Maternal mortality can be particularly high in conflict and chronic emergency settings, partly
due to inaccessible maternal care. This paper examines associations of refugee-led health
education, formal education, age, and parity on maternal knowledge, attitudes, and
practices among reproductive-age women in refugee camps in Guinea.
Data comes from a 1999 cross-sectional survey of 444 female refugees in 23 camps.
Associations of reported maternal health outcomes with exposure to health education
(exposed versus unexposed), formal education (none versus some), age (adolescent
versus adult), or parity (nulliparous, parous, grand multiparous), were analysed using
No significant differences were found in maternal knowledge or attitudes. Virtually all
respondents said pregnant women should attend antenatal care and knew the importance
of tetanus vaccination. Most recognised abdominal pain (75%) and headaches (24%) as
maternal danger signs and recommended facility attendance for danger signs. Most had
last delivered at a facility (67%), mainly for safety reasons (99%). Higher odds of facility
delivery were found for those exposed to RHG health education (adjusted odds ratio 2.03,
95%CI 1.23-3.01), formally educated (adjusted OR 1.93, 95%CI 1.05-3.92), or grand
multipara (adjusted OR 2.13, 95%CI 1.21-3.75). Main reasons for delivering at home were
distance to a facility (94%) and privacy (55%).
Refugee-led maternal health education appeared to increase facility delivery for these
refugee women. Improved knowledge of danger signs and the importance of skilled birth
attendance, while vital, may be less important in chronic emergency settings than
improving facility access where quality of care is acceptable....
Comprehensive studies of family planning (FP) in refugee camps are relatively uncommon.
This paper examines gender and age differences in family planning knowledge, attitudes,
and practices among Sierra Leonean and Liberian refugees living in Guinea.
In 1999, a cross-sectional survey was conducted of 889 reproductive-age men and women
refugees from 48 camps served by the refugee-organised Reproductive Health Group
(RHG). Sampling was multi-stage with data collected for socio-demographics, family
planning, sexual health, and antenatal care. Statistics were calculated for selected
Women knew more about FP, although men’s education reduced this difference. RHG
facilitators were the primary source of reproductive health information for all respondents.
However, more men then women obtained information from non-health sources, such as
friends and media. Approval of FP was high, significantly higher in women than in men
(90% vs. 70%). However, more than 40% reported not having discussed FP with their
partner. Perceived service quality was an important determinant in choosing where to get
contraceptives. Contraceptive use in the camps served by RHG was much higher than
typical for either refugees’ country of origin or the host country (17% vs. 3.9 and 4.1%
respectively), but the risk of unwanted pregnancy remained considerable (69%).
This refugee self-help model appeared largely effective and could be considered for
reproductive health needs in similar settings. Having any formal education appeared a
major determinant of FP knowledge for men, while this was less noticeable for women.
Thus, FP communication strategies for refugees should consider gender-specific messages
Providing reproductive and sexual health services is an important and challenging
aspect of caring for displaced populations, and preventive and curative sexual health
services may play a role in reducing HIV transmission in complex emergencies. From
1995, the non-governmental “Reproductive Health Group” (RHG) worked amongst
refugees displaced by conflicts in Sierra Leone and Liberia (1989-2004). RHG
recruited refugee nurses and midwives to provide reproductive and sexual health
services for refugees in the Forest Region of Guinea, and trained refugee women as
lay health workers. A cross-sectional survey was conducted in 1999 to assess sexual
health needs, knowledge and practices among refugees, and the potential impact of
Trained interviewers administered a questionnaire on self-reported STI symptoms,
and sexual health knowledge, attitudes and practices to 445 men and 444 women
selected through multistage stratified cluster sampling. Chi-squared tests were used
where appropriate. Multivariable logistic regression with robust standard errors (to
adjust for the cluster sampling design) was used to assess if factors such as source of
information about sexually transmitted infections (STIs) was associated with better
30% of women and 24% of men reported at least one episode of genital discharge
and/or genital ulceration within the past 12 months. Only 25% correctly named all key
symptoms of STIs in both sexes. Inappropriate beliefs (e.g. that swallowing tablets
before sex, avoiding public toilets, and/or washing their genitals after sex protected against STIs) were prevalent.
