Thursday, July 3, 2014

Disaster Risk Reduction. Effective Law and Regulation

Effective law and regulation for disaster risk reduction: a multi-country report International Federation of Red Cross and Red Crescent Societies (IFRC); United Nations Development Programme - Headquarters (UNDP), 2014

The aim of this report is to support legislators, public administrators, DRR and development practitioners and advocates to prepare and implement effective disaster risk management (DRM) legal frameworks for their country's needs, drawing on examples and experience from other countries. The report considers both legislative provisions and stakeholder views on implementation. Its four objectives are to: (i) present examples of DRR legal provisions...

Themes: Capacity Development; Disaster Risk Management; Governance

Wednesday, July 2, 2014

Too hot for your health

http://www.nih.gov/news/health/jul2014/nia-02.htm


National Institutes of Health (NIH) - Turning Discovery Into Health

For Immediate Release: Wednesday, July 2, 2014

Hyperthermia: Too hot for your health

NIH provides advice on heat-related illness for older adults
During the summer, it is important for everyone, especially older adults and people with chronic medical conditions, to be aware of the dangers of hyperthermia. The National Institute on Aging (NIA), part of the NIH, has some tips to help mitigate some of the dangers.
Hyperthermia is an abnormally high body temperature caused by a failure of the heat-regulating mechanisms in the body to deal with the heat coming from the environment. Heat stroke, heat syncope (sudden dizziness after prolonged exposure to the heat), heat cramps, heat exhaustion and heat fatigue are common forms of hyperthermia. People can be at increased risk for these conditions, depending on the combination of outside temperature, their general health and individual lifestyle.
Older people, particularly those with chronic medical conditions, should stay indoors, preferably with air conditioning or at least a fan and air circulation, on hot and humid days, especially when an air pollution alert is in effect. Living in housing without air conditioning, not drinking enough fluids, not understanding how to respond to the weather conditions, lack of mobility and access to transportation, overdressing and visiting overcrowded places are all lifestyle factors that can increase the risk for hyperthermia.
People without air conditioners should go to places that do have air conditioning, such as senior centers, shopping malls, movie theaters and libraries. Cooling centers, which may be set up by local public health agencies, religious groups and social service organizations in many communities, are another option.
The risk for hyperthermia may increase from:
  • Age-related changes to the skin such as poor blood circulation and inefficient sweat glands
  • Alcohol use
  • Being substantially overweight or underweight
  • Dehydration
  • Heart, lung and kidney diseases, as well as any illness that causes general weakness or fever
  • High blood pressure or other health conditions that require changes in diet. For example, people on salt-restricted diets may be at increased risk. However, salt pills should not be used without first consulting a physician.
  • Reduced perspiration,caused by medications such as diuretics, sedatives, tranquilizers and certain heart and blood pressure drugs
  • Use of multiple medications. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.
Heat stroke is a life-threatening form of hyperthermia. It occurs when the body is overwhelmed by heat and is unable to control its temperature. Heat stroke occurs when someone’s body temperature increases significantly (above 104 degrees Fahrenheit) and shows symptoms of the following: strong rapid pulse, lack of sweating, dry flushed skin, mental status changes (like combativeness or confusion), staggering, faintness or coma. Seek immediate emergency medical attention for a person with any of these symptoms, especially an older adult.
If you suspect someone is suffering from a heat-related illness:
  • Get the person out of the heat and into a shady, air-conditioned or other cool place. Urge the person to lie down.
  • If you suspect heat stroke, call 911.
  • Apply a cold, wet cloth to the wrists, neck, armpits and/or groin. These are places where blood passes close to the surface of the skin, and the cold cloths can help cool the blood.
  • Help the individual to bathe or sponge off with cool water.
  • If the person can swallow safely, offer fluids such as water or fruit and vegetable juices, but avoid alcohol and caffeine.
The Low Income Home Energy Assistance Program (LIHEAP) within the Administration for Children and Families in the U.S. Department of Health and Human Services helps eligible households pay for home cooling and heating costs. People interested in applying for assistance should contact their local or state LIHEAP agency or go to http://www.acf.hhs.gov/programs/ocs/liheap External Web Site Policy.
For a free copy of the NIA’s AgePage on hyperthermia in English or in Spanish, contact the NIA Information Center at 1-800-222-2225 or go tohttp://www.nia.nih.gov/health/publication/hyperthermia-too-hot-your-health orhttp://www.nia.nih.gov/espanol/publicaciones/hipertermia (Spanish).
The NIA leads the federal effort supporting and conducting research on aging and the medical, social, and behavioral issues of older people. The Institute’s broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, health and aging, go to http://www.nia.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Nigeria: Health Minister Debunks Outbreak of Ebola Virus in Nigeria, Says Is Dengue Fever

