'Millions denied end-of-life drugs'
By Tulip Mazumdar Global health reporter

Ugandan woman Betty Naiga: 'My family hate looking at me and my tumour'

Lack of access to pain relief for dying patients is a "public health emergency", say experts.

Figures suggest almost 18 million people - mainly in developing countries - died in unnecessary pain in 2012.

In Ethiopia, there are reports of cancer patients throwing themselves in front of trucks to escape pain.

The Worldwide Palliative Care Alliance says part of the problem is the refusal of governments to give patients access to painkillers such as morphine.
It says restrictions are in place because of exaggerated fears about the risk of addiction.

Last month, health officials from almost 200 countries met at the UN and pledged to make palliative care a higher priority.

This is the first time the specialty has been recognised in this way and championed by the World Health Organization (WHO).

Nestled in a banana plantation in a tiny village in Wakiso district in central Uganda, Betty Naiga, 48, lies on a thin mattress on the floor of her small yellow hut.
Continue reading the main story
“Start Quote

I had given up on life”

Betty Naiga Cancer patient

She was diagnosed with breast cancer two years ago.

She couldn't afford treatment and the tumour grew to the size of a football.

"The pain was too much before," she said.

"I would not sleep. I would not do anything. It was excruciating. I had given up on life. I wished I was dead."

Betty lay in agony for a year, feeling lost and abandoned by her family. Until she was found by a community volunteer called Allen.

Allen is one of hundreds of volunteers trained by the country's leading palliative care provider, Hospice Africa Uganda, to go out and find people like Betty suffering in silence.
Torture

After the hospice got involved with her care, Betty was given access to free chemotherapy and the desperately needed powerful painkiller morphine.

"My life has changed enormously since getting treatment. The medicines help ease my suffering," she said.

Uganda is leading the way in Africa in terms of palliative care. The country makes its own oral morphine using a simple and inexpensive mix of morphine powder and water.

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Nigeria kidnapped girls: Support rallies banned in Abuja

The schoolgirls are believed to be held in a remote part of Borno state
Nigerian police have banned public protests in the capital Abuja for the release of more than 200 schoolgirls seized by Islamist militants in April.

Abuja police commissioner Joseph Mbu said the rallies were "now posing a serious security threat".

Nigeria has seen almost daily rallies calling for the government to take firmer action to rescue the girls.

Boko Haram militants snatched the girls from the remote Chibok village near the Cameroon border on 14 April.

There have been mass demonstrations both in Nigeria and abroad demanding the release of the girls
In a statement, Mr Mbu said that public protests had "degenerated" and were now a security threat.

He was also quoted by the state-run Agency of Nigeria as saying that "dangerous elements" could join the demonstrations.

Nigeria's government has been facing growing pressure both at home and abroad to do more to tackle the group and bring about the girls' release.

A deal for the release of some of the abducted schoolgirls in Nigeria was close to being secured when the Nigerian government called it off late last month, the BBC has learned.

Some of the girls were set to be freed in exchange for imprisoned Islamist militants, reports the BBC's Will Ross.

Thousands of people have died since Boko Haram began a violent campaign against the Nigerian government in 2009 and in the subsequent security crackdown.
Who are Boko Haram?

Boko Haram leader Abubakar Shekau has threatened to treat the girls as slaves

Founded in 2002
Initially focused on opposing Western education - Boko Haram means "Western education is forbidden" in the Hausa language
Launched military operations in 2009 to create Islamic state
Thousands killed, mostly in north-eastern Nigeria - also attacked police and UN headquarters in capital, Abuja
Some three million people affected
Declared terrorist group by US in 2013

Rape 'routine' in DR Congo prisons

Security officials "routinely" rape women in prisons in DR Congo as punishment for their political activities, a UK-based charity says.

Freedom From Torture said medical reports of 34 women showed many of them had been brutally gang-raped.

The women - who included traders and professionals aged between 18 and 62 - are seeking asylum in the UK.

Democratic Republic of Congo government spokesman Lambert Mende told the BBC the report lacked credibility.

It did not contain enough facts and details, he said.

Two Congolese human rights groups told the BBC they had not received any reports of political rape in the country's prisons, although they said it might happen in secret detention centres.

In its report, Freedom From Torture said one woman was arrested and raped after organising a protest against sexual violence.

