Cameroon struggles to cope with cholera outbreak

A raft of international aid agencies is rushing urgent supplies to Cameroon as the country deals with its worst outbreak of cholera in six years. The outbreak started in May in the country’s Far North region and subsequently spread to the neighbouring North region causing over 2,199 confirmed cases of cholera resulting in 163 deaths. UNICEF and other agencies are rapidly distributing supplies for medical workers and water treatment kits for families, along with medication. The waterborne infection is highly contagious yet is easily preventable with clean water and sanitation.

Over five million people live in the Far North and North regions of Cameroon and the regions share borders with Nigeria, Chad and the Central African Republic. Parts of the Far North region have suffered extensive flooding over the past month, leaving many communities increasingly vulnerable to disease. UNICEF said it was concerned that any further spread of the outbreak could have serious consequences for women and children across the sub-region. Al Jazeera has reported outbreaks in Chad and Nigeria with 400 deaths in these two countries in the past few months.

The latest outbreak was triggered by unusually heavy rains which caused severe flooding and landslides. The landslides submerged houses and made traditional pit toilets unusable. Safe drinking water is rare in the Far North region due to drought and the poor are turning to untreated water from hand-dug wells, increasing the region's vulnerability to cholera and other water-linked diseases. Authorities have begun disinfecting wells and other water points and are urging communities to practice proper hygiene. “We are urging people to be careful with the food and water they consume, and with how they handle the remains of people who died of cholera,” one official said.

All 13 regional hospitals in the Far North are full with little or no room to treat any more cases. Cameroon minister of public health Andre Mama Fouda said the risk of cholera spreading further south was very high with Cameroon still in the middle of its rainy season. "We are calling on the population to adopt strict personal hygiene and follow food and water consumption guidelines,” he said. “They should avoid drinking unchlorinated water and eating at makeshift street markets where food is not well preserved.”

Superstition is hampering relief efforts. Some communities have stopped attributing the increasing number of deaths to cholera. A volunteer leading said the hardest thing was stopping people from being sceptical. “For example, they believe that if you're not a sorcerer, cholera can't get you, and so it only affects sorcerers,” he said. Another volunteer said local religious leaders told everyone to stay away from the fields because of the risk of getting cholera. The volunteers’ message to people is simple: stop defecating in the open, use latrines, wash hands with soap and boil all water before use.

According to the World Health Organisation, cholera is an acute diarrhoeal disease that can kill within hours if left untreated. The infection is caused by ingestion of food or water contaminated with the bacterium vibrio cholerae. The short incubation period of between two hours to five days can make an outbreak explosive in its impact. There are up to five million cases every year with 120,000 fatalities. Control measures rely on prevention, preparedness and response.

80 percent of cases can be successfully treated with oral rehydration salts. But oral rehydration treatments remain scarce in the world's poorest countries. Some have blamed Big Pharma for making drug treatments too expensive but writing in The Wall Street Journal Alec Van Gelder of the International Policy Network does not agree. He puts the blame on lack of investment in domestic health care infrastructure. He said that in July's AU summit, leaders were confronted with WHO figures showing that only six member countries have met their 2001 pledge to invest 15 percent of their national output on health care. “The real global public health problem is that for every aid dollar African governments receive for health care they divert up to $1.14 of their own resources to other areas,” Van Gelder said.

Chad and Niger: Neighbours in crisis

Two UN humanitarian coordinators have said the central African countries of Chad and Niger are on the verge of widescale famine. Michele Flavigna, the UN representative in Chad told a news conference last week almost one in five people are starving in that country. “Two million Chadians, or 18 percent of the population, are in a situation of food insecurity," he said. "A great deal needs to be done to counter this grave problem," he said.

Neighboring Niger is also facing a severe food shortage that could affect 7.8 million people, according to one estimate released in late January. Niger’s situation is worsened by political woes as its government was overthrown last week in a military coup. A junta calling itself the Supreme Council for the Restoration of Democracy stormed the presidential palace and captured president Mamadou Tandja and his ministers in a four-hour gunbattle that left at least three people dead. The junta gave no indication of how long it intended to hold power but called on the people and the international community to support its actions. A UN official in Dakar said Niger needs a stable government to address the food crisis, and urged the new military junta to move swiftly to set elections.

