Stephen, 12, romps confidently around the sunlit courtyard, weaving in between wheelchair-bound patients as he plays with the other children, his prosthetic leg barely a hindrance.
When he was five years old, the car he and his family were travelling in hit a landmine in South Sudan’s northern town of Bentiu. His grandmother was killed. His left leg was shattered and had to be amputated.
Stephen was flown to a physical rehabilitation centre run by the International Committee of the Red Cross (ICRC) in Juba, which serves both as a prosthetics factory and a hospital for patients coming from all around the country to be fitted with new limbs.
“It helped me to go to school,” Stephen says shyly, pointing to his artificial leg.
After receiving his first prosthesis in 2013, war prevented Stephen from being able to return for new fittings every six months as recommended.
When he finally made it to the centre this month, his prosthesis was far too short.
South Sudan’s five-year-long civil war has left possibly tens of thousands of people without limbs — a toll that may never be accurately established.
But much of the country faces limited access to healthcare, a result of fighting or simply a lack of infrastructure, with roads typically being utterly impassable during the rainy season.
Many limbs are amputated for no other reason than lack of treatment.
“A simple injury or fracture that could be treated easily in most countries… can result in infections here which result in an amputation because of problems with healthcare,” said ICRC prosthetic specialist Regis Tiffeneau.
“The large majority of patients are affected by the war in one way or the other.”
Others became disabled by polio, rickets – linked to malnutrition – or other diseases that have been eliminated in so many other parts of the world.
Lack of access
In the factory, plaster is slapped on models of legs whirring on machines as workers shape them and then slather them in dark brown plastic.
Workshop manager Emmanuel Loubari said that the prosthesis can be made within a day of a patient being measured and a cast taken. Last year the centre made 580 prosthetic limbs, with the cost of all treatment borne by the ICRC.
But many challenges face patients who need to get fittings.
“We have a lot of patients who are supposed to be fitted, but they cannot have access to the centre,” Loubari said.
In South Sudan, roads are so bad that the ICRC relies on a fleet of planes and helicopters to bring patients to hospitals and the physical rehabilitation centres.
In the rainy season, it can be hard to land in many remote locations.
Bringing people from across the country, injured in fighting mostly of an ethnic nature, brings its own problems.
“They come here, they are traumatised, most of them are injured by gunshots and mines,” said social worker James Soma. “We talk to them about forgiveness.”
He said an argument had broken out the previous day in which one patient accused another of targeting her because of her tribe, and said she would “bring one of my relatives and shoot you all.”
Toddlers shot on mothers’ backs
For those who have used a prosthesis before, like Stephen, it takes only two or three days before they are ready to go home. But for new
Other patients at the centre currently include a young man with severe scoliosis — a curved spine — who was being taken to school in a wheelbarrow until he was brought in to get a customised wheelchair.
Another was bitten by a snake and was not treated for almost two weeks, so his leg had to be amputated.
“We have a lot of children coming in,” said physiotherapist Oketta Robert Kanyara. “We have five children in the centre, shot in different styles… We have children shot while tied to their mothers’ backs.”
Five-year-old Laytol was probably bitten by a snake. Her mother comes from the Murle people, and the doctors have difficulty understanding the language. But they believe her leg “could probably have been saved” if she had got help in time.
Laytol is trying out her new leg for the first time, balancing herself calmly between two metal bars.
Kanyara, the physiotherapist, said training children requires using games, as they do not understand the idea of shifting their weight and struggle to follow instructions.
But progress can be made. When the physiotherapist started work with Stephen, the boy who lost his leg in a landmine in 2013, the challenges were many.
“It was very, very difficult,” Kanyara said. “You tell him to do weight bearing, but he starts crying, so you have to go slowly.”
Little Laytol took to her new leg more quickly.
“She is very good,” Kanyara said. “She is fitted today, and she is not crying. She is walking.”
Prime Minister under Muammar Gaddafi’s rule freed in Libya
Mahmoudi was arrested in September 2011 as he tried to flee across the border to Tunisia, and was extradited to Libya
Baghdadi al-Mahmoudi, Libya’s last prime minister under ousted dictator Muammar Gaddafi, has been released from jail for health reasons four years after being sentenced to death, Tripoli’s justice ministry said Saturday.
Mahmoudi, in his 70s, was premier when a NATO-backed uprising in 2011 toppled and killed Gaddafi.
He was handed the death sentence in July 2014 along with eight other Gaddafi-era officials including the leader’s son Seif al-Islam, over their alleged role in a bloody crackdown on protesters.
The justice ministry said Mahmoudi was released “for health reasons” at the recommendation of a medical commission “so that he could be treated at specialised medical centres”.
It gave no further details on the nature of his illness or when he was liberated.
Mahmoudi was arrested in September 2011 as he tried to flee across the border to Tunisia, and was extradited to Libya the following year.
During his detention in Tunisia, he claimed that Libya had financed the 2007 election campaign of former French president Nicolas Sarkozy, according to his lawyers.
The French ex-president vehemently denied the allegations, initially made by Seif al-Islam.
But Sarkozy was charged in March 2018 over accusations he accepted millions of euros from Gaddafi.
The battle for women’s rights in ‘new’ Sudan is not yet over
We will no longer wait for our rights, we will fight to obtain them,” – Amani Osmane
She may have spent 40 days in jail for demonstrating against President Omar al-Bashir who has since been toppled but activist Amani Osmane says the battle for women’s rights in Sudan is far from over.
Women have been at the forefront of the revolt which led to Bashir’s overthrow by the military on April 11 after three decades of iron-fisted rule.
