Does the global HIV response understand sex?

Condoms, sure, but honest conversation? Photo: Wikimedia Commons

MELBOURNE, 28 August 2014 (IRIN) – Stigma, squeamishness and misunderstanding of anal sex is leading to research gaps and inaccurate information about the risks of this common sexual behaviour, and hindering effective HIV/AIDS prevention strategies, experts say. A move towards “sex positive” approaches could enhance social acceptance and increase protection.

“If we look at historical art depictions and carvings, heterosexual anal sex has been part of the human sexual repertoire for a long time. Not discussing anal sex and its relationship to HIV transmission leads people to making wrong assumptions about its risks,” Jim Pickett, director of prevention advocacy and gay men’s health at the AIDS Foundation of Chicago, told IRIN.

In 2011 the UN General Assembly issued its “Political Declaration on HIV/AIDS” which, among other goals, set the target of reducing sexual transmission of HIV by 50 percent by 2015.

According to the Joint UN Programme on HIV/AIDS (UNAIDS), the number of new HIV infections among adults in low- and middle-income countries in 2012 was 30 percent lower than in 2001, which the agency attributes in its 2013global report as: “primarily represent[ing] a reduction in sexual transmission.”

However, some experts warn, even with this decreased infection rate, the HIV response remains harmfully incomplete unless it begins to acknowledge a range of sexual behaviours, including those that are stigmatized, misunderstood, or deemed disgusting.

Mixed messages cause risky oversight

The risk of HIV transmission for anal intercourse is 18 times higher than for vaginal intercourse because the anus has thinner membranes and does not self-lubricate like the vagina – making it more prone to tears and lesions.

Historically interventions that mention anal sex have focused on men who have sex with men (MSM) and transgender women, who are often (wrongly, many argue) categorized as male for public health purposes. Research focused on MSM populations has uncovered some important facts about anal sex, including dangerous gaps in personal lubricant availability around the world.

Pickett argued that anti-sodomy laws further add to the stigmatization of anal sex and also link it to being something only MSM do.

Some 76 countries criminalize homosexuality in some way, many by specifically outlawing “sodomy” - often understood to be anal sex.

However, new evidence is emerging that the MSM focus may lead to assumptions that heterosexual intercourse does not include anal penetration and therefore sends the wrong message about who needs to protectthemselves.

study on the practice of heterosexual anal sex in five communities in Kenya, Tanzania and Uganda found that it is widely practiced for a variety of reasons including the preservation of virginity, contraception, economic gain and maintaining fidelity.

The 2009 National Survey of Sexual Health Promotion and Behavior by Indiana University in the US showed that among the men and women surveyed, around 45 percent admitted to having anal sex.

However, despite it being relatively common behaviour, there is a dearth of accurate information on it.

“Even though most people who have anal sex engage in it only occasionally, anal sex is a fairly common practice. And if people are going to engage in a sexual behavior, then they deserve enough information to help make that behavior as safe, pleasurable and satisfying as possible,” wrote Debby Herbenick, one of the authors of the 2009 survey, which was published in The Journal of Sexual Medicine.

Other experts agree, and argue that part of the reason anal sex gets overlooked is the reluctance to explore the behaviour in studies.

“We’re not asking, so people are not telling,” said Pickett who attributes this disinclination to stigma around the anus as a body part.

“We have been conditioned to think of it as filthy and unclean so we do not talk about it,” said Pickett, who coordinates the International Rectal Microbicide Advocates (IRMA), a global network that works to create “safe, effective, acceptable and accessible rectal microbicides for the women, men, and transgender individuals around the world who engage in anal intercourse.”

“If we cannot talk about all sex acts and what is risky and less risky, people cannot really make intelligent choices,” said Pickett.

Going “sex positive” with HIV messages

“Anal sex is one of the last taboos of the HIV world. It is not mentioned in campaigns targeting straight couples and leads to informal messaging that it is actually safe or there is no need to wear a condom,” said Anne Philpott, founder of The Pleasure Project, an organization that works with NGOs, sex counsellors and erotic film producers on incorporating “sex-positive” approaches to sex education.

A 2014 study published in the British Medical Journal revealed that the first experience of anal sex among teenagers was often painful and coercive. Many of the study’s participants, however, perceived anal sex as “safer” because they did not think it was possible to get sexually transmitted infections from it.

Easy access to pornography featuring anal sex scenes among heterosexual couples also contributes to the expectation that anal sex is part of the “standard sex routine”, the study suggested.

“About four percent of websites are now pornographic. We need to be proactive about creating more safe porn, and models of sex that do not legitimize unsafe sex,” added Philpott who explained that in countries where there is little or no sexuality education, pornography can become a default information source.

Philpott pointed out that unprotected anal sex also has a higher rate of infection for the receptive partner – in heterosexual couples, the woman. During anal sex without a condom, an insertive partner has about a one in 909 chance of HIV infection compared to a one in 154 chance for the receptive partner.

A 2008 National Health Statistics Report in the US showed that of the more than 13,000 respondents 36 percent of women and 44 percent of men reported having anal intercourse with the opposite sex.

However, a related study indicates that only 13 percent of receptive women used condoms during their past 10 anal intercourse events, compared to 44 percent of receptive men – a significant behavioural gap in heterosexual intercourse.

“Not even mentioning this risk to straight couples is a huge mistake. Not giving them tips and information on how to make anal sex safe is a huge loss,” said Philpott.

This was re-posted from IRIN News.

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[DASH of SAS] HIV: Young people are dying when they shouldn’t be

The numbers will tell you their own story of how HIV is a concentrated epidemic among men who have sex with men, between the ages of 20-29.

My Facebook newsfeed reads like something out of the 1980s.

I see a lot of short eulogies posted by friends paying homage to friends who have been taken before their time.

There is usually something consistent about these memorial tributes: the deceased is a young person – usually in their 20s – and the circumstances surrounding his passing are vague.

Sometimes a cause is mentioned: pneumonia, tuberculosis, meningitis. But often questions in the comments thread are swept under an answer of “gone too soon.”

