Sex workers in Kamituga face health risks and stigma as mpox spreads through the mining hub, threatening livelihoods.

Sex workers in Kamituga, eastern Congo, are at the center of an mpox outbreak, grappling with health risks, stigma, and economic hardship. With around 40,000 sex workers in this mining hub, the majority of mpox cases are contracted through sexual contact, exacerbating vulnerabilities. Despite the outbreak, many sex workers continue working due to economic necessity, while facing stigma from clients and the wider community. The lack of vaccines and condoms, along with social and legal barriers, hinders efforts to control the virus’s spread. Health officials push for intervention, but the response remains limited.

The outbreak in Kamituga highlights broader systemic issues, such as poverty, the precarious situation of women, and the sex industry’s entanglement with mining economies. As sex work remains the primary income source for many women, particularly single mothers, stopping the spread of mpox without providing economic alternatives remains a challenge.

Health officials warn that without targeted support for sex workers, the virus could extend further into Congo and the region.

Confronting Mpox in East Africa’s Conflict Zones: Strategies for a Critical Response

Nigeria Receives Critical Mpox Vaccine Shipment from USAID

IOM Appeals for $18.5 Million to Combat Mpox Crisis

Mpox Outbreak in Africa Risks Becoming the Next Global Pandemic

The Mpox Epidemic in the DRC: A Deepening Crisis with Global Implications

DR Congo faces catastrophic health, humanitarian crisis

At 86, Edna Adan Ismail stands as a living testament to the power of resilience, courage, and determination. A nurse, midwife, and advocate for women’s health and human rights, she has spent decades breaking barriers and shattering cultural taboos—particularly those surrounding female genital mutilation (FGM). She became the recipient of the prestigious Templeton Prize, a recognition of her lifelong commitment to transforming the lives of women and girls in Somaliland and across Africa.

Ismail’s journey is not just one of personal triumph, but of creating systemic change in a region historically plagued by instability and gender inequality. As Somaliland’s first trained nurse and midwife, and later as its first foreign minister, Ismail has dedicated her life to the fight against FGM and the advancement of maternal health. Today, her proudest achievement is the Edna Adan Maternity Hospital, which she founded in 2002 to address the health crisis left in the wake of the Somali civil war. The hospital is now a beacon of hope in Somaliland, training hundreds of healthcare workers and providing life-saving maternal and child healthcare services.

A Battle Against FGM

For Ismail, the battle against FGM is deeply personal. Having suffered the practice herself, she has fought tirelessly to ensure that no more girls endure the same trauma. “I’m a midwife, and my job is to deliver babies in a safe way,” she explains. “I fight [FGM] because all the girls in my country are subjected to it, and because anybody who has any compassion for human values and the rights of the girls should be fighting it.”

Female genital mutilation, often performed in secret, is recognized globally as a violation of human rights and a form of gender-based violence. Yet, it remains a widespread practice, affecting over 200 million women and girls, according to the World Health Organization. The physical and emotional scars left by FGM are lifelong, increasing the risk of complications during childbirth and posing severe health risks.

But Ismail has seen progress. In the 45 years she has been involved in advocacy, discussions about FGM have gone from unspoken to mainstream. “In my culture, and I’m sure in many African countries, girls are brought up to be ‘respectful,’” she says. “We didn’t talk about a part of the body that is considered to be indecent to speak about… But nowadays, discussions are being held about FGM on the radio, in schools, even in places of worship.”

For Ismail, the breaking of these taboos is a victory in itself, but there is still much work to be done. Her relentless advocacy, however, continues to raise awareness and challenge deep-seated cultural norms, making it increasingly difficult for the practice to remain hidden.

A Legacy of Healthcare and Empowerment

Ismail’s dedication to maternal health is just as profound. When she returned to Somaliland in 1997, the country was in shambles after years of civil war. There were only 18 qualified nurses serving a region the size of England and Wales, and no formal training institutions. Driven by her father’s example—himself a pioneering doctor in Somaliland—Ismail decided to take on the challenge of rebuilding the country’s healthcare infrastructure.

