Morley D, Chavasse D. Fly traps. Lancet 1997;349(9055):886.
7. Meegan M, Morley DC, Brown R. Child weighing by the unschooled: a
report of a controlled study of growth monitoring over 12 months of
Maasai children using direct recording scales. Trans R Soc Trop Med
Hyg 1994;88(6):635-7.
8. Conroy RM, Meegan ME. Dwindling donor aid for health programmes in
developing countries. Lancet 1994;343(8907):1228-9.
9. Meegan MK. Rethinking famine relief. Lancet 1992;340(8830):1293-4.
10. Konings E, Anderson RM, Morley D, O'Riordan T, Meegan M. Rates of
sexual partner change among two pastoralist southern Nilotic groups
in east Africa. Aids 1989;3(4):245-7.
11. Meegan M, McCormick J. Prevention of disease in the poor world.
Lancet 1988;2(8603):152-3.
12. Meegan M. Starvation and suffering. Lancet 1983;2(8365-66):1506.
13. Meegan M. The reality of starvation and disease. Lancet 1981;1
(8212):146.
Published Books
Changing the World
Feb 2009 256 pgs www.eye-books.com
Take my hand, a spiritual journey
With Sharon Wilkinson, Forward by T Hogan, 58 pgs www.michaelmeegan.com July 2008
Surprised by joy; a story of hope in the midst of tragedy ( forward by Stephen Sackur) 156 pgs
July 2006 www.maverickhouse.com
All Will be Well (Forward by John Hurt) Eye-Books, 149 pgs
May 2004.
ISBN 1903070279 www.eye-book.com
All Shall be Well, Forward by John Powell SJ, ISBN 000-627006-9, Collins. 146 pgs. First edition 1986, Reprint Jan 1999.
In preparation
The path of change
Meegan M ,Conroy R Scrima M
Eye Books May 2011 www.eye-books.com
The Tribe of One With Colin Meagle www.eye-books.com
May 2011
So you want o be a volunteer A guide for International volunteers
Pain and fear
Understanding death dying and suffering a practical companion guide
With Thomas Ernst MD
Bright darkness Fortress monastery on Montpellier, guarding the secrets of the last king of Jerusalem 1200 pgs, historical Novel 2013
Illustrative general articles
AFRO Journal Italy, regular contributor on Global health, poverty and International health trends and patterning Oct 09 Feb 09 Dialogue on Diarrhoea , regular contributor
World Health Organsation (WHO ) guidelines Trachoma prevention, fly traps , M Elmore-Meegan Prof D Morely et al, Geneva, Switzerland. 2001
Peer Reviews for key publications & major conferences and journals incl Int AIDS Conference
Scientific conferences and presentations (illustrative)
Health care in regions of absolute Poverty
Seminar , Dept International health, Faculty of Medicine
University of Tampere, Finland 30th November 2009
SODIS in KENYA, 20 years of field implementaton
SODIS International Conference Phnom Phen Cambodia
International seminar of the impact of Solar disinfection
International Research Colloquium of the Network to promote
Household Water Treatment and Safe Storage (HWTS), Twenty years of SODIS in Kenya.
Royal College of Surgeons in Ireland, Dublin 21st - 23rd September 2009
Changing dynamics of Morbidity, Mortality and poverty of children in the Third World.
Senate Hearing, Italian Senate, Rome
Senatorial Commission on International Children’s Rights , At the request of Italian Senate Commission, Rome , 31st April 2009
Global health and interdependency,
The Royal College of Surgeons Charter day lecture 2009
Royal College of Surgeons,Dublin. 12th Feb 2009
Emerging mega-trends in Global health
Future shocks; disasters and relief in a changing world, RedR Conference, Royal College of nursing, London, 5th December, 2007
Locally appropriate technologies in low income settings, Dept International health, Tampere University, Finland. 29th Nov 2007
Applied operational study of pain determinants in terminally ill patients in Bondo, Kenya XVI International AIDS Conference,Toronto, August 06 Francis,P,Meegan,M
The 46th Robert Graves Lecture
Royal Academy of Medicine in Ireland
Creating long term change through culturally acceptable cost effective public health interventions.
Dublin 10 May 06
IFCW World Forum. “AIDS orphans & Vulnerable Children; an evidence-led response.” Cape Town, South Africa. 2003
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “An assessment of home-based care interventions among 2,116 terminally ill patients in Bondo and Siaya using clinically validated scales.
Interim results.” Nairobi, Kenya. 2003
"AIDS and the changing face of Africa: The impact on children, WUSC-Carleton, Médecins Sans Frontières, CARE Carlton University Canada, 25th Nov 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Modeling cultural determinants of sexual behavior” - A Pilot Study. Nairobi, Kenya. 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “AIDS, children and poverty, an alternative model to international Aid, ‘Love, evidence and common sense.” Nairobi, Kenya. 2002.
