Tag: Advice

  • Joint Leader’s statement – Violence against children: A hidden crisis of the COVID-19 pandemic

    Joint Leader’s statement – Violence against children: A hidden crisis of the COVID-19 pandemic

     

    The COVID-19 pandemic is having a devastating impact across the world. Efforts to contain the coronavirus are vital to the
    health of the world’s population, but they are also exposing children to increased risk of violence – including maltreatment,
    gender-based violence and sexual exploitation.

    As leaders of organisations committed to ending violence against children, we come together in solidarity to share our deep
    concern, call for action and pledge our support to protect children from violence and reduce the impact of COVID-19 on
    children in every country and community.

    A third of the global population is on COVID-19 lockdown, and school closures have impacted more than 1.5 billion children.
    Movement restrictions, loss of income, isolation, overcrowding and high levels of stress and anxiety are increasing the
    likelihood that children experience and observe physical, psychological and sexual abuse at home – particularly those
    children already living in violent or dysfunctional family situations. And while online communities have become central to
    maintain many children’s learning, support and play, it is also increasing their exposure to cyberbullying, risky online behavior
    and sexual exploitation.

    The situation is aggravated by children’s lack of access to schoolfriends, teachers, social workers and the safe space and
    services that schools provide. The most vulnerable children – including refugees, migrants, and children who are internally
    displaced, deprived of liberty, living without parental care, living on the street and in urban slums, with disabilities, and living
    in conflict-affected areas – are a particular concern. For many, growing economic vulnerability will increase the threat of child
    labour, child marriage and child trafficking.

    We must act now. Together, we call on governments, the international community and leaders in every sector to urgently
    respond with a united effort to protect children from the heightened risk of violence, exploitation and abuse as part of the
    broader response to COVID-19.

    Governments have a central role to play. They must ensure that COVID-19 prevention and response plans integrate age
    appropriate and gender sensitive measures to protect all children from violence, neglect and abuse. Child protection services
    and workers must be designated as essential and resourced accordingly.

    Working with and supporting governments, our collective response must include: maintaining essential health and social
    welfare services, including mental health and psychosocial support; providing child protection case management and
    emergency alternative care arrangements; ensuring social protection for the most vulnerable children and households;
    continuing care and protection for children in institutions; and communicating with and engaging parents, caregivers and
    children themselves with evidence-based information and advice. National helplines, school counsellors and other child-friendly
    reporting mechanisms enable children in distress to reach out for help, and must be adapted to the challenges of COVID-19.

    Given the heightened risks of online harms, technology companies and telecoms providers must do everything they can
    to keep children safe online. This includes providing access to cost-free child helplines, age-appropriate services and safe
    e-education platforms – and using their platforms to share child online safety advice. They must also do more to detect and
    stop harmful activity against children online, including grooming and the creation and distribution of child sexual abuse
    images and videos.

    As global organisations working to end violence against children, we will continue to advocate for and invest in effective child
    protection solutions. We will collectively develop and share technical resources and guidance for policymakers, practitioners,
    parents, caregivers and children themselves. And we will support the courageous health, child protection and humanitarian
    professionals working around the clock to keep children safe during these unprecedented times.

    In recent years, the global community has made significant gains in protecting children from violence. We must not allow those
    gains to be lost during the current turmoil. We must do all we can to keep children safe now. And we must plan ahead together,
    so that once the immediate health crisis is over, we can get back on track towards the goal of ending all forms of violence,
    abuse and neglect of children

     

    Joint Leader's statement - Violence against children: A hidden crisis of the COVID-19 pandemic 1

     

    Joint Leader's statement - Violence against children: A hidden crisis of the COVID-19 pandemic
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    https://www.who.int/news-room/detail/08-04-2020-joint-leader-s-statement—violence-against-children-a-hidden-crisis-of-the-covid-19-pandemic

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  • #BeActive for the UN International Day of Sport for Development and Peace

    #BeActive for the UN International Day of Sport for Development and Peace

    FIFA has joined forces with the United Nations (UN) and the World Health Organization (WHO) in supporting the #BeActive campaign launched on the UN International Day of Sport for Development and Peace to encourage people to be #HealthyAtHome as the world comes together in the fight against COVID-19, today and every day.

    WHO recommends all healthy adults do at least 30 minutes a day of physical activity and children at least 60 minutes per day. As part of this, #BeActive and remain #HealthyAtHome include the following suggestions along with any other form of recreation
    to stay healthy at home:

    #BeActive for the UN International Day of Sport for Development and Peace 2

    1. Taking some online exercise classes,
    2. Dancing,
    3. Playing active video games,
    4. Jumping rope, and
    5. Practising muscle strength and balance training.

    “We are delighted that football is strongly supporting the International Day of Sport for Development and Peace by asking everyone to #BeActive and to remain healthy at home during this difficult time,” said António Guterres Secretary-General
    of the United Nations. “FIFA has asked the football community, from member associations and clubs, to players and fans, to show their support, to put their rivalries aside and to show a new solidarity so we can overcome the coronavirus.
    This is an important lesson not only for today, but for every day.”

    “More than ever, especially now, one thing must be clear to everyone, health comes first,” said FIFA President Gianni Infantino. “FIFA is delighted to support both the United Nations and the World Health Organization in amplifying
    the #BeActive campaign today, and we are encouraged that the football community is also playing an active role in ensuring the message understood globally. For the first time ever, we are all on the same team and together, with team spirit and
    positive energy, we will win.” 

    “WHO is proud to collaborate as part of the UN family with FIFA and football lovers worldwide to promote the importance of being active for both physical and mental health,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “The #BeActive campaign supports WHO’s drive to help people be healthy at home.”

    The campaign kicks off with Real Madrid CF, FC Barcelona, Liverpool FC and Manchester United FC asking football fans to set aside their rivalries and to come together to #BeActive in order to defeat the coronavirus. Other clubs, including Club América,
    CD Guadalajara, Beijing Guoan FC, Shanghai Shenhua FC, Mohun Bagan AC, East Bengal FC, Melbourne City FC, Sydney FC, Auckland City FC, Team Wellington FC, CA River Plate, Olympique de Marseille, TP Mazembe, CR Flamengo and SE Palmeiras will also
    join the initiative in the coming days.

    As part of the campaign, world-famous players share the following message: “At this time, even rivals need to stick together. We have to keep our distance, but we do not lose our focus. We can show solidarity by being active, and active means
    following the guidelines from the WHO.”

    The video campaign will
    be published on various FIFA digital channels, with regular subsequent updates from clubs and players across the world during subsequent days. #BeActive is also being supported with graphics toolkits for the 211 FIFA member associations and various
    media agencies to facilitate additional localisation and to further amplify the message.

    WHO, the UN’s specialized health agency, and FIFA, football’s world governing body, collaborate closely to promote healthy lifestyles through football globally and launched the “
    Pass the message to kick out coronavirus” campaign last month to share advice effective measures to protect people from COVID-19.

    The video campaign can also be downloaded here for editorial purposes.

     

     

    #BeActive for the UN International Day of Sport for Development and Peace
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    https://www.who.int/news-room/detail/06-04-2020-beactive-for-the-un-international-day-of-sport-for-development-and-peace

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  • Women in the New Age

    Women in the New Age

    42. The Transvaluation of Values

    The gradual emancipation of ladies that has been happening for the final century has nonetheless a protracted technique to proceed earlier than they’re wholly delivered from their conventional burdens and so stand away from the oppressions of males. But already, it should be plain, they’ve made monumental progress—maybe greater than they made within the ten thousand years previous. The rise of the commercial system, which has borne so harshly upon the race normally, has introduced them sure unmistakable advantages. Their financial dependence, although nonetheless adequate to make marriage extremely enticing to them, is nonetheless thus far damaged down that giant lessons of ladies are actually virtually free brokers, and fairly impartial of the favour of males. Most of those girls, responding to concepts which can be nonetheless highly effective, are but intrigued, after all, by marriage, and like it to the autonomy that’s coming in, however the truth stays that they now have a free alternative within the matter, and that dire necessity now not controls them. After all, they needn’t marry if they do not need to; it’s doable to get their bread by their very own labour within the workshops of the world. Their grandmothers had been in a much more troublesome place. Failing marriage, they not solely suffered a merciless ignominy, however in lots of instances confronted the menace of precise hunger. There was merely no respectable place within the economic system of these occasions for the free girl. She both needed to enter a nunnery or settle for a disdainful patronage that was as galling as charity.

