COVID-19 revealed flaws in Australia’s food supply. It also gives us a chance to fix them


Penny Farrell, University of Sydney; Anne Marie Thow, University of Sydney; Helen Trevena, University of Sydney; Sinead Boylan, University of Sydney, and Tara Boelsen-Robinson, Deakin UniversitySince COVID hit, many Australians have seen first-hand what shocks to the food system can do.

Uncertainty around panic-buying, food supply and pricing have thrown our national food system into the spotlight. And it was already under extreme pressure from climate change and prolonged drought.

The pandemic has revealed vulnerabilities in the Australian food system, but it also presents an opportunity to make it more resilient.




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Global ructions, local effects

Australia produces enough fresh food to feed the nation. In fact, more than 90% of the fresh food sold in supermarkets is produced here.

However, the pandemic and its effects on global economies has made it hard, at times, to maintain the supply of food we are used to due to workforce and logistics issues.

In particular, agricultural workforce shortages resulting from international border closures continue to threaten supply of fruit and vegetables, and may also affect price stability.

Food insecurity

Before the pandemic, more than 20% of Australians were estimated to be experiencing food insecurity. Since COVID, food insecurity has increased in Australia.

In Victoria, household budget pressures during the first lockdown forced one in four families to live without healthy food.

Food insecurity can worsen diet quality and increase the risk of various health conditions, including excess weight, obesity and diabetes. These conditions also put people at increased risk of getting very sick or dying from COVID-19.

Unhealthy diets are a leading cause of poor health and death worldwide, so the rising number of people without sufficient access to healthy diets should ring alarm bells for anyone interested in the health of Australians.




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But along with these newly exposed vulnerabilities, there are many examples of agility and resilience across the Australian food system.

The agriculture sector has successfully shifted many businesses online. Charities in Victoria moved quickly to provide culturally appropriate food to communities in lockdown.

And the federal government has provided significant support to older people isolating at home, including roughly A$50 million for the “Meals on Wheels” program. There’s also been extra targeted support to farmers.

An opportunity for a coordinated approach

The COVID pandemic has forced many of us to appreciate the complexity and scale of the food production and distribution system in Australia.

Yet Australia currently lacks a national food policy, leaving us vulnerable to future shocks and limiting our capacity to protect vulnerable groups.

Integrated policy with buy-in of government sectors and portfolios beyond health (such as business, trade, agriculture, economics, and education), can maximise the economic, social, nutritional and environmental outcomes of our food system.

We need to encourage innovation and coordination between national, state, and local government levels to support food supply systems that deliver healthy food across the population.

We have already seen it’s possible to make significant policy changes to strengthen food systems in time of crisis. For example, the Australian Competition and Consumer Commission temporarily relaxed anti-collusion rules for big supermarkets during the pandemic, so they could coordinate to “ensure essential supplies get through to vulnerable and isolated people”, as one media report put it.

A more resilient food system

In Australia, an integrated policy could help make our food system more resilient in the face of future shocks.

Perhaps the pandemic provides an opportunity for us to stop and take stock of what worked well, what didn’t, and where the biggest impact could be made.

For example, we could consider introducing food distribution warehouses in remote Australia so these communities can get healthy, minimally processed foods at affordable prices, even in times of crisis.

Lawmakers should place food security and access to nutritious food at the heart of agriculture, fisheries and trade policies.

We need to ensure nutrition is prioritised in any pandemic response efforts. One approach, advocated by researchers in a recent Nature comment piece, argued:

Cash provision could be coupled with incentives for recipients to participate in well-targeted, culturally sensitive food literacy programmes based on an understanding of barriers to consumption of nutritious foods.

In addition, public distribution programmes, state-managed stores, public restaurants, and other forms of subsidy programmes could focus on providing diverse nutritious foods and meals and minimizing less-healthy foods.

We note that the NSW government’s “Dine and Discover” program has been critiqued for including the fast food giants.

We must incentivise healthy food policies for businesses. For example, “naming and shaming” companies’ commitments to nutrition has resulted in policy and practice changes in Australia. There is recent evidence from that healthy merchandising in food stores can meet both commercial and public health goals in Australia.

The pandemic has highlighted how easily our food supply can be disrupted by crisis. Now, it’s up to us to lean into that disruption and find ways to build resilience into the food system.




