Lessons for Karachi sex workers

Zeba Raman is a 28-year-old Pakistani sex worker. Born into the profession in Karachi’s red light district of Napier Road, she plies her trade all over the city.

I did not know that precautionary measures should be taken during sex Nadia, sex worker

She is celebrating the launch of an initiative to promote health awareness among sex workers.

“We are now revealed to society,” says Ms Rahman.

But prostitution remains illegal and anathema to many in Muslim-majority Pakistan. It is an ever-present fact of life, but never really acknowledged.

The last two decades, given the increasing Islamisation of Pakistani society, have further reinforced stereotypes about such women.

But the profession has only grown.

Karachi alone has at least 100,000 female sex workers, according to data gathered by local welfare organisations.

Lahore has 75,000 sex workers while the military garrison town of Rawalpindi has at least 25,000.

‘Spirit of openness’

Pakistan’s first workshop on health awareness among sex workers has contributed to a new spirit of openness in the profession.

“Earlier we were doing our jobs secretly, but now we can raise our voice for our rights,” Ms Raman says.

It was very difficult to gather sex workers under one roof. Many were simply afraid of being arrested Dr Ghulam Murtaza

The three-day event was recently held in Karachi by Gender & Reproductive Health Forum (GRHF) – a local social welfare organisation – in collaboration with the United Nations Fund for Population (UNFPA).

“I am very happy that a number of sex workers attended the workshop,” says Ms Raman.

“This has provided us an opportunity to gather and exchange views and experiences.”

She is not the only one to have benefited.

“I became a sex worker five years back,” says Nadia, 26.

Nadia said that she learned about safe sex measures at the workshop.

“I had heard about HIV/Aids, but I thought that it could only be transmitted through blood transfusions.

“I did not know that precautionary measures should be taken during sex as well,” she said.

Before the workshop, most of sex workers who attended did not know about measures for safe sex, Nadia added.

Dr Ghulam Murtaza is the head of the GRHF organisation and the man behind the workshop.

Ms Raman said she drew a lot of confidence from the workshop

The man behind the workshop, GRHF head Dr Ghulam Murtaza , said the organisation was working to create awareness of safe sex among female sex workers.

“It was very difficult to gather sex workers under one roof. Many were simply afraid of being arrested,” he said.

“We offered several incentives and assurances and paid them 1,000 rupees ($20) per day for their attendance,” he said.

“Finally, we succeeded in gathering almost 100 sex workers at the workshop held at a local hotel”.

Most of the sex workers who attended avoided the cameramen there., saying they were afraid of being exposed to their families.

Many said their husbands or family members did not know they were sex workers. They told their families that they work for private firms.

Despite these barriers, Dr Murtaza said the workshop had been successful.

“We have trained some female sex workers. They will now go to their community to create awareness among their co-workers.”

‘Reinvigorated’

The international participants at the workshop were of the view that Pakistan was still relatively safe as far as HIV/Aids was concerned.

I can now continue with my profession with more confidence Zeba Raman

The UNFPA representative, Dr Safdar Kamal Pasha, said at least 100 HIV- positive sex workers had been found in central Punjab. But the number of HIV-positive women was not high among female sex workers in Pakistan.

“It can be controlled by creating awareness about the disease among sex workers and about usage of precautionary measures,” he said.

The workshop was widely considered to be a success and Dr Pasha said they were considering organising a national convention for sex workers next year.

The sex workers themselves were moved by the workshop.

“Having attended the workshop, I feel reinvigorated,” Zeba Raman declares.

“I can now continue with my profession with more confidence.”

Turkey smoke ban extends to bars

Local authority staff will impose fines on those breaking the ban

Turkey has extended an existing ban on smoking in public places to all bars, cafes and restaurants.

The ban has come into force despite opposition from some bar and cafe owners who fear losing business.

It comes after the government banned smoking from most enclosed public spaces in May last year in an effort to improve the nation’s health.

Turkey has more than 20 million smokers but polls suggest 95% of people support the ban.

