Tag: death

  • The Sorry State Of Nigeria’s Judiciary Among Others Makes The Battle Cry For A Revolution Inevitable By Francis Adewale

    The Sorry State Of Nigeria’s Judiciary Among Others Makes The Battle Cry For A Revolution Inevitable By Francis Adewale

    Lawyers
    Lawyers

    “Those who make peaceful revolution impossible will make violent revolution inevitable.”
                                                   – President John F. Kennedy (1962)

    This week may be one of the worst weeks for Nigerian judiciary and they might have made the much vaunted Sowore’s revolution inevitable. The first salvo was the list of judges released by the National Judicial Council replete with the names of their sons and daughters as well as hangers on. Second is the farcical decision in EFCC vs Kalu where the Supreme Court “suo motu” created a new section to the constitution of Nigeria by vacating a conviction duly given under an extant law. The strange rationale by the Supreme Court is that the presiding judge, now elevated to the Court of Appeal should not have pronounced the sentence. The Court conveniently ignored the fact that the accused counsel had invited the judge to come back and continue the hearing by a formal letter!

    Gone are the days when Nigerian judiciary is famously celebrated as the last bastion of defense for the common man. The days of Kayode Esho, Chukwudifu Oputa, Muhammed Uwais is long gone. Our judiciary is no more like Caesar’s wife, above board. The problem however is not necessarily down to the hydra headed monster of corruption alone but a more sinister evil called, nepotism. It is my humble opinion that an opaque process for selection of judges led us to where we found ourselves this week. And the problem did not start with the current chief justice. The dysfunction and bastardization have been long in coming, and as we will find out in this piece, the cancer has eaten deep into the fabric of this nation. The revolution is inevitable. 

    The Sorry State Of Nigeria’s Judiciary Among Others Makes The Battle Cry For A Revolution Inevitable By Francis Adewale 1Lawyers


    What precipitate this write up is a social media post by a good friend of mine and I obtained his permission to repost his comment with my personal edits:
    “It took Orji Kalu only 4 months including Covid lockdown challenge to move from the High Court to Supreme Court to get his so called sound judgment from Supreme Court while it took ten years to get his case completed at the High Court level. Ten good years! And we are told justice in Nigeria is not cash and carry? The Supreme Court is preparing the ground for a revolution and very soon something extraordinary will take place. The same Supreme Court that will give 2021 and 2022 court date for poor defendants, sat and summarily decide a case within 4 months while cases of those facing a life sentence languish in the labyrinth of jungle justice!”

    My first response to the post, is to retort that the problem did not start with judiciary, but they seem to have led the “nunc dimitis” for the internment of democracy in Nigeria. The judiciary may have pushed us to the praecipe but they were not the only one. We all recalled the impunity days of PDP rule and how they ride roughshod on people’s right, celebrating acquisition of jets obtained from corrupt practices while hordes of masses suffer the indignity of scrapping for foods from the gutter. Towards the end of that era, we all thought, if we can just get a man of integrity into Aso Rock, someone who will brook no atom of corruption, we will change the country. The election of 2015 seems to have lulled Nigerians into thinking that all we need is someone or a duo with integrity, so we elect Buhari and Osinbajo, a puritan and a pastor and went home satiated. What we were not prepared for or more appositely choose to ignore is the fact that the vehicle that brought them into governance is none other than the decrepit system that PDP used to feather their nest. In the first 4 years, we were told that the problem is with the National Assembly where the legistlooters shifted their control of the vortex of power in Abuja, opposing every anti-corruption moves of the executives. Then come the last election where the ruling party now controls the executive and legislative arm, but corruption runs through the gamut of the judiciary and Aso Rock looks the other way while nepotism festers in its rank.

    It is as if the cancer has completely swallowed up the entire fabric of the nation. Cases involving the poor dragged on for years while those who can afford senior advocate can get quick justice. Many warned that this will sound the death knell of democracy in Nigeria. Every attempt to even build on free and fair election has been truncated by the judiciary. What with the recent confounding judgment from Imo and Bayelsa. Our two gargantuan political parties now owned our judiciary lock, stock and barrel. They sit in smoke filled rooms to determine who will be governors, legislators and judges, and those who will play ball are readily appointed as pawns in the chest board of the Nigerian ruling class, wives, nephews, cousins, sons and daughters are made judges and senior advocates overnight without recourse to any modicum of meritocracy. A friend of mine recently quipped that the problem of nepotism is not just that it defeats meritocracy and breeds mediocrity but that it infects the entire body politics and renders it comatose. Corruption can be traced, and ill-gotten wealth recovered but nepotism is more sinister. Those who obtain position of power and authority through nepotism hold fealty only to their masters who appointed them. Such appointee will readily twist the constitution, made up section that does not exist all at the behest of their “godfather”. It is insidious and evil.

    I graduated from Nigerian Law School 30 years ago, after an excellent stint at Great Ife. My class at Ife, drawn from the north, east, west middle belt and south-south has in its rank some of the best legal minds any country will be proud of. We graduated with high hopes to take on the world and change the land. Few of us found ourselves abroad on scholarship where we flourish and excel. Those in legal practice in Nigeria, either at the federal or state ministry of justice or private practice are the ones my heart bleeds for, especially those without access to members of the National Judicial Council. I have had the privilege to advance my career abroad as an attorney and public defender. I frequently sit on panels that recommend colleagues for appointment as judges in a fair, open and transparent process; something my colleagues in Nigeria could only dream of.