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The coronavirus pandemic requires us to understand food’s murky supply chains


This story is part of a series The Conversation is running on the nexus between disaster, disadvantage and resilience. It is supported by a philanthropic grant from the Paul Ramsay foundation. You can read the rest of the stories here.The Conversation

Penny Farrell, Research Fellow and Lecturer, University of Sydney; Anne Marie Thow, Associate Professor in Public Policy and Health, University of Sydney; Helen Trevena, Adjunct lecturer, University of Sydney; Sinead Boylan, Research Associate, University of Sydney, and Tara Boelsen-Robinson, Research Fellow, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Yes, export bans on vaccines are a problem, but why is the supply of vaccines so limited in the first place?



Cecilia Fabiano/AP

Deborah Gleeson, La Trobe University

News of the blockage of a shipment of 250,000 COVID-19 vaccines from Europe to Australia has caused concern and outrage.

The immediate problem will probably be quickly solved through diplomatic channels. Even if it is not, onshore manufacturing of the AstraZeneca vaccine will soon make up for any shortfall in Australia’s vaccine supply.

But to avoid these types of supply shortfalls in future, it’s important to address the underlying problems behind this example of vaccine nationalism. Australia is both a victim of these problems, as well as a contributor.

Why has Australia’s shipment of vaccines been blocked?

Italy has blocked the shipment of AstraZeneca vaccines based on export authorisation rules introduced by the European Union in January. These rules require vaccine manufacturers in the EU to seek authorisation to export vaccines to some countries outside the bloc.

This is the first time this process has resulted in a planned delivery of vaccines being blocked. The EU could have objected to Italy’s action, but did not.

The EU introduced the authorisation requirement due to concerns it was not receiving the quantities of the Pfizer and AstraZeneca vaccines that the companies had agreed to provide within certain time frames.

Italy’s blocked vaccine export was the first intervention under the EU’s controversial export authorisation scheme.
Cecilia Fabiano/AP

How much of a problem will the blockage be for Australia?

The immediate problem will probably be quickly solved through diplomatic negotiations. The EU is also likely to face intense criticism and pressure from other countries that fear the more widespread use of export restrictions.

So, it’s unlikely the export ban on these 250,000 vaccines will remain in place for long, or that Australia will face further export restrictions.




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Even if the shipment never arrives in Australia, onshore manufacturing of the AstraZeneca vaccine by CSL will soon fill the gap, with the first locally produced doses expected to be available around the end of March. Any resulting delay in the rollout of Australia’s COVID-19 vaccination program is likely to be shortlived.

But the blockage of a vaccine shipment points to bigger problems that threaten to undermine the global distribution of vaccines and the world’s recovery from the pandemic.

The bigger picture of vaccine nationalism

The global distribution of COVID-19 vaccines has so far been extremely inequitable. By November 2020, governments had negotiated pre-purchase agreements for almost 7.5 billion doses, 51% of which had been reserved by wealthy countries representing only 14% of the global population.

In mid-January, the director-general of the World Health Organization warned of a “catastrophic moral failure”. He said that 39 million vaccine doses had been administered in high-income countries at that time, but just 25 doses had been provided in “one lowest-income country”.

At this rate, it could be 2023 or 2024 before vaccination brings the pandemic under control globally.

Studies by the RAND Corporation and the International Chamber of Commerce have found that hoarding of vaccines by wealthy countries could cost the global economy trillions of dollars.

Uncontrolled transmission of the virus in some parts of the world also raises the risk of more variants emerging that are resistant to existing vaccines.




Read more:
Herd immunity is the end game for the pandemic, but the AstraZeneca vaccine won’t get us there


The underlying problem of artificial scarcity

Much of the reporting on vaccine nationalism tends to focus on the hoarding of vaccines by particular countries. But we should question why the supply of vaccines is so limited in the first place.

This comes down to privately held monopolies on the intellectual property and other types of knowledge, data and information needed for making vaccines. While there is manufacturing capacity available globally to ramp up vaccine production, the exclusive rights to make and sell the vaccines are held by a small number of companies. This is despite a huge investment of public funding in the development of many vaccines.

It’s estimated most high-income countries will achieve widespread vaccination coverage by the end of 2021, but low- and middle-income countries will have to wait.
John Locher/AP

The intellectual property rights that impede rapid scaling-up of vaccine production are enshrined in the World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). This agreement requires that WTO members make available 20-year patents for new pharmaceutical products, along with other types of intellectual property protection.