    Nothing might be plainer than the impact that the rising financial safety of ladies is having upon their entire behavior of life and thoughts. The diminishing marriage fee and the much more quickly diminishing delivery charges present which manner the wind is blowing. It is frequent for male statisticians, with attribute imbecility, to ascribe the autumn within the marriage fee to a rising disinclination on the male aspect. This rising disinclination is definitely on the feminine aspect. Even although no appreciable physique of ladies has but reached the particular doctrine that marriage is much less fascinating than freedom, it should be plain that giant numbers of them now method the enterprise with far better fastidiousness than their grandmothers and even their moms exhibited. They are tougher to please, and therefore happy much less usually. The girl of a century in the past may think about nothing extra beneficial to her than marriage; even marriage with a fifth fee man was higher than no marriage in any respect. This notion is progressively feeling the opposition of a opposite notion. Women normally should desire marriage to work, however there may be an rising minority which begins to understand that work could supply the better contentment, notably if it’s mellowed by a certain quantity of philandering.

    There already seems on the planet, certainly, a category of ladies, who, whereas nonetheless not genuinely averse to marriage, are but free from any idea that it’s needed, and even invariably fascinating. Among these girls are an excellent many considerably vociferous propagandists, virtually male of their violent earnestness; they vary from the man-eating suffragettes to such preachers of free motherhood as Ellen Key and such skilled shockers of the bourgeoisie because the American prophetess of birth-control, Margaret Sanger. But amongst them are many extra who wake the world with no such noisy eloquence, however content material themselves with finishing up their concepts in a quiet and respectable method. The variety of such girls is way bigger than is usually imagined, and that quantity tends to extend steadily. They are girls who, with their financial independence assured, both by inheritance or by their very own efforts, mainly within the arts and professions, do precisely as they please, and make no pother about it. Naturally sufficient, their superiority to conference and the frequent frenzy makes them extraordinarily enticing to the higher form of males, and so it isn’t unusual for certainly one of them to seek out herself voluntarily sought in marriage, with none preliminary scheming by herself—certainly an expertise that only a few odd girls ever get pleasure from, save maybe in desires or delirium.

    The previous order changeth and giveth place to the brand new. Among the ladies’s golf equipment and within the girls’s faculties, I’ve little doubt, there may be nonetheless a lot debate of the previous and foolish query: Are platonic relations doable between the sexes? In different phrases, is friendship doable with out intercourse? Many a girl of the brand new order dismisses the issue with one other query: Why with out intercourse? With the decay of the traditional idea of ladies as property there should come inevitably a reconsideration of the entire intercourse query, and out of that reconsideration there should come a revision of the mediaeval penalties which now punish the slightest frivolity within the feminine. The notion that honour in girls is completely a bodily matter, {that a} single aberrance could convert a girl of the best deserves into a girl of none in any respect, that the only real invaluable factor a girl can convey to marriage is virginity—this notion is so preposterous that no clever particular person, male or feminine, truly cherishes it. It survives as one of many hole conventions of Christianity; nay, of the levantine barbarism that preceded Christianity. As girls throw off the opposite conventions which now bind them they are going to throw off this one, too, and so their advantage, grounded upon fastidiousness and self-respect as an alternative of upon mere concern and conformity, will grow to be afar extra laudable factor than it ever may be below the current system. And for its absence, in the event that they see match to get rid of it, they are going to no extra apologize than a person apologizes immediately.

    43. The Lady of Joy

    Even prostitution, in the long term, could grow to be a roughly respectable occupation, because it was within the nice days of the Greeks. That high quality will certainly connect to it if ever it grows fairly pointless; no matter is pointless is at all times respectable, for instance, faith, modern clothes, and a information of Latin grammar. The prostitute is disesteemed immediately, not as a result of her commerce entails something intrinsically degrading and even unpleasant, however as a result of she is presently assumed to have been pushed into it by dire necessity, towards her dignity and inclination. That this assumption is normally unsound is not any objection to it; practically all of the pondering of the world, notably within the area of morals, is predicated upon unsound assumption, e.g., that God observes the autumn of a sparrow and is shocked by the autumn of a Sunday-school superintendent. The fact is that prostitution is without doubt one of the most tasty of the occupations virtually open to the form of girls who have interaction in it, and that the prostitute generally likes her work, and wouldn’t trade locations with a shop-girl or a waitress for something on the planet. The notion on the contrary is propagated by unsuccessful prostitutes who fall into the fingers {of professional} reformers, and who assent to the imbecile theories of the latter as a way to domesticate their good will, simply as convicts in jail, questioned by tee-totalers, at all times ascribe their rascality to alcohol. No prostitute of something resembling regular intelligence is below the slightest duress; she is completely free to desert her commerce and go into a store or manufacturing facility or into home service each time the impulse strikes her; all of the prevailing gabble about white slave jails and kidnappers comes from pious rogues who make a dwelling by feeding such nonsense to the credulous. So lengthy as the common prostitute is ready to make an excellent dwelling, she is sort of content material together with her lot, and disposed to distinction it egotistically with the slavery of her virtuous sisters. If she complains of it, then you might ensure that her success is under her expectations. A ravenous lawyer at all times sees injustice, within the courts. A nasty doctor is a bitter critic of Ehrlich and Pasteur. And when a suburban clergyman is pressured out of his treatment by a vestry-room revolution he virtually invariably concludes that the sinfulness of man is incurable, and typically he even begins to doubt among the typographical errors in Holy Writ.

    The excessive worth set upon virginity by males, whose esteem of it’s primarily based upon a mix of vainness and voluptuousness, causes many ladies to protect it in their very own individuals with a jealousy far past their non-public inclinations and pursuits. It is their idea that the lack of it could materially impair their probabilities of marriage. This idea isn’t supported by the information. The fact is that the girl who sacrifices her chastity, all the pieces else being equal, stands a significantly better probability of creating a creditable marriage than the girl who stays chaste. This is very true of ladies of the decrease financial lessons. At as soon as they arrive into contact, hitherto socially troublesome and typically virtually unimaginable, with males of upper lessons, and start to tackle, with the curious facility of their intercourse, the refinements and tastes and factors of view of these lessons. The mistress thus gathers allure, and what has begun as a sordid sale of amiability not uncommonly ends with formal marriage. The variety of such marriages is enormously better than seems superficially, for each events clearly make each effort to hide the information. Within the circle of my essentially restricted private acquaintance I do know of scores of males, a few of them of wealth and place, who’ve made such marriages, and who don’t appear to remorse it. It is an previous commentary, certainly, {that a} girl who has beforehand disposed of her advantage makes an excellent spouse. The frequent idea is that it’s because she is grateful to her husband for rescuing her from social outlawry; the reality is that she makes an excellent spouse as a result of she is a shrewd girl, and has specialised professionally in masculine weak spot, and is thus extra-competent on the conventional enterprise of her intercourse. Such a girl usually reveals a really magnificent sagacity. It could be very troublesome to deceive her logically, and it’s unimaginable to disarm her emotionally. Her revolt towards the pruderies and sentimentalities of the world was proof, to start with, of her mental enterprise and braveness, and her success as a insurgent is proof of her extraordinary pertinacity, resourcefulness and acumen.

    Even probably the most lowly prostitute is healthier off, in all worldly methods, than the virtuous girl of her personal station in life. She has much less work to do, it’s much less monotonous and dispiriting, she meets a far better number of males, and they’re of lessons distinctly past her personal. Nor is her occupation hazardous and her final destiny tragic. A dozen or extra years in the past I noticed a considerably amusing proof of this final. At that point sure sentimental busybodies of the American metropolis during which I lived undertook an elaborate inquiry into prostitution therein, and a few of them got here to me prematurely, as a sensible journalist, for recommendation as to the way to proceed. I discovered that each one of them shared the frequent superstition that the skilled lifetime of the common prostitute is simply 5 years lengthy, and that she invariably ends within the gutter. They had been enormously amazed after they unearthed the reality. This fact was to the impact that the common prostitute of that city ended her profession, not within the morgue however on the altar of God, and that those that remained single usually continued in follow for ten, fifteen and even twenty years, after which retired on competences. It was established, certainly, that absolutely eighty per cent married, and that they virtually at all times obtained husbands who would have been far past their attain had they remained virtuous. For one who married a cabman or petty pugilist there have been a dozen who married respectable mechanics, policemen, small shopkeepers and minor officers, and a minimum of two or three who married well-to-do tradesmen {and professional} males. Among the 1000’s whose careers had been studied there was truly one who ended because the spouse of the city’s richest banker—that’s, one who bagged the perfect catch in the entire group. This girl had begun as a home servant, and deserted that harsh and dreary life to enter a brothel. Her experiences there polished and civilized her, and in her previous age she was a grande dame of nice dignity. Much of the sympathy wasted upon girls of the traditional occupation is grounded upon an error as to their very own angle towards it. An educated girl, listening to {that a} frail sister in a public stew is anticipated to be amiable to all kinds of bounders, thinks of how she would shrink from such contacts, and so concludes that the precise prostitute suffers acutely. What she overlooks is that these males, nonetheless gross and repulsive they could seem to her, are measurably superior to males of the prostitute’s personal class—say her father and brothers—and that communion with them, removed from being disgusting, is usually relatively romantic. I effectively keep in mind observing, throughout my collaboration with the vice-crusaders aforesaid, the delight of a girl of pleasure who had attracted the discover of a police lieutenant; she was intensely happy by the concept of getting a consumer of such haughty manners, such sensible costume, and what appeared to her to be so dignified a occupation. It is at all times forgotten that this weak spot isn’t confined to prostitutes, however run by the entire feminine intercourse. The girl who couldn’t think about a bootleg affair with a rich cleaning soap producer and even with a lawyer finds it fairly simple to think about herself succumbing to an envoy or a duke. There are only a few exceptions to this rule. In probably the most reserved of recent societies the ladies who characterize their highest flower are notoriously complaisant to royalty. And royal girls, to finish the circuit, not sometimes yield to actors and musicians, i.e., to males radiating a glamour not encountered even in princes.

