Rwanda Achieves Universal Healthcare

Rwanda continues to impress beyond measure.

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The Rwandan healthcare system now covers over 90% of the population, the highest coverage rate in Africa. The informal community-based health insurance (CBHI) scheme, known as Mutuelle de Santé, focuses mainly on maternal and child health. According to the East African, the scheme is one of the most successful on the continent and it is credited for the country’s lower maternal and infant mortality rates of over 70% since 2000.

CBHI was originally voluntary and when contributions became compulsory, many saw it as paving the way to national coverage. Rwanda’s potential model for Africa is pivotal to development, as the WHO estimates that 100 million people are pushed into poverty and 150 million suffer financial catastrophe because of out-of-pocket expenditure on health services every year. Kenya is now using the CBHI model in pilot programs, while Tanzania and Uganda are openly considering it.

Benjamin Chemouni argues that Rwanda’s expansion of health insurance coverage is made possible by the concentration of power in the ruling coalition. He says the CBHI policy and its implementation are forged through both political interests and ideology. Kenya, Tanzania, and Uganda are certainly different milieus than Rwanda, so time will tell how the CBHI programs would fare in other countries.

If any country could make this model a success, however, it’s Rwanda. I have written about Africa’s innovation leaps forward and Rwanda is at the fore. Pretty impressive from a country that has done so much rebuilding in just a few decades since massive conflict. We can’t help but root for Rwandans.

 

DR Congo – Election Fraud Exposed — Africa Research Online

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Whistleblowers in the government leak results confirming claims by the Catholic Church that the announced result was false. A cache of data leaked from the state’s electoral commission points to an overwhelming victory by opposition presidential candidate Martin Fayulu, reinforcing earlier calls by regional organisations for a recount. The leaked data starkly contradicts the official results announced […]

via DR Congo – Election Fraud Exposed — Africa Research Online

Book Chapter on LGBTI Refugees from Pakistan

screen shot 2019-01-17 at 12.11.42 pmI recently had a book chapter published by Springer in LGBTI Asylum Seekers and Refugees from a Legal and Political Perspective. This qualitative research project on transgender refugees from Pakistan began during my time in Lahore in 2017. I later conducted in-depth interviews over the phone with transgender asylum seekers in Europe. I also published an article with The Islamic Monthly on the topic.

I am posting here because these same issues of LGBTI persecution exist in some African countries. I have posted about homosexuality in Uganda and Nigeria, the two African countries with the strictest laws against same-sex relations. Additionally, Nigeria and Pakistan share similar characteristics conducive to a legal and political comparison:

  • high population density
  • majority Muslim population with at least some degree of sharia law in place
  • high contrast between relative wealthy urban areas (Lagos, Lahore) and impoverished rural ones (Sokoto State, Balochistan)
  • histories of military take-overs and political instability, in which repression of sexual minorities can be part of the political agenda
  • Artificial borders drawn by the British that undergird religious/ethnic identities today

My chapter, “Fleeing Gender: Reasons for Displacement in Pakistan’s Transgender Community,” can be previewed here. The abstract is below.

Transgender women in Pakistan, or khwaja siras, continue to suffer human rights abuses that cause many to become Internally Displaced Persons, despite legal protections in their favor. The chapter poses a two-fold question to explore this inconsistency. Firstly, it draws from illustrative case study research to identify the discrimination that informs transgender perceptions of persecution and forces them from their homes. Based predominantly on qualitative data, it presents a 5-part typology of cumulative forms of discrimination against khwaja siras in terms of family, employment, housing, education, and healthcare. Importantly, police act as key agents of persecution for them, permitting and participating in their oppression. Secondly, this sociolegal study asks how such widespread discrimination against transgender women can persist notwithstanding legal reforms—a problem of social progress failing to result from legal progress. It finds that human rights protections for the transgender population lack actual implementation due to inaccurate legal wording, low level of trust in legal institutions, and generalized social stigma against the LGBTI community. This analysis revealed not only that mainstream social conservatism mitigates enforcement of LGBTI-friendly laws, but also that such conservatism creates an environment in which their persecution qualifies khwaja siras for, but yet impedes their ability to gain, UN protection as refugees at the international level. The empirical data from this research draws heavily on four comparative life histories of khwaja siras, two who gained refugee status and two who did not, which demonstrate the patterns of persecution against the transgender community in Pakistan.