Regional DR Congo talks planned

Fears are growing for thousands of people who have fled into the bush

The Rwandan and Congolese presidents have agreed to try to end fighting in the Democratic Republic of Congo.

Rwanda’s Paul Kagame and his Congolese counterpart Joseph Kabila agreed to attend a regional summit after talks with a senior EU official on Friday.

French Foreign Minister Bernard Kouchner and UK Foreign Secretary David Miliband are due to meet the two men and visit Goma on Saturday.

The UN refugee agency has described the situation as “a total disaster”.

Aid groups say they are struggling to reach 250,000 people fleeing fighting between government and rebel forces.

European Union Development and Humanitarian Aid Commissioner Louis Michel said the only way to resolve the crisis was through a summit involving all regional leaders.

He said agreement had been reached on the prospect of a regional summit after two days of talks in the Congolese capital Kinshasa and the Rwandan capital, Kigali.

“They are both fully agreed on the idea of having this summit,” Mr Michel told.

But renegade rebel general Laurent Nkunda had not yet been asked to join the talks, Mr Michel added.

A ceasefire is holding in and around Goma, the capital of North Kivu province, but aid agencies say the situation there remains highly volatile.

Gen Nkunda’s forces are positioned some 15km (nine miles) from the city, which they have threatened to take unless UN peacekeepers guarantee the ceasefire and security there.

Refugee stampede

As diplomatic efforts to end the crisis gathered pace on Friday, UN Secretary-General Ban Ki-moon on Friday called leaders in Africa, Europe and the US to urge them to “do all they can to bring the parties to a neutral venue for negotiations”.

Tanzanian President Jakaya Kikwete, the current African Union chairman, and AU Commission chief Jean Ping said the summit could be held in the Tanzanian capital Dar es Salaam or the Ethiopian capital Addis Ababa.

Food, water and medicine in the city are scarce, and many international relief workers have pulled out after reports widespread rape and looting by retreating Congolese troops.

The BBC’s Orla Guerin witnessed scenes of chaos at a refugee camp in Kibati outside Goma, as desperately hungry people surged towards aid distribution points.

Children were trampled underfoot and panicked aid staff were forced to beat back the heaving crowd.

Some who reached Kibati told the BBC they had more chance of getting food in the forests than inside Goma.

Trading accusations

The UN refugee agency said camps sheltering 50,000 refugees in Rutshuru, 90km north of Goma, had been forcibly emptied, looted and then burnt to the ground.

“There are some 50,000 people who were in those camps,” said UNHCR spokesman Ron Redmond. “We don’t know where they would be, we’re afraid that they may have just dispersed off into the bush.”

The UN has more than 17,000 peacekeeping troops in DR Congo – the largest UN force in the world – but correspondents say it is struggling to cope with the scale of the current crisis.

The origin of the ongoing conflict in eastern DR Congo is the 1994 genocide in neighbouring Rwanda.

Gen Nkunda says he is fighting to protect his Tutsi community from attack by Rwandan Hutu rebels, some of whom are accused of taking part in the genocide.

The Congolese government has often promised to stop Hutu forces from using its territory, but has not done so.

There have also been accusations of collusion between DR Congo’s army and Hutu guerrillas.

The Congolese government, for its part, has accused Rwanda of backing Gen Nkunda.

Rwanda denies this, but it has twice invaded its much larger neighbour in recent years.

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Swaziland king celebrates in style

One of the world’s last remaining absolute monarchs, King Mswati III of Swaziland, has held lavish celebrations to mark his 40th birthday and 40 years of independence from Britain, reports.

King Mswati III was flanked by dignitaries as he delivered his speech

Mswati III arrived in the stadium framed by mountains in the capital Mbabane in a brand new BMW – one of 20 bought just for the occasion.

The king, dressed in traditional clothing and wearing a beaded necklace, was welcomed by cheering, flag-waving supporters.

“We all trust him,” said a young man with a front-row seat, also in traditional dress.

“He’s a good man. He believes in his country. He loves everybody. We are all like the royal family.”

The king has a taste for the finer things in life – something he shares with his 13 wives.