Parallel to this are real life conversations that have crossed the digital divide, carried out in hushed whispers and muted grief.

Ranier Naldoza, 26, has heard at least two of these conversations. Once was at the wake of a friend where a relative of the deceased consoled him saying, “Don’t worry, at least now, he is in heaven.”

At another wake, he was discreetly informed that the testing and diagnosis for his deceased friend came too late for him to be treated. “Why he didn’t come to me, why he didn’t ask me for help?” Ranier wondered even though he already knew the answer.

Moral verdict

Ranier has been living with HIV since he was 19. He remembers all too well how difficult it is to muster the courage to get tested and disclose your HIV status.

“When first got tested, I asked my most trusted friend to go with me and he did. The day that I told him I tested positive was the last time I heard from him,” said Ranier.

“If someone I considered as my closest friend could shut me out like that, I figured anyone else could.”

Now, at 26, Rainer is the HIV focal person for the Family Planning Organization of the Philippines (FPOP) and has served as peer counselor in various organizations. He continues to see the difficulty of young people in accessing sexual health information and services.

“There is this ‘moral verdict’ that you’re too young to be asking (about) or doing those things,” he said about the silent and sometimes voiced accusation against a young person asking about sexual health matters.

HIV Rising

Every month the Department of Health – National Epidemiological Center (DOH-NEC) releases a surveillance report on the number of HIV infections in the country.

The numbers will tell you their own story of how HIV is a concentrated epidemic among men who have sex with men, between the ages of 20-29.

It was in 2007 when the DOH first warned the public about a spike in HIV cases and possible continuous uptrend if nothing is done. (Read: Is HIV going out of fashion?)

Scientific interpolation gave them the benefit of clairvoyance, while the denial of the general public and government’s downplay of the issue allowed for their prophecy to come true.

In 1984 when the DOH-NEC Registry first started, there were 2 reported HIV cases. As of the May 2014 report, there have been 2,320 cases since the start of the year.

There are an estimated 18,836 HIV reported cases in the Philippines. Activists and health workers say many more go unreported. (WATCH: Love in the time of HIV)

No one dies from HIV

“It’s true. We just might see what New York and San Francisco saw in the 80s. This is not hearsay,” said Chris Lagman, director for communications of Love Yourself, an organization that offers free HIV testing and counseling in partnership with the Research Institute for Tropical Medicine (RITM).

Chris and I could still remember those days in the 80s, a then unnamed disease swept through San Francisco and New York.

Chris and his friends had conversations that echoed the posts on my timeline years ago and decided to do something about it.

“Love Yourself was formed by a group of people who felt that they had lost one too many friends to HIV-related deaths,” said Chris who also started the blog Manila Gay Guy.

In the 3 years since the group was formed, Chris estimates that they have tested over 16,000 people, about 14% have tested positive.

“We still have 86% who are negative. We need to help them stay negative,” said Chris.

But he still gets keeps getting the same message.

“I hear news about someone dying about once a week. Once, I got news of as many as three people dying in one week,” Chris said.

He’s noticed another trend, too. Now women are coming in for testing when three years ago, they were not. And some women are testing positive.

“It’s (HIV) not a ghost story anymore. It really is happening. And it will continue to happen.”

Both Ranier and Chris say that late diagnosis and getting lost in follow up testing are common reasons why HIV is not treated or managed even though anti-retroviral (ARV) medication is available.

Chris, however, added another factor: love. “There are many we have counseled who don’t use or stop using condoms when they are in a serious monogamous relationship. That goes for both men and women.”

As they say, when you sleep with someone, you sleep with their (sexual) history. Monogamy cannot guarantee protection against sexual history or indiscretions.

Philippines losing against HIV

In just 30 years, scientists and epidemiologists have made incredible advancements starting with the discovery that HIV is the virus that causes AIDS. The Center for Disease Control (CDC) now classifies HIV as a “chronic, manageable disease.”

And yes, it’s true that no one dies from HIV. They die from opportunistic infections as a result of HIV. (This is likely why it is difficult to identify HIV-related deaths.)

In its simplest terms, the way that HIV works is that it attacks your immune system so your body gets sicker and sicker until it cannot fight off what they call “opportunistic infections” like pneumonia, tuberculosis, or meningitis.

“Sadly, HIV in the Philippines is fast rising,” Laurindo Garcia, a civil society advocate and founder of the social enterprise, B-Changetold me during the AIDS2014 conference in Melbourne, Australia. At a conference presentation, Laurdino showed a graph to show just how fast. “It was almost a straight vertical line. If there is any reason for us to be worried, it’s now. We are in crisis mode.”

“Two things have to happen,” said Laurindo. “First, the community has to speak up and make our voices heard. Second, the government has to acknowledge there is problem.”

Laurindo slammed the DOH’s recent move to push for mandatory testing as “an easy way out” that will only undermine current efforts to curb HIV.

Seeing the end of HIV in our lifetime

At the AIDS2014 conference, many scientific advancements in HIV prevention, treatment and care were reported. Save for the news about the MH17 crash, there was much to be applauded.

In just 30 years since the epidemic was first discovered and scientists scrambled to understand it, people could now dare to imagine and even speak about an AIDS-free generation. (READ: Urban boom and its bang on HIV)

In just 30 years. Shorter than one person’s lifetime.

We have the opportunity that no one thought was possible three decades ago: putting a stop to the spread of HIV.

I dare say we have the same opportunity here in the Philippines. But first, we have to make a stand and put an end to young people dying because in this day and age of HIV advancement, they simply should not be.

This is also posted on Rappler.


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[Dash of SAS] Time to end the ‘R word’

‘No father, no mother and no sibling of a child with special needs should ever have to feel alone’

A couple of weeks ago, I came across a blog post by Michelle Aventejado, who wrote about her youngest daughter, Gelli and ending the “R word.” Gelli was born with Down’s Syndrome and Michelle wrote her post after seeing some high–profile people use the R word on Twitter. She called out to everyone to end the R word and create awareness and an environment of inclusiveness for children with special needs.