“We are working to protect our future, to save our youth,” said Health Minister Recep Akdag.

Anyone caught lighting up in a designated smoke-free area faces a fine of 69 liras ($45:£28) while bar owners who fail to enforce the ban could be fined from 560 liras for a first offence up to 5,600 liras.

Local authorities have hired thousands of extra staff to track down smokers and impose the fines.

Many people in Istanbul said they thought the ban was a good move.

“We were being destroyed in the places where you were allowed to smoke inside,” said Istanbul cafe patron Hanife Demirm.

“I was choosing the non-smoking places automatically, but after the ban is extended I will not need to be selective. I’ll be very comfortable in every place that I go,” he told the AP news agency.

‘Unnecessary stress’

Turkey is one of the world’s heaviest smoking countries

But the BBC’s David O’Byrne in Istanbul says many Turkish people see the ban as an erosion of their democratic rights and have called for bars to be able to apply for a smoking licence.

Some cafe owners have also said they were concerned the ban would drive away customers.

“They will simply leave and never come back, or we would get in trouble for letting them smoke,” said Istanbul cafe owner Selahattin Nar.

“Then both we and they would be filled with unnecessary stresses. In the end they will not be able to relax and we will have to shut down.”

But Mr Akdag said there was no reason for cafe and bar owners to be worried about a drop in trade.

“The public supports a smoke-free environment and the only ones to suffer will be the cigarette producers and sellers,” he said.

A no smoking rule has been in place for the past 15 months in government offices, workplaces, shopping malls, schools and hospitals.

All forms of public transport, including trains, taxis and ferries, are also affected but there are exemptions for special zones in psychiatric hospitals and prisons.

Swine flu pregnancy tips reissued

A suppressed immune system makes pregnant women more vulnerable

The Department of Health has attempted to clarify its guidelines to expectant mothers and parents with children under five on how best to avoid swine flu.

Its advice to practise good hygiene by washing hands and surfaces regularly has been re-issued after a woman with the virus died soon after giving birth.

The Royal College of Midwives (RCM) says all expectant mothers should avoid crowded places and unnecessary travel.

But the DoH says only the “particularly concerned” should consider the advice.

Concern over the effects of swine flu on new and expectant mothers has heightened since the death of Ruptara Miah, 39, in London’s Whipps Cross Hospital on 13 July. Her baby is said to be very ill in intensive care.

Good hygiene

Another child under six months old, who died in London, is also among the latest victims of the virus.

The refreshed DoH advice has been given greater prominence on its website.

Health experts say expectant mothers could suffer possible complications if they contract swine flu, such as pneumonia, breathing difficulties and dehydration, because they have suppressed immune systems. Young children are also vulnerable.

Most mothers-to-be with swine flu are being prescribed Relenza, an inhaled antiviral drug which treats the virus without reaching the foetus. However, where it is particularly severe, doctors can offer Tamiflu instead.

The NHS website stresses that most expectant mothers who contract swine flu will only have mild symptoms and recover within a week.

Belinda Phipps, chief executive of the National Childbirth Trust (NCT), said that while the risks for expectant mothers were low, women needed information to make an informed decision.

“If you are pregnant, you are slightly more susceptible to all infections. One of them is swine flu.

“It is important that pregnant women know that – and particularly other members of the population know that – so that they behave responsibly and if they are sick they don’t go and put themselves close to a pregnant woman.”

If you are pregnant, you are slightly more susceptible to all infections. One of them is swine flu Belinda Phipps, NCT

The Department of Health said it advised women to plan their pregnancy carefully, but was not advising against trying to conceive.

“Mums-to-be are more vulnerable to any type of flu. It is particularly important that anyone who has existing health problems and is thinking about starting a family should talk to their GP first, as they normally would,” a DoH spokesman said.

Louise Silverton, deputy general secretary of the RCM, said women could not be expected to wait for the first wave of the pandemic to end before trying for a baby.

Speaking on BBC One’s Andrew Marr Show, Alan Johnson, the new home secretary, said an unexpected aspect of the virus was that it was attacking the young, not the elderly as with seasonal flu.