“When I came back, we had 18 qualified nurses. Today, Somaliland has over 1,000 midwives and eight training schools,” she says proudly. Thanks to her efforts, maternal mortality in Somaliland has steadily, if slowly, decreased, and the country now boasts over 15 hospitals, 200 maternal-child health centers, and private clinics. The Edna Adan Maternity Hospital has become the foundation of this transformation, serving as both a medical facility and a training institution.

In a country where healthcare was once practically non-existent, the changes have been monumental. Somaliland’s healthcare workforce has not only grown but has also started attracting medical professionals from abroad. Ismail’s hospital, and the university that grew alongside it, have become pillars of Somaliland’s recovery, ensuring that women receive the care they need while fostering the next generation of health workers.

Inspiring Future Generations

Throughout her career, Ismail has broken numerous glass ceilings. She was Somalia’s first lady, Somaliland’s first foreign minister, and one of the first women in her region to receive a formal education. But her impact reaches far beyond titles and accolades.

“I wish to be remembered as an experimental animal,” Ismail says, with her characteristic humility. “In the experiment of teaching a girl to read and write, to become a nurse and a midwife, to hold community and national responsibility… And the experiment was a success.”

Her life is a story of perseverance and possibility, a living example of how education, determination, and a deep sense of responsibility can change lives and inspire others. By paving the way for women in healthcare and leadership, Ismail has become a role model for girls across Africa, proving that no cultural or societal barrier is insurmountable.

Edna Adan Ismail’s work is not yet done. As she continues to raise awareness about FGM, advocate for women’s rights, and build healthcare infrastructure, her legacy grows. For the girls and women whose lives she has touched, she is not just a healthcare provider or an advocate—she is hope personified. In a world that often dismisses the contributions of women, particularly in places like Somaliland, Ismail’s example is proof that change is not only possible—it is inevitable when driven by a force as unyielding as hers.

Her dream is simple, yet profound: to ensure that the doors she has opened remain open for future generations of women, so they, too, can change the world.

 Mental health issues prevents many Somalis from seeking treatment or assistance.

As antimicrobial resistance (AMR) surges, new antibiotics are scarce. With global leaders set to discuss the crisis, why is the development pipeline so dry and what can be done to address the growing threat?

As the world faces an escalating crisis of antimicrobial resistance (AMR), the need for new antibiotics has never been more urgent. Yet, despite the looming threat of drug-resistant infections, the pipeline for novel treatments remains alarmingly thin. This paradox is set to be a focal point at the upcoming UN General Assembly, where global leaders will grapple with strategies to address AMR and revitalize antibiotic development.

The rise of drug-resistant infections is a stark reminder of how modern medicine’s triumphs are increasingly under threat. The death toll from drug-resistant bacteria reached 1.27 million in 2019, and the economic costs of AMR are projected to surpass $1 trillion by 2030. Sub-Saharan Africa bears a disproportionate burden, particularly among children under five, where drug resistance compounds an already dire public health situation.

The crisis is exacerbated by a troubling stagnation in antibiotic development. Since 1990, only one new class of antibiotics has been discovered, a significant drop from the more than 25 new classes identified between 1940 and 1979. This slowdown is largely due to severe financial constraints and disinterest from major pharmaceutical companies, which have pivoted to more profitable ventures.

One major issue is the financial model for antibiotics. Unlike chronic medications for conditions like diabetes or hypertension, which generate sustained revenue from long-term use, antibiotics are typically used for short durations. This transient use makes it challenging for companies to recoup the substantial costs associated with developing new drugs. As a result, many smaller companies involved in AMR research are struggling financially, with several facing bankruptcy despite their promising breakthroughs.

The landscape of antibiotic research and development is also fraught with difficulties. Of the 112 commercial institutions engaged in preclinical research on AMR, 97 have fewer than 50 employees. This fragility poses a significant risk to the continuity of research efforts and innovation.

To tackle the crisis, experts argue for the need to enhance incentives for both research and market introduction of new antibiotics. In the UK, a subscription model has been introduced, providing drug companies with a fixed annual fee for new antibiotics, regardless of usage. This model aims to ensure that critical drugs remain available while reducing the financial risks for companies.