WHO Trachoma conference
. “Effect of fly control using sustainable interventions on the prevalence of Trachoma in five pastoral tribes in Kenya.” Geneva, Switzerland. 2001
Child Survival. Alternative strategies in reducing infant mortality” International Conference on Child survival. Nairobi, Kenya. 2001
Identifying emerging needs among AIDS orphans in Kenya. “Multicentre Matched Perspective Control Study of 2,786 Children Orphaned by AIDS, 2,420 other Orphans and 3,400”
Nairobi, Kenya. 2000
AIDS orphans. “An emerging crisis: a USAID sponsored conference.” Nanyuki. Kenya. 2000
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Multi centre Matched Perspective Control Study of 2,786 Children
Orphaned by AIDS, 2,420 other Orphans and 3,400.” Nairobi, Kenya. 2000
East African Association of Anthropologists inaugural Conference. “Anthropology and ethnography.” Nairobi, Kenya. 2000
Ongoing education
PhD “The Importance of Local Appropriateness in Health services – A case study effective health programming among the pastoral nomadic Maasai , Kenya, East Africa ”, Doctorate Global Health, Dept International Health, University of Tampere, Finland 2009-12
Food Outlook
According to the latest Famine Early Warning Systems Network (FEWSNET) and WFP joint food security report, the cumulative effects of the failed October to December 2010 rains and the insignificant contribution of early 2011 rains means that food security in lowland and pastoral areas will be classified at emergency levels in the coming months until the next rainy season between October and December 2011. The report adds that significant reduction in herd size (60-80% for cattle, 25-35% for shoats, and 25-40% for camels) has been reported as a result of water and pasture shortages in the southern zones of Somali, lowland areas of Oromia Region (including Bale, Borena, and Guji zones) and in South Omo, SNNPR, in addition to significant reduction in productivity resulting in poor milk availability. Moreover, the purchasing capacity of pastoral and agro-pastoral communities is poor due to unfavorable livestock-to-cereal terms of trade caused by increases in food prices against low prices of livestock and reduced demand.
The below-average performance of the 2011 rains is also likely to result in poor belg harvests in parts of the eastern meher- producing areas, including parts of southern Tigray; Oromia and North Shewa zones of Amhara; and East and West Harerghe zones of Oromia regions. Furthermore, prospects for harvests of short- and long-cycle crops in July and December/January are low, as planting has been significantly affected by the late and insufficient rains. The June to December lean season, coupled with the upcoming dry weather conditions in many lowland/pastoral areas, is expected to exacerbate the food security situation. For more information, contact: ocha-eth@un.org & Ethiopia@fews.net
Market Watch
WFP's April Market Watch reports that the country-level consumer price index has increased by 34.7 per cent food, with the consumer food price index increasing by 40.7 percent and cereal price index by 27.5 percent, in May 2011 as compared to the same month last year. International maize, wheat and sorghum prices remained high in May 2011 and thus import parity prices stood above the 2008 and 2009 levels. In May 2011, the import parity prices at Addis Ababa stood at US$ 584 per MT for maize, at $562 per MT for wheat and at $450 per MT for sorghum. Wholesale prices of cereals have increased continuously for the last four months and currently the prices of maize and wheat stand above the same months from 2008 to 2010. Out of the 23 monitored markets, maize price climbed up in 20 markets. Contrary to seasonal trends, maize prices in most SNNPR markets are similar to those in deficit markets. Meanwhile, the Ethiopian Government has lifted the ceiling prices imposed on basic food and non-food commodities except for wheat flour, edible oil (palm oil) and sugar. The Ethiopian Grain Trade Enterprise has started the distribution of wheat at subsidized prices to millers so that bakeries can maintain an affordable selling price. For more information, contact: wfp.addisababa@wfp.org
WASH Update
Although the late gu/ganna rains temporarily relieved the severe water shortages and led to reduction in water trucking operations, some pocket areas continue to depend on water trucking for their supply of clean water. At present in Oromia region, 22 water trucks are required, out of which 18 are deployed and providing water trucking in West Arsi (2 trucks) and Borena (16 trucks) with the support of Government, UNICEF and NGOs (GOAL, AFD and CONCERN). The NGO Concern is preparing to deploy an additional truck in Dillo woreda (Borena zone). In Somali, where water trucking has been ongoing in pocket areas, Save the Children US undertook a rapid assessment with woreda officials in Moyale and Hudet woredas (Liben zone), the results of which showed a need to resume water trucking in those woredas. Save the Children US will resume water rationing with funding from the Humanitarian Response Fund (HRF). In Afar, water trucking continues in Bidu, Dupti, Elidar, Erebti Kurri, and Yalo woredas. In Amhara, water trucking is ongoing in Minjar Shenkora and East Belesa woredas. Ten water trucks are deployed in Tigray region, including in Ahferom, Geter Adwa, Raya Azebo, Shire and Tsegede woredas. For more information, contact: aayele@unicef.org
Health Update