http://www.health.gov.ng/index.php/news-media/recent-news/9-uncategorised/162-health-minister-debunks-outbreak-of-ebola-virus-in-nigeria-says-is-dengue-fever
Federal Ministry of Health
Federal Ministry of Health


Health Minister Debunks Outbreak of Ebola Virus in Nigeria, Says Is Dengue Fever

The Minister of State for Health, Dr. Khaliru Alhassan has denied a report in section of the media on the outbreak of Ebola disease in Nigeria.

The Minister made the clarification in Abuja today when he briefed the Press on the purported rumour of the ebola virus in Nigeria.

He said as a follow up to the report in a section of the media on the outbreak of Ebola disease in Nigeria, the Federal Ministry of Health wishes to inform the general public that laboratory investigation has revealed that it is a case of Dengue Heamorrhagic Fever and not that of Ebola virus as erroneously reported.

He said that the outbreak of the ebola disease was recorded in Guinea which has so far claimed 80 lives adding that the disease  has spread to Sierra Leone and Liberia which they share border with Guinea. He stated categorically that there is no recorded case of Ebola Virus in Nigeria.

He explained that Dengue Heamorrhagic Fever (DHF) is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen lymph nodes (lymphadenopathy), and rashes. At onset of the disease, it mimics Malaria and, often so, it is mistakenly diagnosed as Malaria. However, other signs of Dengue fever which include bleeding gums, bloody diarrhoea, bleeding from the nose and severe pain behind the eyes, red palms and soles differentiate it from Malaria Laboratory tests are usually necessary for its confirmation.
Dr.Alhassan said that prevention of transmission of Dengue Heamrrhagic Fever is similar to the prevention of Malaria. It is therefore very important to give environmental sanitation and mosquito bites control a high priority to reduce mosquito-human contact and also to eliminate multiplication of mosquitoes that are the vectors of the Dengue fever virus.

He reaffirmed that the Laboratories at the Nigerian Centre for Disease Control (NCDC) have the capacity to confirm the Dengue Heamorrhagic Fever and other Viral Hemorrhagic fevers adding that the Federal Ministry of Health has intensified surveillance activities on this disease and all States Ministries of Health are alerted.

He stressed that any suspected case should be reported to the nearest health facility including General Hospitals, Federal Medical Centres (FMCs) or Teaching Hospitals where non-specific and symptomatic drugs against this disease have been prepositioned.

He announced that all Nigerian Port Health posts and border medical centres have been put on high alert to screen travellers from countries with confirmed Ebola Haemorrhagic Fever occurrences pointing out that Nigerian citizens travelling to these countries are advised to be careful and should report any illnesses with the above stated symptoms to the nearest health facility.

He said that the Federal Ministry of Health is in the process of enhancing multi-sectoral collaboration with the Livestock Department of Federal Ministry of Agriculture, National Emergency Management Agency (NEMA), World Health Organisation (WHO), US Centre Disease Control (CDC), etc.