Some Congolese soldiers were convicted of rape in May

The group's Dr Juliet Cohen told the BBC: "There are some striking consistencies in the experiences of sexual violence and torture of the women in this report which strongly suggests that this horrific abuse is being routinely carried out in prisons in the DRC."
'Not human beings'

DR Congo is often dubbed the "rape capital of the world", with rights groups saying that rape and sexual violence has become a weapon of war since conflict broke out in the early 1990s in the east of the country.

In May, two soldiers were convicted of rape by a military court.
Continue reading the main story
“Start Quote

They raped my niece in front of us”

'Faith' Anti-rape campaigner

The man who has treated 30,000 rape victims
Haunted by Congo rape dilemma

Freedom From Torture said women were raped by security force members to stop "women speaking out about politics, human rights and, in some cases, rape itself".

It says women were abused at several locations in the capital, Kinshasa 1,500 km (1,000 miles) from the conflict zones.

One woman, named as Faith in the report, said security agents raided her home in early 2013 after she organised an anti-rape protest in the province of Bas Congo, west of Kinshasa.
"One of them said: 'You are talking about rape, now we'll show you what rape means'. They raped my niece in front of us. Then they took me to prison," she is quoted as saying in the report.

"Now I know, because I have been there, that it is normal for women to be sexually abused in prison," she said.

"The soldiers and the prison guards, they don't see women as human beings, they don't see any value in women. I can't even remember how many times I was raped."

Since her arrival in the UK, Faith has been admitted to hospital, Freedom From Torture said.

"She suffers from post-traumatic stress disorder and depression and she no longer likes being around other people," it added.

Josephine Mfulu-Batonda, who has monitored human rights abuses in prisons for several years for the organisation ACIDH, told the BBC's Maud Jullien that, in the past year, eight of the 100 women in Kinshasa's main prison, Makala, had reported being sexually abused but these were not political detainees.

Makala is one of the places where Freedom From Torture documented political rape.
Ms Mfulu-Batonda said it was common for prison staff and other inmates to force female prisoners into prostitution and to share the profit.

La Voix des Sans Voix (Voice of the Voiceless) works closely with inmates of visits Kinshasa's main prison and says it hasn't had any reports of rape there since 2006.

The group's Rostin Manketa says if there were any cases of female activists being raped as a result of their political activity, this would be an extremely serious issue and they would have reported it.

Nakupa Habari

http://nakupahabari.blogspot.com/2014/06/libya-fighting-18-killed-in-benghazi.html#linksNakupa Habari

Libya fighting: 18 killed in Benghazi

Forces loyal to renegade General Khalifa Haftar carried out air strikes in Benghazi on Sunday At least 18 people have been killed in intense fighting in eastern Libya, medics say. The fighting started when Ansar al-Sharia militants attacked forces loyal to renegade General Khalifa Haftar in Benghazi, who hit back with airstrikes. Benghazi is at the centre of a two-week long campaign by Gen Haftar's forces against Islamist armed groups. The government in the capital Tripoli has condemned the campaign, calling it an "attempted coup". It is not known whether the casualties from Sunday night's fighting are military or civilian, but both sides have accused the other of firing indiscriminately in residential areas. Dozens were also reported injured in the neighbouring city of Al-Marj. While Libya and in particular Benghazi has been plagued with violence since the uprising against Muammar Gaddafi, the latest fighting has been particularly ferocious. Combat helicopters have reportedly been used to carry out strikes against rival armed groups in the west of Benghazi. Eyewitnesses said one of the rockets fired on Sunday missed its target and instead hit a university engineering faculty.

Fighting has raged in Benghazi ever since the overthrow of Col Gaddafi in 2011

Armed men loyal to General Khalifa Haftar in Benghazi have been involved in clashes on the ground following air strikes launched by his forces on Sunday The groups being targeted by Gen Haftar's forces are the Ansar al-Sharia Islamist militia and the February 17 brigade, which fought against Gaddafi in 2011. The groups are accused of being behind much of the violence and assassinations in Benghazi in recent years, but they deny this. Libya has no functioning national army and has had to rely on armed groups to provide security. However, the groups have clashed on many occasions over political and ideological issues. Crisis government Gen Haftar wants the judiciary to appoint a crisis government to oversee new elections after accusing Libya's leaders of "fostering terrorism".

Unrest in Libya has worsened in recent weeks after Gen Haftar vowed to take on Islamist militants Dozens of state bodies have already pledged their support to him. But the government called his assaults an "attempted coup" and ordered the arrest of those taking part.