    44. The Future of Marriage

    The transvaluation of values that’s now in progress will go on slowly and for a really lengthy whereas. That it’s going to ever be fairly full is, after all, unimaginable. There are inherent variations will proceed to point out themselves till the top of time. As girl progressively turns into satisfied, not solely of the potential for financial independence, but in addition of its worth, she’s going to in all probability lose her current overmastering need for marriage, and tackle herself to assembly males in free financial competitors. That is to say, she’s going to tackle herself to buying that sensible competence, that prime expertise for puerile and mainly mechanical expertness, which now units man forward of her within the labour market of the world. To do that she must sacrifice a few of her current intelligence; it’s unimaginable to think about a genuinely clever human being turning into a reliable trial lawyer, or buttonhole employee, or newspaper sub-editor, or piano tuner, or home painter. Women, to get upon all fours with males in such silly occupations, must commit non secular suicide, which might be a lot additional than they are going to ever truly go. Thus a shade of their current superiority to males will at all times stay, and with it a shade of their relative inefficiency, and so marriage will stay enticing to them, or in any respect occasions to most of them, and its overthrow might be prevented. To abolish it completely, as sure fevered reformers suggest, can be as troublesome as to abolish the precession of the equinoxes.

    At the current time girls vacillate considerably absurdly between two schemes of life, the previous and the brand new. On the one hand, their financial independence continues to be stuffed with circumstances, and however they’re in revolt towards the immemorial conventions. The result’s a normal unrest, with many signs of extravagant and unintelligent revolt. One of these signs is the looks of mental striving in girls—not a striving, alas, towards the real pearls and rubies of the thoughts, however one merely towards the acquirement of the rubber stamps that males make use of of their so-called pondering. Thus we’ve girls who launch themselves into get together politics, and fill their heads with an enormous mass of ineffective information about political methods, customs, theories and personalities. Thus, too, we’ve the girl social reformer, trailing alongside ridiculously behind a tatterdemalion posse of male utopians, every with one thing to promote. And thus we’ve the girl who goes in for superior knowledge of the kind on draught in girls’s golf equipment—in short, the form of knowledge which consists completely of a physique of beliefs and propositions which can be ignorant, unimportant and unfaithful. Such banal striving is most prodigally on show within the United States, the place superficiality quantities to a nationwide illness. Its reputation is because of the comparatively better leisure of the American individuals, who work lower than another individuals on the planet, and, above all, to the comparatively better leisure of American girls. Thousands of them have been emancipated from any compulsion to productive labour with out having acquired any compensatory mental or creative curiosity or social obligation. The result’s that they swarm within the girls’s golf equipment, and waste their time, listening to dangerous poetry, worse music, and nonetheless worse lectures on Maeterlinck, Balkan politics and the unconscious. It is amongst such girls that one observes the periodic rages for Bergsonism, the Montessori methodology, the twilight sleep and different such follies, so pathetically attribute of American tradition.

    One of the evil results of this tendency I’ve hitherto descanted upon, to wit, the rising disposition of American girls to treat all routine labour, notably within the residence, as infra dignitatem and therefore insupportable. Out of that notion come up many lamentable phenomena. On the one hand, we’ve the spectacle of a large number of wholesome and well-fed girls engaged in public actions that, 9 occasions out of ten, are meaningless, mischievous and a nuisance, and however we behold such a decay within the home arts that, on the first onslaught of the late conflict, the nationwide authorities needed to import a overseas professional to show the housewives of the nation the veriest components of thrift. No such instruction was wanted by the housewives of the Continent. They had been merely informed how a lot meals they may have, and their pure competence did the remainder. There is rarely any avoidable waste there, both in peace or in conflict. A French housewife has little use for a rubbish can, save as a depository for uplifting literature. She does her finest with the means at her disposal, not solely in conflict time however always.

    As I’ve stated over and over on this inquiry, a girl’s disinclination to accumulate the intricate expertness that lies on the backside of fine housekeeping is due primarily to her lively intelligence; it’s troublesome for her to pay attention her thoughts upon such silly and meticulous enterprises. But whether or not troublesome or simple, it’s clearly vital for the common girl to make some effort in that course, for if she fails to take action there may be chaos. That chaos is duly seen within the United States. Here girls reveal certainly one of their subterranean qualities: their deficiency in conscientiousness. They are fairly with out that dog-like constancy to obligation which is without doubt one of the shining marks of males. They by no means summon up a excessive pleasure in doing what’s inherently unpleasant; they at all times go to the galleys below protest, and with vows of sabotage; their basic philosophy is nearly that of the syndicalists. The sentimentality of males connives at this, and is thus largely accountable for it. Before the common puella, apprenticed within the kitchen, can choose up a fourth of the culinary subtleties which can be commonplace even to the cooks on eating vehicles, she has caught a person and want concern herself about them no extra, for he has to eat, within the final evaluation, no matter she units earlier than him, and his lack of intelligence makes it simple for her to close off his tutorial criticisms by bald appeals to his feelings. By a straightforward course of he lastly attaches a optimistic worth to her indolence. It is a proof, he concludes, of her fineness of soul. In the presence of her lofty incompetence he’s abashed.

    But as girls, gaining financial autonomy, meet males in progressively bitterer competitors, the rising masculine mistrust and concern of them might be mirrored even within the enchanted area of marriage, and the husband, having yielded up most of his previous rights, will start to disclose a brand new jealousy of those who stay, and notably of the fitting to a good quid professional quo for his personal docile trade. In transient, as girls shake off their historic disabilities they will even shake off a few of their historic immunities, and their doings will come to be regarded with a soberer and extra exigent scrutiny than now prevails. The extension of the suffrage, I consider, will encourage this awakening; in wresting it from the reluctant male the ladies of the western world have planted dragons’ tooth, the which can presently leap up and gnaw them. Now that girls have the political energy to acquire their simply rights, they are going to start to lose their previous energy to acquire particular privileges by sentimental appeals. Men, going through them squarely, will think about them anew, not as romantic political and social invalids, to be coddled and caressed, however as free opponents in a harsh world. When that reconsideration will get below manner there might be a normal overhauling of the relations between the sexes, and among the truthful ones, I believe, will start to marvel why they did not let effectively sufficient alone.

    45. Effects of the War

    The current sequence of wars, it appears seemingly, will proceed for twenty or thirty years, and maybe longer. That the primary conflict was inconclusive was proven brilliantly by the preposterous nature of the peace lastly reached—a peace so synthetic and dishonest that the signing of it was virtually equal to a brand new declaration of conflict. At least three new contests within the grand method are plainly perception—one between Germany and France to rectify the unnatural tyranny of a weak and incompetent nation over a powerful and enterprising nation, one between Japan and the United States for the mastery of the Pacific, and one between England and the United States for the management of the ocean. To these should be added numerous minor struggles, and maybe one or two of just about main character: the trouble of Russia to regain her previous unity and energy, the trouble of the Turks to place down the slave rise up (of Greeks, Armenians, Arabs, and so on.)which now menaces them, the trouble of the Latin-Americans to throw off the galling Yankee yoke, and the joint effort of Russia and Germany (maybe with England and Italy aiding) to do away with such worldwide nuisances because the insane Polish republic, the petty states of the Baltic, and maybe additionally many of the Balkan states. I cross over the chance of a brand new mutiny in India, of the rising of China towards the Japanese, and of a normal battle for a brand new alignment of boundaries in South America. All of those wars, nice and small, are possible; most of them are humanly sure. They might be fought ferociously, and with assistance from harmful engines of the utmost effectivity. They will result in an unparalleled butchery of males, and a big proportion of those males might be below forty years of age.