In Chad, drought has led to a 35 percent fall in crop production leading to severe food shortages. The rate of global acute malnutrition for children under five in the worst-affected areas stands at almost 30 percent - almost double the emergency threshold set by the World Health Organisation. The UN is transporting 30,000 tonnes of food aid into the country from its regional supply base in Cameroon, but says tackling malnutrition will be difficult due to a shortage of human resources and functioning rural health facilities. They are calling on NGOs to increase their number of personnel who can intervene on the ground.

In Niger the approaching food crisis has prompted the UN and NGO partners to issue an appeal for aid internationally. Malek Triki, public information officer for the World Food Program said Niger is facing a structural state of high acute malnutrition and has one of the highest rates of population increase in the world. “It also has a harsh environment, made even worse by climate change and the poor management of environmental resources,” he said. The situation is similar to the 2005 famine though the chaos over the coup is unlikely to help relief efforts.

Both Niger and Chad are in the Sahel desert region which faces perennial food shortages due to unpredictable rains that can cut into crop yields and the region's poverty has been aggravated by various rebel conflicts. The weather in the Sahel is influenced by the erratic behaviour of the Atlantic Multidecadal Oscillation (similar to the El Nino Southern Oscillation that causes such havoc with weather patterns in the South Pacific). Both Niger and Chad had an unusually short rainy season in 2009 leading to fears for this year’s crop.

Both Niger and Chad are already near the bottom of the UN Human Development Index, a composite benchmark that includes literacy rates, life expectancy and economic wealth measures. Chad is ranked 175 and Niger is ranked rock bottom at 182. Niger’s life expectancy is just 50.8 years (Australia’s is 81.4), just 28.7 percent of people over 15 are literate and the per capita GDP is $627 (Australia’s is $34,923 with Liechtenstein the world’s highest at $85, 382). Chad’s figures aren’t much better. Life expectancy is actually worse than Niger’s at just 48.6 years. Adult literacy is 31.8 percent and GDP per capita is $1,477.

Chad’s problems have been exacerbated in recent years by an influx of refugees fleeing the fighting in neighbouring Darfur. Tensions between ethnic groups in the north and in the south of the country have further contributed to political and economic instability. Niger is still recovering from the 2005 famine with child malnutrition a critical issue. Agriculture is the mainstay of Niger’s weak economy, with 82 percent of the population relying on farming. Its story is one of entrenched and deepening poverty with little interest or attention from the outside world.

UN Security council supports Chad’s government against rebel assault

The UN Security Council yesterday condemned rebel attempts to seize power in Chad and called on all countries in the region to co-operate to end the war. The council welcomed the AU decision to mandate Libyan leader Gaddafy and Republic of Congo leader Denis Nguesso to commence negotiations with both sides of the conflict and to initiate efforts aimed to seeking a lasting solution to the crisis. The council also pledged its support for the two international missions to Chad, the United Nations Mission in the Central African Republic and Chad (MINURCAT) and the European Union force (EUFOR TCHAD/RCA) and called upon member states to “provide support as requested'' by the government.

According to many media, including the London Daily Telegraph, the Security Council call was a coded message for France to intervene in the crisis. France is the former colonial power and already has almost two thousand troops in the country. It has been a strong backer of the current administration with weapons and military intelligence. The Telegraph quoted Zalmay Khalilzad, the US ambassador to the UN, who said that if the French decide to intervene, they have the support of the Security Council.

Last week, Chadian rebels launched a major military offensive that reached the capital N’Djaména on the weekend. Government forces countered with tanks and attack helicopters and by Sunday night the rebels were forced into a “tactical” withdrawal from the city. Human Rights Watch (HRW) has called on the Chadian government to ensure that it clearly distinguish between civilians and military targets and asked that both sides not put civilians at risk. There have also been reports of arrests of opposition politicians. HRW said they were concerned that the Chadian government was using the fighting as a pretext for settling scores with the unarmed opposition.

The French foreign minister said the Chadian government was in control of the capital N'Djamena "for the time being". Thousands of people fled the city during a lull in fighting, urged by the rebels. Waves of refugees carried blankets and bed sheets on their heads and crossed a drought-stricken river to get to neighbouring Cameroon. The normal 30 minute trip to cross the Chari River into Cameroon is taking ten hours. There is no firm number on the dead so far. According to one aid worker "There are many deaths, the morgue is full and the Chadian Red Cross will not start picking up bodies from the roads until tomorrow”.