TRIPS includes safeguards like compulsory licensing, which governments can use to enable patented inventions to be produced without the consent of the patent owner in situations like a public health emergency.

But these are time-consuming and difficult to use, and they only apply to patents and not the other types of knowledge, data and information that are needed to manufacture vaccines.




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3 ways to vaccinate the world and make sure everyone benefits, rich and poor


Australia’s support needed for global solutions to vaccine scarcity

Two important mechanisms have been proposed to solve this problem of artificial vaccine scarcity and enable production of COVID-19 medical products to be rapidly scaled up. Neither has received Australia’s support to date.

India and South Africa put a proposal to the WTO in October 2020 that certain intellectual property rights in the TRIPS agreement be waived for COVID-19 medical products during the pandemic. This proposal, known as the “TRIPS waiver”, is supported by many developing countries, but opposed by the EU, US and other wealthy countries, including Australia.

The World Health Organization has also set up a mechanism for sharing intellectual property, knowledge and data for COVID-19 products, known as the COVID-19 Technology Access Pool (C-TAP).

C-TAP has been endorsed by 40 countries and many inter-governmental and civil society organisations, but lacks support from many high-income countries, including Australia. So far, it has been unused.

To address the real problems underlying the current supply blockage, Australia will need to reconsider its opposition to these proposed global solutions.The Conversation

Deborah Gleeson, Associate professor, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What Victoria’s abattoir rules mean for the supply and price of meat


Flavio Romero Macau, Edith Cowan University and Ferry Jie

With Victoria’s declaration of a state of disaster and imposition of Stage 4 restrictions, many Melburnians have returned to panic buying. Supermarket shelves across the city have been stripped of canned goods, fresh vegetables and meat.

The meat buying, at least, makes some sense.

After aged care homes, meat-processing facilities have been a major contributor to Victoria’s COVID-19 outbreak. Hundreds of coronavirus cases have been linked to about a dozen sites, with the biggest outbreaks at those in Melbourne’s outer western and northern surburbs.

There were expectations following the state government’s lockdown announcement on Sunday that these facilities might be closed completely, along with the other business restrictions announced on Monday.




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That didn’t happen. But the state’s 70-plus meat-processing facilities will be required to reduce their production capacity by one-third.

They must also implement, in the words of premier Daniel Andrews, “some of the most stringent safety protocols that have been ever put in place in any industrial setting”, including workers dressing “as if they were a health worker – gloves and gowns, masks and shields.”

This is going to affect the supply of meat to Victorian supermarkets, and prices. But thankfully not for long.

Why meat processors?

Processing meat is the opposite of an assembly line. It’s a disassembly line, the equivalent of auto workers pulling apart cars – removing the wheels, doors, seats, engine and so on – to sell the parts. Now imagine each car is slightly different, and must be taken apart in a slightly different way, at fast pace.

Automating such work is difficult. It is complex and intensive manual labour. Lots of people work close together, in a hard environment, for long hours, in cold and dry spaces. These factors make it easy for COVID-19 to spread.

The Victorian government’s directive that meat-processing facilities reduce output by one-third is to ensure workplace changes such as gaps between shifts, more physical distancing, and more attention to measures such as wearing personal protective equipment and not sharing cutting equipment.

So production will go at a slower pace. Output will be lower, and the per-unit cost of packaging meat products for consumers will be higher.

Slaughterhouse workers processing meat.
Slaughterhouse meat workers.
Shutterstock

Synchronising the system

Quality and price are key purchasing decisions for most meat shoppers, and the meat industry has been geared to providing fresh produce at lowest cost.

Getting your favourite beef, lamb, chicken and pork cuts to your local supermarket or neighbourhood butcher is a complex game. Meat processing and distribution centres work out how much to produce, where to deliver and when to do it with great precision, planning up to 90 days ahead. They must synchronise supplies from farmers with demand from retailers.

Think of the system’s smooth operation as being like keeping a roomful of clocks synchronised.

If one clock fails, no problem. You can fix it. But what if a handful more clocks fail before you can fix it, and then dozens more fail? In a short time there will be so many faulty clocks that coordination is compromised. Eventually you won’t even know what the right time is.

Reducing capacity in one or two abattoirs for a few days could be worked around with minimal effects to consumers. But there’s no quick fix to reducing capacity in all of them for six weeks.

