Menstruation often means missing school for many girls in parts of Africa. But should the state provide sanitary products to girls who cannot afford them to prevent them from falling behind in their studies?

That question continues to stir debate in several East African countries but especially in Kenya, where President Uhuru Kenyatta last year signed the  Basic Education Amendment Act requiring the government to provide free sanitary towels to schoolgirls. 

A 2016 U.N. report estimated that one in 10 girls in Sub-Saharan Africa misses school during her menstrual cycle due to an inability to access affordable sanitary products.

After two years of debate, Kenya’s parliament voted overwhelmingly last year in favor of a measure that advocates say lifts that barrier to education. In June of 2017, President Kenyatta signed the amendment into law.

Sanitary towels handed out

This May, Gender Affairs Cabinet Secretary Margaret Kobia cleared the way for the distribution of one million sanitary towels to girls in Kenya’s Makueni and Kitui counties.

The government said it targeted more than 200,000 schoolgirls for distribution as part of a pilot program.

Through funds provided by the government  and channeled to the county governments, the new law is set to benefit girls in all of Kenya’s 47 counties.

The government allocated $4.6 million to the gender department ministry to buy the towels.

Femme International

Rachel Ouko is the Nairobi program coordinator for Femme International, a non-profit organization that provides menstrual cups and reusable, washable pads to underprivileged girls in Kenya and Tanzania.

“If that system can work very well, it will have a great impact on school-going girl,” Ouko said. “First of all, we have free education, so no girl should have an excuse of not going to school. Then there is free sanitary pads, so no girl should not have an excuse of going to school because they lack sanitary pads.”

Activists around the region say the issue is most pronounced in rural areas, and the problem is more complex than just supplying sanitary pads.

In 2017, the U.N. Children’s Fund estimated around 60 percent of girls in Uganda missed class because their schools lacked private toilets and washing facilities to help them manage during their periods.

Cycle of frustration

Regina Kasebe is a Uganda social worker with Action Alliance, also known as Solidarity Uganda.

“Issues of women and girls cut across nations and you find that in schools when these young girls, most of them come from poor families and in the schools where we majorly work with and the challenge they have is during menstruation,” Kasebe said.

“Because they do not have sanitary towels, they do not use anything, so for those days you have to stay home you cannot go to school when you are in such a situation, so there is missing school during the days of menstruation and also they drop out because they get frustrated because they cannot continue handling the same issue over and over again,” she said.

Kasebe said girls in rural areas are also more likely to be married off once they have started menstruating, further contributing to drop-out rates.

Several African nations have taken steps to improve access to sanitary products for both women and girls.

Uganda announced in 2017 that sanitary pads would be exempt from value-added tax, and in November, Kenya removed duties on raw materials used in the production of sanitary pads to help make the product more affordable.

Missed work, school

According to Sustainable Health Enterprises, an NGO, 18 percent of women and girls in Rwanda missed work or school last year because they could not afford to buy menstrual pads. The NGO estimates that a lack of affordable sanitary pads costs Rwanda’s economy $115 million per year.

Activists hope other countries in the region will follow Kenya’s example and take steps to make sanitary products more accessible, and thus help girls overcome a big disadvantage they have been facing at school.
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As a boy growing up in Kansas, Nick Hague looked up at the stars and wanted to explore the unknown. In October, his dream will come true when he blasts off on a Russian Soyuz spacecraft to the International Space Station.

Before rocketing into space from Kazakhstan on Expedition 57 for his six-month tour, the 42-year-old father has undergone extensive training in everything from spacewalks to robotics to Russian and the psychology of sharing small spaces.

Preparation was “a 2-1/2-year mission on the home front,” Hague said from inside a replica of the space station at the National Aeronautics and Space Administration’s Johnson Space Center in Houston.

An engineer and colonel in the U.S. Air Force, Hague was one of eight selected in 2013 for NASA’s astronaut candidate training program. He is one of 42 active astronauts eligible for a flight assignment.

Hague said he found his love of space early: “Growing up as a little boy, staring up the night sky and wanting to just explore the unknown and figure out what’s out there and go find new things.”