However, similar approaches are still under consideration in other regions, and there are concerns about their potential impact on global access. Health campaigners fear that such models might drive up the costs of antibiotics worldwide, making it even harder for developing countries to obtain these essential medications.

Addressing the AMR crisis requires a multifaceted approach. Governments and the private sector need to collaborate on funding and incentives that support both early-stage research and the market introduction of new antibiotics. Moreover, efforts must be made to ensure that these innovations are accessible and affordable across all countries and populations.

The UN General Assembly’s discussions on AMR will be crucial in shaping the future of global health policy. As the world grapples with this mounting challenge, a renewed focus on innovation, investment, and equitable access will be essential to preserving the effectiveness of antibiotics and safeguarding public health.

In the face of this critical situation, the call to action is clear: the global community must rally to overcome the barriers to antibiotic development and ensure that life-saving treatments remain within reach for all.

Echoes of Trauma: Unmasking the Dark Legacy of Terrorism on Somaliland’s Psyche

For decades, the people of Somaliland have been subjected to horrific acts of violence and terror, leaving deep, indelible scars on their collective psyche. The latest chapter in this dark saga unfolded in Lasanod in 2022, but to fully grasp the gravity of the current trauma, one must first look back to the 1980s, when the Hargeisa Holocaust forever altered Somaliland’s fate.

In the early 1980s, under the iron-fisted rule of the Somali dictator Siad Barre, Somalilanders faced a brutal onslaught that mirrored the darkest periods of human history. Barre’s regime orchestrated a massacre against the people of Somaliland, killing an estimated half a million individuals. This genocidal campaign, characterized by mass killings and systematic violence, was not just an attack on a region but an attempt to erase an entire people from existence. The echoes of this atrocity resonate to this day, often likened to the Holocaust experienced by Jews under Hitler’s regime, reflecting the sheer scale of suffering inflicted upon Somaliland.

Fast forward to 2022, and the suffering of Somalilanders was reignited with the assault on Lasanod by Somali Darood clan terrorists. This attack, which targeted civilians and soldiers alike, was not merely a violent confrontation but a continuation of a historical pattern of terror aimed at breaking the spirit of the Somaliland people. The assault was marked by extreme brutality, including torture and execution of prisoners of war, depicted in harrowing footage and propaganda disseminated online. The terrorists’ propaganda campaigns, showcasing scenes of death and suffering, were designed to demoralize and incite fear among Somalilanders while furthering their violent agenda.

The psychological impact of these events on Somalilanders cannot be overstated. Our analysis reveals that the trauma inflicted by such propaganda and violence is profound and far-reaching. The repeated exposure to graphic content depicting the torture and murder of Somalilanders has resulted in a spectrum of psychological distress. Many have reported symptoms akin to post-traumatic stress disorder (PTSD), including severe anxiety, persistent nightmares, and acute emotional instability. This reaction is not merely a personal struggle but a collective trauma that reverberates through the community.

The recent research highlights that while Somalilanders’ reactions to terrorist propaganda vary, the common thread is the severe emotional and psychological toll it takes. Scenes of extreme violence and suffering trigger intense emotional responses, such as sadness, anger, and fear. The constant barrage of such content can lead to long-term mood disorders and disrupt daily life, affecting concentration, memory, and overall mental health.

Veterans of the Somaliland National Movement (SNM), who endured the Hargeisa Holocaust, display a heightened awareness of the dangers posed by such content. These individuals, having lived through the horrors of Barre’s regime, approach terrorist propaganda with a more cautious mindset compared to younger generations. Their experience underscores the need for a nuanced understanding of trauma and the importance of historical context in addressing current psychological impacts.

The experimental findings from our study further emphasize the urgency of addressing these issues. The biofeedback data indicates that those exposed to terrorist propaganda exhibit stronger emotional reactions and greater psychological distress compared to those who view less disturbing content. This suggests that the intensity of the visual stimuli plays a significant role in exacerbating trauma, highlighting the need for protective measures and mental health support.

The international community’s response to Somaliland’s plight has been woefully inadequate. The atrocities inflicted upon Somalilanders by both Barre’s regime and the recent Lasanod attackers deserve global condemnation and intervention. The lack of significant international support reflects a broader failure to address the psychological and humanitarian crises faced by this beleaguered region.