Supplies for some meat products will almost certainly be lower, and prices could increase. This is most likely to occur for the most common and popular meat cuts, like T-bone steaks or chicken drumsticks. If your preference is offal or giblets, though, you may not have a problem.




Read more:
Disagreeability, neuroticism and stress: what drives panic buying during the COVID-19 pandemic


What is the good news?

Yes, there is good news.

First, thanks to refrigerated transport, meat processors in other states can help meet lower production in Victoria. The industry has some flexibility to move from north to south, from west to east.

Second, supermarkets have been quick to bring restrictions back to prevent the panic buying and hoarding that make shortages even worse. Coles and Woolworths have already imposed two-pack limits on meat packages (and other products).

Third, to hoard meat you need freezer capacity, and it’s quite possible those disposed to stockpiling still have frozen meat from the first COVID-19 wave.




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Fourth, supermarkets and hundreds of smaller operators such as butchers will be affected in different ways at different times. Finding what you want may simply require looking in more than one shop.

Fourth, there are options. Not just between different fresh products such as beef, chicken, pork, lamb and fish, but between preserved, frozen and canned alternatives.

So it might be just a bit harder to have your preferred choice of meat for dinner in the coming days. But the situation won’t be as dire as some fear.The Conversation

Flavio Romero Macau, Senior Lecturer in Supply Chain Management and Global Logistics, Edith Cowan University and Ferry Jie, Asssociate Professor in Supply Chain and Logistics Management, Deputy Director, Centre for Innovative Practice, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A city-by-city guide to how water supplies fared in Australia’s summer of extremes


Ian Wright, Western Sydney University and Jason Reynolds, Western Sydney University

Australia has just experienced a summer of environmental extremes. Water has played a key role. This includes prolonged drought, dry soil and bushland contributing to bushfires, and widespread shortages of water for agriculture and drinking supplies. Thankfully, rain extinguished many bushfires that had burned for weeks and months.

The late summer heavy rain fell in some, but not all, regions. Australia’s capital city water supplies have had different fortunes this summer. The Bureau of Meteorology “water dashboard” provides daily data.




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Cities where storages are low

Five capital city water supplies dropped over summer by between 2.2% and 11.4% of their storage capacity.

Hobart has proportionally dropped the most, by 11.4 percentage points, to 59.8%. This reflects relatively small storages and the city’s dry summer with only 65mm of rain. That’s less than half the historic average.

The Adelaide storages fell by 8.4 points to 43.5%. Adelaide had a typical dry summer with 66mm. That’s close to the historic average, as the city has a Mediterranean climate with hot and dry summers.

Adelaide’s water storages provided only 10% of the city’s water supply in 2018-19, with 83% drawn from the Murray River. The Commonwealth is providing nearly A$100 million for Adelaide’s desalination plant. This aims to allow upstream irrigators to grow fodder with the river water that was destined for Adelaide.




Read more:
Cities turn to desalination for water security, but at what cost?


Perth has had another dry summer. Its catchment rivers have supplied only 44.1 gigalitres (GL) of water since April 2019. This is much lower than the long-term pre-1975 average of 413GL over the same time period.

Perth water storages fell by 5.7 percentage points this summer to 39.5%, the lowest of all capital city supplies.

Canberra lost 4.6% of its water supply. The end-of-summer level of 46.5% continues a rapid decline from 100% in October 2016.

Despite the falling reserves, Canberra’s Icon Water has not imposed water restrictions. It advises that the Cotter Dam was enlarged in 2013. Icon Water can also draw “top-up” water from the Murrumbidgee River.

Melbourne’s supplies fell 2.2 percentage points to 61.6%.

Cities where storages rose

Three capital cities recorded water storage increases this summer.

Darwin’s supply was close to full as recently as April 2018. Since then it has been on a downward trend. A modest 6.4% gain over this summer’s wet season took it to 60.3%.

Darwin appears to be having its second poor wet season in a row. The city had 675mm of rain (Darwin Airport) this summer. That’s about 67% of its historic summer average of just over 1,000mm.

Options canvassed for increasing Darwin water supply include using Manton Dam, which was built in the 1940s but is now used for recreation.

Brisbane’s southeast Queensland storages increased by 8.6 percentage points to 69.6%.

Sydney’s storages increased the most, by 35.7 points to 81.4%.

Sydney was distressed by its dwindling water supplies as summer approached. Storages were at 45.7% at the start of December. Level 2 water restrictions were imposed from December 10.