In the Air Force, Hague worked as an engineer on satellites and aircraft. Then he attended test pilot school at Edwards Air Force Base, and realized his dream might be within reach.

Training was intense. After receiving instructions on how to use equipment during a spacewalk, Hague once donned his space suit for 6-1/2 hours of underwater simulation at the neutral buoyancy laboratory in Houston, which mimics zero gravity in space using a 40-foot deep pool.

“I have practiced a bunch of different skills … whatever they need me to do when I go outside and do a spacewalk,” he said.

In addition to Houston, Hague has trained with NASA’s partners in Russia, Japan and Europe. He said the long periods of separation from his wife, who is also in the U.S. Air Force, and two young boys is one of the most challenging parts of the job.

While his sons appreciate the “neat” work their father is doing, Hague said he remains “just dorky dad” at home.

Hague said he looks forward to being the eyes and ears of scientists back on Earth. He will work with Russian cosmonauts to monitor shifts in bodily fluids that occur in space. Some astronauts have returned from space missions with changes in eyesight.

Scientists said they hope to learn if there is a correlation between fluid shifts and vision. Such issues need to be better understood before humans are sent on longer space flights into deep space.

Just as important as studying the science of the mission, Hague said, is understanding the psychology involved in a space station almost the size of a football field with six sleeping quarters, two bathrooms and a gym.

Astronauts must learn to work in a team, resolve personal conflicts and do even small things like minding their personal items in what Hague called “that flying test bed” so they do not clutter others’ work spaces.

“It’s nerve-wracking. All the emotions that are going to be kind of coursing through me,” he said. “You’re leaving family for an extended period of time, so it can be stressful.”

On the plus side: “You’re getting to fulfill a childhood dream.”
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At a research facility in Gabon, one isolated building stands behind an electrified fence, under round-the-clock scrutiny by video cameras. The locked-down P4 lab is built to handle the world’s most dangerous viruses, including Ebola.

“Only four people, three researchers and a technician, are authorized to go inside the P4,” said virologist Illich Mombo, who is in charge of the lab, one of only two in all of Africa that is authorized to handle deadly Ebola, Marburg and Crimean-Congo haemorrhagic fever viruses. The other is in Johannesburg.

The P4 was put up 800 metres (half a mile) distant from older buildings of the Franceville International Centre for Medical Research (CIRMF), in large grounds on the outskirts of Franceville, the chief city in the southeastern Haut-Ogooue province.

Filming the ultra-high-security lab or even taking photos is banned and the handful of people allowed inside have security badges. Backup power plants ensure an uninterruptable electricity supply. “Even the air that we breathe is filtered,” Mombo explains.

When he goes into the P4 lab to work on a sample of suspect virus such as Ebola — which has claimed 28 lives in the Democratic Republic of Congo (DRC) during an outbreak in the past six weeks — Mombo wears a head-to-foot biohazard suit.

The special clothing is destroyed as soon as he has finished. Draconian measures are in force to prevent any risk of contamination, with potentially disastrous effects.

‘Teams on alert’

Once a suspect virus has been “inactivated” — a technique that stops the sample from being contagious — it is carefully taken from the P4 unit to other CIRMF laboratories in the compound, where it is analysed.

Specialized teams will scrutinize it, looking to confirm its strain of Ebola and hunting for clues such as the virus’s ancestry and evolution, which are vital for tracking the spread of the disease.

CIRMF director Jean-Sylvain Koumba, a colonel in the Gabonese army and a military doctor, said lab teams had been “placed on alert” to handle Ebola samples sent on by the National Institute of Biomedical Resarch in the DRC capital Kinshasa.

The nature of the sample can be determined with rare precision, for the facility has state-of-the-art equipment matched in few other places worldwide.

“On average, it takes 24 to 48 hours between the time when a sample arrives and when we get the results,” Mombo said.

Founded in 1979 by Gabon’s late president Omar Bongo Ondimba to study national fertility rates, the CIRMF moved on to AIDS, malaria, cancer, viral diseases and the neglected tropical maladies that affect a billion people around the world, according to the WHO.

