Twenty-three-year-old Kodi Moumdau laughs with a group of young women in brightly coloured shawls in her ward at the National Fistula Centre [Centre National de Référence de Fistule Obstétricale] in the outskirts of Niamey, the capital of Niger. They can consider themselves amongst the lucky women who have been treated for and survived an obstetric fistula condition.

Kodi Moumdau give birth last year but her child was stillborn and in the process of delivery a fistula, or tear, developed between her vagina and anus. Fistulas of this type can result in a lack of bowel and urine control, leading to embarrassment and shame amongst women who are suffering the condition.

Speaking in her local language Djerma, Kodi Moumdau explained her fears when the fistula first happened: “When I was pregnant, my legs became paralyzed, so I was rushed to the hospital. My baby was still-born and that is when my body tore.”

Many young women with fistulas are shunned by their communities, as the condition, which can frequently lead to bad odours, is considered by some as dirty.

Kodi Moumdau was fortunate to the extent that she was treated quickly, after being taken directly to a specialist local hospital in Tillaberi region in the north-west of Niger and then onto the National Fistula Centre in Niamey.

Fistula Increase

Kodi Moumdau is not alone.

In Niger, the incidence of obstetric fistulas is increasing, in line with population growth and the continuing lack of education about the causes of the condition. Child marriage, early pregnancy and female genital mutilation all contribute to the growing number of cases in Niger and across sub-Saharan Africa. The exact number of affected women in the sub-Saharan region is not known, although the United Nations estimates it could be up to one million.

In the National Fistula Centre, one of 11 fistula treatment centres in Niger, there are 69 women who are accommodated in neatly arranged wards in the dusty and parched hospital compound. Of those, 42 are waiting to have the operation to repair the tear to their bodies.

UNFPA/Ollivier Girard

UN Deputy Secretary-General Amina J. Mohammed (c) stands with Margot Wallstrom, Minister for Foreign Affairs of Sweden (l) and Dr. Lalla Malika Issoufou Mahamadou, second First Lady (r) at the National Fistula Centre in Niamey, Niger.

Dr. Abdoulaye Idrissa, the director of the centre, carries out around six operations a week. Dressed in his theatre scrubs or clothes and white coat, he frequently visits the wards. He moves easily between patients, asking them how they feel and exchanging some much-needed light-hearted conversation. He is clearly liked and respected.

“Even if we carry out one operation, we consider that a success,” he told UN News. “But I have to say we have a heavy and difficult task because as the population of Niger increases, so do the needs. We fight to do our best. Each year we increase the number of obstetricians and surgeons on our staff, we open new clinics, so we are able to reach more parts of the country.”

And he recognizes, the causes behind the increase in obstetric fistulas are common to many developing sub-Saharan countries, saying: “The essential factors remain poverty, illiteracy, access to health care services…there are social factors also, like early marriage.”

The average age of patients who he treats is 18, but he frequently sees girls as young as 12 or 13. The risk of a fistula is far greater for young pregnant girls whose bodies are not yet fully formed.

UN-AU visit

The work of the National Fistula Centre was showcased to a joint high-level visit of the UN and African Union, which spent two days in Niger looking at the issues of women, peace and security and development, as well as empowerment and the importance of getting more women into leadership positions.

The health of women is an important part of making sure they are able to fulfill their potential.

UN Deputy Secretary-General Amina Mohammed led the joint delegation to Niger and met patients and doctors at the centre on Saturday.

“These centres are an oasis, a place of sanctuary for girls in early child marriage, who have ended up needing horrendous fistula repairs,” she said, adding “not only are fistulas damaging to their own wellbeing physically and mentally, women are also stigmatized. Within their families and societies, they no longer have a home.”

“There are two sides to this,” she contiued, “making sure we put more money into the repairs and the work that the doctors do here tirelessly and then also take up the advocacy, because we should be able to prevent and bring zero child marriage to our children in Niger and the rest of Africa.”

Spotlight Initiative

These centres are an oasis, a place of sanctuary for girls in early child marriage, who have ended up needing horrendous fistula repairs  – UN Deputy Secretary-General

This is where a new effort, Spotlight Initiative, a partnership of the European Union and UN, aims to make a difference. A fund in support of the Sustainable Development Goals, and focused on ending all forms of violence against women and girls, the Spotlight Initiative will have a specific focus on early marriage in Africa.

