health

Deadly roads block mothers from care in jihadist-hit Nigeria

BY NICHOLAS ROLL

  • His wife, Ummanim, eventually made it to the hospital, but it was too late: she and the baby both died.
  • When Lawan Mustafa's wife, nine months pregnant, woke up bleeding in the middle of the night, she looked at her husband and warned him: don't go to the hospital.
  • His wife, Ummanim, eventually made it to the hospital, but it was too late: she and the baby both died.
When Lawan Mustafa's wife, nine months pregnant, woke up bleeding in the middle of the night, she looked at her husband and warned him: don't go to the hospital.
Despite a base full of troops stationed on the outskirts of the northeastern Nigerian town where they live, Magumeri is known to crawl with jihadists at night -- as well as anti-jihadist vigilantes who might view Mustafa as a suspect.
Nigeria is the world's most dangerous country to give birth in, with a maternal mortality rate of 993 per 100,000 births, according to the World Health Organization. 
Corruption is endemic and doctors are constantly on strike, demanding backpay and upgrades to aging facilities. 
But in the northeast, in the throes of a 16-year-old insurgency, an untold number of women never make it to the hospital -- hemmed in by roads too dangerous to travel on, or military checkpoints and curfews.
"Before you know it, everywhere was stained with blood," Mustafa, a 35-year-old father of five, told AFP. "I was reassuring her, because there was no way we could go out."
He finally left around 4:30 am, when there would be safety in numbers as fellow Muslim faithful started stirring for the first morning prayers. 
His wife, Ummanim, eventually made it to the hospital, but it was too late: she and the baby both died.
Even as its maternal mortality rate has been steadily ticking down over the past decade, the nation's 75,000 maternal deaths per year account for a quarter of all such fatalities worldwide.
The causes are myriad, experts say: despite the country's vast oil wealth, millions live in poverty. Cultural mores can limit women's access to contraceptives, as well as their ability to travel outside their village, especially in the conservative north.
Children aren't spared: Nigeria ranks only behind neighbouring Niger when it comes to deaths of children under five, according to the World Bank.

Abductions, checkpoints

The country's jihadist insurgency, which was kicked off by Boko Haram's 2009 uprising, only adds to the crisis. 
"You want (a patient) to come to a facility that is far -- she might be thinking, what if I get abducted along this road?" said Ekeh Chizoba, a health outreach officer with International Rescue Committee (IRC), an NGO, noting an increase in reports of kidnapping this year.
Medical workers can also be high-value kidnapping targets, her colleague, Saidu Liman told AFP, adding to the already difficult task of recruiting specialists to rural locales.
Violence in the northeast has receded since its peak a decade ago, and major cities such as Maiduguri -- the capital of Borno state -- are no longer the site of suicide bombings or gun battles.
But swathes of countryside remain outside government control and analysts have warned of an uptick in jihadist attacks this year. 
The military closes the 50-kilometre (30-mile) road from Maiduguri to Magumeri each day around 5:00 pm -- blocking the movement of doctors, patients and medicines from the better-equipped capital.
Even when the road is open, it's no guarantee there won't be attacks.
"They'll mount a checkpoint and tell me I have to stay back while the military clear the road," said Mohammed Bakura, an ambulance driver contracted by IRC who often drives between the two cities.
Such delays are preferable to the times when jihadists have attempted to steal his car while attacking the Magumeri clinic, he said.
In a village on Magumeri's outskirts, surrounded by sprawling fields of sorghum and beans, Falmata Kawu was seated at a small clinic where she took her daughter Aisa last year.
The two-year-old was referred to a hospital in Maiduguri for complications from malnutrition.
The road was open and she was able to go right away, but Aisa died at the hospital.
Kawu, 30, wondered what would have happened if there were less conflict and more money for health care -- if she could have treated Aisa in the village.
"The child could have lived longer," she said.
nro/sn/kjm