Osmane, who is also a lawyer, was detained on the evening of January 12 and escorted to “the fridge”, a grim room where interrogations are paired with extreme cold.
“There are no windows, nothing, just air conditioning at full blast and the lights on 24/7,” she told AFP.
The fridge is part of a detention centre run by the all-powerful National Intelligence and Security Service (NISS) in a building on the Blue Nile that runs through Khartoum.
Dozens of activists and political opponents of Bashir’s regime have passed through what NISS agents cynically refer to as “the hotel”.
Osmane, who spent 40 days behind bars after a frigid seven hours of questioning, said she was arrested “contrary to all laws… because I stand up for women in a country where they have no rights”.
Another activist, Salwa Mohamed, 21, took part each day in protests at a camp outside the army headquarters in central Khartoum that became the epicentre of the anti-Bashir revolt.
Her aim was “to have the voice of women heard” in a Muslim country where she “cannot go out alone, study abroad or dress the way I want”.
Student Alaa Salah emerged as a singing symbol of the protest movement after a picture of her in a white robe leading chanting crowds from atop a car went viral on social media.
Portraits of Salah — dubbed “Kandaka”, or Nubian queen, online — have sprouted on murals across Khartoum, paying tribute to the prominent role played by women in the revolt.
‘We will no longer wait’
The unrest which has gripped Sudan since bread riots in December that led to the anti-Bashir uprising left scores dead.
Doctors linked to the protest movement say that 246 people have been killed since the nationwide uprising erupted, including 127 people on June 3 when armed men raided the protest camp in Khartoum.
On Wednesday, protesters and the generals who took over from Bashir finally inked a deal that aims to install a civilian administration, a key demand of demonstrators since his fall three months ago.
The accord stipulates that a new transitional ruling body be established, comprised of six civilians and five military representatives.
A general will head the ruling body during the first 21 months of a transition, followed by a civilian for the remaining 18 months, according to the framework agreement.
“We will no longer wait for our rights, we will fight to obtain them,” said Osmane, stressing that women wanted 40 percent of seats in parliament.
Amira Altijani, a professor of English at the all-female Ahfad University in Omdurman, Khartoum’s twin city, said: “This movement is an opportunity for women to have their voice heard.”
For Osmane, Bashir “hijacked” sharia laws for three decades to oppress women.
“But a new Sudan is rising, with a civilian government that will allow equality,” she said.
Public clinics in Zimbabwe save lives with TB, diabetes and HIV treatments
the pilot clinics have become lifesavers for the poor – but only if they happen to live near them.
Blessing Chingwaru could barely walk without support when he arrived at the specialist Rutsanana clinic in Harare complaining of chest pains and fatigue.
Weighing a skeletal 37 kilogrammes (5.8 stone), the HIV-positive motor mechanic knew something was wrong.
He was immediately given a number of tests and told the bad news: He was also suffering from advanced-stage tuberculosis. Dual infection by HIV and TB is a notorious killer.
“My health was deteriorating and I kept wondering why,” Chingwaru, 29, recalled at the clinic.
Within hours of the diagnosis, Chingwaru was given free treatment and nursing care.
In a country where more than a dozen people die each day from TB-related sicknesses, it was a rare example of efficient public healthcare.
The Rutsanana Polyclinic in Harare is one of 10 pilot clinics in the country offering free diagnosis and treatment for TB, diabetes and HIV.
The clinic, which opened in 2016, is staffed by 24 nurses and currently treats 120 TB patients.
Among the million-plus people living with HIV in Zimbabwe, TB is the most common cause of death, according to the World Health Organization (WHO).
HIV-positive people, and others with weakened immune systems, are particularly vulnerable to contracting the infection.
After Chingwaru’s initial visit in February, doctors had feared for his life.
But following five months of careful treatment Chingwaru has gained 15 kilos.
“Everything I need, I get here,” said Chingwaru, forming fists with both hands to show off his regained strength.
Economic and financial challenges
In a country where public health services are faced with extreme challenges, containing the spread of TB has been a struggle.
Zimbabwe has been stuck in economic and financial crisis for a long time and many of its doctors are underpaid and under-equipped.
Although TB treatment is free, the annual number of TB infections in Zimbabwe remains among the highest in the world.
The contagious infection is usually found in the lungs and is caught by breathing in the bacteria from tiny droplets sneezed or coughed out.
As HIV-positive people are so vulnerable to TB, the clinics have followed the advice of WHO officials to link TB testing and treatment with HIV prevention programs.
Close to the main gate of the Rutsanana clinic, a green self-testing HIV tent has been erected to encourage people to check their status.
The clinic also offers voluntary HIV counselling and antiretroviral treatment.
Sithabiso Dube, a doctor with the medical charity International Union Against TB who heads the TB and HIV programme, said people with diabetes also have a higher risk of developing TB, so patients are tested for both diseases.
“Instead of going to seek diabetic care at one clinic and TB care at another, they are able to get these services in one place,” Dube told AFP.
Because services are free “they are able to cut down on what we call catastrophic costs to the TB patients,” she said.
Largely funded by a US Agency for International Development (USAID) programme, the pilot clinics have become lifesavers for the poor – but only if they happen to live near them.
The vast majority of the population have no access to the one-stop clinics.
As a result there are plans to scale up the programme, with another 46 similar centres to be rolled out across Zimbabwe.
Rutsanana clinic matron Angela Chikondo said the programme was crucial to minimising complications among TB and diabetes patients.
“If one is on TB treatment and also has diabetes, and the diabetes is well controlled, chances of recovering are very high,” she said.
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