    When I look at the state of Nigerian legal practice my heart bleeds. The career growth of colleagues in the legal profession in Nigeria is stunted not for lack of excellence but influence in the right place. Influence peddling is an art form in Nigeria and politicians used to have the exclusive preserve of selling it to the highest bidder, but our Judicial Council seems to have mastered the art. The problem will not be this pronounced if the sons and daughters they are foisting on Nigerian judiciary are steeped in the Nigerian experience or have a modicum of merit. As many of my colleagues are apt to complain, majority of the recent appointees hardly spend few years in Nigeria. They all went to schools abroad. Totally devoid of the Nigerian experience, and constantly removed from the everyday life Nigerians suffers under. Majority of them lives in the gilded mansions of their forbears in Abuja and other state capitals, where they are rarely touched by the “better angels of our nature” to use the phrase coined by Abraham Lincoln. It is therefore no surprise that they care only for what their “godfather” demand.

    Let me however warns that the biggest mistake we could make is to think that the rot is only in the heart of our judiciary. Think again. Nepotism is next door, next street, next town and everywhere in Nigeria. It rampages through the land, be it North, East or West. Just look at our churches and mosques, who do you see minister or lead the prayers when the founder/visioner is not around? You guess right,  if you say their sons and daughters. Gone are the days when Pa Fadayomi push to have a meritorious doctor of aerodynamics succeed him. Gone are the days when the leader of the faithful in Nigeria is selected by their aptitude in the knowledge of the Quaran. Nowadays, the exit of the leader is the beginning of the reign of the progeny. It has infected our colleges and universities, scholarship and opportunities that used to be available on merit are now exclusive preserve of the vice chancelor’s children and family members. Woe betide the school senate members that dare ask questions. Advertisement for jobs that has already been reserved for the children of the privileged are means to extort money in the form of application fees a la Abba Moro immigration recruitment scheme. A recent recruitment without advertisement at our apex bank reported by Sahara Reporters shows that successful applicants names were picked out of the rolodex of the governor. Commercial Banks staff are not an exemption, they are either recruited based on sex appeal or influential ministers/senators’ “recommendation” which doesn’t come easy for the educated but less privileged applicants.

    A friend concluded an animated discussion on social media on this issue with a distinctively Nigerian resignation: “It is clear that those who do not want things to work properly in Nigeria are more powerful than those who are working towards finding solutions to our problems.” Again, my response is what do we have to lose if we embrace Omoyele Sowore’s revolution, even with its youthful disdain for experience? Especially when our current experienced leadership seems to treat the Nigerian masses with contempt. Look at it this way: They do not need our votes to win election, as they could procure midnight judgment in Abuja a la Bayelsa and Imo. They do not need to legislate to fill any lacunae in our constitutional experience as the Supreme Court proved in Kalu’s case. In fact, as long as oil flows and they have the means to fill their Cayman Island bank accounts, we may as well not exist. Greed and avarice have become the directive principle of Nigerian ruling class. To rescue ourselves from their vice grip, we need revolution now!

    Francis Adewale
    Tioluwanimi@gmail.com

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    The Sorry State Of Nigeria’s Judiciary Among Others Makes The Battle Cry For A Revolution Inevitable By Francis Adewale
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  • Two men burnt to death after car caught fire in Bintulu

    Two men burnt to death after car caught fire in Bintulu

    Two men burnt to death after car caught fire in Bintulu 2

    BINTULU: Two men met with a fiery end when the four-wheel-drive they were travelling in skidded, crashed into a concrete wall and caught fire near the Sungai Adai Bridge in Jalan Sangan/Merit near hear late yesterday afternoon.

    Sarawak Traffic Investigation and Enforcement chief Supt Alexson Naga Chabu said the duo were identified as Nelson Kana Meliu, 32, and his brother-in-law Ginol Sanyu, 42.

    “When the firemen arrived, the vehicle was almost 100% burnt with the two victims still pinned on their seats,” he said, adding that the charred bodies of the victims were later taken to Bintulu Hospital for post mortem. — Bernama

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  • Massive proportion of world’s population are living with herpes infection

    Massive proportion of world’s population are living with herpes infection

    Virus causing genital herpes may put millions of people at greater risk of infection with HIV

    About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

    Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization,
    the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016. 

    “Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical
    Officer at WHO and an author of the study.

    Prevalence and incidence

    An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital
    herpes).

    An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However,
    HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital
    HSV-1 infection, depending on the assumptions used in the estimation model.

    Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

    Health and social impacts

    Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

    When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease. 

    WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to
    HSV-2, which can recur frequently over many years.

    Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

    “Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health”
    says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO. 

    Herpes and HIV

    A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV
    infections in 2016 worldwide were likely attributable to HSV-2 infection (2). 

    Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection.
    In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

    Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health
    and well-being. 

    For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent. 

    Neonatal herpes

    Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk
    for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

    No cure – better treatment and prevention needed

    There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

    As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. 

    In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes
    the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

    “A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
    and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

    Related publications

    WHO guidelines for the treatment of Genital Herpes Simplex Virus

    WHO preferred product characteristics for herpes simplex virus vaccines

     

    ———————-

    (1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

    (2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

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  • New FAQs address healthcare workers questions on breastfeeding and COVID-19

    New FAQs address healthcare workers questions on breastfeeding and COVID-19

    Mothers and healthcare workers who support them have many questions and concerns about whether it is safe for mothers with confirmed or suspected COVID-19 to be close to and breastfeed their babies during the pandemic.

    To address their questions, WHO has released a list of Frequently asked questions: Breastfeeding and COVID-19. The FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection when COVID-19 is suspected and draws upon other WHO recommendations on infant and young child feeding.