    As a consequence there might be a scarcity of husbands in Christendom, and as a second consequence the survivors might be appreciably tougher to snare than the lads of immediately. Every man of agreeable exterior and straightforward means might be pursued, not merely by just a few dozen or rating of ladies, as now, however by entire battalions and brigades of them, and he might be pushed in sheer self-defence into very sharp bargaining. Perhaps in the long run the state must intervene within the enterprise, to forestall the potential husband going to waste within the turmoil of alternative.

    Just what kind this interference is prone to take has not but appeared clearly. In France there may be already a wholesale legitimization of kids born out of wedlock and in Eastern Europe there was a clamour for the legalization of polygamy, however these gadgets don’t meet the principle downside, which is the encouragement of monogamy to the utmost. A plan that means itself is the amelioration of the place of the monogamous husband, now rendered more and more uncomfortable by the legal guidelines of most Christian states. I don’t assume that the extra clever form of girls, confronted by a deadly scarcity of males, would object severely to that amelioration. They should see plainly that the current system, whether it is carried a lot additional, will start to work powerfully towards their finest pursuits, if solely by significantly reinforcing the disinclination to marriage that already exists among the many higher form of males. The girl of true discretion, I’m satisfied, would a lot relatively marry a superior man, even on unfavourable phrases, than make John Smith her husband, serf and prisoner at one stroke.

    The legislation should finally acknowledge this truth and make provision for it. The common husband, maybe, deserves little succour. The girl who pursues and marries him, although she could also be moved by egocentric goals, needs to be correctly rewarded by the state for her service to it—a service certainly to not be flippantly estimated in a navy age. And that reward could conveniently take the shape, as within the United States, of statutes giving her title to a big share of his actual property and requiring him to give up most of his revenue to her, and releasing her from all obedience to him and from all obligation to maintain his home so as. But the girl who aspires to increased sport needs to be fairly prepared, it appears to me, to resign a few of these benefits in compensation for the better honour and satisfaction of being spouse to a person of benefit, and mom to his kids. All that’s wanted is legal guidelines permitting her, if she’s going to, to resign her proper of dower, her proper to upkeep and her immunity from self-discipline, and to make another phrases that she could also be led to treat as equitable. At current girls are unable to make most of those concessions even when they might: the legal guidelines of nearly all of western nations are rigid. If, for instance, an Englishwoman ought to agree, by an ante-nuptial contract, to submit herself to the self-discipline, not of the present statutes, however of the elder frequent legislation, which allowed a husband to right his spouse corporally with a stick no thicker than his thumb, it could be competent for any sentimental neighbour to set the settlement at naught by haling her husband earlier than a Justice of the Peace for carrying it out, and it’s a secure wager that the Justice of the Peace would jail him.

    This plan, nonetheless novel it might appear, is definitely already in operation. Many a married girl, as a way to maintain her husband from revolt, makes roughly disguised surrenders of sure of the rights and immunities that she has below current legal guidelines. There are, for instance, even in America, girls who practise the home arts with competence and diligence, regardless of the plain indisputable fact that no authorized penalty can be visited upon them in the event that they failed to take action. There are girls who comply with exterior trades and professions, contributing a share to the household exchequer. There are girls who obey their husbands, even towards their finest judgments. There are, most quite a few of all, girls who wink discreetly at husbandly departures, overt or in mere intent, from the oath of chemical purity taken on the altar. It is a commonplace, certainly, that many completely happy marriages admit a celebration of the third half. There can be extra of them if there have been extra girls with sufficient serenity of thoughts to see the sensible benefit of the association. The hassle with such triangulations isn’t primarily that they contain perjury or that they provide any basic offence to the spouse; if she avoids banal theatricals, in truth, they generally have the impact of augmenting the husband’s devotion to her and respect for her, if solely because the fruit of comparability. The hassle with them is that only a few males amongst us have sense sufficient to handle them intelligently. The masculine thoughts is instantly taken in by specious values; the common married man of Protestant Christendom, if he succumbs in any respect, succumbs to some meretricious and flamboyant creature, bent solely upon fleecing him. Here is the place the cruel realism of the Frenchman reveals its superiority to the sentimentality of the lads of the Teutonic races. A Frenchman would no extra consider taking a mistress with out consulting his spouse than he would consider standing for workplace with out consulting his spouse. The result’s that he’s seldom victimized. For one Frenchman ruined by girls there are a minimum of 100 Englishmen and Americans, even supposing 100 occasions as many Frenchmen have interaction in that form of recreation. The case of Zola is typical. As is well-known, his amours had been rigorously supervised by Mme. Zola from the primary days of their marriage, and in consequence his life was wholly free from scandals and his thoughts was by no means distracted from his work.

    46. The Eternal Romance

    But no matter the way forward for monogamous marriage, there’ll by no means be any decay of that agreeable adventurousness which now lies on the backside of all transactions between the sexes. Women could emancipate themselves, they could borrow the entire bag of masculine methods, they usually could treatment themselves of their current need for the vegetable safety of marriage, however they are going to by no means stop to be girls, and as long as they’re girls they are going to stay provocative to males. Their chief allure immediately lies exactly in the truth that they’re harmful, that they threaten masculine liberty and autonomy, that their sharp minds current a menace vastly better than that of acts of God and the general public enemy—and they are going to be harmful for ever. Men concern them, and are fascinated by them. They know the way to present their tooth charmingly; the extra enlightened of them have perfected an outstanding strategy of fascination. It was Nietzsche who known as them the recreation of the warrior—not of the poltroon, keep in mind, however of the warrior. A profound saying. They have an infinite capability for rewarding masculine trade and enterprise with small and irresistible flatteries; their acute understanding combines with their capability for evoking concepts of magnificence to make them incomparable companions when the intense enterprise of the day is finished, and the time has come to increase comfortably within the interstellar ether.

    Every man, I daresay, has his personal notion of what constitutes good peace and contentment, however all of these notions, regardless of the elemental battle of the sexes, revolve round girls. As for me—and I hope I could also be pardoned, at this late stage in my inquiry, for intruding my very own persona—I reject the 2 commonest of them: ardour, a minimum of in its extra adventurous and melodramatic features, is just too thrilling and alarming for therefore indolent a person, and I’m too egoistic to have a lot need to be mothered. What, then, stays for me? Let me attempt to describe it to you.

    It is the shut of a busy and vexatious day—say half previous 5 – 6 o’clock of a winter afternoon. I’ve had a cocktail or two, and am stretched out on a divan in entrance of a fireplace, smoking. At the sting of the divan, shut sufficient for me to succeed in her with my hand, sits a girl not too younger, however nonetheless handsome and well-dressed—above all, a girl with a delicate, low-pitched, agreeable voice. As I snooze she talks—of something, all the pieces, all of the issues that girls speak of: books, music, the play, males, different girls. No politics. No enterprise. No faith. No metaphysics. Nothing difficult and vexatious—however keep in mind, she is clever; what she says is clearly expressed, and sometimes picturesquely. I observe the positive sheen of her hair, the gorgeous lower of her frock, the glint of her white tooth, the arch of her eye-brow, the sleek curve of her arm. I take heed to the beautiful murmur of her voice. Gradually I go to sleep—however just for an immediate. At as soon as, observing it, she raises her voice ever so little, and I’m awake. Then to sleep once more—slowly and charmingly down that slippery hill of desires. And then awake once more, after which asleep once more, and so forth.

    I ask you severely: may something be extra unutterably stunning? The sensation of falling asleep is to me probably the most beautiful on the planet. I enjoyment of it a lot that I even stay up for demise itself with a sneaking marvel and need. Well, right here is sleep poetized and made doubly candy. Here is sleep set to the best music on the planet. I match this example towards any that you just ran consider. It isn’t solely enchanting; additionally it is, in a really true sense, ennobling. In the top, when the woman grows prettily miffed and throws me out, I return to my sorrows one way or the other purged and glorified. I’m a greater man in my very own sight. I’ve grazed upon the fields of asphodel. I’ve been genuinely, utterly and unregrettably completely happy.