Tuesday, July 1, 2014

Nov 12-16, 2014. Bermuda's City Of Hamilton To Host The 40th Annual Conference Of Black Mayors

http://www.reuters.com/article/2014/06/30/bermuda-corp-hamilton-idUSnPn6WF6XB+9b+PRN20140630
Reuters
Bermuda's City Of Hamilton To Host The 40th Annual Conference Of Black Mayors
Mon Jun 30, 2014 8:00am EDT
* Reuters is not responsible for the content in this press release.
Bermuda's City Of Hamilton To Host The 40th Annual Conference Of Black Mayors
Event will convene the largest gathering of Black Mayors and elected officials from around the world
PR Newswire
HAMILTON, Bermuda, June 30, 2014
HAMILTON, Bermuda, June 30, 2014 /PRNewswire/ -- Bermuda's Corporation of Hamilton has announced it will host the 40th annual Conference of Black Mayors Convention later this year.  The event, which will take place on November 12 - 16, 2014, at The Fairmont Southampton, will convene the largest gathering of Mayors and local officials from around the world.  Mayors from cities, towns and villages from all over the U.S. will be joined by high level officials from China, Africa, Asia, Latin America and the Caribbean.
In making the announcement, the Chairman of the local Organizing Committee, the City of Hamilton's Deputy Mayor Donal Smith, said the Conference of Black Mayors had grown from modest beginnings into an event of considerable political and economic importance that now includes more than 2,000 African/American Mayors and municipal staff and has attracted the participation of politicians, business and financial leaders not only from the U.S. but increasingly from around the world.
"Today the CBM also includes 39,000 political leaders and elected officials of color from around the world.  Currently we estimate that the City of Hamilton, Bermuda, will be greeting 400 - 500 plus delegates from as far away as Brazil, Colombia, China, Ghana,Cote D'Ivoire, Senegal, South Africa, Nigeria, Uganda, Jamaica and the Caribbean Islandsand we should note that the aim of this great gathering has always been to improve the quality of life in the cities, townships and villages these Mayors and these officials represent."  
The Mayor of Hamilton, The Rt. Worshipful Graeme Outerbridge, JP, said, the CBM represents one of the most influential political and financial groups in the U.S. and in many other countries around the world.  "They represent a powerful voting block in the U.S. and beyond and preside over millions of dollars of municipal funds and new development.  As such, they represent enormous opportunities for our  international business sector to pursue.  We are delighted that the CBM has chosen to come to Bermuda."
Mr. Smith noted that many U.S. politicians and their advisors who are already looking ahead to the 2016 elections will doubtless be planning to attend the Convention."  We shall, as well, be inviting business leaders from the U.S., Europe and beyond to join us as featured speakers," he said.
"This year's convention theme will be '40 FORWARD' and we shall be looking ahead to determine what the future holds for the U.S. and world economies.  A very full program will include panel discussions on important global issues including immigration, education, healthcare and the ways in which the spread of information technology will affect global trade and urban growth in the coming years," he said.
What:      
The Convention of Black Mayors 40th Annual Convention
Who:        
CBM, the international association representing 39,000 black elected and appointed mayors and local officials from throughout the African diaspora.
When:    
November 12-16, 2014
Where:       
The Fairmont Southhampton
101 South Shore Rd
Southhampton, Bermuda SN02
For information about the conference, registration and sponsorship opportunities, contact:
Vanessa Williams
National Conference of Black Mayors
T: (404) 931-2059 C: (404) 964-9201
e-mail: vwilliams@ncbm.org
Danilee Trott
Corporation of Hamilton
T: (441) 292: 1234 Ext. 219  C: (441) 300-1335
e-mail: dtrott@cityhall.bm
Media:
Victor Webb
Marston Webb International
T: (212) 684-6601  C: (917) 887-0418
e-mail: marwebint@cs.com

SOURCE Corporation of Hamilton

Displacement, Immigration. Bodies in the Desert. The Magazine of the Johns Hopkins Bloomberg School of Public Health. Spring 2014

 http://magazine.jhsph.edu/2014/spring/features/bodies-in-the-desert/

Johns Hopkins Bloomberg School of Public Health       

The MAGAZINE of the Johns Hopkins Bloomberg School of Public Health
SPRING 2014 | www.jhsph.edu

