Black November (2012) and its social-change potential: reactions from the audience

This article examines, through multiple film screenings and Focus Group Discussions, the potential of Black November (2012) to initiate social change in the 20th anniversary of Ken Saro-Wiwa’s death. Current research on African film is skewed towards broad representations of urban and rural lives, thus making the reception of indigenous popular films an understudied area. Virtually absent in African film scholarship is the reception of the films as agents of potential social change. The nexus between popular films and social change is examined here in the aftermath of failed formalized processes of conflict resolution. Recent popular film reception studies (Krings and Okome, 2013) have transnational foci, which focus on African emigrants’ conditions of life in foreign localities. The paper, therefore, evaluates the impact of popular films on viewers and how they interpret the film as being instrumental in changing oppressive situations in the Niger Delta. It deploys the theory that the arts function as peace-builders and tools for social change among conflicting parties (Shank & Schirch, 2008) in the light of the Niger Delta struggles, particularly those championed by Ken Saro-Wiwa, which are revisited two decades after his internationally-condemned murder. Findings include that Black November cannot function in isolation to produce social change but must work within a broad framework of strategies serving the same goal. // Cet article examine, à travers différentes projections de film et des Groupes de discussion thématiques, le potentiel de Black November (2012) pour initier un changement social au 20ème anniversaire de la mort de Ken Saro-Wiwa. La recherche actuelle sur le film africain est biaisée se concentrant sur des représentations larges des vies urbaines et rurales, si bien que la réception de films populaires autochtones est un domaine sous étudié. La façon dont les films potentiels agents de changement social sont reçus est virtuellement absente comme thème de la recherche sur les films africains. Le lien entre les films populaires et le changement social est examiné ici suite à l’échec de processus formalisés de résolution de conflit. Des études récentes se penchent sur la réception des films cette attention est transnationale. Ces études se concentrent sur les conditions de vie des émigrés africains dans des régions étrangères. L’article évalue par conséquent l’impact des films populaires sur les spectateurs, la façon dont le film est interprété, et son caractère instrumental pour modifier des situations d’oppression dans le Delta du Niger. La théorie qu’il déploie est que les arts fonctionnent comme des constructeurs de paix et des outils de changement social parmi des parties en conflit à la lumière des luttes dans le Delta du Niger, en particulier celle défendue par Ken Saro-Wiwa, qui sont revisitées une vingtaine d’années après son meurtre internationalement dénoncé. On a découvert que Black November ne peut pas fonctionner de façon isolée pour produire un changement social mais doit fonctionner dans un cadre plus vaste de stratégies visant le même objectif

Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.

INTRODUCTION: HIV-associated cryptococcal, TB and pneumococcal meningitis are the leading causes of adult meningitis in sub-Saharan Africa (SSA). We performed a systematic review and meta-analysis with the primary aim of estimating mortality from major causes of adult meningitis in routine care settings, and to contrast this with outcomes from clinical trial settings. METHODS: We searched PubMed, EMBASE and the Cochrane Library for published clinical trials (defined as randomized-controlled trials (RCTs) or investigator-managed prospective cohorts) and observational studies that evaluated outcomes of adult meningitis in SSA from 1 January 1990 through 15 September 2019. We performed random effects modelling to estimate pooled mortality, both in clinical trial and routine care settings. Outcomes were stratified as short-term (in-hospital or two weeks), medium-term (up to 10 weeks) and long-term (up to six months). RESULTS AND DISCUSSION: Seventy-nine studies met inclusion criteria. In routine care settings, pooled short-term mortality from cryptococcal meningitis was 44% (95% confidence interval (95% CI):39% to 49%, 40 studies), which did not differ between amphotericin (either alone or with fluconazole) and fluconazole-based induction regimens, and was twofold higher than pooled mortality in clinical trials using amphotericin based treatment (21% (95% CI:17% to 25%), 17 studies). Pooled short-term mortality of TB meningitis was 46% (95% CI: 33% to 59%, 11 studies, all routine care). For pneumococcal meningitis, pooled short-term mortality was 54% in routine care settings (95% CI:44% to 64%, nine studies), with similar mortality reported in two included randomized-controlled trials. Few studies evaluated long-term outcomes. CONCLUSIONS: Mortality rates from HIV-associated meningitis in SSA are very high under routine care conditions. Better strategies are needed to reduce mortality from HIV-associated meningitis in the region

Emerging viral threats in Gabon: health capacities and response to the risk of emerging zoonotic diseases in Central Africa

Emerging infectious diseases (EID) are currently the major threat to public health worldwide and most EID events have involved zoonotic infectious agents. Central Africa in general and Gabon in particular are privileged areas for the emergence of zoonotic EIDs. Indeed, human incursions in Gabonese forests for exploitation purposes lead to intensified contacts between humans and wildlife thus generating an increased risk of emergence of zoonotic diseases. In Gabon, 51 endemic or potential endemic viral infectious diseases have been reported. Among them, 22 are of zoonotic origin and involve 12 families of viruses. The most notorious are dengue, yellow fever, ebola, marburg, Rift Valley fever and chikungunya viruses. Potential EID due to wildlife in Gabon are thereby plentiful and need to be inventoried. The Gabonese Public Health system covers geographically most of the country allowing a good access to sanitary information and efficient monitoring of emerging diseases. However, access to treatment and prevention is better in urban areas where medical structures are more developed and financial means are concentrated even though the population is equally distributed between urban and rural areas. In spite of this, Gabon could be a good field for investigating the emergence or re-emergence of zoonotic EID. Indeed Gabonese health research structures such as CIRMF, advantageously located, offer high quality researchers and facilities that study pathogens and wildlife ecology, aiming toward a better understanding of the contact and transmission mechanisms of new pathogens from wildlife to human, the emergence of zoonotic EID and the breaking of species barriers by pathogens

Barriers to antiretroviral therapy adherence in rural Mozambique

<p>Abstract</p> <p>Background</p> <p>HIV is treated as a chronic disease, but high lost-to-follow-up rates and poor adherence to medication result in higher mortality, morbidity, and viral mutation. Within 18 clinical sites in rural Zambézia Province, Mozambique, patient adherence to antiretroviral therapy has been sub-optimal.</p> <p>Methods</p> <p>To better understand barriers to adherence, we conducted 18 community and clinic focus groups in six rural districts. We interviewed 76 women and 88 men, of whom 124 were community participants (CP; 60 women, 64 men) and 40 were health care workers (HCW; 16 women, 24 men) who provide care for those living with HIV.</p> <p>Results</p> <p>While there was some consensus, both CP and HCW provided complementary insights. CP focus groups noted a lack of confidentiality and poor treatment by hospital staff (42% CP vs. 0% HCW), doubt as to the benefits of antiretroviral therapy (75% CP vs. 0% HCW), and sharing medications with family members (66% CP vs. 0%HCW). Men expressed a greater concern about poor treatment by HCW than women (83% men vs. 0% women). Health care workers blamed patient preference for traditional medicine (42% CP vs. 100% HCW) and the side effects of medication for poor adherence (8% CP vs. 83% CHW).</p> <p>Conclusions</p> <p>Perspectives of CP and HCW likely reflect differing sociocultural and educational backgrounds. Health care workers must understand community perspectives on causes of suboptimal adherence as a first step toward effective intervention.</p