According to the Ethiopian Health and Nutrition Institute (EHNRI), the number of new measles cases reported between 20 and 27 June decreased from 114 to 2 cases. The two cases were reported in Addis Ababa. However, the measles epidemic is ongoing in SNNPR, with outbreaks reported in Arba Minch (Gamo Gofa zone), Hadero Tunto (Kembata Tembaro), Hamer, Selamgo, and Bena Tsemay (South Omo) and in Halaba special woreda. EHNRI also received reports of a possible measles epidemic from Begi woreda (West Wollega zone) and sent a team to investigate. Over the past four weeks, total reported cases were nearly 270, with no deaths. Meanwhile,during the same week, 13 suspected cases of acute watery diarrhoea (AWD) were reported from Galadi woreda (Warder zone, Somali Region). Between 6 and 26 June, EHNRI received reports of nearly 200 cases of AWD from Somali region, including from parts of Fik, Shinile and Warder zones). UNICEF had pre- positonned case treatment center kits and sent emergency drug kits to support case management. In collaboration with the Regional Health Bureau (RHB), WHO and partners are strengthening disease surveillance and monitoring health-related emergencies in Amhara, Gambella, Oromia and SNNPR. In SNNPR, support has been provided for assessment of community-level surveillance in 34 woredas of eight zones (Gamo Gofa, Gurage, Hadiya, Kembata Tembaro, Segen Selti, Sidama and Wolayita). In Amhara, WHO supported the assessment of the current status in health emergency preparedness in North Shewa and Oromia zones in light of AWD outbreak risks. For more information, contact: who-wro@et.efro.who.int
Despite China’s rapid economic growth and India’s healthy democracy, you could say that there’s one area where Africa beats the Asian giants: in the famine stakes. Dr Stephen Devereux, editor of the book “The New Famines” (Routledge 2006) talks to WFP web writer Michelle Hough about why Africa is on the frontline of the chronic hunger battle.
Despite China’s rapid economic growth and India’s healthy democracy, you could say that there’s one area where Africa beats the Asian giants: in the famine stakes. Dr Stephen Devereux, editor of the book “The New Famines” (Routledge 2006) talks to WFP web writer Michelle Hough about why Africa is now on the frontline of the chronic hunger battle.
For many of us the face of famine is black, it’s poor and it is above all African.
Through the fuzzy focus of the international news machine chronic hunger seems to have a stranglehold on this vast continent, and most of us probably can’t remember a time when it was any different. However, do a bit of Googling and you’ll find that the top ten worst famines of the twentieth century all took place in Asia.
The media is a major famine prevention tool
Dr Stephen Devereux
In a presentation at WFP’s Rome headquarters for the book “The New Famines”, Dr Stephen Devereux lays it out clearly in a bar chart: over 30 million people dead China in 1958, 9 million dead in the Soviet Union in 1921 and over 7 million people killed by famine in the Soviet Union in 1932.
If you compare the estimated one million who died in the most recent African famine, Ethiopia in 1984, to the large numbers killed in the previous fifty years, there has been a positive change – even though 854 million people around the world are still desperately hungry.
Relative improvment
“There has been a relative improvement,” says Dr Devereux. “Nowadays there are less famines and they affect less people.”
Dr Devereux explains that Asia made the move away from famine through improved infrastructure, technology, agriculture and market access, all of which improved food availability.
Democracy also gave people a voice and the power to protect one of their most basic rights: access to food. In India, the post-independence government was made accountable through a social contract outlining the eradication of famine. The country hasn’t since experienced famine – although the same can’t be said for chronic under-nutrition, which is rife.
Reversal of fortunes
If you look at Africa, says Dr Devereux, not only have factors such as agriculture and democracy not improved, but in some cases there’s been a reversal.
For example, food production in Malawi is falling because families with more children have less land to farm. This is exacerbated by the fact that new generations still rely on farming for their livelihoods rather than moving towards new skills.
"Bread basket"
Zimbabwe used to be known as the “bread basket” of its region but now food shortages are frequent.
“In countries such as Zimbabwe and Somalia, poor governance and conflict increase poverty, which increases hunger,” says Dr Devereux.
“Meanwhile, in countries such as Ethiopia and Malawi, weak democracy has not strengthened citizens’ democratic voices and hunger remains an issue. In Africa, weak democratic processes often exist because minorities take over and exclude the majority,” he says.
Another major problem is the dominance of HIV/AIDS in some African countries. Dr Devereux says that AIDS has been a big factor in the resurgence of famine in Africa in the past twenty years because it depletes people’s resources and coping mechanisms.
Failure to respond
In the era of “The New Famines”, as our potential to eradicate famine increases, so does our potential to cause it, according to Dr Devereux. He thinks that now hunger crises are no longer caused by either food scarcity or market failure, a failure to respond is to blame.