Her post reminded me of an article I once wrote about my youngest sister, Niña, for my college org’s newsletter. My mother was so happy about the piece that she had it laminated (goes to show you how old it is) and I asked my younger sister to dig up the article for me.

I’m re-printing it here.

I probably looked just like my baby sister when I was a kid; at least that’s what my Mom always tells me. For those of you who don’t know I have a baby sister and her name is Niña.

Actually, she’s not so “baby” anymore; she’s 11-years old, almost as tall as I am, with a round stomach that would probably put Santa Claus to shame, big round eyes with long lashes that make her look like innocence personified, and the softest puffiest cheeks (which my other sister and I love to kiss and which I occasionally like to bite) in the whole wide world.

Cute as she is, having a baby sister like Niña still isn’t easy. Sometimes I feel like screaming when she can’t have her way, and I’m sure my other sister will agree with me when I say that having to take care of Niña really requires a lot of patience and understanding.

But you know, now that I think about it, having a baby sister does have its moments. I can’t tell you how much it warms my heart to have Niña come running to me, when she sees me, screaming, “ATE!” so loud I’m sure the whole neighborhood can hear her, or how good it makes me feel to hear her say, “I ya you, Ate” when I’ve had a bad day, or how she always makes me or my Dad smile when she pinches our cheeks and says, “Cute, cute mo, Ate” or “Cute, cute mo, Daddy”.

There are even times when she makes me feel ashamed of myself. I mean, it kind of makes me feel immature to have her be the first one to say, “Soweee, Ate” (complete with the repentant look) when we fight. Yeah, Niña’s very lovable and my Mom’s probably right when she says I looked just like her when I was a kid.

My Mom can never say that without adding that if Niña were normal, she would probably grow up to be just like me. They say that sometimes life plays cruel tricks on you, but I for one, am not blaming anyone for the way my sister is; if life had been kinder, I wouldn’t have been able to experience the joy of loving someone like Niña.


My baby sister, Niña, is now 32 years old and my daughter is only a little older than Niña was when I wrote this.

Reading this again, I was reminded of how one family member tried to dissuade me from writing this piece. She asked me, “What will you write about? Niña’s weaknesses? What for?”

Until she had asked me that, it never crossed my mind that the only thing that could be written about my sister was her weaknesses.

But at that time, that was what mental disabilities were –misunderstood weaknesses that were not to be talked about out in the open… until someone would see or meet Niña and inevitably ask my mother, “Ano siya?” [What is she?]

Special needs

Other people’s open curiosity and sometimes thinly veiled pity weighed heavily on my mother. My other sister and I grew up seeing my parents – mostly my mother — wrestle with how to explain or deal Niña’s special needs

They “talked about it” in terms of should-have’s and will never be’s. They “talked about it” through occasional outbursts like when my mother would wistfully say that if only Nina were normal, she would grow up to be just like me.

When my daughter was born as the first grandchild, the family excitedly cooed over her every little new achievement and applauded her every new word, I would again see the same wistfulness in my mother when I would catch her look at my daughter and look at Niña.

Sometimes, I sensed their pensiveness turn into frustration and gradually evolve into resignation.

Feeling of isolation

With the lack of information, resources and support groups, they just kind of lost hope. For awhile, I resented what I perceived to be their lack of effort, their misplaced need to overcompensate for Niña by pushing me and younger sister to strive.

After reading Michelle’s post, I had a chance to talk to her. I told her about Niña and she told me about Gelli. I realized that I had not really talked to anyone about Niña in a long time. Except for my other sister, I didn’t think anyone would really understand.

After our conversation, Michelle told me, “Thirty something years ago, your mother must have felt so alone at the time.”

And that’s when I thought of digging up this article and sharing it here, with a wider audience than my school org. No father, no mother and no sibling of a child with special needs should ever have to feel alone.

Because often, it is not a loved one’s mental disability that is most difficult to deal with. It is isolation.

This was re-posted from Rappler.

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Alarm over post-Haiyan evacuation centre shortage

A shortage of viable evacuation centres in areas hit by Typhoon Haiyan (locally named Yolanda) has humanitarians and officials in the Philippines concerned that survivors will not have alternative accommodation in case of another one. The typhoon season usually lasts from June to November.

“We urgently need to identify alternative evacuation centres,” said Conrad Navidad, emergency preparedness and response coordinator for the International Organization for Migration (IOM), a global humanitarian agency.

Haiyan, the category 5 super-typhoon that barrelled through central Philippines in November 2013, damaged or destroyed more than one million homes across an area roughly the size of Portugal, affecting more than five million people.

An IOM survey in 10 of the most affected towns in Eastern Samar and Samar, the two provinces hardest-hit by Haiyan, showed that only 53 of the 634 of pre-Haiyan evacuation centres identified by the government could be used in the event of another typhoon.

An estimated three million people have received emergency shelter assistance in the form of tents and tarpaulins, while about 675,000 received building and roofing materials to rebuild their own homes.

But two million people remain at risk without durable shelter, and experts fear the shortage of evacuation centres could make the next major storm even more dangerous.

Designated evacuation centres

Aid organizations and local governments are also reviewing evacuation plans and conducting drills to inform residents about alternative evacuation centres, and prepare them in the event of another emergency. “Our [immediate] goal now is to save lives,” said Navidad.

Shelter crisis

“We are working with aid agencies and local governments to fast-track permanent shelter for those displaced in the 53 municipalities affected by Yolanda,” said Nestor Ramos, regional director of the Department of Social Welfare and Development (DSWD) .

He said the DSWD has already begun preparing for another emergency by stockpiling food and pre-positioning supplies for the affected areas in the region.

“Our challenge is a combination of many factors. There is the large number of affected families left without shelter, and the lack of resources available to rebuild structures,” Ramos said.

In the wake of Haiyan, the lack of building materials, such as corrugated sheets for roofing, was identified as an urgent need of the five million typhoon survivors.