The center is financed by the Gabonese state, whose main wealth is derived from oil exports, and gets help from France.

In all, 150 people work for the CIRMF and live on the huge premises. Its reputation draws scientists, students and apprentices from Asia, Europe and the United States, as well as Africa.

“[The] CIRMF is uniquely suited to study infectious diseases of the Congolese tropical rain forest, the second world’s largest rain forest,” two French scientists, Eric Leroy and Jean-Paul Gonzalez, wrote in the specialist journal Viruses in 2012.

“[It] is dedicated to conduct medical research of the highest standard … with unrivaled infrastructure, multiple sites and multidisciplinary teams.”

Animal ‘reservoir’?

The facility also conducts investigations into how lethal tropical pathogens are able to leap the species barrier, said Gael Darren Maganga, who helps run the unit studying the emergence of viral diseases.

“A passive watch consists of taking a sample from a dead animal after a request, while the active watch is when we go out ourselves to do fieldwork and take samples,” he said.

A major center of interest is the bat, seen as a potential “reservoir” — a natural haven — for the Ebola virus, said Maganga. Staff regularly go out all over Gabon to take samples of saliva, fecal matter and blood.

The consumption of monkey flesh and other bush meat is common practice in central Africa.

“It’s still a hypothesis, but the transmission to human beings could be by direct contact, for instance by getting scratches [from a bat] in caves, or by handling apes which have been infected by bat saliva,” he said.

 

 

 
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We were warned.

On June 23, 1988, a sultry day in Washington, James Hansen told Congress and the world that global warming wasn’t approaching — it had already arrived. The testimony of the top NASA scientist, said Rice University historian Douglas Brinkley, was “the opening salvo of the age of climate change.”

Thirty years later, it’s clear that Hansen and other doomsayers were right. But the change has been so sweeping that it is easy to lose sight of effects large and small — some obvious, others less conspicuous.

Earth is noticeably hotter, the weather stormier and more extreme. Polar regions have lost billions of tons of ice; sea levels have been raised by trillions of gallons of water. Far more wildfires rage.

Over 30 years — the time period climate scientists often use in their studies in order to minimize natural weather variations — the world’s annual temperature has warmed nearly 1 degree (0.54 degrees Celsius), according to the National Oceanic and Atmospheric Administration. And the temperature in the United States has gone up even more — nearly 1.6 degrees.

“The biggest change over the last 30 years, which is most of my life, is that we’re no longer thinking just about the future,” said Kathie Dello, a climate scientist at Oregon State University in Corvallis. “Climate change is here, it’s now and it’s hitting us hard from all sides.”

Warming hasn’t been just global, it’s been all too local. According to an Associated Press statistical analysis of 30 years of weather, ice, fire, ocean, biological and other data, every single one of the 344 climate divisions in the Lower 48 states — NOAA groupings of counties with similar weather — has warmed significantly, as has each of 188 cities examined.

The effects have been felt in cities from Atlantic City, New Jersey, where the yearly average temperature rose 2.9 degrees in the past 30 years, to Yakima, Washington, where the thermometer jumped a tad more. In the middle, Des Moines, Iowa, warmed by 3.3 degrees since 1988.

South central Colorado, the climate division just outside Salida, has warmed 2.3 degrees on average since 1988, among the warmest divisions in the contiguous United States.

When she was a little girl 30 years ago, winery marketing chief Jessica Shook used to cross country ski from her Salida doorstep in winter. It was that cold and there was that much snow. Now, she has to drive about 50 miles for snow that’s not on mountain tops, she said.

“T-shirt weather in January, that never used to happen when I was a child,” Shook said. When Buel Mattix bought his heating and cooling system company 15 years ago in Salida, he had maybe four air conditioning jobs a year. Now he’s got a waiting list of 10 to 15 air conditioning jobs long and may not get to all of them.

Wildfires

And then there’s the effect on wildfires. Veteran Salida firefighter Mike Sugaski used to think a fire of 10,000 acres was big. Now he fights fires 10 times as large.

“You kind of keep saying ‘How can they get much worse?’ But they do,” said Sugaski, who was riding his mountain bike on what usually are ski trails in January this year.