Resist urge to control e-cigarettes', WHO told Comments (861) By Jane Dreaper Health correspondent, BBC News Some doctors argue it is too early to know whether benefits outweigh potential risks, as Jane Dreaper reports Continue reading the main story Related Stories E-cigs 'undermine smoking ban' fear The e-cigarettes phenomenon E-cigarettes 'help smokers to quit' A letter signed by more than 50 researchers and public health specialists is urging the World Health Organization (WHO) to "resist the urge to control and suppress e-cigarettes". The letter says the devices - which deliver nicotine in a vapour - could be a "significant health innovation". But the UK's Faculty of Public Health says it is too early to know whether benefits outweigh potential risks. The WHO said it was still deciding what recommendations to make to governments. Jump media player Media player help Out of media player. Press enter to return or tab to continue. The open letter has been organised in the run-up to significant international negotiations on tobacco policy this year. Supporters of e-cigarettes, who argue the products are a low-risk substitute for smoking, fear they might become subject to reduction targets and advertising bans.

1. On some e-cigarettes, inhalation activates the battery-powered atomiser. Other types are manually switched on 2. A heating coil inside the atomiser heats liquid nicotine contained in a cartridge 3. Liquid nicotine becomes vapour and is inhaled. The 'smoke' produced is largely water vapour. Many e-cigarettes have an LED light as a cosmetic feature to simulate traditional cigarette glow. line break There has been a big growth in the market for e-cigarettes, but the Department of Health says they are not risk-free. Critics say not enough is known about their long-term health effects. A recent report commissioned by Public Health England said e-cigarettes required "appropriate regulation, careful monitoring and risk management" if their benefits were to be maximised. The letter has been signed by 53 researchers - including specialists in public health policy and experts such as Prof Robert West, who published research last week suggesting that e-cigarettes are more likely to help people give up smoking than some conventional methods. Continue reading the main story “Start Quote We are deeply concerned that classifying these products as tobacco will do more harm than good” Open letter to the WHO Some of the signatories work on research into tobacco science and smoking cessation. Three were involved in advising the National Institute for Health and Care Excellence (NICE) on its guidelines about reducing the harm from tobacco. 'Perverse effect' The letter says: "These products could be among the most significant health innovations of the 21st Century - perhaps saving hundreds of millions of lives. "If regulators treat low-risk nicotine products as traditional tobacco products... they are improperly defining them as part of the problem. "Regulators should avoid support for measures that could have the perverse effect of prolonging cigarette consumption. "We are deeply concerned that the classification of these products as tobacco will do more harm than good. "The potential for tobacco harm reduction products to reduce the burden of smoking-related disease is very large."

The organisers of the letter quote a leaked WHO document that refers to e-cigarettes as a "threat... which could result in a new wave of the tobacco epidemic". The WHO treaty on tobacco control currently covers 178 countries and 90% of the world's population. E-cigarettes are battery-powered devices that mimic the experience of smoking. Users inhale a vapour from a heated liquid that contains a concentration of nicotine. Prof West, of University College London told the BBC e-cigarettes should be "regulated appropriate to what they are" and that they are "orders of magnitude safer" than tobacco cigarettes. He called for "bespoke regulation", including banning sales for under-18s and having marketing directed at those who already smoke. Continue reading the main story “Start Quote We need to weigh up the benefits of fewer people smoking against the risk of electronic cigarettes leading to more people starting to smoke” Prof John Ashton Faculty of Public Health A WHO spokesman said: "WHO is currently working on recommendations for governments on the regulation and marketing of e-cigarettes and similar devices. "This is part of a paper that will be submitted to the parties of the WHO Framework Convention on Tobacco Control later this year. "We are also working with national regulatory bodies to look at regulatory options, as well as toxicology experts, to understand more about the possible impact of e-cigarettes and similar devices on health." The British Medical Association (BMA) has called for stronger regulation of the devices in the UK. Dr Vivienne Nathanson, the BMA's director of professional activities, told BBC Breakfast there was evidence that children who had never smoked were starting to use e-cigarettes, having been influenced by marketing campaigns. "Rather like cigarettes in the 50s and 60s, we really need to look at that and, I believe, ban it (advertising), to stop them advertising in a way that attracts children," she added. Prof John Ashton, president of the Faculty of Public Health, said he was also concerned about children using e-cigarettes. 'No uniformity' "We need to weigh up the benefits of fewer people smoking against the risk of electronic cigarettes leading to more people starting to smoke, particularly children," he said. Prof Martin McKee, of the London School of Hygiene and Tropical Medicine, said: "The health community is completely divided on the subject of whether electronic cigarettes are safer than real cigarettes. "While the signatories to this letter are clearly supportive, the World Health Organization, correctly, bases its decisions on the best available evidence." He said it would be "premature" to advocate the use of e-cigarettes until their safety had been established. The Welsh government wants to restrict the use of e-cigarettes in enclosed public places, because of concerns that they normalise smoking. Richard Evans, vice-chairman of the Welsh Pharmacy Board, which is part of the Royal Pharmaceutical Society in Wales, believes they should be regulated in the same way as traditional cigarettes. He said: "At the moment the products that are on the market - we don't know what standard they are. They can vary from product to product - there is no uniformity at all.