To mitigate the ongoing trauma, it is imperative for Somaliland to implement comprehensive mental health strategies. This includes enhancing support services, providing mental health training, and developing coping mechanisms to help individuals deal with the psychological impact of terrorist propaganda. Effective policies should also involve international cooperation to ensure that Somalilanders receive the necessary support to heal from their profound losses.

In conclusion, the suffering of Somalilanders is a stark reminder of the devastating impact of terrorism and violence. From the horrors of the Hargeisa Holocaust to the recent Lasanod attacks, the psychological scars remain deep and pervasive. The global community must recognize and address these issues with the urgency and compassion they demand, offering not just sympathy but tangible support to help Somalilanders reclaim their peace and dignity.

As Mpox Threatens to Worsen the Crisis, Key Actions Needed to Address the Outbreak Amidst Regional Conflicts

As the mpox outbreak continues to surge through East Africa, including Kenya, Rwanda, Burundi, and Uganda, the situation has reached a fever pitch. The epidemic, which began in the Democratic Republic of Congo in January 2023, was declared a public health emergency by the Africa Centres for Disease Control and the World Health Organization in August 2024. The spread of this viral disease is particularly alarming in regions plagued by conflict.

The intersection of mpox and ongoing or recent conflicts presents a grim scenario. War-torn countries in East Africa and the Horn, such as Sudan and Somalia, face catastrophic healthcare challenges. In Sudan, over a year of relentless conflict has crippled 70% of health facilities, leaving the remaining ones besieged by attacks and shortages. Similarly, Somalia, grappling with decades of strife, has one of the world’s lowest childhood immunization rates. Ethiopia, with its recent Tigray conflict, saw its healthcare system in tatters, a crisis that our research underscores.

The Tigray conflict (2020-2022) offers a sobering lesson. The federal blockade led to a collapse of the healthcare system, massive displacement, and severe damage to health facilities. Our research from 2021 revealed that 39% of infants received no basic vaccinations due to the war. This was further corroborated by a recent WHO report, highlighting simultaneous outbreaks of several infectious diseases in Sudan’s states.

These past experiences underscore the dire need for a robust response to the mpox outbreak in conflict zones. Here’s how we can effectively manage the situation:

1. Integrate Vaccine Distribution with Humanitarian Aid: Efficient deployment of mpox vaccines requires blending with broader humanitarian efforts. Coordination ensures that vaccines are delivered alongside other essential supplies, leveraging existing logistical frameworks to reach those in need.

2. Engage Local Communities: Building trust with local communities is crucial. By involving local leaders and residents, we can protect frontline workers from conflict-related dangers and foster acceptance of the vaccine. Establishing permanent vaccination teams from within these communities will enhance the response.

3. Collaborate with Military and Security Forces: Securing the safe delivery of vaccines may necessitate military escorts, similar to practices in humanitarian aid. This collaboration is vital to navigate conflict zones and ensure uninterrupted vaccine delivery.

4. Negotiate Access with Conflict Actors: Understanding and negotiating with the various factions controlling conflict areas can reduce operational risks. Securing physical access through dialogue with these groups is essential for effective vaccine distribution.

5. Address Transit and Cross-Border Vaccinations: Given the frequent displacement of populations in conflict zones, vaccinating at transit points is crucial. This approach will ensure that those moving across borders or fleeing violence are protected.

6. Deliver Vaccines to Refugee and Internally Displaced Person Camps: Special attention must be given to camps housing refugees and internally displaced persons. These areas are particularly vulnerable and require targeted vaccination efforts to prevent the spread of mpox.

In conclusion, the mpox outbreak in East Africa’s conflict zones demands a multifaceted response. By integrating vaccination efforts with humanitarian aid, engaging local communities, and collaborating with military forces, we can mitigate the impact of this deadly virus. The lessons from past conflicts, combined with strategic planning, will be pivotal in controlling the spread of mpox and safeguarding public health in these turbulent regions.

The Swedish government, through the administration of Järva District in Stockholm, has launched a targeted swimming training program for Somali mothers. This initiative aims to enhance the safety and well-being of children during the swimming season and offer benefits to the mothers themselves. Scheduled to commence in early September, the program will span several months and has already attracted over twenty registrants.