Bodies in the DesertMichael Glenwood

Bodies in the Desert

Thousands of asylum-seeking Eritreans, Ethiopians and  Sudanese have been kidnapped  and tortured in the Sinai Peninsula.
Survivors suffer years of  mental anguish and live a stateless, hand-to-mouth existence.
The human trafficking chain must be stopped.
The truck stopped at 2 a.m. somewhere in the Sudanese desert.
The trafficker called to the six women in the back of the truck he was driving, telling them to send out the dark-skinned girl. “I knew he meant me,” recalled Merhawit (not her real name). “The other women gave me up. You have to understand that when people are afraid for their lives, they often do not make noble decisions.”
The trafficker told Merhawit, then 17, to follow him. She told him that she preferred to be killed rather than raped and that he should “pick his best weapon to do so.” The trafficker grabbed a metal pipe and hit her over the head. “I felt my hands go numb and then slowly the rest of my limbs. I was drenched in a dark blood that covered my entire body. I eventually fainted on the spot in the desert. He left me alone thinking I was dead,” Merhawit said.
After the man left her, one of the women risked leaving the relative safety of the truck to check on Merhawit. When she saw that Merhawit was still breathing, she returned to the others and begged them to help her carry the wounded woman to the truck. If the trafficker noticed, she would tell him that she couldn’t leave a “sister’s corpse to rot in the desert.” The body, she would say, must be properly buried. The others agreed, creeping out to retrieve Merhawit and lift her into the truck. To prevent the trafficker from noticing their stowaway, they hid her under their seats, praying she would survive.
The truck rumbled on across the border into the endless desert in Egypt, where the man sold the women to traffickers who would take them to the Sinai Peninsula. The new traffickers noticed Merhawit’s condition and gave her some milk to revive her. She’ll never know if altruism or the desire to protect a newly purchased commodity motivated them.
I remember one patient who watched Egyptian soldiers shoot and kill her best friend and one of her children. She had no words for her pain.
Merhawit’s journey was just beginning. In the Sinai, things would get much worse.
Like many of the women and men I interviewed in Israel as part of my doctoral research, Merhawit is an Eritrean asylum seeker who fled her home in the hope of finding freedom and security. She left Eritrea with her sister who died of an illness while they were crossing the border into Ethiopia.  She is one of countless thousands of Eritrean, Ethiopian and Sudanese people who in their flight have fallen victim to a human trafficking chain that, since 2009, has been a source of misery, abuse and torture.
Many of these victims—once their ransoms are paid—are abandoned at the Israeli border. There they find an entirely new struggle for survival. Most of those who make it into Israel to seek asylum are detained and banned from formal employment and citizenship. They lead a stateless, hand-to-mouth existence, taking work where they can and enduring the scorn and resentment of some Israelis.
Before I arrived in Tel Aviv in 2012 to research access to family planning by Eritrean asylum-seeking women in Israel, I knew almost nothing about these horrors even though like Merhawit, I am a member of the Tigrinya-speaking people from the area along the Ethiopian and Eritrean border.
I was born and raised in a tightly knit community of Eritreans and Ethiopians in the U.S. who were resettled from Sudanese refugee camps in the 1980s. Stories of war permeated my childhood. Members of my own family fled the despotic Ethiopian regime that decimated villages where people opposed it. I knew little, however, about the suffering and hardship my family and people in my community endured. I didn’t know how hard it was for them to regain the physical, psychological, economic and political security taken from them.
It was only by speaking with hundreds of asylum seekers like Merhawit that I began to better understand my own family, my own community. Although they are separated from today’s asylum seekers by time, experience and geography, both share the struggle to obtain the basic essentials for a full life. My work with asylum seekers in Israel and my new understanding of my own family’s experiences have reshaped my future and made me commit to helping asylum seekers in their struggle to maintain their resilience in the face of suffering.
A Bitter Journey
Since gaining independence from Ethiopia in 1993, Eritrea has been led by an increasingly authoritarian regime with a zero-tolerance policy to opposition. In addition to forced military conscription, the regime has expelled international NGOs, closed its main institution of higher learning (the University of Asmara) and persecutes anyone who challenges government policies or does not belong to the four state-sanctioned faiths (Eritrean Orthodox, Roman Catholic, Lutheran, and Islam). Today under the military dictatorship, Eritrea is one of the most socially, politically and economically restrictive countries in the world, according to Dan Connell, PhD, an expert on Eritrea and a professor of journalism and African politics at Simmons College in Boston. As a result, more than 200,000 Eritreans have fled the country since 2004, according to Human Rights Watch estimates.
The journey for those who flee is long and often beyond human endurance. Many report going without food for up to two weeks and drinking urine to survive. Every point along the hundreds of miles of roads and open desert is dangerous because of the threats of kidnappers and bandits. Some asylum seekers pay smugglers to guide them from their homelands to refugee camps in Sudan and Ethiopia or other places of relative safety. Yet, according to European and Eritrean researchers and activists, a significant number of those who cross the Eritrean-Sudanese border fall prey to human traffickers roaming the area. Some people are intercepted while en route to or from a refugee camp, while others are abducted from camps like Shagarab in Sudan. Still others are abducted while working in nearby agricultural fields, living in border cities like Kassala or even within Eritrea itself.
They are then held in the Sinai while kidnappers extort money from their families—often torturing them as their loved ones listen by cell phone. The ransom demanded for each captive ranges from $25,000 to $50,000, and is largely financed by family members who sell property, beg in churches and take loans from banks and friends, said Sweden-based journalist and human rights activist Meron Estefanos. When the ransom payment arrives via an international network of collaborators, some captives are released, some are sold to another trafficker and others are simply killed. Those who survive torture in the Sinai are taken by traffickers to Egypt’s border and told to run toward Israel.
Asylum seekers who escape the bullets of the Egyptian border guards and make it onto Israeli soil are stopped by Israeli soldiers. They are taken to a detention facility in the Negev desert. The first wave of Eritrean asylum seekers who arrived in Israel in 2007 were held briefly and then sent in buses to Tel Aviv and expected to fend for themselves. By 2012, Israel responded to the influx of African asylum seekers by building a fence on the border with Egypt, implementing strict immigration policies and detaining asylum seekers for at least three years without trial (since changed to a minimum of one year). The official stance of the Israeli Ministry of the Interior is that the majority of Eritreans are economic migrants who do not deserve the protection and social support afforded to asylum seekers and refugees under international law.