“There was not enough supply of building materials then,” said Ramos. “We had to bring in everything from other areas in the Philippines or from outside. Now, it is still not enough.” Officials expect the shelter crisis to continue beyond 2014.

The weather bureau of the Philippine Atmospheric Geophysical and Astronomical Services Administration (PAG-ASA) has been monitoring the onset of El Niño, which brings warmer than usual temperatures in the ocean surface to the central and eastern equatorial Pacific, and could cause prolonged dry spells and intensified cyclones in the region.

Surviving so far

In Guiuan, a city in Eastern Samar province where Haiyan first made landfall, there is still one tent city with 128 families in need of permanent shelter. “We cannot recover right away and cannot say we are 100 percent prepared. But [this area has] already been hit by four other typhoons since Yolanda and we’ve been okay,” said Guiuan mayor Christopher Gonzales.

The Philippines is one of the most disaster-prone countries in the world, with an average 20 typhoons each year. Since Yolanda struck in November 2013, six typhoons have hit the island nation.

Typhoon Agaton, which affected parts of Guiuan, killed 45 people and displaced 245,000.

“We’re doing the best we can, with what we have,” said Gonzales. “We can only hope for the best and continue with prayers.”

This story was written for IRIN News.

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Making peace with Paris

What’s it like to visit a place where you’re haunted by painful memories? ‘I was afraid that a visit to the world’s capital of romance would rekindle my own heartbreak,’ writes Ana Santos.

CITY OF LIGHT. Paris moves at the speed of light, life goes on. Photo by Etienne Laurent/EPA

CITY OF LIGHT. Paris moves at the speed of light, life goes on. Photo by Etienne Laurent/EPA

I was maybe 22 when I first started what I called “My Paris Fund.” I put in every peso, every centavo I could save into a bank account so I could have enough for a trip to Paris someday.

When the amounts in the bank account became a little more significant, I invested it little by little into the stock market.

Then the 1997 regional market came crashed. My stocks were worth just a little more than toilet paper and my dream of going to the City of Light was dashed.

Later, an opportunity came again to visit Paris, my honeymoon. I honeymooned in Paris. The use of the words “my” and “I” rather than “we” or “us” is deliberate and appropriate. Somewhere between Manila and Charles de Gaulle, it became clear to me that the union wasn’t going to work. And a little more than a year later, the marriage ended. It would have probably been a lot sooner if I didn’t have a baby in between and was temporarily restricted and immobilized during the pregnancy.

A baby that I learned, when I backtracked, was conceived in a small, quaint Italian village called Assisi.

Being a first-time mother, a newly separated wife, and a working woman was daunting and overwhelming. I did not have a back-up plan and I did not have a safety net—unless you count my steely determination to stand by my decision as a safety net.

The only way I knew how to deal with my new normal was to forget. It was the only way I knew to move on; it was the only way I knew I could somehow function.

I called it my oblivion – this non-selective way of erasing memories that were so painful that they were debilitating. And in my oblivion, I forgot Paris. Except for seeing the Eiffel Tower for the first time, the Mona Lisa and the friendly French waiter who played charades with me and enacted everything on the menu to make sure I did not order something too exotic, Paris became just a place I had once been to and once visited.

For many years, I looked at Paris from the eyes of a distant admirer and enjoyed it at arm’s length, from photos posted by friends. I lived vicariously through vacation photos posted by friends, content to see others enjoy the city, which was nothing more than a vague memory.


Last May, 13 years after my first visit I went back to Paris again. I was alone this time, a journalist on assignment rather than a tourist.

I was thankful for the distraction of managing respondent schedules, navigating my way out of Paris to the suburbs to meet them at their homes. It took my mind off my own ambivalence. I was afraid to sit in a place and have memories that had long been erased come back at me. I was afraid that wandering through the city would make me face my old failures.

I was afraid that a visit to the world’s capital of romance would rekindle my own heartbreak.

In a way, I was also hopeful. I was hopeful that the years that had gone by would allow me to face those memories and finally acknowledge them for what they really were – memories of another time, another life, another person who had very little resemblance to the person I am now.

SACRE COEUR. The basilica is a popular tourist spot in Paris. Photo by Ian Langsdon/EPA

SACRE COEUR. The basilica is a popular tourist spot in Paris. Photo by Ian Langsdon/EPA

On my last day in Paris, an interview with my last respondent ended early and I had just enough time to visit Sacrè Coeur before going to the airport. I did not get to go there on my first and last visit and thought it would be fitting that my last stop would be the highest point of with city.

I climbed up the 90-something steps to reach the foot of the basilica and looked at the city sprawled out in front of me, and thought back to the days that had gone by.

It had rained almost every day that I was there, but it did nothing to take away from the beauty of the city. I met, interviewed and got to know fellow Filipinos working in Paris as domestic workers or garde d’enfants,or babysitters/nannies. The city’s historic landmarks and dazzling lights did nothing to assuage their homesickness and their longing to be with the families back home.

As for me, I was thankful for the chance to see the city again and make new memories. If there is one thing that I learned, it’s when life gives you bad memories, you make new ones – better ones.

After my own vain but humorous attempts at a selfie, I gave up. I looked at Paris one last time and began my descent down the hill to catch the metro.

And then I saw it.

FINDING MYSELF. Finding 'Ana' in Paris. Photo by Ana Santos

FINDING MYSELF. Finding 'Ana' in Paris. Photo by Ana Santos

A name plate souvenir, like so many sold all over the world. Only this time, for the first time, my named was spelled correctly. “ANA” with one N. I forked over my 5 euros and bought my mini-street sign with my name underneath the word “Paris.”

I brought it out of the bag while in the metro and looked at it more intently. All this time, I thought I needed to make peace with Paris, when really, what I needed was to make peace with myself.

This was re-posted from Rappler.