    The FAQs aim to provide information to healthcare workers supporting mothers and families in maternity services and community settings, and communicate how the interim guidance should be implemented. Additionally, the FAQs provide information about the protective effects of breastfeeding and skin-to-skin contact, and the harmful effects of inappropriate use of infant formula milk.

    Accompanying the FAQs is a decision tree which provides step-by-step guidance to health workers on how to support mothers with confirmed or suspected COVID-19 to breastfeed. It provides advice on what to do if mothers are not well enough to breastfeed, as well as appropriate hygiene measures for mothers, including wearing a medical mask if available, to reduce the possibility of the COVID-19 virus being spread to her infant.

    Benefits of breastfeeding outweigh potential risks

    The COVID-19 virus has not been detected in the breastmilk of any mother with confirmed and suspected COVID-19 and there is no evidence so far that the virus is transmitted through breastfeeding. Researchers continue to test breastmilk from mothers with the infection.

    WHO recommends that all mothers with confirmed or suspected COVID-19 continue to have skin-to-skin contact and to breastfeed. In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also reduces the risk of breast and ovarian cancer for the mother. Skin-to-skin contact, including kangaroo mother care, reduces neonatal mortality, especially for low birth weight newborns.

    While infants and children can contract COVID-19, they are at low risk of infection. The few confirmed cases of COVID-19 in young children to date have experienced only mild or asymptomatic illness.

    WHO’s recommendations on the care and feeding of infants whose mothers have confirmed or suspected COVID-19 aim to improve the immediate and lifelong survival, health and development of their newborns and infants. These recommendations consider the likelihood and potential risks of COVID-19 in infants and also the risks of serious illness and death when infants are not breastfed or when infant formula milk are used inappropriately.

    WHO’s Q&A on breastfeeding and COVID-19 also provides additional infection prevention advice to mothers with confirmed or suspected COVID-19.

    New FAQs address healthcare workers questions on breastfeeding and COVID-19
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  • Maternal infections in health facilities

    Maternal infections in health facilities

    A clearer picture of the global impact 

    New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

    Logo of the Lancet Global HealthThe
    results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
    sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world. 

    Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization. 

    Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world. 

    What is maternal sepsis and how does it lead to maternal death?

    Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

    The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

    Few
    previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

    A better understanding of maternal infection

    GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

    The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

    GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
    which are not usually recorded as maternal sepsis, including post-abortion and indirect infections. 

    The result is a more complete understanding of the frequency and impact of maternal infections in health facilities. 

    GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk. 

    Putting global numbers on maternal infection and sepsis

    Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management. 

    Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

    Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
    haemorrhage.

    This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

    Preventing, identifying and treating maternal infection and sepsis

    Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

    GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively. 

    For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

    GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

    This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
    providers to manage the frequency and outcome of maternal infections.

    An opportunity to implement evidence-based practice

    GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives. 

    WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
    on 5 May which celebrates the central role played by nurses and midwives in clean health care. 

    In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
    2017
    WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

    Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

    Related publications

    WHO recommendations for prevention and treatment of maternal peripartum infections

    WHO Clinical practice handbook for safe abortion

    Global guidelines on the prevention of surgical site infection

    WHO statement on maternal sepsis

    World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

    Health Topics

    Antimicrobial resistance

    Infection Prevention and Control

    Water Sanitation Hygiene

    Other links

    Global Maternal Sepsis Study

    SAVE LIVES: Clean Your Hands 5 May 2020

     

     

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  • WHO urges countries to move quickly to save lives from malaria in sub-Saharan Africa

    WHO urges countries to move quickly to save lives from malaria in sub-Saharan Africa

    Severe disruptions to insecticide-treated net campaigns and in access to antimalarial medicines could lead to a doubling in the number of malaria deaths in sub-Saharan Africa this year compared to 2018, according to a new modelling analysis released by
    WHO and partners ahead of World Malaria Day (25 April).

    WHO urges countries to move fast and distribute malaria prevention and treatment tools at this stage of the COVID-19 outbreak in sub-Saharan Africa, and to do their utmost to safely maintain these essential malaria control services.

    The analysis considers nine scenarios for potential disruptions in access to core malaria control tools during the pandemic in 41 countries, and the resulting increases that may be seen in cases and deaths. 

    Under the worst-case scenario, in which all insecticide-treated net (ITN) campaigns are suspended and there is a 75% reduction in access to effective antimalarial medicines, the estimated tally of malaria deaths in sub-Saharan Africa in 2020 would reach
    769 000, twice the number of deaths reported in the region in 2018. This would represent a return to malaria mortality levels last seen 20 years ago.

    According to the World malaria report 2019, sub-Saharan Africa accounted for approximately 93% of all malaria cases and 94% of deaths in 2018. More than two-thirds of deaths were among children under the age of five.

    A window of opportunity

    To date, the number of reported cases of COVID-19 in sub-Saharan Africa has represented only a small proportion of the global total, though cases are increasing every week. This means that countries across the region have a critical window of opportunity
    to minimize disruptions in malaria prevention and treatment and save lives at this stage of the COVID-19 outbreak.

    Mass vector control campaigns should be accelerated, while ensuring that they are deployed in ways that protect health workers and communities against potential COVID-19 transmission. WHO and partners commend the leaders of Benin, the Democratic Republic of the Congo, Sierra Leone and Chad
    for initiating ITN campaigns during the pandemic. Other countries are adapting their net distribution strategies to ensure households receive the nets as quickly and safely as possible.

    Preventive therapies for pregnant women and children must be maintained. The provision of prompt diagnostic testing and effective antimalarial medicines are also essential to prevent a mild case of malaria from progressing to severe illness and death.