Bodies in the DesertMisha Vallejo

Bodies in the Desert

The Price They Pay
I began to learn about the asylum seekers’ plight as I conducted my qualitative study of the factors affecting the sexual and reproductive health of Eritrean asylum-seeking women. In addition to the interviews for my research, I volunteered as a translator at the Physicians for Human Rights-Israel Open Clinic and at the African Refugee Development Center in Tel Aviv, where I met many survivors of human trafficking and torture in the Sinai.
I translated for people who were filing legal requests for resettlement. They were demanding the release of detained victims of human trafficking or seeking services for disabled asylum seekers so they could continue living in Tel Aviv. The more I heard, the more I learned that their suffering didn’t end in the Sinai. People continued their fight to endure on a daily basis.
Every step I took getting to the clinic each afternoon became increasingly difficult. What would I hear today?
I remember one patient who watched Egyptian soldiers shoot and kill her best friend and one of her children. She had no words to describe her pain. I recall a patient who watched his wife, then eight months pregnant, raped repeatedly by traffickers while they were held in the Sinai. When they were finally released, she gave birth to a dead baby in the desert. She was hemorrhaging so they had to run towards Israel where they could seek emergency care, forcing them to leave the infant’s body behind. The husband begged the health care workers to recover his son’s body from the desert so that it could be buried.
The bullet wounds, burns and electrocution marks left on the survivors never ceased to stun me. The traffickers even electrocuted and burned people’s genitals. One patient asked me why my eyes widened every time I heard about the torture. “Ajokhee. It’s okay, halefu Tsega haftey. It has passed,” he said. I could not believe that he was setting aside his own pain in order to comfort me.
“I was so weak, the wind blew me over and even the darkness of night was too bright for my eyes,” Girmay said of his release from the torture house.
Girmay’s Story
One night I was at Physicians for Human Rights–Israel, borrowing the gynecologist’s examination room as a makeshift office. A young Eritrean man came in. Girmay (not his real name) was handsome and in his mid-20s, yet he seemed haggard, fatigued beyond his years. He quietly said that he felt obligated to share his experiences if it could help call attention to horrors experienced by asylum seekers. He spoke almost without interruption for three hours.
Fleeing indefinite military conscription in Eritrea, he crossed the border into Sudan, wearing a jelebaya (a long robe typically worn in many parts of the Middle East and Africa). Things fell apart quickly. He joined other migrants who paid smugglers to take them north, but the smugglers later abandoned them in the desert. Shortly thereafter, traffickers scouring the area for new victims abducted them.
Girmay and a group of 30 asylum seekers were stuffed into bags, thrown into a truck in Kassala, Sudan and taken to the Sinai Peninsula. He tried repeatedly to escape, jumping from the truck and attempting to camouflage himself in the sand. Each time he was returned to the truck, he and the others were beaten. The last time they smashed his head with a rock and beat him until he vomited blood. During his seven months of captivity, Girmay did not see the light of day. “They asked for a $44,000 ransom to release me. I told them to do whatever they wanted to me, because I couldn’t come up with the money. ‘We don’t kill quickly,’ they told me.”
Captives were moved from location to location. Girmay and others (including infants and children) were shackled, often naked, and kept in different torture houses. They starved. They were covered in lice.