He called on parents to keep using their common sense, saying the “vast majority” had been following public health advice.

Twenty-nine people have now died in the UK after contracting swine flu – 26 in England and three in Scotland.

The government has warned that the number of deaths from the virus this winter in the UK could reach between 19,000 and 65,000.

However, during the 1999 to 2000 winter, seasonal flu deaths reached 21,000 and even during average winters there are normally anywhere between 6,000 to 8,000 deaths.

The National Flu Service will go live at the end of next week

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We asked you whether you were concerned about the effects swine flu might have on expectant mothers. Here is a selection of your comments.

I am in the third trimester of pregnancy, and I am asthmatic. I am concerned that neither Tamiflu or Relenza will be suitable for me if I contract swine flu.
Louise, Nottingham

This is such stupid advice. I am pregnant and travel to work every day on a packed Tube. How am I supposed to avoid crowded places and unnecessary travel? It’s impossible. I can’t just stop going to work can I?
Laura, Hertfordshire

My daughter has a 4yr old son who has swine flu, she is 4 months pregnant and worried in case she catches it and it harms the baby, we are also worried about the treatments used in pregnant women. There is to much contradiction going around to know what to believe.
Tina, Essex

I am currently 24 weeks pregnant and have been ill and at home for 5 days now with bad cold symptoms. After consulting the doctor by phone I was told it could possibly be swine flu but how am I to know? I am usually very level headed in these situations but not sure that not swabbing pregnant women with symptoms is wise – at least if we know if we have it we can be better informed!
Anonymous, Wales

I am 36 weeks pregnant and came into contact with Swine flu last week. I experienced a slight sore throat spoke with a nurse at NHS direct and my GP and was completely reassured that I was fine and not displaying any symptoms. There is definitely some scaremongering going on but if you seek appropriate medical advice your fears can be eased.
Jo, Romford, Essex

I have got a 14 month old child and am currently pregnant. I’m very worried we could all catch the virus as a lot of people where we live are getting it. Also it is going round schools where my niece goes. I believe there should be vaccinations soon as possible for young children and those who it could endanger more than others
Nikki, Chelmsford, Essex

US worker dies in chocolate vat

A man has died after falling into a vat of hot chocolate at a factory in the US state of New Jersey.

Vincent Smith Jr, 29, was emptying pieces of solid chocolate into the melting vat when he slipped from a platform into the 2.5m (8ft) deep unit.

A spokesman for the local prosecutor’s office said Mr Smith appeared to have died instantly from a blow to his head by a paddle mixing the chocolate.

His colleagues at the factory tried to shut down the mixer, but were too late.

Mr Smith was a temporary worker at the Cocoa Services Inc plant in the city of Camden.

‘Need answers’

Jason Laughlin, from the local county prosecutor’s office, said: “There are paddles, called agitators, that are moving inside this vat. He was hit by one of them before someone could hit the shut-off valve.”

Investigators said the chocolate had reached 49C (120F). It was being melted in the factory before being shipped out to other companies to make into chocolate bars and other sweets.

Mr Smith had been in the vat for about ten minutes before rescue crews arrived.

Thombe Smith, told journalists: “We just really need to know what happened to my cousin. We just need some answers.”

The Occupational Safety and Health Administration, part of the US Department of Labor, is investigating the accident.

Apple chief Jobs ‘back at work’

Analysts say Mr Jobs will likely start back at work on a part-time basis

Apple chief executive Steve Jobs has reportedly returned to work following six months of medical leave.

Mr Jobs, 54, who is reported to have had a liver transplant, was expected back at his desk at the end of June.

Apple has refused to comment on the matter but did quote Mr Jobs in a press release on first weekend sales figures for the next generation of iPhones.

The blogosphere has noted several sightings of Apple’s co-founder around its campus in Silicon Valley.

“Jobs is in the house!” declared CNBC’s Jim Goldman, who is regarded as having close ties to Apple.