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Philippines government ‘must do better’ to rebuild education

Temporary solutions keep learning going. Photo: Ana Santos/IRIN

MANILA, 6 June 2014 (IRIN) – As some students in areas hit by the Philippines’s devastating Typhoon Haiyan troop back to school this month, the government’s efforts in rebuilding the education service has been met with concerns that, seven-months on, access to learning remains a challenge for far too many children.

The category 5 super typhoon that ravaged the central islands of the Philippines in November 2013 damaged some 2,500 schools and affected an estimated 1.4 million school-aged children. More than 500 day care centres were completely damaged and more than 2,000 suffered partial damage.

Government and aid agencies took advantage of the dry summer months of March and April to fast-track classroom maintenance. But, “classroom repairs are still a major problem,” Manan Kotak, an education specialist for the United Nations Children’s Fund (UNICEF) told IRIN.

As of 14 May more than 4,200 temporary learning spaces – tents or temporary structures made of corrugated metal and wood – had been established and over 515,000 children and teachers had received teaching and educational materials to replace those lost in the storm.

Department of Education (DepEd) officials reported 90 percent of students are enrolled in school, but with a lower rate registered for high school.

“In spite of gaps, we see that education in the typhoon-affected areas is slowly coming back,” said Prudence Martinez-Sanoy education advisor of the development agency Plan International.

Yet as the affected regions re-build, some educators feel the recovery efforts are taking too long, and fear for the upcoming cyclone season. Experts and officials say overhauling education has to take a two-pronged approach to ensure both quantity and quality is revived.

Coming back to school

According to Luisa Yu, DepEd regional director, 35 percent of the totally collapsed and 53 percent of the partially damaged classrooms have already been repaired.

“That is already an accomplishment considering the extent of the damage of Haiayn,” she said. “The DepEd already has a budget allocated and started procurement for the construction of the totally collapsed classrooms.”

But in some areas, road conditions and remote relocation sites mean children still miss out on classroom time. To address this gap Plan, in partnership with other organizations, distributes “self-learning kits” containing workbooks, quizzes and exercises that children can complete on their own.

“We do not have to equate learning to coming to school every day,” argued Plan’s Martinez-Sanoy. “With these self-learning kits, all the children are missing is the everyday classroom experience.”

Decimated classrooms remain unrecovered. Photo: Ana Santos/IRIN

And, Yu admits, even for the children who can access temporary or regular school structures, the environment is not ideal.

“The students are coming to school, they are eager to learn. But we still have the problems of congested classrooms and a shortage of instructional materials and school furniture,” she explained, adding that in some classrooms there are three students sharing one desk.

The government set a target to complete construction of partially damaged classrooms by the end of 2014, and fully destroyed structures by the end of 2015.

“Completion of the reconstruction will really help the children. We first have to address access to education then quality of education. We cannot right now address both,” Yu said.

Not fast enough

However, not all educators are pleased with the progress to date. In Leyte province, where more than 80 percent of fatalities were recorded, four schools in the city of Tacloban continue to be used as evacuation centres to house 578 families – exiling students from their classrooms.

Some worry that the recovery is not on track to prepare them for the upcoming cyclone season, which begins in June and lasts through November.

“It’s been more than six months since Haiyan and the progress has been slow,” said Leo Candido, Chief Superintendent of Hernani, a town in Eastern Samar, one of the provinces worst devastated by the storm.

The Typhoon Haiyan Strategic Response Plan calls for $US46 million for education reconstruction, 60 percent of which had been funded as of 14 May.

This was re-posted from IRIN News.


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Philippines still rebuilding six months after typhoon’s visit

Many typhoon survivors need livelihood support. Photo: David Swanson/IRIN

MANILA, 29 May 2014 (IRIN) – More than six months after Typhoon Haiyan devastated large parts of the central Philippines, progress is being made in rebuilding livelihoods. However, huge challenges remain in making them sustainable.

“What we need now is to intensify emergency employment efforts on the ground and transition into sustainable livelihood programmes,” Ruth Honculada-Georget, early recovery and livelihood co-coordinator for the International Labour Organization (ILO) in Manila, told IRIN, describing their work ahead as “enormous”.

According to a May report by the Geneva-based Internal Displacement and Monitoring Centre, progress on sustainable solutions for survivors remains key to the recovery and resilience of those affected by the Category 5 storm which slammed into the region on 8 November 2013 displacing more than 4 million people and leaving over 6,000 dead.

Of the 14 million affected, 5.9 million workers lost their sources of income and livelihoods, of which 60 percent were men and 40 percent were women, the Early Recovery and Livelihoods Cluster (ER&L – made up of more than 50 international and local NGOs and co-led by the government, ILO, and the UN Development Programme) reported on 14 May.

More than 2.6 million of those affected were already living below the poverty line or were in vulnerable forms of employment before the typhoon, including the agriculture, fishing and forestry sectors, or a combination of all three.

Wind and powerful storm surges destroyed or damaged key assets and disrupted livelihood activities resulting in income losses of up to 70 percent across the region, the Multi-Cluster/ Sector Rapid Assessment (MIRA II), a cooperative effort involving more than 40 agencies working in the nine affected regions, revealed.

The agriculture and fishing sectors were severely affected, with the main impacts on agricultural activities related to the loss of rice, coconut trees and other standing crops, authorities say. Many residents lost the tools of their trade, including farming tools, fishing boats and nets, with very few survivors having the skills to engage in alternative livelihoods during displacement.

Six months on, more than 100,000 people have been provided with short-term employment, livelihood support and services, including skills training and micro-enterprise support. However, the real needs go far beyond that.

“Farmers and fishermen and women urgently need support for the next phase of recovery,” Leo Roozendaal, Oxfam’s Asia deputy regional director, said.

“In-kind food aid will pull out and by then people will need to have restored their livelihood or found alternative livelihoods sources to be able to take over afterwards,” a report by Terre des Hommes (TDH) warned, noting “livelihood needs are largely uncovered”.

The race for rice

According to the UN Food and Agriculture Organization (FAO), the typhoon struck between two planting seasons (April to June and October to December), destroying 600,000 hectares of farmland and washing away rice that had just been harvested or had just been planted, resulting in an estimated 1 million tons of crops lost, amounting to US$213M in agricultural losses.