The Swedish government is fully funding the cost of the courses, including payment for instructors. This initiative reflects a broader commitment to community health and safety. Abdirashid Mohamed, Järva District Commissioner, highlighted the origins of this program, noting that it was reinstated following requests from local mothers who recognized the value of swimming lessons for both themselves and their children.

While the program initially targeted Somali mothers, it is open to all women in the district, encompassing both Somali and non-Somali residents. Järva District, with a population of approximately 92,000, aims to extend this opportunity to all mothers. The goal is not only to provide essential swimming skills but also to foster social connections among the women, as their children often attend the same schools.

The primary aim of the swimming lessons is to ensure that mothers can confidently accompany their children to swimming areas during the hot season. This initiative is designed to alleviate fears and enhance mothers’ ability to support their children in water safely. Additionally, the program promotes socialization and community integration among the participants.

Swimming is recognized for its numerous health benefits. It contributes to cardiovascular health by improving arterial function and reducing the risk of heart disease. The exercise involved in swimming engages multiple muscle groups, which supports overall fitness and longevity. Studies suggest that regular swimming can lead to a longer life and improved joint health, underscoring its value as a holistic physical activity.

The swimming training program in Järva District represents a significant investment in community health and safety. By providing Somali mothers with the skills to support their children in swimming and encouraging broader social engagement, the Swedish government is addressing both practical and communal needs. The program’s emphasis on inclusivity and health benefits highlights its potential to positively impact the lives of many families in the district.

As Mpox Cases Surge Across Africa, Nigeria’s New Vaccine Arrival Marks a Key Step in Combating the Epidemic

In a significant boost to Nigeria’s efforts against the mpox outbreak, the country has received its first shipment of vaccines, courtesy of the United States. The donation, consisting of 10,000 doses of the Jynneos vaccine, arrives at a critical moment as the disease surges across Africa, with Nigeria itself grappling with a substantial increase in cases.

Mpox, previously known as monkeypox, has escalated into a severe public health threat, particularly across Central and West Africa. The Democratic Republic of Congo and several East African nations, including Burundi and Kenya, are at the epicenter of the outbreak. The World Health Organization recently categorized mpox as a global health emergency, intensifying international efforts to curb its spread.

Nigeria, one of the hardest-hit countries, has reported over 40 confirmed cases and approximately 830 suspected ones across 13 states. This alarming rise in infections has prompted urgent action. U.S. Ambassador Richard Mills highlighted Nigeria’s preparedness to deploy the vaccine effectively, noting the government’s detailed vaccination plan designed to maximize the impact of this crucial donation.

“The Nigerian government has crafted a comprehensive plan to use these vaccines strategically,” Mills stated. “This plan ensures that we achieve the greatest possible benefit from this initial 10,000-dose shipment.”

The vaccine’s arrival is particularly timely, as the Africa Centres for Disease Control and Prevention (Africa CDC) reported a staggering 22,863 mpox cases across the continent. Of these, 3,641 have been confirmed, with over 620 deaths documented in 13 African Union member states.

Nigeria’s primary health care director, Muyi Aina, revealed that the vaccine rollout will focus on states with the highest case numbers, predominantly in the southern regions. “We will prioritize these areas and collaborate with state officials to create tailored plans for vaccine distribution,” Aina explained.

Despite the urgency, vaccine hesitancy poses a significant challenge. WHO representative Walter Mulombo emphasized the importance of addressing misinformation. “The vaccine has proven effective against smallpox and shows promise for mpox,” he said. “We must rely on scientific evidence rather than succumb to unfounded fears.”

The international community is rallying to support Africa’s response to mpox. Germany is preparing to donate 100,000 vaccine doses to East Africa, further bolstering the region’s fight against the outbreak. Nigeria, while making strides, faces ongoing hurdles including vaccine shortages and delivery delays, underscoring the need for continued global assistance.

As Nigeria embarks on this crucial phase of its vaccination campaign, the stakes are high. The arrival of the mpox vaccines marks a pivotal moment in the battle against the disease, offering hope for containment and control in a region severely impacted by this evolving health crisis.