    WHO and partners have developed guidance to ensure that those suffering from malaria can safely receive the care they need within the package of essential health services to be delivered in COVID-19 settings. Tailoring malaria interventions in COVID-19 response includes guidance on the prevention of infection through vector control and chemoprevention, testing, treatment of cases, clinical services, supply chain and laboratory activities.

    Note to the editor

    The modelling analysis was conducted by WHO in close collaboration with partners, including PATH, the Malaria Atlas Project and the Bill & Melinda Gates Foundation. 

    The analysis is subject to uncertainties. It does not consider, for example, the effects of an interruption in indoor residual spraying or seasonal malaria chemoprevention (except in Burkina Faso); a suspension of these core malaria prevention tools would
    also lead to considerable loss of life.

    In addition, there is limited understanding of the spread of COVID-19, its epidemiology and interactions with malaria. The model will be updated as such data become available, and countries will be provided with relevant information to tailor their responses
    accordingly.

    WHO urges countries to move quickly to save lives from malaria in sub-Saharan Africa
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  • Hard fought gains in immunization coverage at risk without critical health services, warns WHO

    Hard fought gains in immunization coverage at risk without critical health services, warns WHO

    Shutting down immunization services in the COVID-19 pandemic risks triggering a resurgence of diseases that can be prevented with safe and effective vaccines, warns WHO in the lead-up to World Immunization Week (24-30 April). 

    When immunization services are disrupted, even for brief periods during emergencies, the risk of vaccine-preventable disease outbreaks, such as measles and polio, increase. Last year’s deadly measles outbreak in the Democratic Republic of the
    Congo, which took more than 6000 lives in a country already facing its largest Ebola outbreak, highlights the importance of maintaining essential health services, such as immunization in times of emergency. Further disease outbreaks will also overwhelm
    health systems already battling the impacts of COVID-19.

    “Disease outbreaks must not remain a threat when we have safe and effective vaccines to protect us,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “While the world strives to develop a new vaccine for COVID-19 at record speed,
    we must not risk losing the fight to protect everyone, everywhere against vaccine-preventable diseases. These diseases will come roaring back if we do not vaccinate.”

    WHO is working with partners all over the world to accelerate research and development of a safe and effective vaccine and ensure equitable access for the billions of people who will need it.

    But even with an expedited process, development of a vaccine for COVID-19 will take time. Precautionary measures are essential now to help keep us safe from disease, including diseases for which vaccines already protect children and adults.

    Too many people are still excluded from the benefits of vaccines

    Prior to the COVID-19 pandemic, the world had made immense progress in ensuring that children are vaccinated. In 2018, 86 percent of children under the age of five globally were vaccinated with three doses of diphtheria, tetanus and pertussis (DTP3) and
    one dose of the measles vaccine, up from 72 percent in 2000 and 20 percent in 1980. The number of children paralyzed by polio has been reduced by 99.9 percent worldwide. 

    Yet, global vaccination coverage is still far from the 95 per cent coverage needed to fully protect communities against outbreaks of this vaccine-preventable disease. 

    In 2018 nearly 20 million children worldwide – more than 1 in 10 – missed out on lifesaving vaccines, such as measles, diphtheria and tetanus. Roughly, 13 million of the children have never received any vaccines, putting them and their communities
    at risk of disease and death. The majority of these children live in countries with already fragile health systems, further limiting their access to essential health services when they fall sick.

    Measles continues to remain an ever-present threat, especially if vaccination rates drops. Current projections indicate that the number of reported measles cases for 2019 will be at least 800 000. In 2020 there are increasing concerns about another
    resurgence, especially if vaccination rates fall due to delay or suspension of scheduled immunization activities as a result of COVID-19. 

    Outbreaks of polio, diphtheria and yellow fever are also of high concern, especially in the countries least able to respond quickly and decisively to address an emerging outbreak, as seen in previous emergencies such as the polio outbreak in Syria in
    2013. 

    Maintaining immunization services during COVID-19

    As the response to COVID-19 continues, countries must act now protect immunization services, in order to further minimize disease outbreaks and loss of life. This includes, facilitating urgent catch up programmes in places where
    services have been disrupted, ensuring strong supply chains, disease surveillance and trained health workers. Caregivers should also make sure they continue to vaccinate their children in line with national policies.

    New WHO guidelines on immunization and COVID-19 recommend that governments temporarily pause preventive immunization
    campaigns where there is no active outbreak of a vaccine-preventable disease. But it urges countries prioritize the continuation of routine immunization of children in essential service delivery, as well as adult vaccinations such as influenza
    for groups most at risk. If immunization services must be suspended, urgent catch-up vaccinations should be rescheduled as soon as possible, prioritizing those most at risk.

    Hard fought gains in immunization coverage at risk without critical health services, warns WHO
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    https://www.who.int/news-room/detail/23-04-2020-hard-fought-gains-in-immunization-coverage-at-risk-without-critical-health-services-warns-who

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  • What matters to women in the postnatal period?

    What matters to women in the postnatal period?

    The right to a positive maternity healthcare experience at every stage 

    Each pregnancy is unique and clinical needs can change across the pregnancy, childbirth and postnatal periods. One thing that never changes is the right to a positive experience at every stage. 

    Achieving the best possible physical, emotional, and psychological outcomes for every individual and newborn requires health systems to take a human rights-based approach: not only preventing maternal death and morbidity, but prioritising person-centred
    care and well-being.

    WHO is developing new guidelines for a positive experience of postnatal care, due to be published next year. To inform these guidelines and ensure that postnatal services can better meet the needs of women and their babies, WHO undertook a qualitative
    systematic review on what matters to women in the postnatal period.