“Through collaborated efforts with the government, we were able to meet the December to January [2014] rice planting season,” said Rajendra Aryal, senior emergency and rehabilitation coordinator for FAO.

Around 44,000 families in areas identified by the government were given sufficient rice seed to plant one hectare, in time for the December/January planting season, enough to support a family of five for over a year.

“The expected June harvest will be enough to guarantee a farmer’s food security for a year and will hopefully have a little bit left for selling,” said Aryal.

By June, this will yield enough rice to feed some 800,000 people for a year, at an estimated market value of $84 million, the agency reported.

More than one million coconut farmers were affected. Photo: David Swanson/IRIN

Fishermen in need

Also badly shaken was the region’s fishing sector, which employs close to 150,000 people, with roughly 30,000 fishing boats lost or damaged, according to the Bureau of Fisheries and Aquatic Resources (BFAR).

“At the start, we prioritized boat repair and boat-making so the people could fish and at least have food to sustain themselves,” said Asis Perez, BFAR national director.

“We identified 32,000 beneficiaries as our initial target and have given out 24,000 boats already. We are now looking at ways to raise funds for freezers. We need to re-build the [market] value chain so the fishermen can now actually sell and earn from what they catch.”

But even with these improvements, fishermen say the catches are slim.

“The fishermen tell us that the debris swept away by the storm surge has settled at the bottom of the sea, onto the reefs and corals which are the breeding grounds of the fish,” Maria Madamba-Nunez, media, advocacy and campaigns manager for Oxfam, explained.

On average, the daily income from fishing activities ranges from $7 to $13 per day, depending on the weather, seasonality and the time, the TDH report said.

And while there are ongoing efforts to rehabilitate other areas of the fisheries sector such as seaweed farming and aquaculture, BFAR conceded that these were small steps in the bigger scheme of things. “I wish we could say that we are moving into diversifying livelihoods [for sustainability], but right now, we really need to fix the basics first,” Perez said.

Thousands of fishermen were affected. Photo: David Swanson/IRIN

Why coconuts matter

Typhoon Haiyan struck a particularly devastating blow to the country’s vitally important coconut sector, with many saying it will take a decade for the industry to recover.

The Philippines is one the largest coconut producers in the world, accounting for 26.6 percent of global production.

At the same time, its devastation created knock-on effects along the entire value chain, affecting people who were engaged both directly and indirectly – from farm owners, workers and traders to those involved in transport and logistics, according to FAO.

An estimated 33 million coconut trees were damaged or lost in the storm, affecting around one million farmers, the Philippine Coconut Authority reported, with losses to the sector estimated at close to $400 million.

“Many of the coconut farmers were dependent on coconut farming alone. We need to teach them alternative skills and intercropping with crops with quick gestation given that it will take between six to eight years for a coconut tree to grow again,” Oxfam’s Madamba-Nunez said.

At the same time, clearing the trees to make space for re-planting also remains a challenge. Already, there are reports of beetle infestation, which will render the fallen trees unusable for recycling into coco lumber.

The government has committed to clear 390,000 trees within the next 90 days. However, this is only a small percentage of all the fallen trees that need to be removed.

“Farmers are in crisis. Food distributions have stopped, cash support is slowing down, and yet coconut farmers have no way of earning money to support their families,” said Maria Mendoza, executive director of Fair Trade Alliance, who alongside Oxfam and others is calling on the government to step up its clearing activities.

“The more we delay in clearing the farms, the more time it will take to plant quick-growing crops and secure immediate food and income,” she said.

Under the Philippines $788 million Typhoon Haiyan Strategic Response Plan, of the $117 million required for early recovery and livelihood activities, just 27 percent has been received thus far, leaving a gap of some $85 million as of 28 May.

This was re-posted from IRIN News.

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Radyo Bakdaw: Airwaves aid in disaster relief


ON AIR. Radyo Bakdaw is the only running radio station in Guian. All photos contributed by Ana. P. Santos

ON AIR. Radyo Bakdaw is the only running radio station in Guian. All photos contributed by Ana. P. Santos

GUIUAN, Philippines – Every Friday afternoon, they have a karaoke contest. That may not sound unusual at all for the Philippines and its known penchant for singing, but in the small town of Guiuan, where many of life’s basic necessities have yet to be restored after Typhoon Yolanda, a karaoke contest is a luxury and a welcome distraction.

The karaoke is an “accidental service” of Radyo Bakdaw, the only running radio station in Guiuan. set up by international media non-profit, Internews.

“We landed in Manila and were looking around for other equipment that we might need for the radio station. We saw the magic mic in the mall and thought, ‘Yeah! Let’s get one of these,” said Styn Aelbers, team leader of Internews Humanitarian News Service, about their light bulb moment. (READ about another emergency radio effort in Tacloban)

Human news service

Radyo Bakdaw (bakdaw means “rise” in waray-waray) is the information service of INTERNEWS, as part of Communicating with Disaster Affected Communities (CDAC) network.

In times of disaster, when mobile service is cut, mobile connection is down and devices have been washed away, there is an information gap that urgently needs to be filled.

“Absence of information creates anxiety and spreads rumors,” said Aelbers. “Radyo Bakdaw was set up to help fill that need.”

Aelbers, one of a two-man team set up in Guiuan two weeks after Yolanda hit using an emergency telecoms kit and transmitter.

At the time, the need was for very basic information: location and schedule of food distribution, where shelter materials were available and who would be qualified as a beneficiary for shelter material. “This is information that is all essential during the time of a disaster,” said Aelbers.

Liaising with the program officers of the various humanitarian agencies on the ground, information was gathered and broadcast it over the airwaves.