The conflict is related to the problems in the Darfur region of western Sudan. Long-term Chadian President Idriss Deby's has accused Sudan of backing the militants attacking N'Djamena, while Sudan accuses Chad of supporting rebels in Darfur. The Chadian rebels are from the Unified Military Command, an umbrella group of anti-Deby forces. The war in Chad intensified last year after the collapse of a Libyan brokered ceasefire between Chad and four rebel groups.

The conflict is delaying the deployment of the outside military force EUFOR TCHAD/RCA. This EU-led bridging operation in eastern Chad and north-eastern Central African Republic was authorized by UN Security Council resolution 1778 last year to “contribute to the protection of vulnerable civilian populations and to facilitate the provision of humanitarian assistance”.

The council also approved the establishment of a UN Mission in Chad and the Central African Republic (MINURCAT) and authorised the EU to deploy forces in these countries for a period of 12 months. But EUFOR has been delayed and won't start until the fighting stops in Chad. This is a ridiculous catch-22 situation; EUFOR is waiting for the situation to improve so they can implement their mandate to “protect civilians in danger”. Once again, Africa weeps while Europe dithers.

War escalates in Chad

Chad’s army has launched a major offensive against two of the rebel groups massed in the east of the country close to the border with Darfur. For the last two days government troops have attacked fighters of the Rally of Forces for Change (RFC), a fact confirmed by an RFC spokesman. The fighting comes barely a week after government forces fought several major battles with the Union of Forces for Democracy and Development (UFDD) that left hundreds dead.

The RFC said its positions had been bombed by Chadian helicopters on Saturday. That same day Chadian Foreign Minister Ahmat Allami said RFC rebel forces had clashed with government forces around Kalait, about 200km north of regional capital Abeche. Meanwhile 100km east of Abeche at Abougouleigne, military sources said battles between the government and the UFDD left "several hundred (rebels) dead, several injured and several prisoners of war" in military custody.

Hostilities have broken out after the collapse of a Libyan brokered ceasefire in October between Chad and four rebel groups (including the RFC and the UFDD). N'Djamena blames Sudan for backing the UFDD. The conflict is intertwined with the one in Darfur. Chad's president is from the same ethnic group as some of Darfuri rebels who oppose Sudan’s Arab-dominated government, and each country accuses the other of supporting rebel groups on their soil. London based African analyst Rolake Akinola said the peace deal was not well respected and was very complex to begin with. "Commitment from both groups and both sides has been very shaky," he said. "On the one hand, the rebels have accused N'Djamena and the government of failing to attend Sudan for peace talks. The government itself is not entirely sure how it is going to accommodate the various ethno-regional interests into one political dispensation.

The fighting could push back the deployment of a planned European force to the region until January. On 1 December the UFDD declared war against the French and other foreign military forces involved in the EU mission. They released a statement saying it "considers itself to be in a state of war against the French army or against any other foreign forces on national territory". France already has troops in the country and the UFDD said French warplanes had overflown rebel positions. “Providing diplomatic, strategic and logistical support to the tyrant Idriss Deby (Chad’s president) is an act of hostility and will be treated as such," the UFDD said.

French President Sarkozy said the declaration of war would have no effect on the planned EU mission to Chad. France will make up half of the 3,500 force, with Ireland, Austria, Netherlands, Poland and Sweden also contributing. The operation will go ahead," said Sarkozy. "If we decided to send a European force to one side of the border and a mixed force on the other side it is because there are problems, conflicts, difficulties.”

There is no doubt this is a complex war. Initially a fight between nomadic Arab tribes and settled African farmers, the conflicts in Chad and Darfur have grown increasingly complicated as rebel groups splintered and formed new alliances. Anarchic bandits have taken advantage of the lawlessness to attack civilians, and local politicians do what they do everywhere and used ethnic rivalries to fan the violence. According to the UN High Commissioner for Refugees an estimated 180,000 Chadians have been internally displaced by the wars which erupted in 2005 and again in 2006 and 2007.

The proposed EU force is widely recognised as strengthening Chadian President Deby's regime. Idriss Deby has been in power since 1990 when he seized power from former dictator Hissène Habré. Before being overthrown in Habré unleashed his troops on a killing spree in the capital N’Djamena. Thousands died. Habré drained the treasury of millions, fled the country and left much of the capital in ruins. Deby was treated as the country’s liberator. But many observers believe he has now stayed in power for too long. He won his third election victory in 2006. Outsiders declared the election fair but opposition parties boycotted the ballot denouncing the process as a sham.