Our study revealed a high prevalence of STI symptoms, and gaps in sexual health
knowledge in this displaced population. Learning about STIs from RHG health
facilitators was associated with better knowledge. RHG’s model could be considered
in other complex emergency settings....
June 1, 2006 Sciences Po // Center For Peace And Human Security
Situated in between Ghana and Benin, with a coastline of no more than 56km, Togo is one of Africa's smallest countries. However, what has habitually been a little talked about West African nation holds a long history of political unrest and has recently entered into a phase of instability in the beginning of 2005. Civil society members and organizations are now regrouped in the WANEP network, (West African Network for Peacebuilding) in a joint effort to set a national agenda toward reconciliation, peace and security and lead the way in facing Togo's unprecedented public health, development and education challenges....
The tongues of yellow flames from flaring gas burn like candlesticks lined up in a cathedral, lighting the night sky of the port city of Malabo and sending black fumes billowing upwards. In the waters offshore, oil rigs and production platforms sit majestically, sucking hundred of thousands of barrels a day from the deep sea oil fields of Equatorial Guinea.
Until a few years ago, this nation of 486,000 - consisting of five islands and a square snip of coastal West Africa between Cameroon and Gabon - was a small and insignificant sideshow in the political drama of the African continent. But the beginning of large scale oil production in 1996, along with new concerns about the security of Mideast oil supplies, has thrust West African nations like Equatorial Guinea to the forefront of the global politics of oil. ...
Five actual or potential conflict situations around the world deteriorated and two improved in December 2010, according to the latest issue of the International Crisis Group’s monthly bulletin CrisisWatch released today.
Côte d’Ivoire was gripped by political crisis as incumbent President Laurent Gbagbo refused to cede power after losing to rival Alassane Outtara in the late-November presidential runoff polls. Post-election violence claimed thTensions remained high on the Korean peninsula just one month after North Korea shelled Yŏnp’yŏng Island in South Korea. Pyongyang threatened “brutal consequences beyond imagination” against the South as Seoul held live-fire artillery drills on the island. Russia and China called for a calming of tensions on the peninsula, but South Korea refused to cancel the drills amid domestic pressure to stand firm against the North.
Nigeria was hit by several deadly bomb attacks and ongoing Islamist militant violence over the month. At least 80 people were killed in coordinated explosions in the central city of Jos on 24 December. e lives of at least 170 people and more than 15,000 fled to neighbouring countries.
In Pakistan, the Taliban launched a wave of suicide attacks during the month that left scores dead. Many of those killed were locals supporting efforts against the militants. The situation in Guinea improved as former Prime Minister Cellou Diallo conceded defeat in the November presidential runoff and Alpha Condé was sworn in as the country’s first democratically elected president. Following a tense election period and concerted international efforts to avert renewed conflict, world leaders commended Guinea for a “historic achievement”.
Iraq ’s parliament unanimously approved a new 42-member government under incumbent Prime Minister Nouri al-Maliki on 21 December. The move ends nine months of political deadlock and protracted negotiations over government formation following parliamentary elections in March.
CrisisWatch also notes a marked deterioration in Mexico’s drug-related violence over the course of the past year, despite the killing of several high-profile cartel leaders...
Nine actual or potential conflict situations around the world deteriorated and one improved in November 2010, according to the latest issue of the International Crisis Group’s monthly bulletin CrisisWatch released today.
Tensions surged on the Korean peninsula as two South Korean civilians and two marines were killed when North Korea fired dozens of artillery shells at Yeonpyeong Island, where South Korea was conducting military drills. Haiti ’s late month presidential elections ended in confusion, as several opposition candidates called for the vote to be annulled amid reports of fraud, and thousands of people took to the streets in protest. International observers from the OAS called the vote valid despite “serious irregularities”, but tensions remain high. Ivory Coast saw deadly pre-election clashes on the streets of the capital Abidjan between rival supporters of the two presidential candidates, incumbent Laurent Gbagbo and former Prime Minister Alassane Ouattara. The tightly contested 28 November run-off and delays in announcing the preliminary results has led to heightened tensions between the two camps and fears of further violence.
In Guinea, preliminary results declaring opposition leader Alpha Condé winner of the 7 November second round presidential election sparked three days of violence resulting in at least four deaths and dozens injured. CrisisWatch also noted deteriorated situations in Burundi, Central African Republic, Madagascar, Egypt and Western Sahara.
