Mysterious & Devastating – Nodding Syndrome   Leave a comment


Mysterious and Devastating - Nodding Syndrome

Lubiri Village (Pader District), Uganda – Nodding Syndrome (NS) is a mysterious and devastating neurologic condition which stunts growth, causes its victims to nod (repeatedly dropping their heads forward), have epileptic seizures (resulting in badly bruised faces and bodies), and causes cognitive deterioration. In severe cases it can result in death. Also at an advanced stage the syndrome causes its victims to wander aimlessly, hence families will tie the person with a rope or chain to prevent them from getting lost, injured or in the case of a young woman raped.


The condition mostly affects children 5-15 years in northern Uganda, South Sudan and Tanzania – although apparently there are no active cases in Tanzania. According to Komakech Paul, a senior clinical officer at the Atanga Health Centre III in Lubiri Village, Uganda, NS is concentrated in Pader, Kitgum, Lamwo, Lira and Gulu districts in northern Uganda. It has been active in the region since 1997 and the first really bad cases began to appear in 2006, said Mr. Komakech. “It’s associated with river blindness which is linked to blackflies. Blackflies breed in fast flowing fresh water. Sub-counties in the aforementioned districts, which are along the Aswa, Pager and Agago Rivers, are where the families affected by NS live. The link to river blindness is an assumption that’s still being investigated,” stated Mr. Komakech.

New research, presented in the International Journal of Infectious Diseases, suggest that blackflies, infected with the parasite Onchocerca volvulus (the parasite that causes river blindness), may indeed be capable of passing on a secondary pathogen that is to blame for the spread of NS. This new study is from the Institute of Tropical Medicine in Antwerp, Belgium. It documents how the use of insecticides and application of larvicides to rivers (keys to controlling the blackfly population) have affected the rates of NS in areas like northern Uganda.

Mysterious and Devastating - Nodding Syndrome


Mysterious and Devastating - Nodding Syndrome

This supports claims by officials at the Atanga Health Centre III, that the area has not seen any new cases of NS since the government launched an intervention program in 2012. Under the program river dosing was started: chemicals that kill blackflies have been used to treat rivers (it continues today). As a second part of the program village health teams administered ivermectin (the anti-parasitic drug used to prevent river blindness) to people in affected communities. The drug clears filarial worms from the body; the larvae from the worms enter humans via blackflies stated Mr. Komakech. Health officials at the Atanga Health Centre III are attributing the absence of new cases to these interventions.


Mysterious and Devastating - Nodding Syndrome


Mysterious and Devastating - Nodding Syndrome

Nevertheless, despite the absence of new cases health officials have an existing population of young people who require treatment for NS. The primary drug of treatment is sodium valproate. Unfortunately not all patients respond to the drug. It is not a cure. While some children have recovered to the point that they lead normal active lives, if they cease taking the drug they revert.

Mysterious and Devastating - Nodding Syndrome


Mysterious and Devastating - Nodding Syndrome

The aforementioned new study while not providing a cure does provide possible answers regarding how NS is spread. The report on the study cites the following: NS epidemics come and go because indigenous populations may become immune to the NS pathogen over time, but that when forced migration moves a non-immune population into an area with a large number of blackflies, NS cases erupt. “Population displacement resulting from civil conflict has preceded NS outbreaks in both northern Uganda and South Sudan,” states Robert Colebunders, MD, PhD and head of HIV/STD Unit, Department of Clinical Sciences at the Institute of Tropical Medicine, professor of infectious diseases at the University of Antwerp.

Mysterious and Devastating - Nodding Syndrome

So while the new study is informative the search for a cure continues. The Center for Disease Control (CDC), in the United States, has been actively involved in trying to discover a cure for NS since 2011, said Mr. Komakech. He went on to describe how officials with the CDC took ten Ugandan children from one family (in Lamwo district) to the U.S. to be examined: five of the children had NS and five were unaffected. The results have not yet been released. “We’re working with something that’s still not well known and our community desperately needs to be informed,” concluded Mr. Komakech.

Mysterious and Devastating - Nodding Syndrome


Mysterious and Devastating - Nodding Syndrome


Mysterious and Devastating - Nodding Syndrome


Mysterious and Devastating - Nodding Syndrome


Mysterious and Devastating - Nodding Syndrome


Additional photographs by Ric Francis may be viewed at













Beyond Coffee – Livelihood Diversification   1 comment


Ethiopian coffee farmers are involved in a five year program to teach them to diversify their source of income: The Livelihood Diversification for Smallholder Coffee Farmers program.