These were the toughest summer water restrictions for an Australian capital city. All use of hoses for gardens and washing cars was banned. Many Sydneysiders struggled to keep their gardens alive, lugging around buckets and watering cans. A catchcry across Sydney was “let your lawn die”.

On February 6 2020, heavy rains started falling in coastal southeastern Australia, including Sydney and its water catchments.




Read more:
Heavy rains are great news for Sydney’s dams, but they come with a big caveat


The automatic weather station at Mount Boyce, near Blackheath on the edge of the Warragamba Dam catchment, recorded 415mm in four days. From February 6-27 Sydney’s water storages nearly doubled, from 41.7% to nearly 82%. This added more than 1 million megalitres (ML), equivalent to more than 1.5 years’ demand.

On February 6, parched catchments were adding 10ML a day to Warragamba Dam. A week later the catchment rivers had risen and many were in minor flood, adding 65,000ML a day on February 13.

At the end of summer Sydney Water announced it was dropping level 2 restrictions.

Some parts missed out

The February rains were patchy, however. Many water-stressed parts of New South Wales were not so lucky.

Orange in the state’s Central West remained on level 5 water restrictions all summer. Orange Council pleaded with residents to curb water use to less than 160 litres per person per day. Residents responded by using even less, averaging 126 litres a day in February.

Nearby Bathurst declared “extreme” water restrictions from February 24. Its main storage, Chifley Dam, is just under 30% and also had a blue-green algae alert.

Chaffey Dam provides drinking water to the Tamworth area and sits at just 14.3%. Over summer it received over 800ML but has to balance this inflow with environmental releases. Tamworth remains on level 5 restrictions. If Chaffey Dam drops below 10% a daily target of 100 litres per person looms.

A cause for concern is that many large NSW irrigation dams across the Murray-Darling River system remain very low for the start of autumn. For example, Burrendong Dam near Dubbo was at 4.5% at the end of summer. This dam supplies water to the city via the Macquarie River.

The Macquarie River also supplies other settlements, irrigators and industry, such as the mines at Cobar.

Flooding rains in inland Queensland are returning healthy flows to dry inland rivers such as the Barwon and the Darling. On February 25, Bourke Shire Council announced happy news that “strong flows in the Darling River” allowed the lifting of water restrictions. Bourke residents had endured water restrictions for more than 550 days.The Conversation

Ian Wright, Senior Lecturer in Environmental Science, Western Sydney University and Jason Reynolds, Senior Lecturer in Geochemistry, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How drought is affecting water supply in Australia’s capital cities


Ian Wright, Western Sydney University and Jason Reynolds, Western Sydney University

The level of water stored by Australia’s capital cities has steadily fallen over the last six years. They are now collectively at 54.6% of capacity – a decline of 30% from 2013.

We’re going into a hot summer and Sydney has just announced level 2 restrictions, the toughest for any capital. Data from the Bureau of Meteorology shows other capital cities facing mixed results.

The results show that Darwin’s water supply has lost about 25% over the last year. On the plus side, Melbourne’s supply actually increased over 2019, having fallen below 50% earlier this year, and now sits on 63.9%.

While the national average is trending downwards, the patterns for each city are very different. Sydney and Perth water supplies have had contrasting journeys over the last six years. In October 2013 Perth’s supply was a very low 33.8% and Sydney was a comfortable 91%.

Now, for the first time in many years Perth does not have Australia’s lowest level of all capital city water storages. As of last week, Sydney has taken this unwanted distinction from Perth.

For Perth residents, the news is good as their surface water storages are at a six-year high of 46.4%. In Sydney they are worried, as they have a six-year low of 46.2%.

Sydney has experienced a steep decline over the last 30 months, from nearly full storages (96%) in April 2017. The speed and severity of the Sydney drought is starting to resemble previous dry spells. One was in the 1940s and the other was the Millennium drought.

Perth has lived with the most water stress of any capital city. They have had to contend with a steady 45-year decline in rain. The inflow of water into Perth’s dams has also fallen dramatically.

Perth has adapted to its drying climate by sourcing water from many different supplies. It now uses its surface water storages for about 10% of its water supply. Much larger proportions of Perth’s supply comes from its two desalination plants, which unlike the other capitals are constantly in operation. It makes greater use of groundwater and highly treated recycled water. Perth also has permanent water restrictions.