    47. Apologia in Conclusion

    At the top I crave the indulgence of the aesthetic reader for the imperfections essentially seen in all that I’ve right here set down—imperfections not solely resulting from incomplete data and fallible logic, but in addition, and maybe extra importantly, to sure basic weaknesses of the intercourse to which I’ve the honour to belong. A person is inseparable from his congenital vanities and stupidities, as a canine is inseparable from its fleas. They reveal themselves in all the pieces he says and does, however they reveal themselves most of all when he discusses the majestic thriller of girl. Just as he smirks and rolls his eyes in her precise presence, so he places on apathetic and unescapable clownishness when he essays to dissect her within the privateness of the laboratory. There is not any e book on girl by a person that’s not a stupendous compendium of posturings and imbecilities. There are however two books that present even a superficial need to be trustworthy—”The Unexpurgated Case Against Woman Suffrage,” by Sir Almroth Wright, and this one. Wright made a gallant try to inform the reality, however earlier than he obtained half manner by his job his ineradicable donkeyishness as a male overcame his scientific frenzy as a psychologist, and so he swiftly washed his fingers of the enterprise, and affronted the even handed with a half baked and preposterous e book. Perhaps I’ve failed too, and much more ingloriously. If so, I’m stuffed with honest and indescribable remorse.

    Extract from IN DEFENSE OF WOMEN by H. L. Mencken

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  • Nigeria’s Unhealthy Healthcare In Eye Of Coronavirus By Runcie C.W. Chidebe

    Nigeria’s Unhealthy Healthcare In Eye Of Coronavirus By Runcie C.W. Chidebe

    Nigeria’s Unhealthy Healthcare In Eye Of Coronavirus By Runcie C.W. Chidebe 3

    Nigeria’s Unhealthy Healthcare In Eye Of Coronavirus By Runcie C.W. Chidebe 4


    Coronavirus (COVID-19) is right here to show us a lesson; I hope we be taught. Nigeria’s healthcare is unhealthy. But as an alternative of fixing it our rulers have been busy flying up and down to profit from different nation’s productive well being system. With Coronavirus, actuality is upon us. No extra operating abroad for medical trip. Our rulers can’t journey to the United Kingdom, United States of America or India anymore for medical care. These nations are additionally hanging on their final breath, battling to outlive the COVID-19 pandemic. 

    In 2017, President Muhammadu Buhari spent 103 days in London receiving medical therapy for an undisclosed sickness, spending taxpayers’ cash as an alternative of investing within the nation’s healthcare. Thousands of Nigerians died in the identical interval from totally different sicknesses. More than 3,000 girls died of breast most cancers, greater than 2,000 girls died of cervical most cancers and greater than 1,500 males died of prostate most cancers, in line with World Health Organization (WHO) figures on annual most cancers mortality.  

    I had hoped that on his return to Nigeria, President Buhari would declare a state of emergency within the nation’s well being sector. Painfully, nothing of such occurred. Nigeria’s funds allocation to healthcare has remained lower than 5% of the whole funds for the previous 5 years. Simply put, in 2020 the federal authorities budgeted N2,000 (£4.2) for every Nigerian with a complete of N427.Three billion as funds allocation to the well being sector whereas the United Kingdom budgeted £2,159.6 for every citizen with a complete well being funds of £143.4billion. It is similar dismal story within the states throughout Nigeria. Healthcare isn’t a precedence. In some states in Nigeria, a hospital is a 20-minute boat journey and an hour-long automobile journey. Because many poor Nigerians don’t personal boats, a girl in labour may bleed to loss of life earlier than she reaches the hospital.

    On March 22, 2018, Bill Gates, founding father of Microsoft and the Bill & Melinda Gates Foundation, criticized Nigerian authorities’s poor funding of healthcare within the nation. In his phrases, “One in three children is chronically malnourished.” This tragedy has large implications for the economic system. According to the World Bank, addressing the stunting disaster in Nigeria would add virtually $30 billion to Nigeria’s GDP. It is painful that regardless of Mr. Gates assertion, nothing has modified. Nigeria has remained one of many nations on this planet with the worst healthcare system with over 60 deaths per 1000 stay births. Nigeria has one of many worst most cancers survival charges on this planet, with solely 2 to three most cancers radiotherapy machines working at any time and fewer than 70 oncologists for a inhabitants of over 200 million. 

    COVID-19 is exposing the insensitivity of our leaders to issues that matter most to us. That Nigerians are disobeying the federal government’s security recommendation on COVID-19 is a transparent reflection of residents’ distrust for his or her leaders. Many Nigerians belief their non secular leaders greater than they belief our political leaders. Successive governments have failed the nation, and it doesn’t appear like factor will change anytime quickly. 

    Nigeria is a rustic the place our rulers make legal guidelines as we speak and break the identical legal guidelines tomorrow. The Nigeria Centre for Diseases Control (NCDC) adopted the World Health Organization (WHO) guideline and strongly inspired all Nigerians coming from sure nations to self-isolate and monitor themselves, as a method to comprise or to delay the unfold of COVID-19. The president’s Chief of Staff, Abba Kyari, returned from Germany and as an alternative of isolating himself he was leaping from one state to a different, attending occasions and conferences with totally different folks, breaching the federal government’s personal advice and inserting the lives of different Nigerians in danger! 

    Now that COVID-19 is in Nigeria we have to face it with all that we’ve. But can we? The Nigeria Centre for Disease Control (NCDC) is now the nation’s solely perceived hope. Many Nigerians have been calling NCDC scorching traces, criticizing NCDC for not testing sufficient folks. But we must always face the music and never the dancer. NCDC is crippled and never effectively outfitted to guard Nigerians from the illness. 

    In 2016, NCDC budgeted N3.7m for its recurrent and N248m for capital allocations. That is a complete of N251.7m. Out of this, solely N155m was launched to the centre. In the identical 12 months, 1,166 Nigerians died of Cerebrospinal Meningitis. In 2017, the NCDC had a funds of N1.5b. Only N782m was launched. In the identical 12 months, greater than 120 Nigerians contracted Monkeypox and 7 folks died from the illness. That identical 12 months, the Presidency budgeted N77m for Aso Rock lease, N1b for journeys and sitting allowances, and N94m for meals. In 2018, the NCDC had a funds of N1.9b. Only N654m was launched. In the identical 12 months, N7.2b was proposed for Presidential Air Fleet. N440m was proposed for necessary improve and set up of stay TV and web service within the presidential aircrafts, N375m for brand spanking new cabin administration, N418m for the touchdown gears. In whole, over N1b was budgeted for the presidential aircrafts which is used for medical tourism and frequent journeys overseas. 

    On November 12, 2018, the NCDC institution invoice was signed by President Muhammadu Buhari, because of the efforts of Senator Mao Ohuabunwa, the then Chair, Senate Committee on Primary Healthcare and Communicable Diseases. On this premise, the NCDC was empowered with a laws for its work in stopping and making ready for outbreaks of infectious illnesses. Interestingly, the NCDC acquired the worst funds in 2019, the 12 months following the passage of the NCDC Act. The Centre had a funds of N1.4b, however solely N224m was launched. In the identical 12 months, over 472 Nigerians have been identified with Lassa fever and over 110 folks died from this viral hemorrhagic fever. Clearly, NCDC can’t carry out magic. They need assistance. Nigeria is grossly under-testing for COVID-19, the laboratories usually are not sufficient, and NCDC and its affiliate businesses wouldn’t have sufficient manpower and sources. 

    Months in the past, being unwell evoked empathy; as we speak being unwell evokes concern. The concern of COVID-19? No! It is the concern of not gaining access to the care that you just want, the concern of absence of ventilators, the concern of a damaged well being system. It is the concern of loss of life. Our political leaders have stolen from the sick by corruption. Many Nigerian governors construct non-functional hospitals of their states. Usually, after the commissioning of those hospitals, all of the CT Scan, Magnetic Resonance Imaging (MRI) and different medical machines—a few of them faux—are returned to the place they have been bought or left to rot. 

    Hospitals in Nigeria are among the worst on this planet. Our educating hospitals at the moment are museums the place lower than 5% of medical trial and analysis is occurring due to poor laboratory. Medical tourism has due to this fact grow to be the norm. Dubai hospitals, Saudi Arabian hospitals, and so on., are promoting in Abuja and Lagos for Nigerian sufferers. They are recruiting Nigerian docs, together with consultants. Nigeria isn’t solely going through “brain drain,” we’re additionally going through “patient drain.” Our docs and nurses work within the worst situations. Hazard allowance for well being staff is about N5,000 whereas wardrobe allowance for members of the National Assembly runs into hundreds of thousands. 