Some of them arrived for the so-called “40-40” celebrations fresh from a shopping trip to Dubai.

With marching bands and dancing troupes, and a garden party to follow, it was a party fit for a king.

But can his impoverished kingdom afford it?

Contempt

The official budget is $2.5m (£1.4m) but some estimates claim the real cost could be five times that.

Critics say that it is money that could have been better spent elsewhere – on education, on health, and on saving lives.

Cheering crowds turned out to welcome the king to the stadium

With the world’s highest rate of HIV (adult prevalence of 26.1%), many believe there is nothing to celebrate.

For two days this week trade unions and civic groups took to the streets in protest calling for change and for multi-party democracy.

“We condemn this party with the contempt it deserves,” said Swazi Trade Union leader Jan Sithole, as he marched in the capital.

“People feel so strongly because this is a plundering of the country’s resources in the height of grinding poverty for most of the Swazi masses.

“People feel their money is being wasted, with arrogance.”

Powerlessness

Take a drive into the bush, and poverty is written all over the landscape – dirt roads, rundown homes, and hungry children.

A collection of African heads of state made the trip to Mbabane

Sibusiso Mamba is one of them. His name means blessing. Sibusiso is an Aids orphan, who is HIV positive himself. Now aged 14, he looks more like a seven-year-old.

For the past two months he has been on anti-retro viral drugs (ARVs).

They brought him back from death’s door, according to his grandmother, Ntsambose, who is caring for him at a remote homestead – 80km (49.7 miles) from the nearest hospital.

Now, as the king is having a banquet, she has run out of food.

“I feel bad when I see that he’s hungry,” she said. “It hurts me. He’s better because of the medicine. But the problem of hunger will make him sick again.”

Ntsambose knew nothing of the celebrations in the capital, or of the money being spent.

“Who am I to say anything?” she asked. “There’s nothing I can say about what is done by the king.”

Zimbabwe President Robert Mugabe was among those present

Many feel powerless to speak up against the monarch – criticism of Mswati is still frowned upon here.

Ntsambose can hardly see, so she relies on her grandson to gather firewood.

It takes all his strength to carry a few sticks. He dreams of being well enough for school next year, and of growing up to be a policemen. But he may not live to his next birthday.

Aids campaigners Tengetile Hlope, whose has been helping Sibusiso and his grandmother, believes this is no time for parties.

“HIV is killing the country. When you think of the budget that is being used for the 40-40 celebrations, you just feel like crying,” she said.

“There are people here who don’t have water, food or transport to a clinic.

“They are just out in the rural areas on their own. The people who are organising and celebrating the 40-40, they don’t even know about this place.”

’40 years of poverty’

The government denies that the birthday party is extravagant, and insists it’s a fitting way to mark a milestone.

“I think the nation can celebrate the achievements of the past 40 years,” said Percy Simelane, a government spokesman.

After the celebrations, many of those who attended waited in line for food

“The country has changed tremendously. At independence we used to get teachers, doctors and nurses from other countries. Now we export them. ARVs are provided free.

“Aids orphans go to school free of charge, and the government pays for meals.”

But a short distance from Sibusiso’s homestead we found more evidence of the hardships many face, at a neighbourhood children’s centre.

About 60 children visit the centre every day – more than half of them are Aids orphans.

The volunteers who run the centre feed them when they can – that is about two days a month.

On the day of our visit, there were songs, games and informal education for the children, but nothing to eat.

Tengetile Hlope believes this is the reality of life for many in rural Swaziland, four decades on.

“I feel like I am just celebrating 40 years of poverty and hunger in this country,” she said.

Vein tubes ‘fitted needlessly’

Cannulas are used to help take blood and to give drugs and fluids

A third of patients have unnecessary tubes inserted into veins when they are in hospital, pharmacists have warned.

Researchers from Aberdeen’s Robert Gordon University said this needlessly exposed them to serious complications, such as infections and blood clots.

Just under 350 patients were studied over six weeks, the majority of whom had the tubes, called cannulas, fitted.

An A&E expert recognized cannulas should be used less frequently and for shorter periods.