In fact, wildfires in the United States now consume more than twice the acreage they did 30 years ago.

The statistics tracking climate change since 1988 are almost numbing. North America and Europe have warmed 1.89 degrees — more than any other continent. The Northern Hemisphere has warmed more than the Southern, the land faster than the ocean. Across the United States, temperature increases were most evident at night and in summer and fall. Heat rose at a higher rate in the North than the South.

Heat records

Since 1988, daily heat records have been broken more than 2.3 million times at weather stations across the nation, half a million times more than cold records were broken.

Doreen Pollack fled Chicago cold for Phoenix more than two decades ago, but in the past 30 years nighttime summer heat has increased almost 3.3 degrees there. She said when the power goes out, it gets unbearable, adding: “Be careful what you ask for.”

The AP interviewed more than 50 scientists who confirmed the depth and spread of warming.

Clara Deser, climate analysis chief at the National Center for Atmospheric Research, said that when dealing with 30-year time periods in smaller regions than continents or the globe as a whole, it would be unwise to say all the warming is man-made. Her studies show that in some places in North America — though not most — natural weather variability could account for as much as half of local warming.

But when you look at the globe as a whole, especially since 1970, nearly all the warming is man-made, said Zeke Hausfather of the independent science group Berkeley Earth. Without extra carbon dioxide and other greenhouse gases, he said, the Earth would be slightly cooling from a weakening sun. Numerous scientific studies and government reports calculate that greenhouse gases in the big picture account for more than 90 percent of post-industrial Earth’s warming.

“It would take centuries to a millennium to accomplish that kind of change with natural causes. This, in that context, is a dizzying pace,” said Kim Cobb, a climate scientist at Georgia Tech in Atlanta.

Since the 1800s, scientists have demonstrated that certain gases in Earth’s atmosphere trap heat from the sun like a blanket. Human activities such as burning of coal, oil and gasoline are releasing more of those gases into the atmosphere, especially carbon dioxide. U.S. and international science reports say that more than 90 percent of the warming that has happened since 1950 is man-made.

Extremes

Others cautioned that what might seem to be small increases in temperature should not be taken lightly.  

“One or two degrees may not sound like much, but raising your thermostat by just that amount will make a noticeable effect on your comfort,” said Deke Arndt, NOAA’s climate monitoring chief in Asheville, North Carolina, which has warmed nearly 1.8 degrees in 30 years.

Arndt said average temperatures don’t tell the entire story: “It’s the extremes that these changes bring.”

The nation’s extreme weather — flood-inducing downpours, extended droughts, heat waves and bitter cold and snow — has doubled in 30 years, according to a federal index.

The Northeast’s extreme rainfall has more than doubled. Brockton, Massachusetts, had only one day with at least four inches of rain from 1957 to 1988, but a dozen of them in the 30 years since, according to NOAA records. Ellicott City, Maryland, just had its second thousand-year flood in little less than two years.

And the summer’s named Atlantic storms? On average, the first one now forms nearly a month earlier than it did in 1988, according to University of Miami hurricane researcher Brian McNoldy.

The 14 costliest hurricanes in American history, adjusted for inflation, have hit since 1988, reflecting both growing coastal development and a span that included the most intense Atlantic storms on record.

“The collective damage done by Atlantic hurricanes in 2017 was well more than half of the entire budget of our Department of Defense,” said MIT’s Kerry Emanuel.

Arctic ice

Climate scientists point to the Arctic as the place where climate change is most noticeable with dramatic sea ice loss, a melting Greenland ice sheet, receding glaciers and thawing permafrost. The Arctic has warmed twice as fast as the rest of the world.

Alaska’s annual average temperature has warmed 2.4 degrees since 1988 and 5.4 degrees in the winter.  Since 1988, Utqiagvik, Alaska, formerly known as Barrow, has warmed more than 6 degrees yearly and more than 9 degrees in winter.

“The temperature change is noticeable. Our ground is thawing,” said Mike Aamodt, 73, the city’s former acting mayor. He had to move his own cabins at least four times because of coastal erosion and thawing ground due to global warming. “We live the climate change.”