The program, funded by the Green Mountain Coffee Roasters and supported by Catholic Relief Services, is also being implemented in Kenya and Rwanda. It’s designed to increase food security and access to financial services through the introduction of small ruminant (sheep or cow) rearing/fattening, oxen fattening, bee keeping (honey production), Farmer Field Schools and Savings and Internal Lending (SILC) groups.

What follows are photographs (20) of Ethiopian coffee farmers and communities involved in the program:


Oromia region (Gelan District) – Workers at the Oromia Coffee Farmers Cooperative Union (OCFCU) Ltd. processing coffee beans.


Oromia region (Gelan District) – Men at OCFCU process sacks of coffee beans for cleaning.


Debeka Village – Ayele Dergaso, 65, with assistance from his son Astarke Ayele, 25, digs up sweet potatoes.


Debeka Village – Ayantu Gumi, 45, makes Ethiopian coffee by first roasting coffee beans. Afterwards the beans will be ground in a wooden mortar and then brewed in a Jebena (a pottery boiling pot).


Debeka Village – Freshly roasted coffee is brewed in a Jabena.


Debeka Village – Neighbors and family members relax over coffee and sweet potatoes.


Debeka Village – Martha Wakayo, 18, Ayantu Gumi, 45, and Tamru Ayele, 12, converse with other family members and neighbors.


Debeka Village – Ayele Dergaso, 65, right, shares coffee with neighbors Adane Washola, 15, left, Tamrat Gelgele, 24, third from left, and his son Fekadu Ayelel, 14.


Debeka Village – Children go about their way on a very hot afternoon.


Magala Lemefa Village – Abbiti Shorre, 6 (foreground), Abreham Shorre, 8 (center-blue shirt) and Gete Shorre, 10 (directly behind Abreham) walk to school.


Bochesa Village – Abiti Tariku, 8, plays with a one-week old lamb on the grounds of his grandmother’s coffee field


Magala Lemefa Village – Hirbaye Shorre, 46, stands idle after trimming False Banana trees on the grounds of her coffee field, while her cow feeds and a grandchild plays; she owns two coffee fields in separate villages.


Bochesa Village – Hirbaye Shorre herds her cow and sheep home after they grazed at her coffee field.


Bochesa Village – Hirbaye Shorre walks around her coffee field picking the few coffee  beans that were not harvested, while her grandson plays in a tree.


Magala Lemefa Village – Bekelech Shorre, 15, collects an empty coffee cup from her four-year old cousin, Jaleta Tariku.


Ejersa Fora Village – A farmer displays green onions and ginger for sale at the Wacheray Market.


Ejersa Fora Village – A farmer sells peppers to a young girl.


Ejersa Fora Village – Adnech Gocha unties rope from the legs of her sheep.


Ejersa Fora Village – Before the start of the Livelihood Diversification for Smallholder Coffee Farmers program, locals would informally gather to collect money to loan to one another; after the program began they converted their traditional money collecting methods into this Savings and Internal Lending Community (SILC) group.


Ejersa Fora Village – Adnech Gocha, 42, sells Kocho (a food made from False Banana trees) to customers at the Wacheray Market.

Additional photographs by Ric Francis may be viewed at

Ethiopian Coffee Farmers – Farmer Field School   Leave a comment


Buoyed by rhythmic chants the farmers swung their labor intensive agricultural hand tools in unison, each motivating the other to move swiftly, tirelessly and happily as they prepared a field for seeding at the farmer field school (FFS) in Fogi Village, Ethiopia.


It is late morning and the sun bathes the farmers with its rays, yet despite the heat and hard work it is apparent these men and women could not be happier. As members of a farmer field school they’re linked by camaraderie and an urgency to improve the lives of their families. Eighteen members of the Wolda Misoma Group (a Savings and Internal Lending Community Group – SILC) own and operate this school, created with the assistance of the Ethio-Wetlands and Natural Resources Association (EWNRA), as part of the Livelihood Diversification for Smallholder Coffee Farmers program in Ethiopia. The program is funded by Green Mountain Coffee Roasters (GMCR) and supported by Catholic Relief Services (CRS). This five year program, which has also been implemented in Kenya and Rwanda, is designed to increase food security and access to financial services through the introduction of small ruminant (sheep or cow) rearing/fattening, oxen fattening, bee keeping (honey production), Savings and Internal Lending  (SILC) groups and Farmer Field Schools (FFS).


Farmer field schools fall under the category of farmer groups which are informal organizations whose members have similar interests. Farmer groups also include SILC, Seed Growers, Marketing, and Irrigation Users. During an interview with members of the FFS, Getu Jebo, 25 (head of the school, married with five children), and Bikila Tero, 25 (married with four children), they discussed how the school grew out of the Wolda Misoma (SILC) Group. Before the creation of the school EWNRA trained field agents (such as Mr. Tero) to organize SILC groups in the area. Afterwards EWNRA searched for a strong SILC group through which it could execute its idea for a farmer field school. The idea for the FFS came from a need to ensure the sustainability of different interventions, implemented by the Livelihood Diversification for Smallholder Coffee Farmers program.