Sydney’s desalination plant, after hibernating for 7 years, is now supplying water. It was switched on in late January 2019 when Sydney supply hit 60%, and can supply 15% of water demand. Unusually perhaps, the desalinated water does not reach all parts of Sydney.

Sydney Water has announced plans to double the capacity of the desalination plant. Construction is expected to begin soon.

Melbourne and Brisbane water supplies are currently at similar levels. However, since 2013 Melbourne’s storages have generally been lower than Brisbane’s. Melbourne’s supply has risen in 2019 after good winter rainfall in its catchments. The storages have increased from under 50% (49.6%) in late May 2019. Today, Brisbane storage levels are now at 59.2%.

Melbourne residents use less water than the other capital cities. In 2018 the average Melbourne resident used 161 litres per day, approximately 30% less than Sydney residents.

Melbourne’s supplies have also been supplemented with the reactivation of its Wonthaggi desalination plant in 2019. It is Australia’s largest desalination plant, capable of producing 410 million litres a day.




Read more:
Why Sydney residents use 30% more water per day than Melburnians


Brisbane also built a desalination plant after the Millennium Drought. In addition, they also made very large investments in Australia’s largest waste water recycling scheme. The Western Corridor recycled water scheme opened in 2008, cost $2.5 billion and features three advanced waste water treatment plants, with more than 200 km of pipelines and three advanced waste water treatment plants.

Hobart, Darwin and Canberra are the three Australian capital cities without desalination plants. Canberra has had a steady decline in its supply over three years. It was full in October 2016, gradually dropping to 51.6% in November 2019. Hobart’s storages were above 80% for most of the last six years. They were just above 90% 12 months ago and have since fallen to their current level of 72%.




Read more:
Fish kills and undrinkable water: here’s what to expect for the Murray Darling this summer


Darwin’s water supply was full as recently as April 2018. Now, 18 months later, it is just touching 54%. This is its lowest level in six years. Darwin, our tropical capital, has the most seasonal rainfall of Australia’s capitals. Typically, they have almost no rain June to September during their dry season, and a wet season of heavy rains from October to April.
However, the last wet season was one of the driest on record.

Adelaide’s water storage has fluctuated over the last 6 years. Adelaide gets more rain in winter and has dry summers, an opposite pattern to that of Darwin. Over the last 3 years the level has dropped from over 97% in October 2017 to just below 58%.




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Up the creek: the $85 million plan to desalinate water for drought relief


The desalination plant in Adelaide can supply up to 50% of its water supply. It has been operating in 2019, although not in the wetter months of July and August. The Murray also continues to supply a large proportion of Adelaide’s water supply. The Commonwealth has agreed to use drought funding for the Adelaide desalination plant, so more river water can be used by farmers upstream to grow fodder for livestock.

Australia is set for a dryer and hotter summer than average, particularly in the east. Coupled with continued high levels of household demand, we can expect further declines in water storage levels through the first half of 2020.The Conversation

Ian Wright, Senior Lecturer in Environmental Science, Western Sydney University and Jason Reynolds, Research Lecturer in Geochemistry, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Pay pharmacists to improve our health, not just supply medicines



Pharmacists receive no financial incentive to counsel patients about how to take their medicines. That needs to change.
from www.shutterstock.com

John Jackson, Monash University and Ben Urick, University of North Carolina at Chapel Hill

When you have a medicine dispensed at your local pharmacy under the
Pharmaceutical Benefits Scheme (PBS), two things happen. The federal government determines how much the pharmacy receives for dispensing your medicine. It also decides what you need to pay.

This so-called fee-for-service funding means pharmacies maximise their revenue if they dispense many prescriptions quickly.

Rather than fast dispensing, it would be better for patients and the health-care system if the funding model paid pharmacists for improving the use of medicines, not just for supplying them.

This is possible, according to our research published recently in the Australian Health Review. And it should be considered as part of the next Community Pharmacy Agreement, which outlines how community pharmacy is delivered over the next five years.




Read more:
Explainer: what is the Community Pharmacy Agreement?


Dispensing medicine is more complex than it looks

Dispensing medications may seem simple but this can be misleading: it includes both commercial and professional functions.

Under the PBS, the pharmacy receives a handling fee and mark-up on the cost of the drug to cover the commercial cost of maintaining the pharmacy and stock.