“Confirmed! Steve Jobs did report for work today, according to employees who have seen him on campus,” wrote Mr Goldman in his TechCheck column.

Reuters news agency quoted sources saying Mr Jobs “was seen leaving the main Apple building in Cupertino and getting into a black car alone that was driven off by men in black suits with ear-pieces.”

Revelations

In 2004, Mr Jobs was treated for pancreatic cancer.

Last year there were fears that the cancer had returned when he appeared at a major Apple event looking thin and gaunt.

Months of rumour ensued and the company’s share price rose and fell as a result.

In January, Mr Jobs revealed that he was being treated for a “hormone imbalance”.

Over a week later he sent an e-mail to employees and told them that his medical problems were more complex than first thought and he would take six months off work to concentrate on his health.

The Wall Street Journal reported over the weekend that Mr Jobs underwent a liver transplant over two months ago, but Apple remained tight-lipped on the subject.

Analysts have predicted that Mr Jobs will stay on as chief executive officer on a part-time basis with a view to moving on to become chairman of the company.

Why Kenyan women crave stones

Nancy Akoth is four months pregnant and like many women in her state has strange cravings.

Some women eat coal, gherkins or soap but Mrs Akoth craves soft stones, known in Kenya, where she lives, as “odowa”.

“I just have this urge to eat these stones. I do very crazy things, I would even wake up at night and go looking for them,” she told.

“I consulted my doctor and all he told me is that maybe I’m lacking iron and gave me medication on iron, but I still have the urge to eat those stones.”

Luckily for Mrs Akoth, she is not alone in craving stones and they are easily found on sale in Nairobi’s sprawling Gikomba market.

It can actually cause things like kidney damage and liver damage, if you don’t take enough fluid Alice Ndong, nutritionist

Among the fish-mongers and dealers in second-hand goods who flock to the market are traders who specialise in odowa.

Stone-seller Stephen Ndirangu unsurprisingly says women are his main customers.

“Most of them buy the stones to go and sell them to women who are pregnant,” Mr Ndirangu says.

He says he sells one 90kg sack for about $6.

‘Pleasant taste’

Although they are stones, they are too soft to break the teeth of Mrs Akoth and her fellow cravers.

Nutritionist Alice Ndong says the stones have a bland taste.

“It’s a pleasant taste. It doesn’t have a tangy flavor or a salty or a sugary flavor. It’s a bit like eating flour,” she told.

I cannot do without it Sylvia Moi

She says that because of their abrasive nature, the stones actually clean the teeth as the stone is chewed and the finer particles pass through the mouth.

However, she warns this should not be used as an excuse to eat the stones as the habit can also have harmful consequences.

“If somebody eats those stones and they don’t take enough water, then they will actually get severe constipation… It can actually be very dangerous,” she says.

“It can actually cause things like kidney damage and liver damage, if you don’t take enough fluid because it will form a mass that cannot be excreted.”

“When you eat these stones, it’s like eating metal. The particles – because it’s not food – are not digested as finely as fruits or vegetables,” she says.

‘Irresistible’

The phenomenon of craving non-food items like soil or soft stones is referred to as pica, a Latin word for magpie, the bird notorious for eating almost anything.

Researchers from the University of Nigeria interviewed 1,071 pregnant women attending a prenatal clinic at the Pumwani Maternity Hospital in Nairobi.

At least 800 of those interviewed said they ate soil, stones and other non-food items during their pregnancy.

But it is not only those who are pregnant who indulge in this habit.

Sylvia Moi still finds the soft stones irresistible, 14 years after she gave birth.

“I cannot do without it… Walking without it makes me feel bad, as if I’m lacking something [or] I’m hungry,” Mrs Moi says.

She says she would like to quit the habit but just cannot stop herself.

“When you eat it you look awkward, people think: ‘What is it that you lack in you that makes you eat that awkward stone,'” she says.

Infection

Experts say that the craving to eat odowa is largely due to a deficiency of vital minerals, like calcium, in the body.

“Unfortunately, these stones don’t offer a lot of calcium. They offer some other forms of minerals like magnesium but not much calcium,” says Mrs Ndong.