In Niger, the situation improved as results from the 31 October referendum showed 90 per cent of voters in favour of the new constitution, paving the way for January 2011 elections and a return to civilian rule.
Once again this month CrisisWatch describes violence against civilians in North and South Kivu provinces in the Democratic Republic of Congo....
Three actual or potential conflict situations around the world deteriorated and none improved in October 2010, according to the latest issue of the International Crisis Group’s monthly bulletin CrisisWatch released today.
Twin bomb blasts struck the Nigerian capital Abuja at the beginning of the month, killing at least a dozen people during celebrations of the country’s 50th anniversary of independence. A statement by the Niger Delta militant group MEND claiming responsibility for the blasts was later denied by former MEND leaders, although the group subsequently released a statement threatening a repeat of the attack. Meanwhile, tensions increased in Borno state as hundreds of troops were deployed in the state capital in response to a series of deadly attacks blamed on Islamic sect Boko Haram. Zimbabwe’s inclusive government looked increasingly unstable , threatening to fracture over differences on implementation of the 2008 Global Political Agreement and elections. The situation again deteriorated in Guinea, where CrisisWatch also identifies a conflict risk alert for November. October saw further political violence surrounding the second round of the presidential election between leading candidate Cellou Diallo and his rival Alpha Conde. Persistent tensions between the two camps following the controversial first round in June have been exacerbated by further delays to the run-off.
The announcement on 22 October that the polls would be postponed for a third time sparked more clashes along ethnic lines between rival supporters....
Seven actual or potential conflict situations around the world deteriorated and none improved in September 2010, according to the latest issue of the International Crisis Group’s monthly bulletin CrisisWatch.Guinea saw increased political and ethnic divisions, exacerbated by controversies related to the presidential elections. Two days of violent clashes in the capital between rival supporters of the two presidential candidates, Alpha Conde and Cellou Diallo, left one person dead and dozens injured. Continued delays in the timing of the run-off and Diallo’s rejection of the appointment of the election commission’s new head led to further tensions between the two camps.
In Sri Lanka moves by President Rajapaksa to consolidate his power through a de facto constitutional coup transformed the political terrain. On 8 September the parliament passed the 18th Amendment to the Constitution, which gives the President nearly unbridled power by scrapping term limits on the presidency, abolishing the Constitutional Council and allowing the President to appoint directly officials to the judiciary, police and electoral bodies.
More protesters were killed by police in Kashmir as anti-India demonstrations continued and spread to new areas, bringing the death toll from the demonstrations since June to over 100. The Indian government on 25 September announced an eight-point plan aimed at calming the situation. Separatist leaders rejected the initiative and said that protests will continue.
The situation in Burundi deteriorated as violent clashes between security forces and armed groups increased, alongside kidnappings and fatal attacks on civilians. There are increasingly credible indications that elements disgruntled with elections held earlier this year have re-established bases and taken up arms in the Rukoko and Kibira areas. However, local authorities deny that former rebels are regrouping and insist that bandits are behind the recent attacks.
The month saw a new upsurge of violence in Russia’s restive North Caucasus region, demonstrating the growing ability of guerrillas to carry out major operations. In the deadliest terrorist strike anywhere in Russia since the March subway bombings in Moscow, a suicide attack killed at least 17 at a market in the capital of North Ossetia. A spate of bold guerrilla attacks also struck security personnel and infrastructure in Dagestan. The situation in Ecuador took a dramatic turn at the end of the month when disaffected members of the police and armed forces staged a protest against proposed austerity measures, taking control of the National Assembly building and airport and laying siege to a hospital where President Correa had sought refuge. President Correa later said the revolt amounted to an attempted coup. Meanwhile, in Mozambique 13 people were killed and over 170 injured in three days of riots that took place early in the month over food and energy price increases....
September 28, 2009 Integrated Regional Information Networks // United Nations Office for the Coordination of Humanitarian Affairs
Recently a commercial billboard near Guinea’s presidential palace featured three towering question marks on a white background. That image matches the way many Guineans describe their country’s current condition, eight months after Moussa Dadis Camara came to power in a bloodless coup: utter uncertainty.