Niger is one of eight implementing countries selected on the continent. In discussions with the Prime Minister and ministers during the trip, it was clear that the Initiative brought both great hope and expectations – including for significant investments in more centres such as this. 

Two months after her operation, Kodi Moumdau is looking forward to returning home and being reunited with her husband. She chats and laughs with her fellow fistula survivors on the bed she has slept in since she arrived from the countryside to where she will soon return, confident that she can resume her life at home.
 

Since South Sudan became the world’s youngest country in 2011, 2.6 million of the 3.4 million babies have been born in war, the United Nations Children’s Fund (UNICEF) revealed Saturday.

“As South Sudan turns seven, a seemingly endless war continues to devastate the lives of millions of children,” said Henrietta H. Fore, UNICEF’s Executive Director who visited Juba, Ganiyel and Bentiu in the war-ravaged country earlier this year. 

Conflict and underdevelopment have plagued the area for decades, leaving its children out of school, malnourished and vulnerable to disease, abuse and exploitation. 

“Warring parties can and must do more to bring back peace,” she continued, “The children of South Sudan deserve better.” 

After gaining independence in 2011, a civil war erupted in 2013 – rendering short-lived the prospect of a better future.

Although 800 children have been released from armed groups since the beginning of the year, an estimated 19,000 others continue to serve as fighters, porters and messengers and to suffer sexual abuse, which is up from 500 since the war broke out.

The proportion of people who do not know where their next meal is coming from jumped from 35 per cent in 2014 to nearly 60 per cent at present, with some areas of the country just one step away from famine, especially during the lean season.

Malnutrition rates are at critical levels, as more than one million children are malnourished, including 300,000 on the brink of death.

With one-in-three schools destroyed, occupied or closed since 2013, the conflict has also left some two million children without an education, earning South Sudan the distinction of having the highest proportion of out-of-school children in the world. 

The children of South Sudan deserve better –  UNICEF chief

Moreover, efforts to aid those in greatest need are being hampered. 

Since 2013, more than 100 aid workers have been killed in the violence, including a driver for UNICEF just last week.

While a massive number of refugees had returned when the country first gained independence,  sinde . However, since 2013, more than 2.5 million, including over one million children, have again fled for safety in neighboring countries.

On a brighter note, the signing of a permanent ceasefire between the two main warring parties in Khartoum last month was a positive step – offering a flicker of hope in what has been a faltering peace process. 

“We now count on the leadership and commanders to respect it while ensuring that aid workers are given unrestricted access to those in need,” said Ms. Fore.

Flagging that South Sudan was the first country she visited as UNICEF chief, she concluded by saying: “I saw for myself how harmed children have been by the war. They simply cannot endure anymore.”
 

The role of women in leadership positions is critical to the future of a peaceful Niger according to the UN Deputy Secretary-General, Amina Mohammed. 

Ms Mohammed was speaking at a meeting with the Nigerien president, Mahamadou Issoufu, on Saturday in the capital Niamey which was part of a joint United Nations -African Union (UN-AU) mission to the country.

“I stressed to the President the importance of women’s participation and leadership in preventing conflicts,” she said. “I also underlined the need to include women in all national and regional responses to the ongoing environmental, humanitarian and development challenges that Niger and the Sahel region face.”

The deputy UNchief is leading the UN-AU visit to Niger, which includes many of the most senior women in the UN, the African Union, Special Envoy on Women, Peace and Security, as well as the Foreign Minister of Sweden, Margot Wallström. 

A key focus of the two-day trip is women’s participation and leadership in conflict prevention, including violent extremism.
Security.

The security situation in Niger has worsened since 2015, when the first attack was launched by Boko Haram extremists in Diffa in the east of the country – an attack which displaced some 300,000 people, the majority of whom are women and children.

The presence of Boko Haram, whose goal is to create an Islamic state in the north of Nigeria, has been particularly harmful to women and girls who have experienced what the UN has called “staggering and multiple forms of sexual and gender-based violence.” 

Humanitarian situation

Insecurity which has caused displacement, and climate change, including insufficient rains, have led to a deterioration of the humanitarian situation in Niger. The number of people in need of assistance has reached 2.3 million in 2018, an increase of 400,000 over 2017.

Moreover, the country is currently hosting some 165,000 refugees the majority from neighbouring north-eastern Nigeria, the epicenter of Boko Haram activities. 