This meshed perfectly with Wolda Misoma Group members who recognized the importance of diversifying crops and income while providing their village with vegetables. “In this area consumption of vegetables has not been a firmly established part of our diet. We saw vegetables when we visited urban areas but we didn’t understand their importance. Our attitude has changed because of the FFS,” stated Mr. Tero. He and Mr. Jebo agreed that all of the group’s members have benefited from the school learning how to grow a variety of vegetables, e.g., carrots, cabbage and onions, while also becoming more efficient as coffee farmers through the use of improved spacing techniques.


The members were excited about the idea of starting a FFS and receiving training that would otherwise be unavailable individually. So after calling their interest to the attention of EWNRA, this implementing partner made an agreement with local government administrators and secured rented land (0.35 hectare for three years for 3000 Birr – 19 Birr equals $1.00) for the school. Initially EWNRA provided training to four FFS members who then shared the knowledge with the group. The project has provided the school with seed, farming tools, watering cans and experts on how to properly plant, manage and harvest crops.


The school provides the added benefit of educating passing locals who observe how vegetables are grown and replicate the lessons at home. Every tuesday and thursday the eighteen members work collectively in the field from 9:00 a.m. until noon. Daily they work in pairs, each responsible for watering three beds of coffee seedlings mornings and evenings; there are 33 coffee seedling beds.

 The school embodies the concept of “each one, teach one.” “We commonly work happily together. We use songs to motivate one another and to tease, particularly if someone is having a low-energy day,” said Mr. Jebo laughingly. Everyone is rewarded for their efforts with free vegetables; if there’s a surplus harvest it’s sold at the market.

“In the future we plan to expand production to utilize all of the school’s land to include maize, and fence the area off through the creation of a live fence,” stated Mr. Jebo. The live fence would be made using elephant grass which could also serve as feed.


The concept of “each one, teach one” is indeed the essence of the farmer field school.

Additional photographs by Ric Francis may be viewed at

Empowering Youth In Kenya   Leave a comment

Garissa Youth Bunge Forum

In December 2013 approximately 400 youth bunge (Swahili for parliament) members from Garissa, Kenya met to elect local representatives. Garissa is a predominantly Muslim (Somali) town. It is a hub in the ongoing humanitarian food aid program into the northeast of Kenya.


The country’s youth bunges serve as a counterweight to political apathy and unemployment while helping to cultivate the leaders of tomorrow. The youth come together from different villages to join as bunge members. The bunges serve as a youth-owned, youth-led and youth-managed space for young Kenyans to develop leadership skills and promote decision-making about their priorities.

 Garissa Youth Bunge Forum

Garissa Youth Bunge Forum

The bunge model was introduced by the U.S. Agency for International Development (USAID), based on significant research into the causes of Kenya’s post-election violence during 2007/2008, where youth were both victims and perpetrators. “The research showed that youth had no confidence in civil society or in the existing public or private institutions in Kenya. They wanted to run their own organizations and to help strengthen Kenya’s post-election recovery. Simply put, they wanted to be empowered,” says Dwaine Lee, director of the Education and Youth Office at USAID/Kenya.


Garissa Youth Bunge Forum

According to Kenya’s 2009 census over a third of the national population, that numbered 40 million, are youth (defined by the government as 18 to 35) and the vast majority are out of school with no regular work or income. Bunges give them an opportunity to coalesce around what they need and expect from Kenya’s elected leaders.

Garissa Youth Bunge Forum

Garissa Youth Bunge Forum

Garissa Youth Bunge Forum

Additional photographs by Ric Francis may be viewed at

2013 in review   Leave a comment

The stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 1,700 times in 2013. If it were a cable car, it would take about 28 trips to carry that many people.

Click here to see the complete report.

Posted December 31, 2013 by documentedAwareness in Uncategorized

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Elephant Orphans and Ivory   3 comments

Elephant Orphans and Ivory

Since 2012 the poaching of elephants in Africa has been on the rise, fueled mostly by Far East countries, notably China where much of the material ends up on sale. The number of elephants being poached is now at the highest it has been for two decades, according to a United Nations backed report. Orphaned elephants are one of the effects of the ivory trade.

Elephant Orphans and Ivory

Elephants also become orphans after they become trapped in wells or due to human related disasters. The most successful orphan elephant rescue and rehabilitation program in the world is The David Sheldrick Wildlife Trust. The Trust has 26 orphaned elephants at its elephant nursery in Nairobi, Kenya.