euthanasia

Resilient young woman leads fight for euthanasia in Mexico

BY HERIKA MARTINEZ IN CHIHUAHUA AND JEAN ARCE IN MEXICO CITY

  • She asked her parents what they thought.
  • Samara Martinez, a young Mexican woman who is sick and dying, smiles as she asks her many TikTok followers a difficult question.
  • She asked her parents what they thought.
Samara Martinez, a young Mexican woman who is sick and dying, smiles as she asks her many TikTok followers a difficult question.
The 30-year-old lives with several chronic and degenerative diseases, including kidney failure, and spends 10 hours a day hooked up to a dialysis machine to survive.
"Instead of seeking euthanasia, why don't I just unplug the machine and say goodbye?" Martinez, a journalist by trade, says in her video.
She then explains to her nearly 400,000 followers what it is like to suffer from several terminal diseases -- and why she is spearheading a campaign to legalize a person's right to euthanasia in Mexico.
As she prepares to answer her initial question, the camera zooms in on Martinez's face for a close-up. 
"Because I do not want to suffer and I want to die with dignity," she says.
A paradox is at work here: as she advocates for such a gravely serious issue as death, Martinez does so with vigor, enthusiasm and creativity over social media.
Her work helps her "stay alive," Martinez told AFP during an interview at her home in the city of Chihuahua in northern Mexico.
"Social media also serves to change the world," said Martinez, who feels that before she became a social media influencer she was an "agent of change."
After undergoing two failed kidney transplants, and with no possibility of being cured, in August she launched her campaign for Mexico to give people the right to die with dignity.
"I am going to be the person who legalizes euthanasia in Mexico," said Martinez.
She expressed confidence that she will succeed because, unlike previous campaigns with the same goal, this time it is a sick patient at the forefront.
Earlier this month, Uruguay became the first country in Latin America to decriminalize euthanasia through a law passed by congress. Colombia and Ecuador did the same in 1997 and 2024, respectively, through court rulings.

For love and respect

After more than a decade striving to get healthy, deciding she was ready to die posed a dilemma for Martinez. 
She asked her parents what they thought. "We support you," she said they told her.
"I am doing it for myself, and for the respect I have for my body, and because I love myself so much. That is what is behind all this," said Martinez.
With stoicism and good humor that could stun the many people who watch her online, Martinez explains her end-of-life decision.
"It is not that I gave up. Rather, I have unblocked that part of understanding which says death is not an enemy, that it is not pain. Death is a sister, a friend, and one embraces it."
Sitting in her office at a university in Chihuahua, where she is a tenured professor, Martinez analyzes her options.
She says in a steady voice that no one can make her keep doing dialysis.
"I would take 15 days to die, but those would be 15 days of agony and suffering because your whole body is poisoned. You can drown in your own liquids. It is a very undignified death," said Martinez.
To stop dialysis, she said, would be a form of passive euthanasia -- withholding treatment that would keep a dying person alive.
Another option is to resort to a law in Mexico under which a person sound of mind can ask that their life not be prolonged artificially and they only be given palliative care until they die.
This week, Martinez herself will present to the Mexican Senate a bill to make euthanasia part of Mexico's body of law, letting people decide when they want to die and to do so without unnecessary suffering. 
The lower chamber of congress must also approve the initiative.
"It is high time we stopped penalizing compassion," said Martinez.
She has amassed 118,000 signatures on a petition backing her idea and is now trying to win over lawmakers. 
When the time comes, Martinez envisions expiring by the sea, at dusk, with a quiet ceremony. 
"A celebration of life with my family, surrounded by people I love and who love me, and going peacefully, with no pain," she said.
jla-hmp/acc/ad/dw/jgc

