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Issue 146

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[image, unknown] HEALTH[image, unknown]

With a pinch of salt
Novel medication in India

Half the poor world's women are anaemic.
Photo: Dexter Tiranti

The Indian Government is establishing a nationwide programme to control iron-deficiency anaemia by distributing medicated table salt.

According to the World Health Organization, half of all the women in the Third World suffer from anaemia caused by a deficiency of one or more essential nutrients, most frequently iron. WHO figures also show that anaemia is more prevalent in pregnant women. In Asia, out of 43 million pregnant women, 65 per cent are anaemic compared to only 57 per cent of the 253 million non-pregnant women. This discrepancy is due to the marked increase in nutrient requirements that occur during pregnancy.

In India anaemia is commonplace and the results of an inadequate diet are exacerbated by poor absorption of iron from the millet-based meals. Intestinal or malarial parasites can also cause or aggravate anaemia, which in its mild form adversely affects work capacity as well as lowering tolerance to infection. Severe anaemia causes giddiness, lassitude, breathlessness and anorexia (loss of appetite). Women who are reproductively active are most vulnerable as regular menstrual blood loss causes the equivalent of a monthly iron loss of 18mg.

Following research at the National Institute of Nutrition at Hyderabad, common salt fortified with iron will be made available to the whole population. Salt is being used as it is eaten by everyone and, as it is manufactured in only a few locations, the addition of iron can be undertaken with the minimum of expense.

Ferrous sulphate, an iron compound readily absorbed by the human body, is being used but unfortunately this compound has been found to change the colour of the salt. Scientists at NIN have now devised an acceptable mixture consisting of ferrous sulphate, orthophosphoric acid (which prevents colour change) and sodium acid sulphate (which improves absorption of iron). This formula remains stable for up to eight months without colour loss or reduction in effectiveness.

Long-term field trials in five cities have been sponsored by UNICEF and have shown the treatment to be successful. At present, the Indian Government is already supplying significant quantities of medicated salt to the sub-Himalayan region.

This salt is fortified with iodine which is effective in treating goitre (caused by the malfunction of the thyroid gland) which is endemic in the area. It is envisaged that, as anaemia is also common in the area, salt with additional iron and iodide can be distributed to treat both conditions simultaneously.

The value of using salt as a means of dispensing medication to large populations has been proved by the success of such measures in reducing the incidence of filarian roundworms in China. Prior to the introduction in 1956 of the National Filariasis Control Programme, 22 million people were believed to be suffering with roundworm infection. Treatment was effected by using table salt medicated with the drug diethyl-carbamazine citrate, the salt being distributed nationwide. By 1980, 21 million patients who either had been previously infected, or showed signs of immature worms, had been cured. Furthermore, the rate of infection had diminished markedly.

Andy Crump

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[image, unknown] HOUSING[image, unknown]

Free offer! - shelter
Rent abolished in Burkina Faso

Some of the newer African governments seem prepared to take radical and unconentional measures to fight poverty. One such government is that of Thomas Sankara in the newly-named Burkina Faso (formerly Upper Volta).

On January 1, 1985, people awoke to discover that rent had been abolished overnight. For a year no Burkinabe will be obliged to pay their landlord. Landlords won’t gain a penny from foreigners either - non-nationals will continue to pay rent, but only to the state.

It’s hard to say how this radical measure will go down in Burkina. The government, now in its eighteenth month of office, has shown itself keen to encourage the construction industry. In a government reshuffle in August, for example. President Sankara sent several of his ministers off to supervise housebuilding programmes in the provincial towns - prominent business-people and politicians were ordered to build between one to ten villas to rent at reasonable rates.

The abolition of rents, however, has taken people by surprise. Many small proprietors have been hit hard. In the popular quarters of Ouagadougou. for example, families who own modest mud-built houses tend to rent out one or two rooms just to earn a living. Without this money coming in, there may well be difficulties for the not-so-well off.

Fears abound, though, that this new legislation may lead to some sort of black market rent, secretly payable to landlords. It is thought, too, that prospective property owners will be discouraged from house-building or letting out their property in future. However no-one will be evicted in 1985 and the committees for the defence of the revolution are taking active steps to protect all those who rent rooms.

On the whole it seems to be the foreign landlords who are complaining loudly. Burkinabe landlords seem more philosophical. Whilst popular tribunals continue to try those guilty of corruption, and to question the ownership of extensive property, the measure is one more proof to the average Burkinabe citizen that the government is on their side and intends to counter exploitation in every way it can.

Sally Lyall Grant

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[image, unknown] FAMINE[image, unknown]

Letting them starve
Attention switches from Ethiopia to Sudan - but the West still stands aloof

HUNDREDS of thousands of people - some say something like a million in all - are at this moment literally lying about the vast, arid wilderness of the Sudan in various stages of sickness and death.

Many have marched a thousand miles or more from Ethiopia on one side or Chad on the other in the belief that the land is greener on the other side. It is not. At the end of their trek they are worse off than ever. Not only is there no food. In some places the tiny handful of relief workers and doctors struggling to help do not know how in the next few weeks there will be even enough water to keep people alive. There is no way the Sudan’s frail economy can cope with a million starving people; rich countries would find it hard going if such numbers suddenly descended on them.

Nor, of course, is the Sudan problem the half of it. In Ethiopia itself and right across the Sahel belt of Africa hundreds of thousands of people are starving. It is estimated seven and a half million people are at risk. The figures are too large for us to comprehend.