    Now is the time for Nigeria to confront its healthcare disaster. The Nigerian authorities should settle for its failure. Our political leaders should brace as much as their duty and critically replicate on the issue their greed has delivered to Nigeria. This is the time to put money into a result-oriented healthcare system. Health is wealth because the saying goes. healthcare system is the muse of any nation. 

    If we survive COVID-19, we have to contemplate a legislation to limit all public officers from searching for medical care overseas. It could also be perceived as strict, however it can save future generations since we don’t know which pandemic would come subsequent and when. 

    Let’s give each Nigerian an area to stay and a not probability to die. 

    Runcie C.W. Chidebe is Executive Director, Project PINK BLUE. He is at the moment a Commonwealth Scholar on Transforming and Leading in Health Care at Birmingham City University, United Kingdom. He tweets @runciecwc

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  • 5 Steps to the Most Influential Customer Communications: Create the Right Messaging First (Enhanced Rule 25 in “42 Rules of Product Marketing”)

    Engaging your prospects with extra influential communications is a good way to improve the effectiveness of your advertising and gross sales efforts. This article exhibits you the way to outline and create the proper messaging, after which use it as a catalyst to interact prospects with the most influential content material and gross sales conversations, extra persistently, throughout extra contact factors.

    This put up was first launched in “42 Rules of Product Marketing,” which was printed in March 2012. It?s full of nice recommendation from some of Silicon Valley?s finest thought leaders.

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  • Africa Can’t Run Away From Coronavirus, Medical Expert Says

    Africa Can’t Run Away From Coronavirus, Medical Expert Says

    Africa Can’t Run Away From Coronavirus, Medical Expert Says 5

    Africa Can’t Run Away From Coronavirus, Medical Expert Says 6


    A medical professional, Abu Clement Okolo, has stated that Africa can’t run away from Coronavirus, therefore the necessity to embrace the rules given by the World Health Organisation.

    Clement, who spoke to SaharaReporters on the preparedness of Nigeria and Africa as a complete, stated it’s unimaginable to foretell the potential turnout of occasions in Africa as many international locations on the continent usually are not ready for the pandemic.

    He additionally expressed fear about medical consultants contracting the illness.

    Last week, the Provost and Deputy Provost of University College Hospital, Ibadan, Oyo State, Ezekiel Olapade-Olaopa and Obafunke Denloye each examined constructive for the virus. 

    On the identical day, the Chief Medical Director of the hospital, Jesse A. Otegbayo, additionally examined constructive for the virus. 

    Speaking on the worldwide unfold of the virus that has now infested over a million individuals worldwide, Clement stated happenings in European nations solely go to indicate how unprepared Africa is.  

    He stated, “Corona shouldn’t be one thing we will run away from. Corona is actual. We, as scientists, know we aren’t ready in Africa for what is occurring.

    “What all people must do is to brace up, heed the social distancing, keep at dwelling. Nobody can say the flip of the occasion within the coming days.

    “If it’s beginning with the individuals on the prime of the medical group which is one of the best within the Nigerian setting, you possibly can think about what might occur.

    “My advice to everyone should abide by the WHO instructions—stay home. Believe in God and Make peace with God.”

    Nigeria has recorded 174 confirmed instances to date and two recorded deaths.

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  • Four zones for classification of Covid-19 areas

    Four zones for classification of Covid-19 areas

    Four zones for classification of Covid-19 areas 7

    KUALA LUMPUR: The areas of Covid-19 have been categorised into 4 zones primarily based on the quantity of instances in an space by the Ministry of Health (MOH).

    National Security Council (MKN) in its response to the often requested query (FAQ) on the second part of the Movement Control Order (MCO 2) mentioned that the crimson zone refers to areas with greater than 40 constructive instances, whereas the orange zone is for areas with 21 to 40 constructive instances.

    The yellow zone refers to areas with one to 20 constructive instances and the inexperienced zone is with none constructive case.

    “The Enhanced Movement Control Order (EMCO) was carried out at sure areas or localities within the crimson zone on the recommendation of the MOH when there’s a sudden unfold of the virus in that locality,“ mentioned MKN.

    MKN famous that throughout the MCO 2 interval beginning yesterday till April 14, solely 10 important sectors had been allowed to function, together with meals companies, water, vitality, communications and web in addition to safety and defence.

    Solid waste administration, public cleaning and sewerage; healthcare and medical together with dietary complement; banking and finance; e-commerce and logistics are additionally confined to important companies. — Bernama

    Four zones for classification of Covid-19 areas
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  • Medical Product Alert N°3/2020

    This Medical Product Alert warns consumers, healthcare professionals, and health authorities against a growing number of falsified medical products that claim to prevent, detect, treat or cure COVID-19. 

    The Coronavirus disease (COVID-19) pandemic (caused by the virus SARS-CoV-2) has increased demand for medicines, vaccines, diagnostics and reagents, all related to COVID-19, creating an opportunity for ill-intended persons to distribute falsified medical products 

    Due diligence is required from all actors in the procurement, use and administration of medical products, in particular those affected by the current crisis of, or related to, COVID-19. 

    1. FALSIFIED IN VITRO DIAGNOSTICS AND LABORATORY REAGENTS 

    WHO has received multiple reports regarding falsified in vitro diagnostics (IVDs) and laboratory reagents for the detection of SARS-CoV-2. Please refer to WHO’s Emergency Use Listing for a list of diagnostics approved for clinical use by WHO. To date, eight countries (Australia, Brazil, Canada, PR China, Russian Federation, Singapore, Republic of Korea, United States of America) have listed IVDs for COVID-19 diagnosis based on expedited regulatory assessments. Please note that, in the European Union, regulatory compliance for SARS-CoV-2 diagnostics are self-declared by the manufacturer.  

    To assist Member States and stakeholders, WHO has published the links to these emergency lists, together with contact details. These links provide information on IVDs authorized for use in the jurisdictions of the International Medical Device Regulators Forum, as well as policies and guidance. WHO will provide updated versions as new information becomes available.

    End-users are encouraged to check the labelling against the information posted by regulatory authorities upon listing to ensure they are in possession of the genuine product. This information might include product name, product code, expiry date, instructions for use and manufacturer details. 

    Unregulated websites supplying medicines and/or vaccines, particularly those concealing their physical address or landline telephone number, are frequently the source of unlicensed, substandard and falsified medical products. WHO has been made aware of various unregistered websites claiming that products on sale can treat or prevent COVID-19. Such products are likely to be falsified medicines. In addition, some websites may appear to provide easy access to legitimate medicines that are otherwise not readily available. End-buyers and consumers should be especially wary of such online scams and exert due diligence when purchasing any medical product, whether online or not.

     2. FALSIFIED MEDICINES AND VACCINES

    At this stage, WHO does not recommend any medicines to treat or cure COVID-19. However, the SOLIDARITY trial, led by WHO, is reviewing potential treatments for COVID-19. 

    WHO requests increased vigilance from national health authorities, healthcare professionals, members of the public and supply chain stakeholders worldwide to prevent the distribution of these falsified medical products. Increased vigilance should focus on hospitals, clinics, health centres, clinical laboratories, wholesalers, distributors, pharmacies and any other suppliers of medical products. All medical products must be obtained from authentic and reliable sources. Their authenticity and condition of the product should be carefully checked. Consumers are advised to seek advice from a healthcare professional in case of doubt. 

    National health authorities are requested to immediately notify WHO if these falsified products are discovered in their country. If you have any information concerning the manufacture, distribution, or supply of these products, please contact rapidalert@who.int

    WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products
    For further information, please visit our website: https://www.who.int/medicines/regulation/ssffc/en/ 

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  • Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 8

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 9


    A lot of legal issues are bound to arise as an aftermath of the outbreak of Coronavirus otherwise referred to as COVID-19.  There is therefore a need to shed light on some of the issues that may arise and how to navigate them. This article will x-ray the rights of patients, the rights of health workers and the basic minimum obligations of the government.