Our biggest challenge is to move beyond emergencies and have a sustained attacked on hunger. We need to make ending global hunger a political priority
Dr Stephen Devereux
National governments may not be able to protect food security due to conflict or natural disasters. The international community, on the other hand, tends to prioritise some crises rather than others.
“Some famines get international attention, others don’t,” explains Dr Devereux. “There was a big reaction to the possibility of famine in the Balkans in the 1990s because famine in Europe would have been unacceptable. Iraq got action. Sudan hasn’t.”
Media old and new
In the “new famine” scenario, the heady mix of national governments, NGOs and the international community means it’s often difficult to lay accountability at the feet of one actor. And besides, no crisis should ever be allowed to get to the emergency stage when fingers are being pointed because it should have been spotted and dealt with earlier, says Dr Devereux.
“The media is a major famine prevention tool,” says Dr Devereux. “It highlights crises that have been concealed and forces people to respond, such as in Malawi in 2002.”
He goes one step further and suggests that victims of hunger can use new media such as the internet to raise awareness about their condition. I tell him that one refugee in a Kenyan camp did exactly that when he sent a text message to WFP in London to say the people in the camp didn’t have enough food.
Before hunger takes hold
Dr Devereux stresses that the media shouldn’t just focus on the powerful images created once famine has firmly taken hold eg. starving children and mass migration.
It should get in there earlier on in the process, when the situation is less “camera friendly” and highlight the numbers affected. It’s worth remembering that the effects of malnutrition kill many more people than famine.
WFP tackles hunger before it takes hold with projects such as school feeding and food-for-work which have the dual purpose of providing food assistance while promoting education and training - and in the long-run, providing a brighter future for beneficiaries.
Hopes for the future
Dr Devereux is hopeful for the future. He thinks the “Right to Food” campaign and other international initiatives will increase and there will be a concerted attempt to prevent famine.
He envisages democracy improving in countries wracked by food insecurity, and biotechnology may offer the potential to increase and stabilise food production. Nevertheless, AIDS will continue to be a big problem, in his opinion.
But, says Dr Devereux, wiping famine from the face of Africa will only be possible if the political will is behind it.
“Our biggest challenge is to move beyond emergencies and have a sustained attacked on hunger. We need to make ending global hunger a political priority,” says Dr Devereux.
Perspectives de l'alimentation
Selon les dernières Famine Early Warning Systems Network (FEWS NET) et le PAM rapport conjoint de la sécurité alimentaire, les effets cumulatifs de l'échec Octobre to Décembre 2010 pluies et de la contribution insignifiante des pluies au début de 2011 signifie que la sécurité alimentaire dans les plaines et les zones pastorales seront classés à des niveaux d'urgence dans les mois à venir jusqu'à la prochaine saison des pluies, entre Octobre et Décembre 2011. Le rapport ajoute que la réduction significative de la taille du troupeau (60-80% pour les bovins, 25-35% pour les gorets, et 25-40% pour les chameaux) a été signalé à la suite de pénuries d'eau et des pâturages dans les zones méridionales de la Somalie, les zones de plaine de la région d'Oromia (y compris Bale, Borena et Guji zones) et dans le Sud Omo, SNNPR, en plus de la réduction significative de la productivité résultant de la disponibilité de lait pauvre. Par ailleurs, la capacité d'achat des communautés pastorales et agro-pastorales est pauvre à cause de l'élevage défavorables à céréales termes de l'échange causée par l'augmentation des prix des denrées alimentaires contre les bas prix du bétail et de la demande réduite.