HUMANITARIAN RADIO. A radio announcer at this booth in Radyo Bakdaw in Guiuan, Eastern Samar

HUMANITARIAN RADIO. A radio announcer at this booth in Radyo Bakdaw in Guiuan, Eastern Samar

Two-way communication

When Internews first set up, they put up billboards with a straight-forward announcement: the name, radio frequency and the station’s mobile number. They also gave out an initial 200 solar-powered radios to residents.

“The communication process envisioned by INTERNEWS is one that is a two-way process. We also want to get questions from the community, what do they want to know and what are their concerns.”

Radyo Bakdaw gets about 300 text messages a day from the basic questions about where to buy candles or where to charge cellphones. These questions and or their answers are broadcast over the airwaves. During the early part of the emergency, there were also requests from listeners to broadcast that they are alive and safe so their families who may be listening will hear.

“We also get requests to help look for the missing, but in those cases, we refer them to the ICRC (the International Committee of the Red Cross) because that is their mandate; ours is communication,” clarified Aelbers. (READ: The Comfort of closure)

Field reporters

Radyo Bakdaw also employs reporters, local residents and journalists from Guiuan to look for news. Their job is to go out into the community, get to know what the community wants and what the community needs.

The radio format also includes guestings and radio interviews with key aid agencies and local officials. “Listeners can send us their questions through text or we get (questions) from our field reporters. The idea is we have to know what the community wants to know,” said Aelbers.

In between these news programs and radio interviews, they play music. “That (music) is also so vital at a time like this. Can you imagine being deprived of music in this day and age?”

The karaoke contest is broadcasted every Friday afternoon and the winner gets to take home a solar radio as a prize.

“We discovered some great singing talents during these contests,” said Aelbers about this way of communication that is also a form of aid. But their biggest achievement is what the service of Radyo Bakdaw has given back to the people of Guiuan.

“The biggest compliment that we have received is from the people who tell us ‘We feel alive again.”

This was re-posted from Rappler.


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Importance of tech response during disasters


STRATEGIC PARTNERSHIPS. WFP's Praveen Agrawal and Ericsson's Ellie Hanna, Rima Qureshi, and Brent Carbno discuss the importance of providing technical assistance during disasters.Photo by Sheila Rada

STRATEGIC PARTNERSHIPS. WFP's Praveen Agrawal and Ericsson's Ellie Hanna, Rima Qureshi, and Brent Carbno discuss the importance of providing technical assistance during disasters.Photo by Sheila Rada

GUIUAN, Eastern Samar – In Guiuan, where Yolanda first made landfall, there is no electricity, water is distributed everyday through water tanks, and many people are living in tent cities which serve as temporary shelters – but there is WiFi.

Though intermittent and sometimes slow during a weather disturbance, there is WiFi connectivity that allows the various humanitarian organizations on the ground to coordinate with one another, report back to their Manila headquarters, and send vital status updates that help in avoiding replication and duplication of efforts and maximize resources.

It is Michael Hanrahan’s job – a telecoms engineer and volunteer from the Ericsson Response Team – to make sure that the WiFi connection is working smoothly, to trouble shoot the usual technical problems, and set up new connections like the Internet connection in the field hospital set up in Guiuan by international medical organization, Médecins Sans Frontières (MSF).

Hanrahan is one of the 150 full-time Ericsson employees around the world who have volunteered to be on a rapid deployment list where they could be activated at any time to set up communications in emergency situations.

“We saw the warnings about the typhoon (coming to the Philippines) and we were on standby to come here. Within a day after the typhoon hit, we got the call for the need for telecom assistance and got ready to make our way to Tacloban,” said Hanrahan.

Tech response during disaster

When disaster strikes, the usual first response is to provide food, shelter, and financial aid. But when power and communication lines are destroyed and the connection to the outside world is lost – as was the case with Typhoon Yolanda – the need for technical response is vital.

Connectivity facilitates decision-making in a timely manner through the movement of data.

According to Praveen Agrawal, Country Director of The World Food Programme (WFP) Philippines, “The right decisions at the right time will save lives.”

The Ericsson Response Team is partnered with several organizations within the United Nations, most importantly the WFP who heads the Emergency Telecom Cluster (ETC). It is partnerships like this that allow for immediate response during disasters.

On November 9, the day after Yolanda hit the Visayas, Agrawal was on the first C130 flight to Taclobanto get response operations underway. Within the first 48 hours, a team was on the ground with emergency telecoms equipment, and the WiFi system was up and running during the first week.

“It is our job to provide telecom expertise – everything from fully functioning mobile connection to a localized WiFi network so all NGOs coming through can connect with one another,” said Hanrahan.

For Yolanda, Ericsson Emergency Response deployed a WiFi system called WIDER: Wireless LAN in Disaster and Emergency Response that provided Internet connectivity in Roxas City, Guiuan, and Tacloban for humanitarian workers in the area. The system provides wireless hotspots, telecommunications, and Internet connectivity between different relief agencies at disaster sites.

“Communication makes a huge difference out in the field. Ericsson provides our telecoms expertise to set up communications systems to serve and assist the relief community in their efforts,” said Hanrahan.

Currently, there are about 15 Ericsson volunteers working in Yolanda-affected areas to assist the communication needs of about 6,000 registered users.

Employee Initiative

Ericsson Response Team started out as an employee initiative in 2000. An employee expressed interested in doing humanitarian work and using technical knowledge to help those in need. It was a suggestion that was welcomed by Ericsson who turned it into a global program whose objective is to work with humanitarian organizations to fulfill a basic human need of communication, a need that becomes more pronounced in the advent of a disaster.

Volunteers are full-time Ericsson employees who have been trained by the UN, WFP, and other humanitarian agencies to understand the needs of the humanitarian community on the ground and how to best provide solutions. They are also oriented on the possible challenges during the mission.

“We could easily provide financial assistance. We could provide food, clothing, medication but we believe we can make much more of a difference by providing our technical expertise. So the way we do that is by working with established processes, established organizations such as the UN so they can do their job better,” said Rima Qureshi, Global Senior Vice President for Special Projects and Head of Ericsson Response Team.