All this is happening in an age when the money and technology and know-how are available to provide succour for everyone in a matter of weeks. Scores of satellites from East and West circle the globe watching and reporting what is happening down here: the movements of people and material, weather patterns and much more besides - information that can contribute enormously towards the saving of life in times of natural catastrophe. We are told a satellite can read a newspaper as a man sits looking at it in the street.

In addition to space technology, the big powers are loaded with helicopters and every kind of transport plane. They are awash with sophisticated equipment, with every device for instant communications, for setting up field hospitals, kitchens, the lot. And they are awash, too, with food, having in the northern hemisphere recently gathered in their biggest harvest ever.

So why are the have nations - the US, the Soviet Union, European states east and west, Japan - not doing much more?

Only one thing is missing: political will. The will of the rich powers to plunge in there and end what is nothing short of an international obscenity.

It is true that there are great logistical problems, that roads are few and so forth. And it is true there are international political difficulties in Ethiopia. It is true, too, that the Western countries, notably the Americans, are putting a great deal of food and other help into Ethiopia, that the UN agencies are in there and so are the relief agencies. But in many regions bands of dedicated voluntary workers are struggling with an impossible task that is beyond the bounds of human endurance. A great deal more could be done for them if governments really set their minds to it.

If there is the will, nations can move with remarkable speed and operations of great complexity can be mounted in days. When Britain decided to sail a fleet to the Falklands, ships and equipment were mobilised in a couple of weeks. The liner Queen Elizabeth was pulled out of service, stripped of its fittings and equipped as a troopship in a week or two. And the huge sum of money required to mount the operation was suddenly found.

The reality is that the industrialised countries could be giving really massive logistical support to an African relief operation carried out over several months that would alleviate the suffering while plans are worked out for a long-term programme aimed at preventing such a disaster recurring in a few years time.

Furthermore, the US, the countries of Europe and Japan could finance the operation without even feeling it. Governments would not publicly agree with that statement - particularly in these days of monetarism - but nations that can pour billions into space programmes, not to mention phenomenal arms programmes and research into Star Wars, and whose people enjoy the highest standards of living yet achieved on earth, are just finding excuses for not doing more.

The real test is to ask the unpalatable question: if there were a million white people out there dying in the African desert would governments be acting more decisively? The answer is that they would. If, for example, the Po Valley of Italy flooded and a million people were in danger the response would surely be of a quite different order.

One factor that holds governments back is the notion that an operation of this kind would not have the backing of their electorates. All the indications are to the contrary. In Britain individuals have contributed £30 million out of their own pockets towards famine relief in Ethiopia. In many other developed countries people have also voted with their pocket.

It has to be said that the behaviour of the Ethiopian government has done tremendous harm to the cause of the suffering people. It is particularly at fault now in refusing to give passage to relief organisations in the war area of Tigray Province. The difficulty of so-called interfering in a sovereign state is real. But perhaps in these days of increasing interdependence and in the name of humanity there is a strong case for ‘interfering’, if that is what it is called, and damn the consequences. In any case, Ethiopia has its own special complications and it is not the only area of suffering: the Sudan is shaping up to be even worse and there the political problems are less complicated.

The likelihood is that in a hundred years time it will seem inconceivable that in 1985 help was not forthcoming for millions of suffering people on this planet. It will be seen the way slavery in the 19th Century is seen today - it will be totally impossible to imagine why it was allowed to happen.

Derek Ingram/Gemini

Facts behind the Ethiopian famine

. The government believes the population is 32 million. Aid workers believe the figure is about 40 million. The nation’s first ever census was being carried out in mid – 1984. The smaller population figure gives the nation per capita Gross National Product of $142, making it the poorest country in Africa. The higher population figure makes the nation much poorer, with a per captia GNP of only about $114.

. Life expectancy at birth is 40 years, the lowest in the world (tied with Chad and Afghanistan). Over 85 per cent of the population has access to safe water. There is one doctor for every 58,500 inhabitants.

. Ethiopia is one of the few African nations which was not colonised (except for the 1936 – 41 Italian colonization. One effect of this history is that the nation does not have many of the censuses, detailed maps and soil, water, vegetation and forestry surveys which colonial powers carried out elsewhere in Africa. It has no code of land use laws.

. Some 70 – 78 per cent of the population lives in the central highlands north of Addis Ababa, the capital. The once fertile area rich in volcanic soils has been drastically over cultivated, over grazed and deforested. The nation’s cultivated areas lose about one billion tonnes of topsoil per year in erosion. At the turn of the century about 40 per cent of the country was forested; today the figure is 4 per cent. Ethiopia has the biggest livestock population in Africa.

. Some 69 per cent of the country is classified as ‘agricultural land’, but only about 15 per cent is being used, partly because of traditional settlement patterns and partly because Ethiopia has the lowest density of rural roads of any nation in the world and the third lowest density of all roads. Little more than 7 per cent of agricultural production is by modern methods, and most of this goes for coffee, which accounts for 61 per cent of exports.

. In each of the past ten years some regions of Ethiopia has been affected by drought, and in no year has the nation produces enough crops to feed itself. The 1972-74 drought in the central highlands is estimated to have killed some 200,000 people; it led to the downfall of Haile Selassie

. Ethiopia’s links with the USSR means it receives little foreign development aid – only about $6 per person, compared with a per capita average for Africa of $20.

Earthscan

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