The amount of Arctic sea ice in September, when it shrinks the most, fell by nearly one third since 1988. It is disappearing 50 years faster than scientists predicted, said Michael Mann, a climate scientist at Pennsylvania State University.

“There is a new Arctic now because the Arctic ocean is now navigable” at times in the summer, said Mark Serreze, director of the National Snow and Ice Data Center.

The vast majority of glaciers around the world have shrunk. A NASA satellite that measures shifts in gravity calculated that Earth’s glaciers lost 279 billion tons of ice — nearly 67 trillion gallons of water — from 2002 to 2017. In 1986, the Begich Boggs visitor center at Alaska’s Chugach National Forest opened to highlight the Portage glacier. But the glacier keeps shrinking.

“You absolutely cannot see it from the visitor center and you haven’t in the last 15 or so years,” said climatologist Brian Brettschneider of the University of Alaska Fairbanks.

Ice sheets in Greenland and West Antarctica have also shriveled, melting about 455 billion tons of ice into water, according to the NASA satellite. That’s enough to cover the state of Georgia in water nearly 9 feet deep.

Sea level

And it is enough — coupled with all the other melting ice — to raise the level of the seas. Overall, NASA satellites have shown three inches of sea level rise (75 millimeters) in just the past 25 years.

With more than 70 percent of the Earth covered by oceans, a 3-inch increase means about 6,500 cubic miles (27,150 cubic km) of extra water. That’s enough to cover the entire United States with water about 9 feet deep.

It’s a fitting metaphor for climate change, say scientists: We’re in deep, and getting deeper.

“Thirty years ago, we may have seen this coming as a train in the distance,” NOAA’s Arndt said. “The train is in our living room now.”
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Exhausted but relieved, Yariani Flores lay next to her healthy newborn son, along with four other Venezuelan women who just gave birth in a hospital in Colombia’s border city of Cucuta.

Thousands of Venezuelan women have done the same over the past few years, as the health system in their home country has crumbled. They crossed the border, driven by fear that they or their babies could die.

Early in her pregnancy, Flores sought a pre-natal checkup at a municipal hospital in Venezuela’s frontier state of Tachira only to be told that there was little point.

“The doctor said, ‘Don’t bother coming here, I can’t do much for you,'” said Flores, lying in the 12-bed maternity ward at Cucuta’s Erasmo Meoz University Hospital. “She recommended I come to Cucuta and have the birth here.”

Venezuela’s economic crisis has laid waste to its health system. The numbers of babies and women dying during or after childbirth have soared, while medicines and supplies have become increasingly scarce.

“You have to bring everything to the hospital in Venezuela,” said Flores, a 33-year-old mother of five. “There aren’t even any surgical gloves.”

A March survey of 137 hospitals, led by the opposition-dominated Congress, showed that they often lack basic equipment like catheters, as well as incubators and x-ray units.

Venezuelan hospitals are also plagued by water and electricity outages, and only 7 percent of emergency services are fully operative, the survey found.

Infant mortality in the oil-rich nation rose 30 percent last year, according to latest government data. Maternal mortality – dying during pregnancy or within 42 days of giving birth – shot up by 65 percent.

Healthcare Overwhelmed

Venezuela’s economic meltdown, including hyperinflation, is now putting a financial strain on the health system in Cucuta and other Colombian cities.

Nearly 820,000 Venezuelans have left their homeland to live in Colombia during the last 15 months, with arrivals expected to continue, according to Colombian authorities.

Cucuta, the largest city along the porous frontier and separated by a bridge that connects with Venezuela, has borne the brunt of the influx.

At the main hospital alone, Erasmo Meoz, about 14,000 Venezuelan patients have been treated in the past three years, most with no health insurance, said Juan Agustin Ramirez, director of the 500-bed facility.

The hospital has debts of about $6 million accumulated to care for Venezuelans, which the Colombian government has yet to reimburse as it promised last year, Ramirez said.

“This has created a financial crisis … and there comes a time when we collapse,” he said.

Until recently, the hospital treated only a few Venezuelans, mostly for road injuries, Ramirez said.