“[The traffickers] beat us so badly. All of the scars on my legs are from them walking over my body and beating me senseless. They walk on your wounds, you know,” Girmay told me. During his long months of captivity, Girmay was burned with boiling plastic and electrocuted. It was common for women’s vaginal areas and nipples to be burned. Captives were also forced to torture others, including raping their female and male counterparts. This torture would last through the night. He recounts vividly the day that two of the traffickers raped two young Eritrean women in the adjacent room. When one trafficker pulled down his pants and asked for the virgin first, Girmay and his fellow detainees clanked their shackles and screamed for them to stop. “They were taken away and raped anyway,” he said. He recalled sadly the fate of a young Ethiopian woman who was raped and tortured, taken forcibly as a trafficker’s wife, and then, after many months, dragged by her chains to a holding cell to be raped, burned and strung from the ceiling by her arms. Girmay watched countless people murdered, even after their ransoms of up to $35,000 were paid.
To find a way to pay their ransoms, the captives dialed random phone numbers abroad. Many calls were to Israel where many survivors live. In the beginning, Girmay said, he didn’t want to call his family in Eritrea; it was a holiday and he didn’t want them to spend the time mourning for him. When they refused to call anyone for help, the traffickers beat them more, dragged them by their chains and hanged them upside-down. After one man fainted, the traffickers poured water on his face to see if he was alive. When they saw that he was breathing, they told Girmay to choke him to death. “I was horrified. I did it. I pretended to choke him. Thankfully, he didn’t die,” Girmay said. When the newly arrived captives saw those living in the torture houses they were shocked. “Our skin hung from our bodies as if we were 90 years old. I had lost all of my hair,” he said.
Girmay paused for a moment as he explained that he remained in the Sinai Peninsula torture houses until, after the seven long months, his family paid $25,000. “When I was freed, I had no strength left in my body,” he said.
The traffickers released Girmay, two men and three women at night. “These people were not as abused as I… I was so weak, the wind blew me over and even the darkness of night was too bright for my eyes,” he said. The traffickers wanted to take the women separately, but Girmay and the other men refused, knowing what would happen to them. Repeatedly, and even at the end, they tried to separate the women and rape them. Finally, a trafficker was charged with taking them all to the Israeli border.
Girmay and the others crawled under the border fences. Israeli soldiers detained them, bandaged and fed them. He and the others were put in a tent. It was January, freezing cold and raining. “Despite the harsh weather I couldn’t feel because all of my nerves were no longer working, and I felt as if all of my skin cells were dead,” he said. “To this day my nerve endings feel permanently damaged.” Finally, he was taken to a hospital and eventually to Tel Aviv.
I recount these details not to shock but to share the reality of the ongoing torture that asylum seekers experience in the hands of human traffickers.
Both Girmay and Merhawit arrived in Israel before 2012, so their detention period was short. Like many asylum seekers during that time, they had significant psychological and physical trauma, no understanding of their surroundings and no social support. Many had nowhere to go and, until they found shelter, slept in the park near the central bus station.
After my interview with Girmay, we walked together to the bus stop. I didn’t know what to say to him, other than to express the horror that I felt. I asked him what I should say to other survivors in the future, when they shared their experiences with me. He said “tsinaat nay Iyob yi habkum” or, “May the strength of Job be with you.”