Gates

Climate change won't end civilization, says Bill Gates

  • While the planet is dangerously off course in meeting the Paris Agreement's goal of limiting long-term warming to 1.5 degrees Celsius, Gates argued that rather than fixating on the precise figure, the world should strengthen its resilience.
  • Climate change "will not lead to humanity's demise," billionaire philanthropist Bill Gates has said in a long memo in which he argued that tackling global disease and poverty will help prepare the planet's poorest for a warming world.
  • While the planet is dangerously off course in meeting the Paris Agreement's goal of limiting long-term warming to 1.5 degrees Celsius, Gates argued that rather than fixating on the precise figure, the world should strengthen its resilience.
Climate change "will not lead to humanity's demise," billionaire philanthropist Bill Gates has said in a long memo in which he argued that tackling global disease and poverty will help prepare the planet's poorest for a warming world.
The missive was seen as a pivot by the 70-year-old Microsoft co-founder, a major backer of green technologies through his Breakthrough Energy organization, and comes days ahead of the COP30 climate summit in Brazil, whose leadership Gates praised for placing climate adaptation and human development high on the agenda.
Gates acknowledged that critics may charge him with hypocrisy because of his significant carbon footprint or argue the memo was a "sneaky way of arguing that we shouldn't take climate change seriously."
But he said that while climate change will have "serious" consequences, "people will be able to live and thrive in most places on Earth for the foreseeable future."
Gates's memo outlined his "Three tough truths about climate": climate change will not end civilization, limiting temperature is not the best measure of progress, and health and prosperity are the strongest defenses against climate destabilization.
He also pointed to significant progress in cutting emissions to date and said he was optimistic future technology innovation would pave the way for more.
While the planet is dangerously off course in meeting the Paris Agreement's goal of limiting long-term warming to 1.5 degrees Celsius, Gates argued that rather than fixating on the precise figure, the world should strengthen its resilience.
For most of the world's poor, he added, poverty and disease remain the more pressing problems, he added.
"Our chief goal should be to prevent suffering, particularly for those in the toughest conditions who live in the world's poorest countries," he said.
That means, for example, less focus on limiting extremely hot and cold days, and more on ensuring "fewer people live in poverty and poor health so that extreme weather isn't such a threat to them."
Looking ahead, Gates said a key climate strategy should be to reduce the so-called green premium -- the cost difference between clean and dirty ways of doing something -- to zero for materials such as cement, steel, and jet fuel.
He compared the memo to one he wrote at Microsoft 30 years ago urging the company to put the internet at the heart of everything it did.
Likewise, he said, the climate community needs a "strategic pivot" at COP30 and beyond.
"Prioritize the things that have the greatest impact on human welfare," he said.
Critics said Gates' essay lacked substance and posed a false choice between climate action and reducing human suffering.
"Mr. Gates has set up a false frame that pits improving lives against science-based temperature and emissions goals. In fact, the two are intrinsically connected," Rachel Cleetus of the Union of Concerned Scientists told AFP.
"The warming climate is directly undermining poverty eradication and human development goals around the world.
"Hurricane Melissa, a climate change-fueled monster storm, is just the latest example of the deadly and costly consequences of climate change for nations already struggling with complex humanitarian challenges."
Transitioning away from fossil fuels will bring health and economic benefits while disrupting the "malign influence" of Big Oil on the future of the planet, she added.
ia/bgs

conflict

WHO pleads for sick Gazans to be allowed to leave

  • If that route opened, it would really be a... game-changer."
  • The UN's health agency pleaded Friday for thousands of people in desperate need of medical care to be allowed to leave Gaza, in what it said would be a "game-changer".
  • If that route opened, it would really be a... game-changer."
The UN's health agency pleaded Friday for thousands of people in desperate need of medical care to be allowed to leave Gaza, in what it said would be a "game-changer".
The World Health Organization has supported the medical evacuation of nearly 7,800 patients out of the Gaza Strip since the war with Israel began two years ago -- and estimates there are 15,000 people currently needing treatment outside the Palestinian territory.
But a US-brokered ceasefire that came into effect on October 10 has not sped up the process -- the WHO has been able to evacuate only 41 critical patients since then.
Rik Peeperkorn, the WHO's representative in the Palestinian territories, called for all crossings out of Gaza into Israel and Egypt to be opened up during the ceasefire -- not only for the entry of aid but for medical evacuations too.
"All medical corridors need to be opened," he said, particularly to hospitals in the West Bank and East Jerusalem, as happened routinely before the war.
"It is vital and is the most cost-effective route. If that route opened, it would really be a... game-changer."
Speaking via video link from Jerusalem, he told journalists in Geneva that two evacuations were planned for next week, but he wanted them every day and said the WHO was ready to take "a minimum of 50 patients per day".
At the current rate, he said evacuating the 15,000 people needing treatment -- including 4,000 children -- would drag on for a decade or so.
The WHO says more than 700 people have died waiting for medical evacuation since the war began.
The UN health agency has called for more countries to step up and accept Gazan patients. While over 20 countries have taken patients, only a handful have done so in large numbers.
Peeperkorn said only a fraction of Gaza's health system remained in service -- just 14 of 36 hospitals are even partially functional for a population topping two million.
rjm/nl/jxb