It’s entirely reasonable to look at their use Dr Martin Shalley, emergency medicine consultant

The study was presented to the British Pharmaceutical Conference in Manchester.

Cannulas – hollow plastic tubes with a needle at the tip which cost around £1.70 each – are used to give medication and fluids to people who cannot swallow because they are unconscious or being given nil by mouth, and it has been estimated that around 80% of hospital patients have them fitted.

Drugs may also be more easily absorbed if given this way.

But potential complications include problems with veins (phlebitis), drugs leaking into tissues around the site of the tube, serious infection and blood clots.

‘Common practice’

Of the patients studied – who were all treated in the acute medical assessment unit of Aberdeen Royal Infirmary, 91% of patients had a cannula inserted. But 28% of the tubes were never used.

The researchers also found that in 71% of patient records there was no documentation of a cannula being inserted, while in 57% there was no documentation of it being removed.

Four patients had developed blood poisoning, which infection control specialists said was likely to be linked to the cannula.

The researchers, led by Dr Yash Kumarasamy, said that in many UK hospitals, it has become common practice to insert an intravenous cannula when the patient is admitted, irrespective of need.

He said: “We would like to see the introduction of a formal procedure under which hospital pharmacists review patients and their medications and make recommendations to the treatment team about whether or not a cannula is needed.”

Dr Martin Shalley, a former president of the British Association of Emergency Medicine, agreed there had been an over-reliance on cannula use.

He said many trusts had policies saying cannulas had to be removed after 72 hours

“It used to be a knee-jerk response to insert a cannula – but we now recognise there’s a need to think if fitting one is a benefit for that patient.

“It’s entirely reasonable to look at their use. That’s the case in A&E medicine and across acute medicine too.”

And Dr Shalley said he thought the level of use of cannulas had increased the level of hospital-acquired infections such as MRSA.

Cheap drug hope for breast cancer

In the UK, almost 46,000 new cases of breast cancer are diagnosed each year

A combination of two inexpensive existing drugs may offer a new way to treat breast cancer, according to UK and Finnish researchers.

The common chemotherapy drug and a brittle bone medicine almost completely stopped the growth of tumours in mice.

The Journal of the National Cancer Institute said the combination cost a twentieth of Herceptin, given to breast cancer patients by the NHS.

Specialists said the results of human trials now under way would be crucial.

The results of this study could change the way breast cancer patients are treated Pamela Goldberg Breast Cancer Campaign

In the UK, almost 46,000 new cases of breast cancer are diagnosed each year.

Although modern treatments mean that cases caught sufficiently early, some via breast screening programmes, have an excellent chance of being successfully treated.

The study was a joint project between researchers at the University of Sheffield and the Kuopio University in Finland.

Its findings could offer an even more effective way to help some patients.

It used a dose of the drug doxorubicin, a common component of chemotherapy regimes, followed 24 hours later by zoledronic acid, currently given to osteoporosis patients.

In the mice, this stopped 99.99% of new cancer cell growth in tumours.

It is thought the first drug could be “priming” the tumour to be more sensitive to the cancer-cell killing qualities of the second drug.

Dr Ingunn Holen, who led the study, said that the study showed that the drug cocktail could “kill breast tumours”.

“These results show that a patient may benefit the most if these two drugs are given in this particular order.”

She said that the results of a human trial were expected later this year.

Speed advantage

If that proves successful, the drugs would not have to undergo a lengthy licensing process, simply have the change of use included in their current licence.

Breast Cancer Campaign, the charity which funded the study, said it was encouraged by the potential for the drug to be made swiftly available to women.

Its chief executive, Pamela Goldberg, said: “The results of this study could change the way breast cancer patients are treated.

“The good news is the that the two treatments are relatively inexpensive and already used in the clinic.”

A spokesman for Cancer Research UK said that a study in humans would be important.

“Establishing the most effective combinations of drug treatments and the timings in which they are given is an important area of clinical research.

“But the benefits of giving zoledronic acid after doxorubicin have only been shown here in mice and now need to be evaluated more fully in people with breast cancer.”