A report by UNAIDS, “Miles to go—closing gaps, breaking barriers, righting injustices”, warns that the global response to HIV is at a critical point.  Eastern and southern Africa remain the regions most affected by the HIV epidemic, accounting for 45 percent of the world’s HIV infections and 53 percent of people with HIV globally.

An estimated 800,000 people in eastern and southern Africa acquired HIV in 2017, and an estimated 380,000 people died of AIDS-related illness, the report indicated.

Mozambique, South Africa and Tanzania accounted for more than half of the new HIV infections and deaths from AIDS-related illness in the region last year.

The survey also indicated that there was discrimination against HIV positive persons in healthcare settings, especially towards key populations.

Key populations include men who have sex with men, drugs users, transgender persons and sex workers, considered to be most at  risk at contracting HIV.

There are nearly 1 million sex workers estimated to need services in the region.

“For us it is important in fact we do have within NASCOP, a key population program, mainly targeting the key populations, the female sex workers, men who have sex with men and injecting drug users,” said Dr. Kigen Barmasai, the director at Kenya’s National Aids and STI Control Program, NASCOP “One, we know that this contributes to 33 percent of new infections in Kenya, from this key populations, of course the prevalence varies, we have prevalence from 29 percent in female sex workers to 18 percent among the injected drug users. So as a program we are working on this and we are spearheading the HIV prevention, treatment and care efforts to reverse the epidemic. For the last ten years we have been working on that.”

More than half of the people surveyed who inject drugs said they avoided health-care services, citing discrimination or fear of law enforcement authorities.

In Kenya homosexuality is illegal and being found guilty can lead to a sentence of up to 14 years in prison.  Sex work is also illegal in Kenya.

“The criminal nature of Key populations, and the acts of Key populations that make people shy away from accessing health care and even organizing, coming together so that they can organize,” said Grace Kamau, chairperson of the Key population consortium in Kenya. “The main thing is the criminal nature. People fear to be arrested”

The report said about two-thirds of all people living with HIV in the region were accessing antiretroviral therapy in 2017.

Kamau attributes the successes in reaching large numbers of Key populations in Kenya to availability of HIV resources made possible by donor funding, but she says more people are yet to be reached.

“One of the things we have in Kenya is private clinics that are donor funded,” said Kamau. “That is where the sex workers feel comfortable and that is where they access their services. And that is what has made the number to go high.”

The report indicates that there were 19.6 million people living with HIV in eastern and southern Africa at the end of 2017.

Out of this number 81% were aware of their HIV status, an increase from 77% in 2016.

West and central Africa continues to lag behind as statistics indicated AIDS-related deaths have fallen by only 24% in western and central Africa, compared to a 42% decline in eastern and southern Africa.

Nigeria has more than half of the HIV burden in the region and there has been little progress in reducing new HIV infections there in recent years.

 
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A cholera outbreak in Cameroon has claimed at least a dozen lives. Hundreds of people have been rushed to several hospitals in the central African state. It is feared some of the cases were imported from Nigeria and may contaminate refugees fleeing the Boko Haram insurgency. 

Arabo Saidou, the highest government official in charge of health in Cameroon’s north region says the first cases of cholera were reported along Cameroon’s border with Nigeria two months ago.

He says the disease has continued to spread since four cases of cholera were recorded in the northern Cameroon town of Mayo Oulo that borders Nigeria on May 18. He says many people, especially children, have been dying both in and out of hospitals.

In May, the Word Health Organization reported that Nigeria’s Adamawa, Borno and Yobe states had been experiencing recurrent cholera outbreaks since February, with a total of 1,664 suspected cases and 31 deaths.

Many people from the three Nigerian states travel to Cameroon for business. At least a hundred thousand are in Cameroon as refugees fleeing the Boko Haram insurgency, with over 90,000 at the Minawao refugee camp.

Issac Bayoro, a Cameroonian epidemiologist working in the Mokolo administrative area where the Minawao refugee camp is located says they are educating refugees to respect hygiene norms and are also screening Nigerians coming to the camp in a bid to protect not only the refugees but their host communities.

He says many people continue to defecate in the open air or in streams and river beds where both humans and animals go to find water to drink thereby facilitating the spread of cholera. He says hygiene is not respected as many people do not wash their hands with soap as advised. He says people should stop trusting the belief that an African is naturally vaccinated and can not die of dirt.

Cameroon’s ministry of health indicated that the disease quickly spread to Yaounde and Douala, major cities in the central African state. The case reported in Yaounde was of a teenager who travelled to Yaounde from northern Cameroon with his mother. He latter died in a hospital according to the government.

Thomas Tawe, a university student and resident of Yaounde says he fears cholera may spread rapidly in the city because just 30 percent of the population has access to good drinking water.