    Joys and challenges in the postnatal period

    There is limited research about values and preferences in the postnatal period, defined by WHO as the first six weeks after childbirth. Studies have often focused on the results of specific postnatal interventions, rather than on the individuals who use
    them. 

    ‘What matters to women in the postnatal period: A meta-synthesis of qualitative studies,’ published in PLOS ONE, gives long-overdue respect to the authority of women’s own experiences. The authors review first-hand data from 15 countries
    and 36 studies published after the year 2000 relating to women’s beliefs, expectations and values at this significant time of life.  

    These studies affirm that a positive postnatal experience can result in joy, self-confidence and enhanced capacity to thrive as both a person and a parent.

    They are also vocal about the potential challenges of adjusting to a ‘new normal’ following childbirth, including changes in self-identity, relationships, and sexual behaviour.

    What is a positive postnatal experience? 

    A positive postnatal experience for a woman will be one that responds to her specific context and preferences. 

    It will provide the confidence, knowledge and skills women need in the weeks following childbirth, supporting them to adjust to any changes in their intimate relationships and build new family ones. Women will be better equipped to navigate physical and
    emotional challenges and to experience the dynamic achievement of personal growth. 

    This should be a shared responsibility, not a solitary one. Community has a critical role in enabling a positive postnatal experience, including partners, family and elders.

    It is crucial that healthcare providers meet each woman’s needs, as well as those of their babies. 

    Supporting choices and rights to improve postnatal health outcomes

    There are an estimated 303 000 maternal deaths annually, according to recent WHO figures. Most of these deaths occur postnatally. 

    The postnatal period is therefore a vital opportunity to improve both maternal and neonatal health and wellbeing: supporting healthy behaviors, providing life-skills education, facilitating breastfeeding, counselling women about family planning options,
    supporting good mental health, preventing and treating childbirth-related complications. 

    Health care systems that empower individuals by supporting their values, preferences and rights are fundamental to improving maternal and newborn health outcomes. 

    WHO’s guidance for positive maternity care

    WHO has recently released recommendations on antenatal care for a positive pregnancy experience, and on intrapartum care for a positive childbirth experience.

    These publications made important clinical updates, including an increase from four to eight recommended antenatal contacts, and a revision to the decision-making process for interventions to accelerate labour. 

    They also uphold every woman’s right to a positive maternity care experience: one where her pregnancy does not erase her competency, autonomy and right to participate in decision-making for her own care and the care of her newborn. 

    Women’s choices and rights to sexual and reproductive health care, including maternity care, should be respected at every stage of the continuum of maternal and newborn care. This is true across all income settings, as well as in humanitarian settings
    and during public health emergencies.

    When WHO’s postnatal guidelines are released next year, they will complete the maternity care series built around what matters to women.

    Rather than dividing care into three periods of antenatal, intrapartum and postnatal, these publications can be used to establish a model in which health systems support women, their baby and wider network physically, psychologically, socially and emotionally
    through this significant life event. 

    Other resources

     

    What matters to women in the postnatal period?
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    https://www.who.int/news-room/detail/22-04-2020-what-matters-to-women-in-the-postnatal-period

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  • New Ebola case confirmed in the Democratic Republic of the Congo

    A new case of Ebola virus disease was confirmed today in the city of Beni in the Democratic Republic of the Congo (DRC).

    “While not welcome news, this is an event we anticipated. We kept response teams in Beni and other high risk areas for precisely this reason,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.  

    As part of the active Ebola surveillance system in place to respond to this ongoing outbreak in DRC, thousands of alerts are still being investigated every day. An alert is a person who has symptoms that could be due to Ebola, or any death in a high risk area that could have been as result of Ebola.

    As with all confirmed cases, efforts are already underway to find everyone who may have been in contact with the person in order to offer them the vaccine and monitor their health status.

    “WHO has worked side by side with health responders from the DRC for over 18 months and our teams are right now supporting the investigation into this latest case,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Although the ongoing COVID-19 pandemic adds challenges, we will continue this joint effort until we can declare the end of this Ebola outbreak together.”

    The news of the confirmed case came minutes after the conclusion of a meeting of the International Health Regulations Emergency Committee on Ebola in DRC. The Emergency Committee will reconvene next week in order to re-evaluate their recommendations in light of this new information.

    Prior to this, the last person who was confirmed to have Ebola in DRC tested negative twice and was discharged from a treatment centre on 3 March 2020.

    As of 10 April 2020, 3456 confirmed and probable cases and 2276 deaths have occurred as a result of the outbreak.

    Read More
    https://www.who.int/news-room/detail/10-04-2020-new-ebola-case-confirmed-in-the-democratic-republic-of-the-congo

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  • RACE SUICIDE

    RACE SUICIDE

    A favorite argument of certain opponents of scientific Birth Control is that such teachings and modes of conduct tend toward Race Suicide, and the consequent weakening and final destruction of the human race by means of “bleeding it white” by draining from it its normal supply of children. Those who hold this view argue that if Birth Control methods become popular, and sanctioned by the law and public opinion, then the race will eventually die out and disappear from the face of the earth. Some vary the argument by insisting that those nations favoring Birth Control would suffer decline and gradual extinction at the hands of other nations opposed to scientific methods of regulating the number and frequency of offspring. This is a serious charge against Birth Control, which if proved would probably serve to array all right-thinking persons against it.