    The Code of Medical Ethics in Nigeria 2008 lists acts that constitute professional negligence. Rule 29.4 of the Code outlines some of these acts as follows:-

    a)      Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so;

    b)     Manifesting incompetence in the assessment of a patient;

    c)      Making an incorrect diagnosis particularly when the clinical features were so glaring that no reasonable skillful practitioner could have failed to notice them; 

    d)     Failure to advise, or proffering wrong advice to  a patient on the risk involved in a particular operation or course of treatment, especially if such an operation or course of treatment is likely to result in serious side effects like deformity or loss of organ, or function;

    e)      Failure to obtain the informed consent of the patient before proceeding on any surgical procedure or course of treatment when such consent was necessary; 

    f)       Making a mistake in treatment e.g. amputation of the wrong limb, carelessness that results in the termination of a pregnancy, prescribing the wrong drug, or dosage in error for a correctly diagnosed ailment, etc;

    g)     Failure to refer, or transfer a patient in good time, when such a referral or transfer was necessary;

    h)     Failure to do anything that ought reasonably to have been done under any circumstance for the good of the patient;

    i)       Failure to see a patient as often as his medical condition warrants or to make appropriate comments in the case notes of the practitioner’s observations and prescribed treatment during such visits. It also includes failure to communicate with the patient or with his relatives as may be necessary with regards to any developments, progress or prognosis in the patient’s condition.

     

    Rule 11.2 of the 2008 Code of Medical Ethics in Nigeria provides that, “A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died.”

                 Rule 44 of the Code of Medical Ethics has extensive provisions on Confidentiality and when disclosure of information can be made. The Rule provides in part that:

    “Disclosure of information on the patient by the doctor can only be made following an informed consent of the patient in writing. It is clear that the ethic covers even such information as induced abortion, venereal disease, attempted suicide, concealed birth and drug dependence but would exclude situations in which a discretionary breach of confidentiality is necessary to protect the patient or the community from danger and this must be made clear to the patient at the time of the confidential disclosure. Where statutory notification of disease is involved, the consent of the patient is not required.”            

                Confidentiality: To Disclose Identity Of Covid-19 Patients Or Not To Disclose?

    COVID-19 is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.[1]

    The Federal Ministry of Health confirmed the first case of COVID-19 in Nigeria on the 27th of February 2020. It is the case of an Italian citizen who works in Nigeria and returned from Milan, Italy to Lagos, Nigeria on the 25th of February 2020. In reaction to the report, the social was divided between those who want the name of the Italian disclosed and those that preferred it remains confidential. The outcry was even more when the Chief of Staff to the President tested positive according to reports from various media houses[2], but the Minister of Health decided to keep mute on the identity of the President’s aide who contacted the virus, citing confidentiality.

    It will ordinarily be wrong to disclose the medical status of someone infected with COVID-19, for instancethe case of the Italian who was the index case. However in view of the proviso to Rule 44 of the Code of Medical Ethics 2008 which provides that a discretionary breach of confidentiality is necessary in order to protect the community from danger, I am of the view that the test results of popular figures who hold strategic offices like the Chief of Staff to the President or a Governor must be disclosed to guaranty public safety. This is necessary in view of the countless number of people from all works of life they come in contact with on a daily basis.  It will be correct to have made their status public in the overriding interest of the public, since it will enable those who have come in contact with them isolate, just like we have seen in the cases of the British Prime Minister, the Bauchi State Govenor, Prince Charles, the First Lady of Canada and many more. We must commend those who announced their status in public themselves-it is the best thing to do in the interest of humanity

    The World Health Organization (WHO) provides additional guidelines for the management of coronavirus patients specifically.[3]

    Health workers should:

    •follow established occupational safety and health procedures, avoid exposing others to health and safety risks and participate in employer-provided occupational safety and health training; 

    •use provided protocols to assess, triage and treat patients; 

    •treat patients with respect, compassion and dignity; 

    •maintain patient confidentiality; 

    •swiftly follow established public health reporting procedures of suspect and confirmed cases; 

    •provide or reinforce accurate infection prevention and control and public health information, including to concerned people who have neither symptoms nor risk;

    •put on, use, take off and dispose of personal protective equipment properly;

    •self-monitor for signs of illness and self-isolate or report illness to managers, if it occurs; 

    •advise management if they are experiencing signs of undue stress or mental health challenges that require support interventions; and 

    •report  to  their  immediate  supervisor  any  situation  which  they  have  reasonable  justification  to  believe presents an imminent and serious danger to life or health.

     

    Doctors and health workers in Nigeria must endeavor to digest the guidelines in the Code of Medical Ethics as well as the WHO Guidelines for management of Coronavirus victims and ensure they work strictly by their provisions. A breach of these duties have dire consequences. 

    Options Available To Covid-19 Patients Who Are Victims Of Medical Negligence

    A Coronavirus patient who has suffered medical negligence has a number of options:

    1. He could file a complaint with the regulatory body (e.g. the Medical and Dental Council of Nigeria, in the cases involving a Doctor). The Doctor will in the first instance be investigated by the Medical and Dental Practitioners Investigation Panel, after which he will be tried by the Medical and Dental Practitioners Disciplinary Tribunal. If found culpable,  the Doctor may be warned, suspended from practicing for a period not exceeding 6 months or in very serious cases, have his name can be removed from the Register of Medical Practitioners. The Medical and Dental Practitioners’ Disciplinary Tribunal does not award monetary damages.

    2. A suit can be filed against the Medical Doctor, the Hospital, Agency or Government in the High Court for Medical Negligence and monetary damages will be awarded if the Defendant(s) are found culpable.

          3.  If there is an element of Crime, a report could be made to the Police who would conduct Criminal Investigation and where the investigation reveals gross negligence, recklessness or wanton disregard for life of the victim, the police can prosecute or forward the case file to the office of the Attorney General of the State for possible prosecution in deserving cases.  

    A Need To Do More For Doctors And Other Professionals In The Health Sector

    Health workers are at the front line of any outbreak response and as such are exposed to hazards that put them at risk of infection with an outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure, long working  hours,  psychological  distress,  fatigue,  occupational  burnout,  stigma,  and  physical  and  psychological violence. 

    During the outbreak of Ebola more than 500 health care workers died in Guinea, Liberia and Sierra-Leone alone. We also lost some of our finest doctors and health workers to the disease in Nigeria, the most prominent being Dr. Stella Adadevoh, who is credited with having curbed a wider spread of the Ebola virus in Nigeria by placing the index patient, Patrick Sawyer, in quarantine despite pressures from the Liberian  government. As we speak, The coronavirus is waging a war of attrition against health care workers throughout the world, but nowhere is it winning more battles at the moment than in Italy and in Spain, where protective equipment and tests have been in severely short supply for weeks. In Spain 13.6% (6500) of those affected with the coronavirus are health workers and in Italy 10% (7400) of those affected with the virus are health workers. [4] In New York dozens of health workers have been affected with the virus, while hundreds are in quarantine.[5] According to reports filtering in as the time of concluding this article, three health workers have been infected with COVID-19 in Abuja, Nigeria.[6]

    Human Rights Watch research into health system collapse in Hungary and Venezuela suggests the nations’ mismanaged, underfunded, and understaffed public healthcare system is poorly equipped to handle a COVID-19 outbreak. Patients and medical experts described a lack of basic hygiene protocol, lack of isolation rooms, and a shortage of health professionals, doctors and nurses, and medical supplies in general.

    The situation is not too different in Nigeria at the moment and except something drastic is done we might be witnessing a devastating effect of the pandemic. Nigeria’s, public health capacity has been diminished by large scale public sector corruption. Medical personnel lack surgical masks and local supplies have been diverted and shipped to other markets partly due to corruption. Many states are ill-prepared to combat the impeding surge in patients. A senior health worker with a government hospital in Abuja, in an interview with Sahara Reporters, lamented the lack of quality Personal Protective Equipment for them, adding that government must invest in the protection of health workers at the frontline of the battle against the virus. He said, “The unfortunate thing is that the government is not providing us with what to work with. It is sad that our PPE are not up to the world standard and can be penetrated by viruses. Some of us (health workers) have to use our personal funds to purchase gloves as we do not trust the ones government supplied. Nigerians should please remember us in their prayers and government should provide us with what we really need to work.” [7]

    There was report that in Bauchi State a Coronavirus patient rejected the isolation centre at the Bauchi Specialist Hospital and went back home while describing it as “too dirty”.[8]  

    It is disappointing to hear that the hazard allowance for doctors and health workers is N5,000 per month in Nigeria. The amount is very paltry compared to the risks and the attendant emotional and psychological stress suffered by the health-care workers (HWCs) particularly during monumental outbreaks like this. Unfortunately, when a patient is mismanaged, these doctors and health workers bear the burden of paying huge compensation and sometimes losing their jobs. More importantly, the brain-drain in the health sector is monumental, almost all my friends who are doctors, work abroad. Unfortunately, there are concerted efforts by the US Government to engage foreign Doctors to further fortify its health work force as COVID-19 ravages. Many young Nigerian doctors are already considering the offers because the Nigerian government has paid little attention to their welfare and the welfare of the general health workforce. To stop the exodus of our doctors, who are already in short supply, the government must act fast by improving their welfare packages in line with acceptable international standards.