Research shows that these habits have negative side-effects on the women’s health, ranging from parasitic infestations, anaemia and intestinal complications

“The problem with these stones is sometimes they’re not hygienic. I remember up-country I’ve seen people just go somewhere, dig up and maybe people urinate in that spot,” she says.

Experts warn pregnant women and others who enjoy eating odowa to try to ignore these cravings for the sake of their health.

The researchers say that the women are better off eating a balanced diet, than remaining hooked to the myth that their changing bodies need soft stones and soil.

Tea ‘healthier’ drink than water

Tea ‘healthier’ drink than water

The researchers recommend people consume three to four cups a day

Drinking three or more cups of tea a day is as good for you as drinking plenty of water and may even have extra health benefits, say researchers.

The work in the European Journal of Clinical Nutrition dispels the common belief that tea dehydrates.

Tea not only rehydrates as well as water does, but it can also protect against heart disease and some cancers, UK nutritionists found.

Experts believe flavonoids are the key ingredient in tea that promote health.

Healthy cuppa

These polyphenol antioxidants are found in many foods and plants, including tea leaves, and have been shown to help prevent cell damage.

Tea replaces fluids and contains antioxidants so its got two things going for it Lead author Dr Ruxton

Public health nutritionist Dr Carrie Ruxton, and colleagues at Kings College London, looked at published studies on the health effects of tea consumption.

They found clear evidence that drinking three to four cups of tea a day can cut the chances of having a heart attack.

Some studies suggested tea consumption protected against cancer, although this effect was less clear-cut.

Other health benefits seen included protection against tooth plaque and potentially tooth decay, plus bone strengthening.

Dr Ruxton said: “Drinking tea is actually better for you than drinking water. Water is essentially replacing fluid. Tea replaces fluids and contains antioxidants so it’s got two things going for it.”

Rehydrating

She said it was an urban myth that tea is dehydrating.

“Studies on caffeine have found very high doses dehydrate and everyone assumes that caffeine-containing beverages dehydrate. But even if you had a really, really strong cup of tea or coffee, which is quite hard to make, you would still have a net gain of fluid.

“Also, a cup of tea contains fluoride, which is good for the teeth,” she added.

There was no evidence that tea consumption was harmful to health. However, research suggests that tea can impair the body’s ability to absorb iron from food, meaning people at risk of anaemia should avoid drinking tea around mealtimes.

Tea is not dehydrating. It is a healthy drink Claire Williamson of the British Nutrition Foundation

Dr Ruxton’s team found average tea consumption was just under three cups per day.

She said the increasing popularity of soft drinks meant many people were not drinking as much tea as before.

“Tea drinking is most common in older people, the 40 plus age range. In older people, tea sometimes made up about 70% of fluid intake so it is a really important contributor,” she said.

Claire Williamson of the British Nutrition Foundation said: “Studies in the laboratory have shown potential health benefits.

“The evidence in humans is not as strong and more studies need to be done. But there are definite potential health benefits from the polyphenols in terms of reducing the risk of diseases such as heart disease and cancers.

“In terms of fluid intake, we recommend 1.5-2 litres per day and that can include tea. Tea is not dehydrating. It is a healthy drink.”

The Tea Council provided funding for the work. Dr Ruxton stressed that the work was independent.

Poland’s former leader on trial

Gen Jaruzelski remains a highly controversial figure in Poland

Poland’s last communist leader, General Wojciech Jaruzelski, has gone on trial accused of committing a crime by imposing martial law in 1981.

Eight other former officials will also be tried for the clampdown against the opposition Solidarity movement, during which dozens of people were killed.

Gen Jaruzelski, who is now 84 and in poor health, says he had to act to prevent a Soviet invasion of Poland.

If found guilty he faces up to 10 years in prison.

Although there is little public clamor in Poland to send Mr Jaruzelski to prison, a crowd of journalists and members of the public packed the courtroom as the trial began.

Gen Jaruzelski and three of his co-defendants were identified before a panel of judges.