While Deby's shenanigans in Chad were neglected for many years, that has all changed with a new and thriving export market in oil. It was discovered in the Doba Basin in the south of the country in 1974 and established in commercial quantities in 1996. A consortium of Shell, Exxon-Mobil and Elf relied on a 1070km oil pipeline between Doba and Cameroon’s coast to be financed by a $3.6 billion loan from the World Bank. The project was delayed by fights between the multinationals and local environment groups who accused the World Bank of ‘corporate welfare’. The project was delayed by Shell and Elf pulling out and the difficulties of laying the pipe through heavily populated areas in Cameroon.

When the project was finally completed in 2003, Chad began exporting oil on a significant basis. But Chad’s government reneged on the World Bank conditions that profits would go to poverty alleviation programs and gave itself more discretion to spend the oil revenue as it pleased. At least $30 million was diverted to President Deby’s military programs. In response the World Bank froze large sums of development aid and suspended its loan programme to Chad over the government's breech of the agreement.

The problem as Asuman Bisiika reports is one common to many African countries: where there are no strong national institutions, it is very difficult to stop a small group of political elite from "eating" public funds under their trust. Deby has shown he has a big appetite. The question is who is prepared to clean up after him.

Zoe's Ark group tried for kidnapping children in Chad

Ten French and Spanish citizens appeared in court today in Chad charged for their role in a mass child kidnapping case. Six of the ten are members of the organisation Zoe's Ark, which was attempting to transfer 103 orphaned children from Darfur to France for foster care. They claimed they had the right to do so under international law. That claim is refuted by UN and Chadian officials say most of the 103 children (all under ten years old) were neither orphans nor Sudanese. Most have at least one living parent on the Chadian side of the crisis-ridden Sudanese border area.

Three French journalists working with Zoe’s Ark were released on Sunday. Journalist Marc Garmirian, who works for French news agency CAPA, said the group had lied about their plans and released film footage showing they had put bandages on the children to feign injury. The footage shows the convoy heading to Abeche airport in eastern Chad. Zoe’s Ark staff can be seen putting fake wounds on the children to convince officials they are evacuating them for health reasons. "You could say that they are lunatics,” Garmirian said. “Up until the moment I left the prison, [Zoe’s Ark] remained convinced that their mission was legitimate.”

Zoe’s Ark (L'Arche de Zoe) was formed by members of the French four-wheel-drive community to aid victims of the December 2004 Indian Ocean tsunami. They set up four temporary camps in Banda Aceh in Sumatra in the wake of the tsunami. The group has about 50 volunteers. Its founder, Eric Breteau, is a volunteer fireman and Zoe's Ark says it is motivated by the firefighter's spirit and sense of duty. In April, Zoe's Ark announced a campaign to evacuate 10,000 orphans from Darfur.

Its plan was to place young orphaned children from Darfur in foster care with French families, invoking its right to do so under international law. They sent a seven person team, including a doctor, a nurse and fire-fighters, to Chad. There the group sought authorisation from France to grant safe passage to the children. In August however, the French Foreign Ministry issued a warning saying there was no guarantee the children were orphans and also cast doubt on the project's legality.

On Tuesday last week, local authorities arrested 17 Europeans and 4 Chadians on charges of kidnapping and complicity. Those arrested included Zoe’s Ark head Eric Breteau. In the first hearing Breteau claimed the children were from Sudan not Chad. He also spoke in support of the journalists and aircrew arrested with him, saying only he and his fellow charity workers were responsible for the operation. The main accused face possible forced labour terms of five to 20 years.

The stakes were raised dramatically on the weekend when French President Nicolas Sarkozy became involved. He flew to Chad on Sunday and arranged to free the three French journalists and four Spanish flight attendants. But Chad’s president Idriss Deby ruled out a French demand to extradite the remaining ten accused to France for trial. Deby said justice would be done in Chad. “It is out of the question for the Chadian judiciary to abandon the case,” he said. “On the contrary, the Chadian judiciary will get to the bottom of it”.

Deby has ruled Chad since 1990 but the floods of refugees crossing the border from Darfur have destabilised his regime. Over 200,000 refugees have crammed into the town of Abeche where the Zoe’s Ark group were based. Deby has tried to maintain a neutral stance in the conflict but he has faced internal criticism for lack of support for his Zagawa kinsmen slaughtered across the border in Sudan by the pro-government Janjaweed militia. Deby survived a mutiny in 2004 and an undeclared war has existed between the two countries since 2005.