    The psychological needs of doctors and health workers are also often ignored. Unsafe working conditions contribute to health worker attrition in many countries due to work-related illness and injury and the resulting fear of health workers of occupational infection, including from HIV and Tuberculosis. The 2006 World Health Report – Working Together for Health reported on a severe health workforce crisis in fifty-seven countries, most of them in Africa and Asia. [9]

    Protecting the occupational health of health workers is critical to having an adequate workforce of trained and healthy health personnel. Governments at the Federal and State levels are urged to do more by complying fully with the World Health Organization’s guidelines regarding the Rights of Health Workers while combating COVID-19. Some of the rights are:

    ·         assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks;

    ·         provide information, instruction and training on occupational safety and health, including; Refresher training on infection prevention and control(IPC); and Use, putting on, taking off and disposal of personal protective equipment(PPE);

    ·         provide adequate IPC and PPE supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to healthcare or other staff caring for suspected or confirmed COVID-19 patients, such that workers do not incur expenses for occupational safety and health requirements;

    ·         not be required to return to a work situation where there is continuing orserious danger to life or health, until the employer has taken any necessary remedial action;

    ·         allow workers to exercise the right to remove themselves from a work situation that they have reasonable justification to believe presents an imminent and serious danger to their life or health. When a health worker exercises this right, they shall be protected from any undue consequences; 

    ·         honour the right to compensation, rehabilitation and curative services if infected with COVID-19 following exposure in the workplace. This would be considered occupational exposure and resulting illness would be considered an occupational disease,

    ·         provide access to mental health and counselling resources; and 

    ·         enable co-operation between management and workers and/or their representatives. Etc.

    In conclusion, professional care givers for COVID-19 patients should uphold four basic principles formulated by Beauchamp and Childress in their book ‘Principles of Biomedical Ethics’ in order to protect themselves from liability for negligence. The four basic principles are autonomy, beneficence, non-maleficence and justice.

    Autonomy: People have the right to control what happens to their bodies. This principle simply means that an informed, competent adult patient can refuse or accept treatments, drugs, and surgeries according to their wishes. People have the right to control what happens to their bodies because they are free and rational. And these decisions must be respected by everyone, even if those decisions aren’t in the best interest of the patient.

    Beneficence: All healthcare providers must strive to improve their patient’s health, to do the most good for the patient in every situation. But what is good for one patient may not be good for another, so each situation should be considered individually. And other values that might conflict with beneficence may need to be considered.

    Non-maleficence: “First, do no harm” is the bedrock of medical ethics. In every situation, healthcare providers should avoid causing harm to their patients. You should also be aware of the doctrine of double effect, where a treatment intended for good unintentionally causes harm. This doctrine helps you make difficult decisions about whether actions with double effects can be undertaken.

    Justice: The fourth principle demands that you should try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. You should be able to justify your actions in every situation. For instance, it will amount to a professional misconduct for a Health-care Worker to remove a poor man from the ventilator because a Senator was rushed in. 

    Ahmed Adetola-Kazeem is a partner in Adetola-Kazeem Legal Practice and specializes in Medical and Health Law

    Email: aadetolakazeem@gmail.com;aadetolakazeem@gaklp.com

    [1] https://www.who.int/health-topics/coronavirus#tab=tab_1(Accessed on the 28th of March 2020)

    [2] https://businessday.ng/coronavirus/article/abba-kyari-tests-positive-for-coronavirus-buhari-negative/

    https://www.channelstv.com/2020/03/24/buharis-chief-of-staff-abba-kyari-reportedly-tests-positive-for-coronavirus/ (Accessed on the 28th of March 2020)

    [3] Coronavirus Disease (Covid-19) Outbreak: Rights, Roles and Responsibilities Of Health workers, Including Key Considerations For Occupational Safety And Health”. https://www.who.int/docs/default-source/coronaviruse/who-rights-roles-respon-hw-covid-19.pdf?sfvrsn=bcabd401_0   (Accessed on the 26th of March 2020)

    [4] https://abcnews.go.com/Health/wireStory/collapsing-virus-pummels-medics-spain-italy-69789413 (Accessed on 26th March 2020)

    [5] https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses-emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html (Accessed on 28th of March 2020)

    [6] http://saharareporters.com/2020/03/28/exclusive-two-nurses-one-doctor-infected-coronavirus-abuja-hospital

    [7] Supra

    [8] https://www.dailytrust.com.ng/coronavirus-patient-rejects-bauchi-isolation-centre-returns-home.html (Accessed on 28th March 2020)

    [9] https://www.who.int/occupational_health/topics/hcworkers/en/(Accessed on 26th March 2020)

     

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  • Medical Product Alert N°2/2020

    Medical Product Alert N°2/2020

    This Medical Product Alert relates to a confirmed falsified human immunodeficiency virus (HIV) in vitro diagnostic medical device (IVD) that has been identified circulating in Guyana and Kenya.

    Through its Global Surveillance and Monitoring System (GSMS) for substandard/falsified medical products,
    WHO was informed that at least 8,240 falsified rapid diagnostic tests to detect HIV-1/2 have been distributed in Guyana at end-user level. The product is Uni-Gold™ HIV and claims to be manufactured by
    Trinity Biotech plc. Subsequent reports
    revealed that the same falsified product is also circulating in Kenya.

    Uni-Gold™ HIV is a single-use rapid diagnostic test – an immunoassay for the qualitative detection of antibodies to HIV-1 and HIV-2 in serum, plasma and whole blood. Uni-Gold™ HIV is intended for use in point of care settings as an aid
    in diagnosis of HIV-1 and HIV-2 infection.

    The WHO testing strategy recommends three HIV reactive test results to confirm an HIV-positive status in a
    patient. The use of this falsified Uni-Gold™ HIV, subject of WHO medical product alert n°2 of 2020, is likely to lead to delayed diagnosis of HIV status.

    Table 1: Specific details of the falsified product Uni-Gold™ HIV, subject of WHO Medical Product Alert n°2 of 2020

    Product Name

    Uni-Gold™ HIV

    Lot Number

    HIV7120026

    Expiry Date

    5 DEC 2020

    Stated manufacturer

    Trinity Biotech

    The packaging of this falsified HIV test kit is in English.

    The genuine manufacturer (Trinity Biotech plc) has confirmed that:

    • They did not manufacture the falsified product in Table 1.
    • Genuine lot HIV7120026 was made by Trinity Biotech plc and expired in 2019.
    • The expiry date is incorrect and does not correspond with their batch manufacturing records.

    Photographs and advice to the public are available below.

    Figure 1 – Falsified Uni-Gold™ HIV, lot number HIV7120026, displaying falsified expiry date

     

    Falsified UniGold HIV Images 1 and 2 Alert

    Figure 2 – Falsified Uni-Gold™ HIV, displaying labelling inconsistencies

    Falsified UniGold HIV Image 3 Alert

     

    Advice on action to be taken by end-users:

    • Please check to see if any Uni-Gold™ HIV test kits in your facility have lot number HIV7120026.
    • If you are in possession of these falsified test kits with lot number HIV7120026:
    1. Please do not use.
    2. Please immediately contact the organization that supplied you with the product (either your HIV testing programme, nongovernmental organization or local distributor).
    3. Please contact Trinity Biotech plc

    Phone : +353 1 276 9800

    E-mail : hiv@trinitybiotech.com

    1. Please contact your national health authorities

    All medical products must be obtained from authentic and reliable sources. Their authenticity and condition should be carefully checked.

    Advice on action to be taken by national health authorities:

    WHO requests increased scrutiny within the supply chains of all countries, particularly at testing sites (health facilities, community-based), clinical laboratories, medical stores/warehouses, and at the facilities of relevant economic operators (agents,
    authorized representatives, distributors, wholesalers, etc.).

    If these falsified test kits with lot number HIV7120026 are discovered, please do not use.

    National health authorities are asked to immediately inform WHO, if these falsified products are discovered in their country using the WHO IVD complaint form.

    If you have any information concerning the manufacture, distribution, or supply of this product, please contact rapidalert@who.int

     

    WHO Global Surveillance and Monitoring System for Substandard and Falsified Medical Products

    For further information, please visit our website: https://www.who.int/medicines/regulation/ssffc/en/ 
     

    Medical Product Alert N°2/2020
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