When Camara took power citizens poured into the streets cheering; Guineans say they were celebrating a rupture with the 24-year regime of Lansana Conté.
“We hate that the military has taken power again,” a Guinean told IRIN the day of the coup. “But we hate it less than we hated the Conté regime.”
Now many Guineans are wondering where the Camara government - which calls itself the National Council for Democracy and Development - is taking the country. Here is a timeline of some events since independence from France in 1958....
July 13, 2006 Project on International Courts and Tribunals // African International Courts and Tribunals
The Economic Community of West African States (ECOWAS/CEDEAO) is well known for its military intervention in Liberia and Sierra Leone. ECOWAS was created in 1975 to replace the Customs Union of West African States originally created in 1959 to redistribute customs duties collected by the coastal states of West Africa. The Treaty on the Economic Community of West African States was revised at the Cotonou Summit of July 1993 to replace the inexistent Tribunal originally envisioned with a Community Court of Justice....
July 13, 2006 Project on International Courts and Tribunals // African International Courts and Tribunals
The Common Court of Justice and Arbitration (CCJA) is the court of the Organization for the Harmonization of Business Law in Africa (OHADA), one of the most successful regional legal harmonization efforts on the Continent. Unlike the other continental regional integration groups, OHADA does not seek to conform national law to an overarching treaty and successive regulations and directives, which allow national legislature some leeway. Instead, OHADA uses the integration method of issuing binding uniform acts that automatically supercede all prior and future inconsistent national laws. With the goal of creating a secure, simple and modern legal framework for the conduct of business in Africa, OHADA has issued eight uniform acts on general commercial law, commercial companies and economic interest groups, securities, arbitration, simplified recovery procedures and measures of execution, collective insolvency and accounting....
Regional leaders created the Economic Community of West African States (ECOWAS) on May 28, 1975 in Lagos, Nigeria. ECOWAS is comprised of 15 countries, which include: Benin, Burkina Faso, Cape Verde, Cote d'Ivoire , The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Niger, Nigeria , Senegal, Sierra Leone, and Togo. The leaders established ECOWAS to promote regional integration and economic growth in West Africa, as well as to create a monetary union in the region. However, ECOWAS has encountered problems in the process of regional integration including: political instability and lack of good governance that has plagued many member countries, the insufficient diversification of national economies, the absence of reliable infrastructure, and the multiplicity of organizations for regional integration with the same objectives....
April 28, 2006 Government of the United Kingdom // Home Office
This Country of Origin Information Service Key Documents was produced by the RDS of the Home Office, for use by officials involved in the asylum / human rights determination process. The COI Key Documents identifies general background information about Guinea from a variety of recognised sources. The material identified concentrates on the issues most commonly raised in asylum / human rights claims made in the United Kingdom and is not intended to be exhaustive. None of the documents identified contain any Home Office opinion or policy....
January 4, 2011 Foreign Policy Magazine // International Crisis Group
Across the globe today, you'll find almost three dozen raging conflicts, from the valleys of Afghanistan to the jungles of the Democratic Republic of the Congo to the streets of Kashmir. But what are the next crises that might erupt in 2011? Here are a few worrisome spots that make our list. [Captions provided by International Crisis Group]
An in-depth investigation into the September 28, 2009 killings and rapes at a peaceful rally in Conakry, Guinea, has uncovered new evidence that the massacre and widespread sexual violence were organized and were committed largely by the elite Presidential Guard, commonly known as the “red berets,” Human Rights Watch said today. Following a 10-day research mission in Guinea, Human Rights Watch also found that the armed forces attempted to hide evidence of the crimes by seizing bodies from the stadium and the city’s morgues and burying them in mass graves.
Human Rights Watch found that members of the Presidential Guard carried out a premeditated massacre of at least 150 people on September 28 and brutally raped dozens of women. Red berets shot at opposition supporters until they ran out of bullets, then continued to kill with bayonets and knives.
“There is no way the government can continue to imply the deaths were somehow accidental,” said Georgette Gagnon, Africa director at Human Rights Watch. “This was clearly a premeditated attempt to silence opposition voices.”...