Elephant Orphans and Ivory

Baby elephants are extremely difficult to care for and so are attended to 24-hours each day. They are attended to by a team of “Keepers” who represent a family and replace the orphan’s lost elephant mother. Working as a team the “Keepers” prevent the orphaned elephants from becoming too attached to just one person; the animals mirror humans in terms of emotion.

Elephant Orphans and Ivory

Eventually all elephant orphans are rehabilitated back into the wild elephant community of Tsavo National Park when grown, a transition that is made at each elephant’s own pace; it usually takes between eight to ten years. They live for approximately 70 years in the wild. The Trust’s fostering program is key to the success of its orphans’ project. For a minimum donation of $50 (per elephant) individuals may foster an animal for one year. The program is of great importance given the problem of poaching.

Elephant Orphans and Ivory

Despite a 1989 ban on international trade in ivory elephants continue to be killed for their prized tusks. According to a BBC report, last year saw the highest number of large seizures of illegal ivory for more than two decades. In several African countries a fierce battle is being waged by African law-enforcement and conservation groups against poachers.

 Elephant Orphans and Ivory

Kenya is a major transportation hub for ivory. Reportedly, nearly 85% of ivory seized from around the world, that could be traced, had come from or passed through East Africa, much of it via the international airport at Nairobi. Its destination? “Ninety per cent of all the people we have arrested at the airport ferrying ivory are Chinese,” said Julius Kipng’etich, director of the Kenya Wildlife Service. “The destinations of all contraband ivory are always neighboring countries around China.”

Additional photographs by Ric Francis may be viewed at

Elephant Orphans and Ivory

EU Supermarkets Blamed for Kenya Food Waste   Leave a comment

EU Supermarkets and Kenya Food Waste

The landscape of a farm, just outside the Kenyan capital of Nairobi, is occupied by half a dozen women harvesting French beans for European Union (EU) supermarkets. After collection the women will pre-grade the beans, discarding 10 to 20-percent because of standards set by EU supermarkets. Thereafter a pack-house (where the beans are cut and packaged for shipment), for one of the top exporting horticultural companies in Kenya, will examine and discard another 15 to 35-percent. This practice has contributed to claims that European Union supermarkets are to blame for food waste in Kenya.

EU Supermarkets and Kenya Food Waste

According to an executive with a Kenyan horticultural company, who insisted neither he nor his pack-house be identified because of possible repercussions from EU companies, “we waste on average between 15 to 35-percent of our crops because of the high specifications set for appearance (size, shape and color) by EU supermarkets.” He went on to explain, “if you took all the vegetable and fruit exporters in Kenya and collected all the produce we’re forced to discard because of EU standards, we could feed all of Kenya’s poor and hungry. One hundred percent of our French bean crop is produced for their market. It’s not a Kenyan food. We’re trying to get our people to eat it but the local market will only take small quantities. If the EU would lower its specifications the food we grow would be of greater value, and we could then invest more into feeding Kenyans.” Unfortunately donating the rejected produce isn’t practical for farmers because of transportation and storage costs; it’s used as feed for pigs and cows.

EU Supermarkets and Kenya Food Waste

According to the Kenyan government, 30-percent of Kenyan children are undernourished and 10 million people suffer from food shortages and poor nutrition. Wasted food also represents a major loss of water, energy, fertilizers and land.

EU Supermarkets and Kenya Food Waste

At the pack-house, which received delivery from the farm described at the beginning, approximately a third of each French bean is cut off before being packed in small packets; the beans have a slight curve and packets for EU supermarkets are short and straight.

EU Supermarkets and Kenya Food Waste

In February the United Nations Environment Programme (UNEP) held a three-course meal, in Nairobi, to highlight a campaign to cut massive levels of global food waste. Hundreds of ministers, diplomats and other high-level officials dined on food grown by Kenyan farmers but rejected by United Kingdom supermarkets due to cosmetic imperfections. It was done in support of the global Think.Eat.Save.Reduce Your Foodprint – an initiative launched in January by UNEP, the Food and Agriculture Organization (FAO) and partners such as Feeding the 5,000.

EU Supermarkets and Kenya Food Waste

Food waste is a global issue. A UN study indicates that globally one-third of all food produced, 1.3 billion tonnes, is wasted or lost annually, while 925 million people around the world are threatened by starvation.

“Post harvest is the problem in the world, not production,” said the Kenyan executive who refused to be identified. “We can be so much more efficient with feeding people with what we already produce.”

EU Supermarkets and Kenya Food Waste
Additional work by Ric Francis may be viewed on his website
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