Four of the eight accused men were absent, citing poor health.

‘Lesser evil’

Reading the charges, the prosecutor said the men had violated their own communist constitution when they created what he called a “criminal military organization” to implement martial law in December 1981.

The trial, in Warsaw, marks the first time Poland has held its former communist leaders criminally responsible for imposing martial law.

Immediately after the fall of communism in 1989, the new Solidarity government rejected calls for political retribution.

But in recent years moves to bring the senior communist party leaders to account for martial law have hastened.

Gen Jaruzelski has always maintained he chose the lesser evil when he ordered tanks onto the snowbound city streets on that night in 1981.

If he had not acted against Solidarity, he says, Soviet troops would have.

According to surveys, many Poles believe him.

Lehman reports third quarter loss

Lehman has suffered heavy losses from the credit crunch

Troubled US bank Lehman Brothers has reported a third quarter net loss of $3.9bn as it unveils radical restructuring plans.

The losses were at the top end of analysts’ expectations.

The bank’s shares on Tuesday plunged 45% on fears about the state of its financial health.

Korea Development Bank (KDB) has said talks with Lehman Brothers have ended for now with regard to possible investment in the US bank.

KDB said in a statement: “We are announcing that we ended talks at this point in time because of a disagreement over conditions of a transaction and considering domestic and foreign financial market conditions.”

State-run KDB said the decision came because of disagreement over terms and current financial market conditions.

Lehman, the fourth-largest US investment bank, had hoped to secure a deal with the Korean fund before announcing its third-quarter earnings.

A Wall Street Journal report said Lehman might be considering selling UK property assets to BlackRock.

N Korea to mark 60th anniversary

A special meeting was held on the eve of the anniversary

North Korea is planning to celebrate its 60th anniversary with a military parade in the capital, Pyongyang.

Reports say the parade will be the largest the North has ever staged, with lots of military hardware on display.

Reclusive leader Kim Jong-il is expected to attend, and the parade will be watched closely because of speculation about his health.

The anniversary comes amid an impasse in international efforts to urge North Korea to abandon its nuclear program.

Health concerns

On Monday, North Korea’s state-run television channel KRT showed footage of the North’s cabinet holding a large indoor gathering to mark the anniversary.

The cabinet released a statement, picked up by monitors in Seoul, saying that North Korea had a powerful army that would “mercilessly punish invaders”.

According to South Korean media, the main parade on Tuesday will be the largest ever staged by its northern neighbor.

“The North probably wants to boost the image of its military might in order to cement unity within the country and secure a better position in the denuclearize negotiations,” a South Korean government source told JoongAng Ilbo newspaper.

North Korean leader Kim Jong-il is notoriously reclusive

Military experts usually watch these parades to see if North Korea will unveil any new weapons systems.

But this time foreign observers will be particularly keen to note whether North Korean leader Kim Jong-il makes an appearance.

The future direction of North Korea is tightly linked to the personality of the country’s reclusive leader.

Mr Kim has not been seen in public since early last month, giving rise to speculation he could be seriously unwell.

He has been known to disappear from public view for extended periods before, and has always returned eventually, but this time the rumours of ill health have been given added impetus by news that a team of Chinese doctors was recently summoned to examine him.

Food shortages

The celebrations are taking place amid rising tensions between Pyongyang and the international community.

North Korea agreed in February 2007 to give up its nuclear ambitions in return for aid and diplomatic concessions, but the progress of the deal has been far from smooth.

After a long delay, Pyongyang handed over details of its nuclear facilities in June 2008.

In return, it expected the US to remove it from the list of state sponsors of terrorism, which the US has yet to do, so the North now appears to be starting to reassemble its main nuclear plant.

Meanwhile the World Food Program estimates that North Korea is suffering from a serious food shortage.

The North has relied on foreign assistance to help feed its 23 million people since its state-controlled economy collapsed in the mid-1990s.

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Are you marking this anniversary? Are you in Pyongyang? What is happening in your area? Tell us your experience