Stepped up U.S. drug enforcement and interdiction in Latin America, coupled with a falling dollar and a surging demand for cocaine on the streets of Europe, is leading to political and economic chaos across West Africa, where international narco-traffickers have established their most recent, and lucrative, staging grounds. In fact, the drug trade is fast turning large parts of the region into areas that are all but ungovernable -- with major implications for international security. "The former Gold Coast is turning into the Coke Coast," said a 2008 report by the United Nations Office on Drugs and Crime (UNODC). "The problem is so severe that it is threatening to bring about the collapse of some West African states where weak and corrupt governments are vulnerable to the corrosive influence of drug money."
Though hardly alone in West Africa, Guinea-Bissau, the world's fifth poorest country, with a population of 1.5 million, has for all intents and purposes become the textbook example of the African "narco-state." Due to its relative proximity to South America, its hundreds of miles of unpatrolled coastline, islands and islets, along with the fact that Portuguese is its lingua franca, Guinea-Bissau has been increasingly targeted by South American drug lords as a preferred traffic hub for European-bound cocaine, according to the UNODC. What's more, as citizens of a former Portuguese colony, Guineans do not need visas to enter that EU country, further facilitating the movement of drugs.
Authorities there can do precious little about it. "Guinea-Bissau has lost control of its territory and cannot administer justice," declared Antonio Maria Costa, the UNODC executive director, in a statement before the U.N. Security Council in December. "There is a permeability of judicial systems and a corruptibility of institutions in West Africa," he added. "Guinea-Bissau is under siege. Literally under siege." Guinea-Bissau enjoys plenty of company among its neighbors: To varying degrees, Ghana, Senegal, Nigeria, Cape Verde, Guinea-Conakry, Togo, Benin, Senegal, South Africa, and other West African and sub-Saharan states (including already-challenged states like Sierra Leone, the Ivory Coast and Liberia) are all beginning to feel the long reach of cocaine smuggling....
After a feasibility study conducted throughout the sub-region, representatives of seven West African countries in 1998 officially launched WANEP in Accra Ghana. They created WANEP as a mechanism to harness peacebuilding initiatives and to strengthen collective interventions that were already bearing good fruits in Liberia, the Northern Region of Ghana, and Sierra Leone.
I consider it a singular honour to have been invited today by Chatham House
to address this august forum. The Economic Community of West African
States (ECOWAS), which I represent, is a regional organisation which has,
over the years, gained your attention only for the unfortunate reasons of state
implosion and instability caused by bad governance and marginalisation. I
therefore welcome the opportunity to throw further light on its objectives,
challenges, and achievements, which factors have effectively brought
together fifteen West African states in the enterprise of improving upon the
living standards of 230 million people as well as integrating them.
The term ‘Chatham House Rule’ is today an internationally-accepted cliché
that this Institute has contributed to international diplomacy discourse, a
reference norm in rigorous and policy-oriented exchanges on global peace
and security. I therefore view your invitation to lead today’s discourse about
‘Democracy in the context of Regional Integration in West Africa’ as an
unique honour for me personally, and a recognition of ECOWAS as a leading
brand in regional integration.
Ladies and gentlemen, the evolution of ECOWAS can only be properly
understood against the backdrop of the fascinating history and circumstances
of West Africa since establishing contact with the world beyond its borders.
The fact that slavery, colonialism, as well as racial and economic
marginalisation, had left an intrinsic yearning for freedom, unity and solidarity
among peoples of African descent everywhere defines its wish to integrate its
states and peoples....
In his books The Bottom Billion: Why the Poorest Countries
Are Failing and What Can Be Done about It and Wars, Guns, and Votes: Democracy in Dangerous Places (cited henceforth
as BB and WGV, respectively), Paul Collier attempts to
bring African and other poor countries with problems of
“stuck” development back into the conversation of economists,
policymakers, and an educated nonspecialist readership. Book cover testimonials from The Economist, Larry
Summers, Larry Diamond, and New York Times columnist
Nicholas Krist of give a sense of the readership Collier
has targeted. Using analysis based on econometric studies
he has conducted with his research colleagues at Oxford
and the World Bank, he first tries to make sense of the
world’s “basket cases,” and then to propose policy interventions
that may help them to set themselves right.