Les performances inférieures à la moyenne de 2011 pluies est également susceptible d'entraîner de mauvaises récoltes belg dans certaines parties de l'Est meher régions productrices, y compris les régions du sud du Tigré; Oromia et du Nord Shewa zones d'Amhara et les zones Est et Ouest Harerghe d'Oromia les régions. Par ailleurs, les perspectives de récoltes des cultures à court et cycle long en Juillet et Décembre / Janvier sont faibles, comme la plantation a été sensiblement affectée par les pluies tardives et insuffisantes. Le Juin to Décembre saison maigre, couplé avec les conditions à venir sécheresse dans de nombreuses plaines / les zones pastorales, on s'attend à aggraver la situation de sécurité alimentaire. Pour plus d'informations, contacter: ocha-eth@un.org & Ethiopia@fews.net
Market Watch
PAM rapports Avril Market Watch que l'indice au niveau des pays prix à la consommation a augmenté de 34,7 pour cent des aliments, l'indice des prix à la consommation alimentaire croissante de 40,7 pour cent et l'indice des prix des céréales de 27,5 pour cent, en mai 2011 par rapport au même mois l'année dernière . Prix internationaux du maïs, du blé et du sorgho est restée élevée en mai 2011 et donc importer des prix de parité était au-dessus des niveaux de 2008 et 2009. En mai 2011, le prix de parité à l'importation à Addis-Abeba s'élevait à US $ 584 par tonne pour le maïs, à 562 $ par tonne métrique pour le blé et à 450 $ par tonne métrique pour le sorgho. Les prix de gros de céréales ont augmenté continuellement au cours des quatre derniers mois et actuellement les prix du maïs et du blé sont au-dessus des mêmes mois de 2008 à 2010. Sur les 23 marchés étudiés, le prix du maïs a grimpé dans 20 marchés. Contrairement aux tendances saisonnières, les prix du maïs sur les marchés les plus SNNPR sont similaires à ceux des marchés déficit. En attendant, le gouvernement éthiopien a levé le prix plafond imposé sur les denrées alimentaires de base et des denrées non alimentaires, sauf pour la farine de blé, l'huile comestible (l'huile de palme) et le sucre. L'entreprise Ethiopian Grain Trade a commencé la distribution de blé à des prix subventionnés aux meuniers afin que les boulangeries peuvent maintenir un prix de vente abordable. Pour plus d'informations, contacter: wfp.addisababa @ wfp.org
WASH mise à jour
Bien que la fin des années gu / ganna pluies temporairement soulagé les graves pénuries d'eau et conduit à la réduction des activités de camionnage de l'eau, certaines zones de poche continuent de dépendre de camionnage de l'eau pour leur approvisionnement en eau propre. A l'heure actuelle dans la région d'Oromia, 22 camions d'eau sont nécessaires, dont 18 sont déployés et en fournissant de l'eau dans l'ouest de camionnage Arsi (2 camions) et Borena (16 camions) avec le soutien du Gouvernement, l'UNICEF et les ONG (BUT, l'AFD et PRÉOCCUPATION ). L'ONG Concern se prépare à déployer un camion supplémentaire dans Dillo woreda (Borena zone). En Somalie, où le camionnage de l'eau a été en cours dans les domaines de poche, Save the Children US a entrepris une évaluation rapide avec les responsables des woredas de Moyale et Hudet woredas (Liben zone), dont les résultats ont montré un besoin de reprendre de camionnage de l'eau dans les woredas. Save the Children US reprendra rationnement de l'eau avec un financement du Fonds d'intervention humanitaire (HRF). En Afar, le camionnage de l'eau continue de Bidu, Dupti, Elidar, Erebti Kurri et Yalo woredas. Dans l'Amhara, de camionnage de l'eau est en cours dans Minjar Shenkora et de l'Est Belesa woredas. Dix camions-citernes sont déployés dans la région de Tigray, y compris dans Ahferom, Geter Adwa, Raya Azebo, Shire et Tsegede woredas. Pour plus d'informations, contacter: aayele@unicef.org
Santé Mise à jour
Selon l'Ethiopian Health and Nutrition Institute (EHNRI), le nombre de nouveaux cas de rougeole signalés entre 20 et 27 Juin diminué de 114 à 2 cas. Les deux cas ont été signalés à Addis-Abeba. Toutefois, l'épidémie de rougeole est en cours dans la région SNNPR, avec des flambées signalées à Arba Minch (Gamo Gofa zone), Hadero Tunto (Kembata Tembaro), Hamer, Selamgo, et Bena Tsemay (Sud Omo) et dans Halaba spéciale woreda. EHNRI également reçu des rapports d'une éventuelle épidémie de rougeole à partir Begi woreda (Ouest Wollega zone) et a envoyé une équipe pour enquêter. Au cours des quatre dernières semaines, le total des cas signalés ont été près de 270, sans aucun décès. Pendant ce temps, durant la même semaine, 13 cas suspects de diarrhée aqueuse aiguë (AWD) ont été signalés dans Galadi woreda (Warder zone, la région Somali). Entre 6 et 26 Juin, EHNRI reçu des rapports de près de 200 cas de diarrhée aqueuse aiguë de la région Somali, y compris des parties de Fik, Warder Shinile et les zones). L'UNICEF avait pré-positonned kits cas du centre de traitement et envoyé des trousses de médicaments d'urgence pour soutenir la gestion des cas. En collaboration avec le Bureau régional de la santé (RHB), l'OMS et les partenaires sont le renforcement de la surveillance des maladies et la surveillance de la santé des urgences liées à Amhara, de Gambella, Oromia et SNNPR. En SNNPR, une aide a été fournie pour l'évaluation du niveau de la communauté de surveillance dans 34 woredas de huit zones (Gamo Gofa, Gurage, Hadiya, Kembata Tembaro, Segen Selti, Sidama et Wolayita). Dans l'Amhara, l'OMS a appuyé l'évaluation de l'état actuel de la préparation aux urgences de santé dans le Nord Shewa et les zones d'Oromia, à la lumière des risques épidémie AWD. Pour plus d'informations, contacter: who-wro@et.efro.who.int
Malgré la croissance économique chinoise rapide et saine démocratie de l'Inde, on pourrait dire qu'il ya bien un domaine où l'Afrique bat les géants asiatiques: dans les enjeux de la famine. Le Dr Stephen Devereux, l'éditeur du livre "Les famines Nouvelle" (2006 Routledge) parle au PAM web écrivain Michelle Hough pourquoi l'Afrique est sur le front de la bataille de faim chronique.