Turkish police have used tear gas to disperse demonstrators in Istanbul and Ankara on the first anniversary of deadly anti-government protests. Some 25,000 police surrounded and blocked Istanbul's Taksim Square, the epicentre of the 2013 rallies. PM Recep Tayyip Erdogan earlier urged youths to not join Saturday's protests. Protests against plans to redevelop Gezi Park in Istanbul turned into mass rallies against PM Erdogan last year after a heavy-handed police response. A number of people were killed in the unrest, with thousands more injured. A 64-year-old woman, who fell into a coma after inhaling tear gas during another crackdown on protesters in the capital in December, died on Friday. Reporter detained Clashes broke out in Istanbul on Saturday after protesters marched on Taksim Square despite a government ban on gatherings in force there. Riot police, water cannon and armoured vehicles were deployed to block access to the square and nearby Gezi Park. A number of demonstrators were reportedly arrested. Security forces also fired tear gas at demonstrators in central Ankara and broke up protests in the southern city of Adana. Earlier on Saturday, Istanbul officers kicked and detained a CNN reporter during a live broadcast from Taksim Square.

A police officer tries to disperse protesters on Istiklal avenue in central Istanbul.

Demonstrators lie on the ground, overcome by tear gas.

A family try to get through a police barricade.

Earlier in the day, riot police blocked access to Taksim Square, the site of last year's deadly crackdown on protesters. Ivan Watson said in a Twitter post that he and his film crew were "released after half an hour". The main organisers behind last year's Gezi Park protests - Taksim Solidarity - had called for a demonstration to mark the one-year anniversary. But Mr Erdogan warned young people not to join, saying: "One year later, people, including so-called artists, are calling for demonstrations, but you, Turkey's youth, you will not respond to the call." Addressing a crowd of young people in the capital on Friday, he described the movement as "terrorist organisations" that "manipulated our morally and financially weak youth to attack our unity and put our economy under threat". line At the scene - James Reynolds, BBC Istanbul correspondent A year ago, protestors took the government by surprise and occupied Istanbul's Taksim Square and Gezi Park. This year, the government deployed thousands of police officers to seal off the square and the park - to prevent protesters from taking back the area. Lines of riot police guarded the streets leading up to the square. Plainclothes police officers, carrying batons and gas masks, sat on Gezi Park's benches. At 1900, several hundred protesters on Istiklal - Istanbul's main shopping avenue - tried to advance towards Taksim Square. Within seconds, the riot police charged forward and fired tear gas. I saw officers take away a number of protesters. Dozens of bystanders took refuge from the tear gas behind the glass doors of a music shop. Every few minutes the manager opened his doors to let in more people. Protestors booed a police helicopter overhead. After a while, many decided to walk away. They were unable to re-take Taksim Square. line String of scandals Protesters have clashed with police in recent months, with two men killed during angry demonstrations over a mining disaster that killed 301 people. Anger also flared in March with the news of the death of a 15-year-old boy who had been in a coma since last June after being hit by a tear-gas canister during a protest. In May 2013, protesters took the government by surprise by occupying Taksim Square and Gezi Park. Riot police evicted them two weeks later using heavy-handed tactics and galvanising anti-government demonstrators in several other cities. line Turkish media comment

Protests against demolition of Gezi Park Political commentator Guven Sak writes in Hurriyet: "Gezi was like a litmus test for all of us… Gezi is the "Basta moment" of the Turkish creative class... If you have any doubts about the impact of Gezi, just observe the number of policemen on the streets this weekend... Gezi freaked out the ruling elite of Turkey a year ago and look who is still freaking out. Just count the number of policemen."