In early 2008, International Alert and its partner organisations in Guinea, Liberia and Sierra Leone
launched a new sub-regional initiative funded by the Ministry of Foreign Affairs of Denmark and
intended to empower citizens to challenge actual and perceived threats to human security and
personal safety experienced by vulnerable groups, especially women and girls, in the war-affected
area where the original three member states of the Mano River Union (MRU) converge.1
Between 1989 and 2003, these three countries experienced a catastrophic series of interlinked
wars that straddled the boundaries of the MRU, killing up to 300,000 people and displacing
several million, hundreds of thousands of them fleeing as refugees to neighbouring MRU states.
One of the legacies of these sub-regional wars and displacements has been a culture of impunity
surrounding sexual and gender-based violence (SGBV).
Untold, thousands of women and girls, but
also many men and boys, live with the psychological and sometimes physical or human legacy of
SGBV across the sub-region.
Such behaviour has not existed in isolation. In parallel to sexual violence, there is a legacy of
domestic violence and disempowerment of women that is embedded in many patriarchal cultures,
not just in West Africa.
In response to these post-war challenges, International Alert and its partners designed a tricountry
initiative to reduce threats to personal security, especially threats to women and girls, and
to challenge the culture of impunity around SGBV. The aim has been to empower communities
to lobby for more comprehensive and gender-sensitive reporting of SGBV, for more inclusive
and gender-sensitive security and justice responses, and for a coherent sub-regional response to
violence in border communities. The project has developed culturally- and linguistically-specific
programming for a network of community radio stations along the borders of the three countries
in order to promote a transformative dialogue that challenges local knowledge, attitudes and
practices around SGBV to reduce perpetration and the stigmatisation of survivors. It has also
developed a network of “animators” in nine war-affected communities who provide information,
counselling and advocacy to men and women in order to guide them through prevention and
redress actions, including access to statutory security and justice systems.
This report aims to capture the experiences of the project over two and a half years in the context
of work in three interlinked but quite specific country contexts. It looks at the extent of SGBV and domestic violence as experienced in the target communities, details the challenges and best
practices of project staff in their attempts to raise awareness and change attitudes and practices,
and analyses the particular challenges of providing security and accessing justice (statutory or
customary) in the various target communities. It concludes with a series of recommendations
for the improved provision of security and justice for women, girls and other vulnerable groups
within the MRU....
In June and November 2010, the Guinean people went to the polls and for the first time since
the country’s independence from France in 1958, elected their president in an atmosphere
largely free of intimidation, fear, or manipulation. Many Guineans viewed these hugely
significant elections as having the potential to end over 50 years of authoritarianism, human
rights abuse, and corruption.
Since independence, Guinean presidents Ahmed Sékou Touré (1958-1984), Lansana Conté
(1984-2008), and Captain Moussa Dadis Camara (2008-2009) have relied on ruling party
militias and security forces to intimidate and violently repress opposition voices. Thousands
of Guineans—intellectuals, teachers, civil servants, union officials, religious and community
leaders, and businesspeople—who dared to oppose the government have been tortured,
starved, or beaten to death by state security forces, or were executed in police custody and
This report calls on the government to bring to justice those responsible for massacres in 2007 and 2009. It says that the government should strengthen the judiciary and provide it with adequate resources, rein in and reform the security sector, and ensure that Guinea’s population can benefit from the country’s abundant natural resources. Human Rights Watch also recommended establishing a truth commission to uncover the causes of Guinea’s violent past and an anti-corruption commission to end the misuse of its wealth....
This special research report provides an analysis of a set of new issues that have been emerging in the West African subregion and possible implications for the Security Council in the coming year(s). It identifies some key emerging threats to peace and security in the 16-state subregion and their linkages to existing security challenges. The report points to a key feature: the fact that some of the new threats are essentially criminal rather than political in nature. However, it explains also the growing political and security implications. The report also highlights action already taken by the Council to recognise these threats and considers options available to the Council to tackle these issues going forward.
The raw material for the study was derived from literature research; field research in a number of countries in the West African subregion (including Guinea-Bissau, Liberia, Senegal, Ghana and Nigeria); and interviews in the region with diplomats, government officials and officials of relevant international intergovernmental bodies (e.g. UN Office in West Africa or UNOWA, UN Office for Drugs and Crime or UNODC, the Economic Community of West African States or ECOWAS and the AU), NGOs and academics....