Chad claims Sudan is trying to destroy his regime by allowing Sudanese militia make daily incursions across the border. Although the two sides signed the Tripoli Agreement in 2006 to end the conflict, rebel groups inside Chad have continued their attacks on government forces. A European peace force is expected to be deployed early next year in eastern Chad to protect Sudanese and Chadian refugees. Meanwhile the war is a humanitarian crisis that Zoe’s Ark wanted to exploit. They lined up 300 families in France who paid between €2,000 and €6,000 for an orphaned child from the region. While the French families feel conned, there is also great anger in Chad. Several hundred locals gathered outside the governor's office in Abeche, where the Europeans were being held and chanted: "No to the slave trade, no to child trafficking."

The battle for Chad's oil

The Central African country of Chad is the scene of an intriguing battle of wills involving a corrupt local government, big oil, Darfur and the World Bank. Chad is one of the world’s newest oil exporters and produces 160,000 barrels of crude oil a day which amounts to 6.7 million gallons of oil (there are 42 gallons to the barrel according to BP.) That’s a lot of oil but nowhere near the big league players. In 2004 middle ranking countries such as the UK and Venezuela both produced over two million barrels a day and top-dog Saudi Arabia produced ten million a day. Nonetheless Chad’s oil industry is a significant part of the economy of the 5th poorest country in the world. The landlocked former French colony in the “dead heart of Africa” is now looking to take more control of its oil industry.

On 26 August, President Idriss Déby announced he was kicking the US oil company Chevron and Malaysian-owned Petronas out of the country for non-payment of taxes. Together these two companies own 60% of the consortium running Chad's $4bn oil pipeline. In a statement on state radio he gave the companies a deadline of 24 hours to start making its exit plans. Deby claimed the international companies had avoided paying tax and Chad would now take over the running of its own oil fields.

Chad is one of the newest oil exporting countries in the world, first coming online in 2003. It is not a member of OPEC and uses its oil revenues to subsidise its most poor agricultural economy. Chad has long been handicapped by its landlocked position, poor communication networks, high energy costs, scarce water and a history of political instability. The oil finds are starting to transform a country that previously relied on foreign aid and capital for public and private sector projects. Exxon-Mobil led the consortium that included Chevron and Petronas. The 1000 km oil pipeline was partially funded by the World Bank and links its southern oilfields to terminals on the Atlantic Ocean via Cameroon. In the two years from 2003-2005 Chad earned $US 307 million in oil revenues which amounts to 12.5% on each barrel exported.

However, at least $30 million of this was diverted to buy arms to keep Deby in power. This has placed them directly in conflict with the World Bank and its new President ex-Bush staffer Paul Wolfowitz. According to Forbes, Chad is now the most corrupt country in the world. Idriss Deby has been in power since a coup in 1990. He graduated from the army where he was Commander-in-Chief in the 1980s. He was forced to flee to Libya and Sudan after being accused by then-president Hissène Habré, but organised an insurgent group which eventually took the capital, N'Djaména in December 1990. He has since been elected three times as president in 1996, 2001 and May this year. Each victory occurred under a cloud of electoral irregularity and the opposition boycotted the latest May poll.

Chad fought a costly war with its western neighbour Sudan between 2005 and early this year which was an overflow from the catastrophic Darfur conflict. The conflict started with a border incursion by Sudan which killed 100 people in the Chadian town of Adre. It escalated to involve troops from countries, as well as France and independent military groups such as the notorious Janjaweed group responsible for many of the atrocities in Darfur. In February the two sides signed a peace agreement in Libya. The accord lasted just two months until rebel forces attacked the Chad capital N'Djamena. Deby kept control but was forced to dig deep into his oil reserves to finance his campaigns.

In July, Chad and the World Bank signed a Memorandum of Understanding under which the Government of Chad has committed 70 percent of its budget spending to priority poverty reduction programs, and provided for long-term growth and opportunity by creating a stabilization fund. In September Chevron announced they would pay an unspecified amount of additional taxes in return for being allowed to stay in the country. Though Deby has declared Chad's newly created oil company, Société des Hydrocarbures du Tchad (SHT), should have a 60% stake in the oil pipeline, the country does not yet have the capacity to run its own industry.

What Chad desperately needs now is a lasting peace so that the agreement hammered out with the World Bank can be honoured for its long suffering people. With Darfur still in turmoil, it looks a doubtful prospect.