Sahel Support Plan

Niger is one of ten countries which are part of the UN Support Plan for the Sahel, a region which stretches from Chad in central Africa to Mauritania and Senegal in the west.

The plan, which was presented by Ms. Mohammed on the margins of the AU summit held in the Mauritanian capital Nouakchott last month, aims to build lasting peace in the ten focus countries. It also prioritizes economic growth, women youth and job creation.

Ibrahim Thiaw, the UN Secretary-General’s Special Adviser for the Sahel was part of the UN–AU joint visit to Niger. 

“There are certainly significant challenges in this region, but there are also opportunities,” he told UN News in the Nigerien capital, Niamey. “The degradation of the environment, insecurity due to extremism and terrorism are both deep-rooted problems. However, the region has enormous potential due to its natural resources and cultural assets as well as, of course, its people.” 

The UN Security Council is due to hold a debate on the Sahel region on Wednesday.

The ten focus countries in the Sahel Support Plan are: Burkina Faso, Cameroon, Chad, The Gambia, Guinea, Mali, Mauritania, Niger, Nigeria and Senegal.

Each year on the first Saturday in July, the international community celebrates the International Day of Cooperatives – successful businesses that respect the resources they offer. This year, the Day focuses on the theme “Sustainable consumption and production of goods and services.” 

Simel Esim, head of the International Labour Organization’s (ILO) Cooperatives Unit, lauded their benefits by sharing stories of how Kenyan producer cooperatives’ coffee has found its way to the shelves of a Denmark coop; biological pineapples from a Togolese youth cooperative are being sold in retail cooperatives across Italy; and consumer cooperatives in East Asia have developed organic and ecolabel products while educating their members on working conditions, reducing food waste and paring down plastic consumption.

Ms. Esim pointed to cooperatives in Northern Sri Lanka that have helped build the resilience of their local communities, saying that she saw firsthand, “the positive impact of cooperatives’ commitment to sustainable consumption and production.”

“A rapid assessment at the start of the ILO’s Local Empowerment through Economic Development project indicated that cooperatives were the only ‘stable’ structures present in Northern Sri Lanka before, during, and after” the years of civil war, she said.

Cooperatives at both ends of the supply chain have been joining forces to improve product traceability and adopt environmentally-friendly practices – with the ILO working with its constituents to improve the social and environmental footprint of cooperatives around the world.

With “concern for community” as one of their guiding principles, cooperatives have sustainability in their DNA.

For two centuries, they have been building sustainable and resilient societies.

The UN’s Department of Economic and Social Affairs explained that each cooperative yields its own gains:

• Agricultural cooperatives harness sustainable farming practices to maintain land longevity for growing crops;
• Consumer cooperatives not only support sustainable product sourcing but also educate consumers about responsible consumption; 
• Housing cooperatives help ensure safe dwellings;
• Utility cooperatives engage in transitioning to cleaner electricity and rural access to energy and water; and
• Worker and social cooperatives aim to provide goods and services in an efficient, planet-friendly way while creating long-term, sustainable jobs.

The 2018 theme aligns perfectly with that of Monday’s 2018 High-level Political Forum for Sustainable Development (HLPF): “Transformation towards sustainable and resilient societies,” where the progress of five of 2030 Agenda for Sustainable Development’s Sustainable Development Goals (SDGs) will be assessed.
 

On Saturday, Secretary-General  António Guterres  welcomed the first anniversary of the adoption of the Treaty on the Prohibition of Nuclear Weapons, previously calling it an “essential pillar” of international peace and security, and the “heart” of the nuclear disarmament and non-proliferation regime.

“The treaty’s adoption on 7 July 2017 by 122 States demonstrated the strong and legitimate international support that exists for a permanent end to the threat posed by nuclear arms,” said Deputy Spokesperson Farhan Haq in a statement on behalf of the UN chief.

The objective of the landmark international treaty is to prevent the spread of nuclear weapons and weapons technology, to promote cooperation in the peaceful uses of nuclear energy and to further the goal of achieving nuclear disarmament and general and complete disarmament.

It represents the only binding disarmament commitment in a multilateral treaty by the nuclear-weapon States. 

Mr. Haq noted that to date, it has 59 signatures and 11 ratifications. Once 50 States have ratified the treaty, it will enter into force , “becoming an important element of the nuclear disarmament and non-proliferation regime.”

“The United Nations remains committed to the total elimination of nuclear weapons as its highest disarmament priority,” the statement concluded.