Private and public partnership

The collaboration between Ericsson and WFP, which began in 2002, highlights the importance of strategic partnerships between private sector and public sector, and how bringing the right kind of knowledge and expertise can save lives.

Agrawal stressed the importance of forging such kind partnerships because it enables them to have immediate access to highly specialized technical people and state of the art equipment that the UN or its agencies may not necessarily have access to.

The emergency communications response provided by Ericsson has been on-going for two months now. A 4th team is scheduled to arrive and continue operations on the ground.

Ericsson will stay as long as the ETC cluster requires their services or until local telecom providers fully resume their operations.

This was re-posted from Rappler.

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Womb for rent

For many Filipino couples that have a hard time conceiving, they go to Obando, Antipolo, and pray to St. Claire to give them a child. For the rest of the world, there is India.

India, most specially the city of Anand in Gujarat has become known as the “Mecca for surrogacy.” Here, couples do not need to dance or offer prayers. They find a fertility clinic that may provide a familiarization tour that orients them on the process, the available facilities for the care of the surrogate mother, and the roles and financial responsibilities of the commissioning parents and legalities.

Once a surrogate is found, both the commissioning couple and the surrogate undergo counseling to manage expectations. A medical check-up is conducted, and a consent form is signed, signalling the start of the process of the embryo transfer.

At the backend of this operation, some clinics recruit what are known as “agents” or “brokers” to look for possible surrogacy candidates. These agents are usually women who belong to the community and conduct recruitment via word of mouth. They may have become a surrogate themselves at one point.

The agent must also ensure that the surrogacy candidate satisfies certain criteria: she must be between 21 – 30 years old, married, has at least one child. The candidate must also get the consent of her husband.

She must have not also experienced complication from previous pregnancy, has no chronic medical condition, and is neither a smoker nor an alcoholic.

Kinds of surrogacy

“There are two kinds of surrogacy,” explains Ritika Mukherjee, a researcher at the Institute of Population Sciences in India.

Mukherjee presented the results of her exploratory study on commercial surrogacy using Kolkata City as a case study at a recently concluded reproductive health conference held in Manila.

Surrogacy may be done for compassionate or financial reasons, said Mukherjee. In the first case, a woman (who may be a friend or a relative) agrees to have a child for another woman who is incapable or, less often, unwilling to bear children. In the other case, the woman agrees to bear a child in exhange for monetary compensation.

The hiring couple is known as the intended parents or the biological parents, or the commissioning couple and the custody of the child is transferred to the ‘real’ mother immediately after birth.

Commercial surrogacy in India has thrived since the Supreme Court made it legal in 2002. India’s reproductive tourism is estimated to be worth about USD 50 billion. (Read: Surrogacy Laws by Country)

The Indian Council of Medical Research (ICMR) has identified 886 surrogacy clinics across the country. At least 50 such clinics are added every year, according to reports.

“India not only caters its service of commercial surrogacy to the couples of its own country but also to couples from all over the world,” said Mukherjee.

“It (surrogacy) has become a survival strategy and a temporary occupation for many poor women,” she added.

Professional surrogate mothers

According to India’s Assisted Reproductive Technology Bill (ART), “surrogacy means an arrangement in which a woman agrees to a pregnancy, achieved through assisted reproductive technology, in which neither of the gametes belong to her or her husband, with the intention to carry it and hand over the child to the person or persons for whom she is acting as a surrogate mother.”

The draft ART Regulation Bill of 2010 aims to regulate commercial surrogacy by setting guidelines which include:

  • Age limit: Surrogate mother cannot be less than 21 years and above 35 years.
  • Maximum number of births: She cannot give more than five live births including her own children.
  • Maximum number of embryo transfer attempts: No surrogate shall undergo embryo transfer more than three times for the same couple.
  • Insurance coverage: Surrogacy contract should take care of life insurance cover for surrogate mother.
  • Sex selection: Sex- selective surrogacy should be prohibited.
  • Documentation: Foreigners coming to India to rent a womb will have to submit two documents confirming: (1) That their country of residence recognizes surrogacy as legal; (2) It will give citizenship to the child born through agreement from an Indian mother.

(Read: India’s Rent-a-Womb Industry Faces New Restrictions)

The low cost of surrogacy in India is its main draw. Mukherjee estimated that surrogacy costs in India run from USD15,000 – USD30,000 compared to USD 50,000-USD 90,000 in other countries.

“It is about one-third the cost of Western countries,” she said.

The lack of regulation makes it an easy place to have a surrogate baby, and the availability of younger surrogate mothers who have a higher chance of a successful pregnancy add to the attraction.

Among other benefits, Mukherjee said, “Intending parents also enjoy their names in the birth certificate and assistance for foreign couples during, before, and after the surrogacy along with all legal matters.

Social cost of commercial surrogacy

However, while numbers and currency influx can be documented, the social cost of this thriving industry has yet to be studied.

“The women who agree to become surrogate mothers are usually poor and uneducated. During the counseling and negotiation process, it is difficult to access how much of what is going on she understands,” explained Mukherjee.

In addition, she said, it is a decision that is often not made by the woman alone.

“There is the husband and sometimes, the mother in law there. To what extent are these women given autonomy to speak?” Mukherjee said.

Women who agree to become surrogate mothers must agree to withhold physical contact with their husbands for (as stipulated in her contract) until she safely delivers the baby. She lives in a hostel or a clinic where clinic personnel who also administer her pre-natal check-ups look her after. She lives away from her family for the duration of her pregnancy.

It is a high price to pay in exchange for the estimated average USD 3,200 that a surrogate mother is paid in installments.

“These women often tell their children that she has found a job in another city and will come back with a lot of money.”

It is money that is badly needed for a daughter’s wedding, to build a house, start a business, repay loans or send children to school.

“Is it natural for a man with a family but with hardly any or no income to gladly support his wife to accept the offer of renting her womb disregarding the social stigma and health risks attached? A legislation and monitoring is important to control and regulate the surrogacy industry and the people involved,” concluded Mukherjee.

This was re-posted from Rappler.

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