    But the advocates of Birth Control seriously and positively controvert and deny the validity and truth of this argument. On the contrary they claim that scientific Birth Control would not only keep up the population of all countries, or any country, to a normal standard proportionate to its ability to sustain properly such population, but will also act to render that population stronger and better, physically, mentally and morally, and far more efficient in every way owing to improved quality of the stock. The first requisite is met by the reduction of the death rate to meet the decreasing birth-rate; and the second requisite is met by the improvement of the stock by proper rearing and training made possible by the decreased size of the average family. Birth control serves to eliminate the waste caused by excessive infant mortality, and to thus fully counterbalance the decreased birth rate.

    The advocates of Birth Control assert that the natural instinct of parenthood, the love of children, and the desire for offspring and the perpetuation of the family name and stock, are too firmly rooted and grounded in human nature to be seriously affected by such knowledge and practice on the part of the race. They point to the fact that in many families in which intelligent modes of Birth Control are favored, and in which the size of the family has been limited to a few children, the children are, as a rule, better cared for and provided for, better reared and better educated, than in the case of families in which children are brought into the world without thought or reason, and without the possibility of proper care and rearing. Birth Control, say its advocates, will not do away with children, but will merely regulate their number to rational limits, and at appropriate intervals between births. Moreover, it is claimed, that while the birth-rate in such families may be smaller, the death-rate is also smaller. And, at the last, it is the number of children that survive that counts with the race, not those who merely are born.

    The fact that many persons consult physicians for a cure for sterility, and go to great trouble and expense to further the bearing of children, and the fact many childless couples adopt children rather than to have a childless home, are evidence of the fact that there is no danger of the parental instinct dying out. It is the experience of physicians generally that the patients who desire information regarding scientific contraceptive methods are usually those who already have as many children as they can well take care of, and not those who wish to escape parenthood in toto.

    We are constantly reminded that the size of the average family is much smaller than it was a hundred years ago—but still the race is rapidly increasing, owing to the decreased death-rate resulting from a better knowledge of hygiene and medicine. Moreover, it is positively asserted that the “old time large family” frequently had one father but several mothers—the husband marrying several times in order to replace with a new life the old wife who had broken down and died from overwork and excessive childbearing.

    It is claimed that in Holland, in which Birth Control is recognized by law, and where it is legally sanctioned and even encouraged among those who are not able to support large families, statistics show that the population is increasing more rapidly than before, owing to the decreased mortality of infants and young children arising from the better care of those who are born.

    Dr. Robinson says on this point: “Here we have a whole country, Holland, in which the prevention of conception is legally sanctioned, in which the use of preventives is practically universal—and is this country dying out? On the contrary, it is increasing more rapidly than before, because we have this remarkable and gratifying phenomenon to bear in mind, that wherever the birth-rate goes down, the death rate goes down pari passu, or even to a still greater degree. This can be proven by statistics from almost every country in the world. For instance, in 1910 the birth-rate in Holland was 32, and the mortality 18; in 1912 the birth-rate fell to 28, but then the mortality rate fell still lower, namely to 12, so we see an actual gain in population, instead of a loss. And the physical constitution of the people has been improving * * *. And in New Zealand, where the sale of contraceptives is practically free, the birth rate is now 20, and the mortality rate is 10. Does that look like race suicide? On the contrary, there is a steady increase at the rate of ten per cent, while sickness and death of children, with their attendant economic and emotional waste, are reduced to a minimum.”

    Not only are the children of small families as a rule better cared for, from economic reasons easy to discern, but it is also a fact that the health of the mothers is far better, and consequently the health of the children when born is better than the average. One has but to look around him upon the families who boast of having had eight, ten, and twelve children born to them, to see what a frightful average percentage of deaths of infants and young children is present, and which brings down the number of the survivors.

    Dr. Alice Hamilton, in “The Bulletin of the American Academy of Medicine,” for May, 1910, reports that she has investigated the families of 1,600 wage workers, and found the following death rate per 1,000 birth among them, viz.:

    Families of 4 children and less 118 deaths per 1,000 births
    Families of 6 children 267 deaths per 1,000 births
    Families of 7 children 280 deaths per 1,000 births
    Families of 8 children 291 deaths per 1,000 births
    Families of 9 children or more 303 deaths per 1,000 births

    Dr. Hamilton sums up her investigation as follows:

    “Our study of the poorer working class shows that child mortality increases proportionately as the number of children increase, until we have a death rate in families of 8 children and over which is two and a half times as great as that in families of 4 children and over.”

    The facts above mentioned, and other facts of the same nature which will be disclosed in the progress of our consideration of the matter in the present book, have evidently been overlooked, deliberately or otherwise, by the fanatics in this country and in Europe who have been preaching to the people that a falling birth-rate means a decaying nation. Careful students of sociology now dismiss altogether the statement so often made that a falling birth-rate means “an old and decaying community.” The Germans for years have contemptuously been making this remark about France, but today they have been forced to recognize an unexpected vitality in the French, while, in fact, their own birth-rate has been falling more rapidly than that of France.

    Nor is it true that a falling birth-rate means a falling population. The French birth-rate has been steadily falling for a number of years, yet the French population has been steadily increasing all the time, though less rapidly than it would had not the death-rate been abnormally high. It is not the number of babies born that counts, but the net result in surviving children. An enormous number of babies are born in China; but an enormous number die while still babies. So that it is better to have a few babies of good quality than a large number of indifferent quality, for the falling birth-rate is more than compensated by the falling death-rate. In England, as the statistics show, while the birth-rate is steadily falling, the population has been steadily growing.

    Small families and a falling death-rate are not merely no evil—they are a positive good. They are a gain for humanity. They represent an evolutionary rise in Nature and a higher stage in civilization. We are here in the presence of a great fundamental principle of progress which has been working through life from the beginning.