Malgré la croissance économique chinoise rapide et saine démocratie de l'Inde, on pourrait dire qu'il ya bien un domaine où l'Afrique bat les géants asiatiques: dans les enjeux de la famine. Le Dr Stephen Devereux, l'éditeur du livre "Les famines Nouvelle" (2006 Routledge) parle au PAM web écrivain Michelle Hough pourquoi l'Afrique est aujourd'hui sur le front de la bataille de faim chronique.
Pour beaucoup d'entre nous face à la famine est noir, il est pauvre et il est avant tout africaine.
Grâce à la mise au point floue de la faim internationales machines nouvelles chroniques semble avoir une mainmise sur ce vaste continent, et la plupart de nous ne peut probablement pas se rappeler un moment où il a été toute différente. Cependant, faire un peu de googling, et vous verrez que les dix premiers pires famines du XXe siècle ont tous eu lieu en Asie.
Les médias sont un outil de grande famine de prévention
Le Dr Stephen Devereux
Dans une présentation au siège du PAM à Rome pour le livre "Les famines Nouveau», le Dr Stephen Devereux qu'il énonce clairement dans un graphique à barres: plus de 30 millions de morts en Chine en 1958, 9 millions de morts en Union soviétique en 1921 et plus de 7 millions personnes tuées par la famine en Union soviétique en 1932.
Si vous comparez les environ un million qui sont morts dans la famine la plus récente en Afrique, en Ethiopie en 1984, au grand nombre de tués dans les cinquante années précédentes, il ya eu un changement positif - même si 854 millions de personnes dans le monde sont toujours désespérément faim .
Improvment relative
"Il ya eu une amélioration relative», explique le Dr Devereux. «Aujourd'hui, il ya moins de famines et ils affectent moins de personnes."
Dr Devereux explique que l'Asie a fait l'abandon de la famine grâce à une infrastructure, une technologie améliorée, l'agriculture et l'accès au marché, qui disponibilités alimentaires.
Démocratie a également donné aux gens une voix et le pouvoir de protéger un de leurs droits les plus élémentaires: accès à la nourriture. En Inde, le gouvernement post-indépendance a été rendu responsable par le biais d'un contrat social décrivant l'éradication de la famine. Le pays n'a pas depuis la famine expérimentés - bien que l'on ne peut pas en dire autant de sous-alimentation chronique, qui est omniprésente.
Renversement des fortunes
Si vous regardez l'Afrique, explique le Dr Devereux, ont non seulement des facteurs tels que l'agriculture et de la démocratie n'est pas améliorée, mais dans certains cas, il ya eu un renversement.
Par exemple, la production alimentaire au Malawi est en baisse parce que les familles avec plus d'enfants ont moins de terres à cultiver. Cette situation est aggravée par le fait que les nouvelles générations comptent toujours sur l'agriculture pour leur subsistance plutôt que de déplacer vers de nouvelles compétences.
"Corbeille à pain"
Le Zimbabwe était autrefois connu comme le «grenier» de sa région, mais maintenant les pénuries alimentaires sont fréquentes.
«Dans des pays comme le Zimbabwe et la Somalie, la mauvaise gouvernance et la pauvreté augmentent les conflits, ce qui augmente la faim», explique le Dr Devereux.
"Pendant ce temps, dans des pays comme l'Éthiopie et le Malawi, la démocratie n'a pas renforcé la faiblesse des voix démocratiques des citoyens et de la faim reste un problème. En Afrique, la faiblesse des processus démocratiques existent souvent parce que les minorités prennent le dessus et exclure la majorité », dit-il.
Un autre problème majeur est la domination du VIH / SIDA dans certains pays africains. Dr Devereux dit que le sida a été un grand facteur dans la résurgence de la famine en Afrique au cours des vingt dernières années, car il épuise les ressources des personnes et des mécanismes d'adaptation.
L'absence de réponse
Dans l'ère de la «Nouvelle famines», comme notre potentiel pour éradiquer la famine augmente, il en va de notre potentiel de le provoquer, selon le Dr Devereux. Il pense que maintenant crises alimentaires ne sont plus causés par la pénurie alimentaire ou une défaillance du marché, une absence de réponse est à blâmer.
Notre plus grand défi est d'aller au-delà des situations d'urgence et ont une attaque soutenue sur la faim. Nous avons besoin de faire éliminer la faim mondiale une priorité politique
Le Dr Stephen Devereux
Les gouvernements nationaux ne peuvent pas être en mesure de protéger la sécurité alimentaire en raison de conflits ou de catastrophes naturelles. La communauté internationale, d'autre part, tend à prioriser certaines crises plutôt que d'autres.