Bodies in the DesertMisha Vallejo

Bodies in the Desert (continued)

"Tell Everyone"
Merhawit declined to talk about the month she was held by traffickers in the Sinai. I can only imagine what horrors she endured in the torture houses. Instead, she continued her narrative after she made it across the Egyptian-Israeli border.
She spoke fervently for more than an hour, and often seemed unable to register the questions that I asked her. As she shared her story with me, she cried. She told me she feels vulnerable, depressed and anxious and often dreams of her sister. Now a young mother in her early 20s living in Tel Aviv, with a husband in detention, Merhawit struggles to raise her child without support.
I did my research and translation work in Tel Aviv from November 2012 until September 2013. After my interviews and translation work ended every day, I would walk or bike the seaside route home. I always felt sad, angry and anxious. What could be done to break the trafficking chains in the Sinai and elsewhere? My feelings were heightened by the knowledge that such atrocities would not be tolerated if the victims were citizens of a nation that advocated effectively on their behalf.
Throughout my time in Israel I was constantly reminded that so much of what I have is based on timing, immigration policies and the geographic location of my birth. Luck. This struck me often when I saw asylum seekers, my age or younger, sweeping streets, working in restaurants and at construction sites. I often ran into community activists whose intellectual vitality rivaled that of people I had met in the most prestigious universities in the U.S.—and they were cleaning toilets to earn money to survive. When our eyes met and we greeted each other with “Selam,” pangs of guilt flooded me.
“Tell everyone. Tell everyone.  
I am expecting you to do so. Write it online. Write it everywhere.”
Memories of these encounters still keep me up many nights.
Once, while I was in Tel Aviv, I was talking with a young friend whom I will call Gebre. He told me about his hopes for the future. When he said he wanted to open a bar, I told him that it was a dangerous line of work for a teenage boy like himself. He gave me the strangest look that said, “Do you know what I have been through?” He showed me his wounds, where he had been burned in the torture houses. At work every day he is insulted because he is African. His boss and co-workers tell him, “You are stupid and black. You are dirty.”
Gebre is a tall and thin 18-year-old, but with the persona of a grown man who is as hard as a rock. He has no choice. To survive, he has to be hard. Then he started to talk about his mother, whom he hasn’t seen in years. In that moment he looked vulnerable, like a little boy. “Before the desert, I was different. I don’t recognize myself now,” he told me.
I am back in the U.S. now, working on my dissertation, but I am not the same. I too have been transformed. The experiences that so many asylum seekers shared in interviews, in conversations, in late night phone calls broken by sobs—they are a part of me now. What do I do with these narratives?
The narratives illustrating the many barriers faced by asylum seekers clarified for me the importance of contextualizing behavior within the wider political, economic and historical framework in which people live. I have resolved to complete the study about access to reproductive health care and to disseminate my findings. I hope my work will serve as an evidence base for improving female asylum seekers’ access to reproductive health services. But I also want to do more. I must speak out about the atrocities that they continue to face. African migrants, including those seeking asylum, continue to be tortured in the Sinai today. It is now, more than ever, essential for my life and work to advance human rights. I will find a way to join researchers and activists who are working toward dismantling this human trafficking chain—and calling attention to the circumstances that force people to take risks that can lead them into the hands of traffickers.
Merhawit’s words during one of our conversations come back to me.
She exhorted me to do something, to use the skills, knowledge and resources I have to make a difference. She told me she didn’t know how to use a computer and that I did, that I could reach many more people than she ever could. This is your responsibility, she told me. Then crying, she said, these words:
“Tell everyone. Tell everyone. I am expecting you to do so. Write it online. Write it everywhere.”

Tsega Gebreyesus is a doctoral student in the Social and Behavioral Interventions Program in theDepartment of International Health. She wishes to thank the people who made her research possible: Samuel Vidal, Emma Williams, Dena Feldman, Britt Fremstad, Laurie Lijnders Tikue, Kidane Isaac, Azezet Kidane, Habtom Mehari, Zebib Sultan, Mutasim Ali, Nadav Davidovitch, Nora Gottlieb, and Peter Winch. And all of those who shared their experiences with her.

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