    At the beginning of life on the earth, reproduction ran riot. Of one minute organism it is estimated that, if its reproduction were not checked by death or destruction, in thirty days it would form a mass a million times larger than the sun. The conger-eel lays fifteen million eggs, and if they all grew up, and reproduced themselves on the same scale, in two years the whole sea would become a wriggling mass of eels. As we approach the higher forms of life, reproduction gradually dies down. The animals nearest to man produce few offspring, but they surround them with parental care, until they are able to lead independent lives with a fair chance of surviving. The whole process may be regarded as a mechanism for slowly subordinating quantity to quality, and to promoting the evolution of life to even higher stages.

    This process, which is plain to see on the largest scale throughout living nature, may be more minutely studied, as it acts within a narrower range, in the human species. Here we statistically formulate it in the terms of birth-rate and death-rate; by the mutual relationship of the two courses of the birth-rate and death-rate we are able to estimate the evolutionary rank of a nation, and the degree in which it has succeeded in subordinating the primitive standard of quantity to the higher and later standard of quality.

    Especially in Europe we can investigate this relationship by the help of statistics which in some cases extend back for nearly a century. We can trace the various phases through which each nation passes, the effects of prosperity, the influence of education and sanitary improvement, the general complex development of civilization, in each case moving forward, though not regularly and steadily, to higher stages by means of a falling birth-rate, which is to some extent compensated by a falling death-rate, the two rates nearly always running parallel, so that a temporary rise in the birth-rate is usually accompanied by a rise in the death-rate, by a return, that is to say, towards the conditions which we find at the beginning of animal life, and a steady fall in the birth-rate is always accompanied by a fall in the death-rate.

    It is thus clear that the birth-rate combined with the death-rate constitutes a delicate instrument for the measurement of civilization, and that the record of their combined curves registers the upward or downward course of every nation. The curves, as we know, tend to be parallel, and when they are not parallel we are in the presence of a rare and abnormal state of things which is usually temporary or transitional.

    A study of the statistics of European countries furnishes us with evidence of the facts above stated. It is instructive to perceive how closely the birth-rate and the death-rate of the several European countries agree. It is perceived that the eight countries of Europe which register the highest birth-rate are the identical countries registering the highest death-rate. This is as might be expected, for a very high birth-rate seems fatally to involve a very high death-rate. The study of the following table may prove interesting—it certainly is instructive. In the following table the European countries having the highest birth-rate are stated in the order of rank according to size of such rate; and the countries having the heaviest death-rate are stated in the order of their rank in size of such rate:

    Highest European Birth-Rate.  Highest European Death-Rate.
    Russia. Russia.
    Roumania. Roumania.
    Bulgaria. Hungary.
    Serbia. Bulgaria.
    Hungary. Spain.
    Italy. Serbia.
    Austria. Austria.
    Spain. Italy.

    Moreover, Japan, with a rather high birth-rate, has the same death-rate as Spain; and Chile, with a still higher birth-rate, has a higher death rate than Russia. So, we see, that among human peoples we find the same laws prevailing as among animals, and the higher nations of the world differ from those which are less highly evolved precisely as the elephant differs from the herring, though within a narrower range, that is to say, by producing fewer offspring and taking better care of them.

    So, when we get to the root of the matter, the whole question of “Does Birth Control tend toward Race Suicide?” becomes clear, and we are able to answer, positively, “It certainly does not; on the contrary it tends toward Race Progress and Race Betterment.” We see that there is really no standing ground in any country for the panic-monger who bemoans the fall of the birth-rate, and storms against small families. The falling birth-rate is a world-wide phenomenon in all countries that are striving toward a higher civilization along lines which Nature laid down from the beginning. We cannot stop it if we would, and if we could we should be merely impeding civilization. It is a movement which rights itself and tends to reach a just balance.

    Instead of trying to raise the birth-rate by offering a bonus on babies as has been proposed in some quarters, it would be saner and better calculated for the betterment of the race to offer a bonus upon young men and women who attained maturity with a definite high standard of physical and mental development. As a writer on the subject has well said: “But we need not therefore fold our hands and do nothing. There is much still to be effected for the protection of motherhood and the better care of children. We cannot, and should not, attempt to increase the number of children born; there is still far more misery in having too many babies than in having too few; a bonus on babies would be a misfortune, alike for the parents and the State. But we may well work for the better quality of babies. There we should be on very safe ground. More knowledge is necessary so that all would-be parents may know how they may best become parents, and how they may, if necessary, best avoid it. Procreation by the unfit should be, if not prohibited by law, at all events so discouraged by public opinion that to attempt it would be considered disgraceful. Much greater public provision is necessary for the care of mothers during the months before, as well as in the period after, the child’s birth. Along such lines as these we may hope to increase the happiness of the people and the strength of the State. We need not worry about the falling birth-rate.”

    The more that one intelligently examines the argument against Birth Control based upon fear of Race Suicide, the more one becomes convinced that not only is there “nothing to it,” but that every fact brought to light in the inquiry reveals itself in the nature of proof of the desirability of Birth Control as a factor of Race Evolution, rather than evidence to the contrary. Therefore, the more inquiry and investigation that such argument brings forth, the stronger is the case disclosed for Birth Control, and the greater the amount of public opinion created in its favor.

    In all considerations of the general question of Race Suicide, one must take note of the general question of Eugenics or Human Breeding. This because the sound breeding of the race operates in a direction diametrically opposed to Race Suicide, while unsound breeding operates directly in favor thereof.