«Certaines famines attirer l'attention internationale, d'autres pas», explique le Dr Devereux. «Il y avait une réaction grande à la possibilité de la famine dans les Balkans dans les années 1990, car la famine en Europe aurait été inacceptable. L'Irak a obtenu l'action. Le Soudan n'a pas. "
Anciens et nouveaux médias
Dans la «nouvelle famine" scénario, le mélange capiteux des gouvernements nationaux, les ONG et la communauté internationale signifie qu'il est souvent difficile de jeter la responsabilité aux pieds d'un acteur. Et d'ailleurs, aucune crise ne devrait jamais être autorisé à accéder à la phase d'urgence lorsque les doigts sont fait parce qu'il aurait dû être repérés et traités plus tôt, explique le Dr Devereux.
«Les médias sont un outil de grande famine de prévention», explique le Dr Devereux. »Il souligne que les crises ont été dissimulés et force les gens à répondre, comme au Malawi en 2002."
Il va encore plus loin et suggère que les victimes de la faim peut utiliser les nouveaux médias comme l'Internet pour sensibiliser à leur condition. Je lui dis que un réfugié dans un camp au Kenya a fait exactement cela quand il a envoyé un message texte au PAM à Londres à-dire les gens dans le camp n'ont pas eu assez de nourriture.
Avant la faim s'empare
Dr Devereux souligne que les médias ne devraient pas se concentrer uniquement sur les images puissantes créé une fois que la famine a pris fermement par exemple tenir. enfants affamés et des migrations de masse.
Il devrait entrer là plus tôt dans le processus, lorsque la situation est moins "caméra amicale" et de souligner le nombre de personnes touchées. Il faut se rappeler que les effets de la malnutrition tuent beaucoup plus de gens que la famine.
Le PAM s'attaque à la faim avant qu'il s'empare avec des projets comme l'alimentation scolaire et de la nourriture contre travail, qui ont le double objectif de fournir une aide alimentaire tout en favorisant l'éducation et la formation - et dans le long terme-, offrant un meilleur avenir pour les bénéficiaires.
Espoirs pour l'avenir
Dr Devereux est optimiste pour l'avenir. Il pense que le "droit à l'alimentation" de campagne et d'autres initiatives internationales va augmenter et il y aura une tentative concertée pour prévenir la famine.
Il envisage la démocratie dans les pays en améliorant ravagé par l'insécurité alimentaire et la biotechnologie peut offrir la possibilité d'augmenter et de stabiliser la production alimentaire. Cependant, le SIDA continuera d'être un gros problème, à son avis.
Mais, explique le Dr Devereux, essuyant la famine de la face de l'Afrique ne sera possible que si la volonté politique est derrière elle.
«Notre plus grand défi est d'aller au-delà des situations d'urgence et ont une attaque soutenue sur la faim. Nous avons besoin de faire éliminer la faim une priorité politique globale ", déclare le Dr Devereux.
ICROSS Research has ben focused for three decades on these core areas.
among the wide ranging publications
1. Elmore-Meegan M, Conroy RM, Agala CB. Sex workers in Kenya,
numbers of clients and associated risks: an exploratory survey.
Reprod Health Matters 2004;12(23):50-7.
2. Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect
on neonatal tetanus mortality after a culturally-based health
promotion programme. Lancet 2001;358(9282):640-1.
3. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of drinking water protects against cholera in children
under 6 years of age. Arch Dis Child 2001;85(4):293-5.
4. Meegan M, Morley DC. Growth monitoring: family participation:
effective community development. Trop Doct 1999;29(1):23-7.
5. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of water reduces diarrhoeal disease: an update. Arch Dis
Child 1999;81(4):337-8.
6. Meegan M, Morley D, Chavasse D. Fly traps. Lancet 1997;349(9055):886.
7. Meegan M, Morley DC, Brown R. Child weighing by the unschooled: a
report of a controlled study of growth monitoring over 12 months of
Maasai children using direct recording scales. Trans R Soc Trop Med
Hyg 1994;88(6):635-7.
8. Conroy RM, Meegan ME. Dwindling donor aid for health programmes in
developing countries. Lancet 1994;343(8907):1228-9.
9. Meegan MK. Rethinking famine relief. Lancet 1992;340(8830):1293-4.
10. Konings E, Anderson RM, Morley D, O'Riordan T, Meegan M. Rates of
sexual partner change among two pastoralist southern Nilotic groups
in east Africa. Aids 1989;3(4):245-7.
11. Meegan M, McCormick J. Prevention of disease in the poor world.
Lancet 1988;2(8603):152-3.
12. Meegan M. Starvation and suffering. Lancet 1983;2(8365-66):1506.
13. Meegan M. The reality of starvation and disease. Lancet 1981;1
(8212):146.