“In the city of Yaounde only those who can pay can have water. When you go into the quarters (neighbourhoods) you see that people are carrying water from inhygienic sources,” said Tawe. “If the water is contaminated, automatically we will be contaminated.”
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A specially-outfitted bathroom in New York City has been converted into a safe haven for drug users. The goal: to curb an overdose crisis that’s sweeping the United States. New data shows drug overdoses killed 47,000 people nationwide in the 12 month period that ended in November 2017. Aside from preventing such deaths, studies show facilities like the one in New York can also reduce HIV infections and emergency calls about overdoses. But the program has its critics. VOA’s Julie Taboh has more.
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Admirers of Neil Armstrong and space exploration have a chance to own artifacts and mementos that belonged to the modest man who became a global hero by becoming the first human to walk on the moon.

The personal collection of Armstrong, who died in his native Ohio in 2012, will be offered for sale in a series of auctions handled by Dallas-based Heritage Auctions, beginning November 1-2 and continuing in May and November 2019.

The collection includes a variety of artifacts from Armstrong’s 1969 lunar landing and private mementos that include pieces of a wing and propeller from the 1903 Wright Brothers Flyer that the astronaut took with him to the moon.

Other items that went to the moon with Armstrong include a U.S. flag, the largest size typically flown during Apollo missions; a United Nations flag; various state flags; and some Robbins Medallions. The sterling silver medallions were paid for by the crews of Apollo missions and were available for purchase only by NASA astronauts. Armstrong’s collection also includes a rare gold medallion.

Among the more personal items to be auctioned are a Purdue University centennial flag from Armstrong’s alma mater that traveled on Apollo 11 and his Boy Scout cap.

Armstrong’s son, Mark Armstrong, said his father never talked to him about what he wanted done with the large amount of items he kept.

“I don’t think he spent much time thinking about it,” Armstrong said. “He did save all the items, so he obviously felt they were worth saving.”

Armstrong, who lives in suburban Cincinnati, said his father did keep all of his “flown” items together.

Faced with the responsibility of conserving, preserving and insuring irreplaceable items and honoring their father’s legacy, Armstrong and his brother, Rick, found that some things needed restoration, and that some required research to be properly identified.

“We felt like the number of people that could help us identify them and give us the historical context was diminishing and that the problem of understanding that context would only get worse over time,” he said.

The Armstrongs turned to Sarasota, Florida-based Collectibles Authentication Guaranty for help with preserving and authenticating the artifacts and memorabilia and chose Heritage Auctions for the sales.

Greg Rohan, president of Heritage Auctions, said it handles numerous categories of collectibles that appeal to various collectors, but items connected with space seem to have a universal appeal.

“Space is one of the very, very few categories that every single person seems to be interested in,” Rohan said. “You show somebody something from the space program, and they are fascinated by it.”

Bids can be taken online, by phone or in person.
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Doctors have been working for decades to find better ways to save people’s damaged or diseased arms and legs and avoid amputations.

Their work paid off for Jeff Bopp, a passenger in a sport utility vehicle near Columbia, Missouri. The Columbia Missourian, a community news organization, reported that the day had been going well for the 47-year-old Bopp.

“We were leading a group of about 10 ATVs [all terrain vehicles] down a wooded trail,” Bopp was quoted as saying, “When we got to the end, the person driving our vehicle turned the wheel very sharply, and I saw his foot mashed on the accelerator. I knew it wasn’t going to be good.”

“The driver thought he was going to whip the back end around, show off maybe a little bit or whatever, but it happened so fast,” Bopp said.

The vehicle flipped, and Bopp’s arm snapped — the muscle and skin torn away. He was flown to the University of Missouri Health Care’s Trauma Center.

“The way they described it in the medical reports, it was a near-field amputation,” Bopp said.

Dr. Jay Bridgeman, a limb reconstruction specialist, met Bopp in the emergency room.

“We were concerned we may not be able to save his arm,” Bridgeman said.

At a trauma center, there’s a team of specialists who could include plastic surgeons, micro surgeons, vascular specialists and more.

Bridgeman said the surgeons took a muscle from Bopp’s back and laid it over the areas that had lost tissue. “And, then, that required the skill of the micro surgeon to sew the blood vessels together and the nerves together.”

With a high-powered microscope, Bridgeman connected the blood vessels of the piece of back muscle with the remaining muscles in Bopp’s arm. The transplanted tissue is now part of his arm.

Bopp had more than a dozen surgeries to finish the job, but he has sensation, he can feel objects and use his hand.

Limb preservation teams are getting better at these procedures, according to Dr. Lee Kirksey,

At the Cleveland Clinic, Dr. Lee Kirksey says at least 80 percent of patients who need this surgery have diabetes.

“About one third of diabetics at some point will develop an ulcer when they’re on their feet. And so where I see this area of limb salvage progressing is that we’ll become better and more skilled, and have more technology, for restoring blood flow for these patients.”

Kirksey is vascular surgeon and vice chair of the Cleveland Clinic’s department of vascular surgery.

When his team can’t save a limb, he says the focus shifts to amputating the limb so the patient can use a well-fitting prosthetic, “and then they’re wildly surprised about how they’re able to achieve a normal activity level in their life.”
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