    When we consider the general subject of Eugenics we touch upon the highest ground, and are concerned with our best hopes for the future of the world. There can be no doubt that Birth Control, considered as a phase of Eugenics, is not only a precious but also an indispensable instrument in moulding the coming man to the measure of our developing ideals. Without Birth Control we are powerless in the face of the awful evils which flow from random and reckless reproduction. With it we possess a power so great that some persons have professed to see in it a menace to the propagation of the race, amusing themselves with the idea that if people possess the meansto prevent the conception of children they will never have children at all. It is not necessary to discuss such a grotesque notion seriously.

    The desire for children is far too deeply implanted in mankind and womankind alike ever to be rooted out. If there are today many parents whose lives are rendered wretched by large families and the miseries of excessive child-bearing, there are an equal number whose lives are wretched because they have no children at all, and who snatch eagerly at any straw which offers the smallest promise of relief to the craving. Certainly there are people who desire marriage, but—some for very sound and estimable reasons and other for reasons which may less well bear examination—do not desire children at all.

    For the class of married people who do not desire children at all, contraceptive methods, far from being a social evil, are a social blessing. For nothing is as certain as that it is an unmixed evil for a community to possess unwilling, undesirable parents. Birth Control would be an unmixed blessing if it merely enabled us to exclude such persons from the ranks of parenthood. We desire no parents who are not competent and willing parents. Only such parents are fit to father and to mother a future race worthy to rule the world.

    It is sometimes said that the control of conception, since it is frequently carried out immediately upon marriage, will tend to delay parenthood until an unduly late age. Birth Control has, however, no necessary result of this kind, and might even act in the reverse direction. A chief cause of delay in marriage is the prospect of the burden and expense of an unrestricted flow of children into the family; and it is said that in Great Britain, since 1911, with the extension of the use of contraceptives, there has been a slight but regular increase not only in the general marriage rate but also in the proposition of early marriage. The ability to control the number of children not only enables marriage to take place at an early age, but also makes it possible for the couple to have at least one child soon after marriage. The total number of children are thus spaced out, instead of following in rapid succession.

    It is only of late years that the eugenic importance of a considerable interval between births has been fully recognized, as regards not only the mother—this has long been recognized—but also the children. The very high mortality of large families has long been known, and their association with degenerate conditions and with criminality. However, of recent years, evidence has been obtained that families in which the children are separated from each other by intervals of more than two years are both mentally and physically superior to those in which the interval is shorter. Investigators have found that children born at only a short interval after the birth of a previous child are notably defective, even at the age of six, in a large percentage of cases; and when compared with children born at a longer interval, or with first children, they are, on the average, three inches shorter and three pounds lighter. These are facts of the most vital significance.

    Thus when we calmly survey, in however summary a manner, the great field of life affected by the establishment of voluntary human control over the production of the race, we can not see a cause for anything but hope. It is satisfactory that it should be so, for there can be no doubt that we are here facing a great and permanent fact in civilized life. With every rise in civilization, indeed with all evolutionary progress whatever, there is what seems to be an automatic fall in the birth-rate. That fall is always normally accompanied by a fall in the death-rate, so that a low birth-rate frequently means a high rate of natural increase, since most of the children born survive.

    Thus in the civilized world of today, notwithstanding the low birth-rate which prevails as compared with earlier times, the rate of increase in the population is still appalling—nearly half a million a year in Great Britain, over a million in Austro-Hungary, and three-quarters of a million in Germany. When we examine this excess of births in detail we find among them a large proportion of undesired and undesirable children. There are two alternative methods working to diminish this proportion: the method of regulating conception under the methods of scientific Birth Control, or the bungling substitutes for the same, on the one hand, and the method of preventing live births after conception by means of the abominable practice of abortion.

    There can be no doubt about the enormous extension of the practice of abortion in all civilized countries, even although some of the extravagant estimates of its frequency in countries, the United States for example, be discarded as unwarranted. The burden of bearing excessive children on the overworked and underfed mothers of the working classes becomes at last so intolerable that almost anything seems better than another child. As a woman in Yorkshire once said to an English investigator of this evil: “I’d rather swallow the druggist’s shop and the man in it, than have another kid.”

    A community which takes upon itself the responsibility of encouraging abortion lays itself open to severe criticism. And it must be admitted that just as all those who work for Birth Control are really diminishing the frequency of abortion, so every attempt to discourage Birth Control promotes abortion. We have to approach this problem calmly, in the light of Nature and reason. We have each of us to decide on which side to range ourselves. For it is a vital problem concerning which we cannot afford to be indifferent.

    There is no desire here to exaggerate the importance of Birth Control. It is not a royal road to the millennium of the race; and like all other measures which the course of progress forces us to adopt, it has its disadvantages. But fairness and honest thought should admit freely that so far as is concerned the question of its being a factor toward Race Suicide, we must pronounce a verdict of “Not Guilty” upon Birth Control. On the contrary, the contrary course of teaching and practice, if carried to their full logical conclusion, would inevitably bring the race to such a stage of degeneracy, and retrogression to primitive type, that a fate far worse than suicide would befall the human race. For the race, as well as the individual, may commit “suicide” and an end to its career, not only by a will-not-to-live but also by a will-to-degenerate.

    The face of Birth Control is set toward the rising sun of Race Betterment, not toward the setting sun of Racial Decline. Its ideas are those of Race Life, not of Race Death. It bids the race not to perish, but rather to live on in greater strength, happiness, and efficiency. Birth Control is in full accord with the Racial Will-to-Live, and not opposed to it. All humanity, all civilization, all human progress, call upon us to take our stand upon this vital question of Birth Control. And, as a writer has well said, in doing so we shall each of us be contributing, however humbly, to that “one far-off event, to which the whole creation moves.”

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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