Published Books
Changing the World
Feb 2009 256 pgs www.eye-books.com
Take my hand, a spiritual journey
With Sharon Wilkinson, Forward by T Hogan, 58 pgs www.michaelmeegan.com July 2008
Surprised by joy; a story of hope in the midst of tragedy ( forward by Stephen Sackur) 156 pgs
July 2006 www.maverickhouse.com
All Will be Well (Forward by John Hurt) Eye-Books, 149 pgs
May 2004.
ISBN 1903070279 www.eye-book.com
All Shall be Well, Forward by John Powell SJ, ISBN 000-627006-9, Collins. 146 pgs. First edition 1986, Reprint Jan 1999.
In preparation
The path of change
Meegan M ,Conroy R Scrima M
Eye Books May 2011 www.eye-books.com
The Tribe of One With Colin Meagle www.eye-books.com
May 2011
So you want o be a volunteer A guide for International volunteers
Pain and fear
Understanding death dying and suffering a practical companion guide
With Thomas Ernst MD
Bright darkness Fortress monastery on Montpellier, guarding the secrets of the last king of Jerusalem 1200 pgs, historical Novel 2013
Illustrative general articles
AFRO Journal Italy, regular contributor on Global health, poverty and International health trends and patterning Oct 09 Feb 09 Dialogue on Diarrhoea , regular contributor
World Health Organsation (WHO ) guidelines Trachoma prevention, fly traps , M Elmore-Meegan Prof D Morely et al, Geneva, Switzerland. 2001
Peer Reviews for key publications & major conferences and journals incl Int AIDS Conference
Scientific conferences and presentations (illustrative)
Health care in regions of absolute Poverty
Seminar , Dept International health, Faculty of Medicine
University of Tampere, Finland 30th November 2009
SODIS in KENYA, 20 years of field implementaton
SODIS International Conference Phnom Phen Cambodia
International seminar of the impact of Solar disinfection
International Research Colloquium of the Network to promote
Household Water Treatment and Safe Storage (HWTS), Twenty years of SODIS in Kenya.
Royal College of Surgeons in Ireland, Dublin 21st - 23rd September 2009
Changing dynamics of Morbidity, Mortality and poverty of children in the Third World.
Senate Hearing, Italian Senate, Rome
Senatorial Commission on International Children’s Rights , At the request of Italian Senate Commission, Rome , 31st April 2009
Global health and interdependency,
The Royal College of Surgeons Charter day lecture 2009
Royal College of Surgeons,Dublin. 12th Feb 2009
Emerging mega-trends in Global health
Future shocks; disasters and relief in a changing world, RedR Conference, Royal College of nursing, London, 5th December, 2007
Locally appropriate technologies in low income settings, Dept International health, Tampere University, Finland. 29th Nov 2007
Applied operational study of pain determinants in terminally ill patients in Bondo, Kenya XVI International AIDS Conference,Toronto, August 06 Francis,P,Meegan,M
The 46th Robert Graves Lecture
Royal Academy of Medicine in Ireland
Creating long term change through culturally acceptable cost effective public health interventions.
Dublin 10 May 06
IFCW World Forum. “AIDS orphans & Vulnerable Children; an evidence-led response.” Cape Town, South Africa. 2003
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “An assessment of home-based care interventions among 2,116 terminally ill patients in Bondo and Siaya using clinically validated scales.
Interim results.” Nairobi, Kenya. 2003
"AIDS and the changing face of Africa: The impact on children, WUSC-Carleton, Médecins Sans Frontières, CARE Carlton University Canada, 25th Nov 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Modeling cultural determinants of sexual behavior” - A Pilot Study. Nairobi, Kenya. 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “AIDS, children and poverty, an alternative model to international Aid, ‘Love, evidence and common sense.” Nairobi, Kenya. 2002.
WHO Trachoma conference
. “Effect of fly control using sustainable interventions on the prevalence of Trachoma in five pastoral tribes in Kenya.” Geneva, Switzerland. 2001
Child Survival. Alternative strategies in reducing infant mortality” International Conference on Child survival. Nairobi, Kenya. 2001
Identifying emerging needs among AIDS orphans in Kenya. “Multicentre Matched Perspective Control Study of 2,786 Children Orphaned by AIDS, 2,420 other Orphans and 3,400”
Nairobi, Kenya. 2000
AIDS orphans. “An emerging crisis: a USAID sponsored conference.” Nanyuki. Kenya. 2000
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Multi centre Matched Perspective Control Study of 2,786 Children
Orphaned by AIDS, 2,420 other Orphans and 3,400.” Nairobi, Kenya. 2000
East African Association of Anthropologists inaugural Conference. “Anthropology and ethnography.” Nairobi, Kenya. 2000
Ongoing education
PhD “The Importance of Local Appropriateness in Health services – A case study effective health programming among the pastoral nomadic Maasai , Kenya, East Africa ”, Doctorate Global Health, Dept International Health, University of Tampere, Finland 2009-12
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