But now, on any given day, up to one in five patients at the hospital is Venezuelan, and its crowded emergency ward is overwhelmed.

Many are children suffering skin diseases, diarrhea and respiratory problems. Others are women who have high risk pregnancies and arrive malnourished, having had few or no pre-natal checkups.

“It’s a sign that something serious is happening with public health in Venezuela,” Ramirez told the Thomson Reuters Foundation.

Brother Nation

Ramirez said Colombia has a duty to help Venezuelans.

Colombians often refer to Venezuelans as their “brothers,” as they share close cultural and family ties.

In past decades, it was Venezuela that opened its doors to millions of Colombians fleeing civil war. Many found jobs and cutting-edge medical care in the once prosperous nation, Ramirez said.

“We can’t forget that during all these years of violence in Colombia, four to five million Colombians went to Venezuela where they were given services for free,” Ramirez said. “We have an immense debt with Venezuela.”

In the past year, about 54,500 Venezuelan migrants have received emergency care in public hospitals across Colombia, according to authorities, while nearly 200,000 have been vaccinated, many at border crossings.

But only patients needing emergency care, including pregnant women, get free treatment.

Those with chronic illnesses, like cancer, kidney failure, and HIV/AIDS are turned away because of a lack of resources.

“For those poor people, the situation is catastrophic,” Ramirez said.

Earlier this month, the Organization of American States reiterated its call on Venezuela to allow international aid into the country, to ease what it has described a “humanitarian crisis.”

Many expect the migration to continue following the re-election of Venezuela’s socialist President Nicolas Maduro last month, which the United States called “a sham” and many countries refused to recognize.

“We are not prepared, nor are we going to be prepared, if there’s a bigger exodus of citizens from Venezuela as conditions deteriorate even more,” Ramirez said.

Malnutrition

Another casualty of Venezuela’s crisis was laid bare at the hospital’s children’s ward.

A severely underweight four-month-old baby from Venezuela’s Yukpa tribe slept, hooked up to an intravenous tube to help him recover from malnutrition.

About 200 Yukpas have fled hunger in their ancestral lands.

They now live in ragged, makeshift tents just inside Colombia, near the border crossing.

Across town at a shelter run by the Scalabrini International Migration Network, a Catholic organization for migrant aid, pregnant women are given priority while other Venezuelans sleep on cardboard outside, waiting for a bed and a hot meal.

Keila Diaz, 23, who is heavily pregnant with her second child, came to the shelter with her husband in May. When the contractions start, she said, she will head to the hospital.

“I’m afraid to have my baby in Venezuela. Babies die, mothers die giving birth over there,” said Diaz, gently rubbing her bulging belly. “I have a better chance here.”
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Women must be at the heart of climate action if the world is to limit the deadly impact of disasters such as floods, former Irish president and U.N. rights commissioner Mary Robinson said on Monday.

Robinson, also a former U.N. climate envoy, said women were most adversely affected by disasters and yet are rarely “put front and center” of efforts to protect the most vulnerable.

“Climate change is a man-made problem and must have a feminist solution,” she said at a meeting of climate experts at London’s Marshall Institute for Philanthropy and Entrepreneurship.

“Feminism doesn’t mean excluding men, it’s about being more inclusive of women and – in this case – acknowledging the role they can play in tackling climate change.”

Research has shown that women’s vulnerabilities are exposed during the chaos of cyclones, earthquakes and floods, according to the British think-tank Overseas Development Institute.

In many developing countries, for example, women are involved in food production, but are not allowed to manage the cash earned by selling their crops, said Robinson.

The lack of access to financial resources can hamper their ability to cope with extreme weather, she told the Thomson Reuters Foundation on the sidelines of the event.

“Women all over the world are … on the front lines of the fall-out from climate change and therefore on the forefront of climate action,” said Natalie Samarasinghe, executive director of Britain’s United Nations Association.

“What we — the international community — need to do is talk to them, learn from them and support them in scaling up what they know works best in their communities,” she said at the meeting.

Robinson served as Irish president from 1990-1997 before taking over as the U.N. High Commissioner for Human Rights, and now leads a foundation devoted to climate justice.
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