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Ebola-Stricken Congo Suffers From A Rebel Attack

The latest Ebola outbreak, which causes hemorrhagic fever, vomiting and diarrhea, is believed to have killed 99 people since July and infected another 48.

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The violence "will have a considerable impact on the whole response to Ebola," a local public health official told Reuters on condition of anonymity. VOA
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At least 14 civilians were killed on Saturday in a six-hour attack by rebels on the town of Beni in eastern Democratic Republic of Congo, local officials told Reuters, warning the unrest may hamper efforts to quash an Ebola epidemic in the area.

The latest outbreak of the deadly disease has been focused in North Kivu and Ituri provinces, which have been a tinder box of armed rebellion and ethnic killing since two civil wars in the late 1990s.

Militants believed to belong to the Allied Democratic Forces, a Ugandan Islamist group active in eastern Congo, clashed with Congolese troops in Beni, a town of several hundred thousand people, local civil society leader Kizito Bin Hangi said by telephone.

“Beni is ungovernable this morning. Several protests have been declared in the town where the people express their anger with consternation,” he said.

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A boy runs past a dispenser containing water mixed with disinfectant, east of Mbandaka, DRC. VOA

In addition to the known fatalities, dozens of civilians were wounded as they fled the violence, which broke out in the early hours of Saturday evening and lasted until midnight, Bin Hangi added.

A spokesman for the army declined immediate comment.

The attack underscores the challenges the government and health organizations face in tackling Ebola in an area where years of instability has undermined locals’ confidence in the authorities.

The violence “will have a considerable impact on the whole response to Ebola,” a local public health official told Reuters on condition of anonymity.

“The general hospital which houses one of the Ebola treatment centers was the focus of angry protests this morning.

Ebola, Congo
Little 11-year-old German Umba, whose father died in May of Ebola and who is being monitored by the U.N. for potential signs of infection along with her 6-year-old brother, hides her face in her shirt, sobbing, outside her classroom in Mbandaka, Congo. VOA

This is a normal reaction for a community that is bereaved for the umpteenth time,” the official said.

Also Read: Ebola Increases The Number of Orphans in DRC: UNICEF

The latest Ebola outbreak, which causes hemorrhagic fever, vomiting and diarrhea, is believed to have killed 99 people since July and infected another 48. (VOA)

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C-Section Births Doubles In Number, Reaching Epidemic Proportions: Doctors

C-section is a type of major surgery, which carries risks that require careful consideration

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C-section
A newborn, one of 12 babies born by C-section, cries inside an incubator at the Bunda Hospital in Jakarta, Indonesia, Dec. 12, 2012. Several hospitals in Indonesia's main cities performed more cesareans than usual with new mothers hoping a 12-12-12 birth date will bring luck to their newborns. VOA

Worldwide cesarean section use has nearly doubled in two decades and has reached “epidemic” proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.

They said millions of women each year may be putting themselves and their babies at unnecessary risk by undergoing C-sections at rates “that have virtually nothing to do with evidence-based medicine.”

In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide, or 21 percent of all births. This was up from 16 million in 2000, or 12 percent of all births, according to research published in The Lancet.

It is estimated that the operation, a vital surgical procedure when complications occur during birth, is necessary 10-15 percent of the time.

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The Yusuf Dantsoho Memorial Hospital has a high success rate with C-sections. Kaduna, Nigeria. Photo by Chika Oduah, VOA

Varying country rates

But the research found wildly varying country rates of C-section use, often according to economic status: In at least 15 countries, more than 40 percent births are performed using the practice, often on wealthier women in private facilities.

In Brazil, Egypt and Turkey, more than half of all births are done via C-section.

The Dominican Republic has the highest rate of any nation, with 58.1 percent of all babies delivered using the procedure.

But in close to a quarter of nations surveyed, C-section use is significantly lower than average.

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Maternal death and disability rates are higher after C-section Flickr

Reasons to opt for surgery

Authors pointed out that while the procedure is generally overused in many middle- and high-income settings, women in low-income situations often lack necessary access to what can be a life-saving procedure.

“We would not expect such differences between countries, between women by socioeconomic status or between provinces/states within countries based on obstetric need,” Ties Boerma, professor of public health at the University of Manitoba, Winnipeg, and a lead author on the study, told AFP.

Jane Sandall, professor of social science and women’s health at King’s College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

These include “a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues.”

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It also identified an emerging gap between wealthy and poorer regions within the same country. Flickr

Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth.

Sandall also said there were often “financial incentives for both doctor and hospital” to perform the procedure.

The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth.

Income a factor

It also identified an emerging gap between wealthy and poorer regions within the same country. In China, C-section rates diverged from 4 percent to 62 percent; in India the range was 7-49 percent.

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Worldwide, more than 11 percent of babies are born premature. Pixabay

While the U.S. saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.

“It is clear that poor countries have low C-section use because access to services is a problem,” Sandall said. “In many of those countries, however, richer women who live in urban areas, have access to private facilities have much higher C-section use.”

Risks to mother, child

C-sections may be marketed by clinics as the “easy” way to give birth, but they are not without risks.

Maternal death and disability rates are higher after C-section than vaginal birth. The procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births.

 

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Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic. Flickr

 

The authors suggested better education, more midwifery-led care and improved labor planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.

“C-section is a type of major surgery, which carries risks that require careful consideration,” Sandall said.

Also Read: Novel Blood Test May Predict Autism Risk In Babies During Pregnancy

In a comment accompanying the study, Gerard Visser of the University Medical Centre in the Netherlands, called the rise in C-sections “alarming.”

“The medical profession on its own cannot reverse this trend,” he said. “Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances.”