It also receives a dispensing fee for the pharmacist’s professional activities. These include reviewing the prescription to ensure it is legal and appropriate, taking into account factors such as your age, whether you are pregnant and which medicines you’ve been prescribed before; creating a record of the dispensing; labelling the medicine; and counselling you, including providing a medicine information leaflet if needed.

Higher dispensing fees are paid for medicines needing greater levels of security (such as controlled drugs including opioids) and for medicines the pharmacist must make up (such as antibiotics in liquid form).




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But for the vast majority of PBS prescriptions, a pharmacy receives the same basic dispensing fee, currently A$7.39.

If you have a medicine dispensed for the first time, if it has a complicated dose, or it carries particular risks such as side effects or interactions, a pharmacist is professionally obliged to provide counselling matched to the risk. The more detailed the counselling, the greater the time needed.

However, at present, the dispensing fee to the pharmacy does not change depending on the level of counselling you need. Indeed, the current funding model is a disincentive for the pharmacist to spend time with you explaining your medicine. That’s because the longer they spend counselling, the fewer prescriptions they can dispense, and the fewer dispensing fees they receive.

What could we do better?

Performance-based funding, in which payment is adjusted in recognition of the efforts of the service provider or the outcomes of the service delivered, is becoming more common in health care and can correct some of the volume-related issues mentioned above.

It’s already being used in Australia. For instance, GPs are paid a Practice Incentives Program (PIP) to encourage improvements in services in areas such as asthma and Indigenous health.

However, performance-based funding has yet to be used for pharmacists’ dispensing in Australia.

We propose dispensing fees should be linked to the effort pharmacists make to promote improved use of medicines. This is based on the principle that counselling means people are more likely to take their medications as prescribed, which improves their health.

In other words, pharmacists would receive higher dispensing fees when more counselling is required or if counselling leads to patients taking their medications as prescribed.

Pharmacists who spend longer counselling, for instance if someone’s health status has changed, should be rewarded for it.
from www.shutterstock.com

Dispensing fees could be linked to the actual time taken to dispense a prescription: the longer the time, the higher the fee. The time taken would depend on the nature of the drug; the complexity of the patient’s treatment; recent changes in the patient’s health status or other medicines that need to be taken into account; consultation with the prescribing doctor; and the level of advice and education provided.

A blended payment model could include a fee-for-service payment for commercial processes and a performance-linked payment for professional functions.

The most experience with performance-based payments to pharmacy is in the United States, where evidence is developing of patients taking their medicine as prescribed and lower total health-care costs.

In England, the government’s Pharmacy Quality Scheme is similar to the Australian Practice Incentives Program for GPs. It funds improved performance in areas such as monitoring use of certain drugs and patient safety.

There is some concern about performance-linked payments. Performance targets need to be achievable without being onerous. And performance needs to be clearly linked to the payment being made, but not if other services suffer.

Incentives could apply to you too

Cost is a barrier to some people taking their medicines with over 7% of Australians delaying or not having prescriptions dispensed due to cost.

However, there is currently no financial incentive for you to have a generic (non-branded) medicine dispensed, which would save on PBS expenditure. So it makes sense for generic medicines to be a lower cost to you.




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Health Check: how do generic medicines compare with the big brands?


There is also currently no financial incentive for you to take your medicine as prescribed, which would likely improve your health and save the health budget in the long run. We are not aware of any country varying patient charges based upon this, although there are ways of monitoring if people take their medicines as directed.

However, countries such as New Zealand and the United Kingdom have lower or no patient prescription charges, minimising costs as a barrier to patients taking their medicine.

What would need to happen?

Dispensing a prescription should be an invitation for the pharmacist to interact with you and help you with advice on the effective and appropriate use of your medicine. At present, there is no incentive, other than professionalism, for pharmacists to add such value.

The proposed changes would require a major restructure to the funding of dispensing to provide incentives that are equitable and transparent and that did not adversely affect disadvantaged, rural and Indigenous people.

There would need to be agreement on reliable and valid performance measures and reliable information systems.

However, funding based on a professional service model rather than a dispensing volume model would support your pharmacist to provide greater benefit to you and the health-care system.The Conversation

John Jackson, Researcher, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University and Ben Urick, Research Assistant Professor, University of North Carolina at Chapel Hill

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Tech giants are battling it out to supply the global internet – here’s why that’s a problem


Claudio Bozzi, Deakin University

The US Federal Communications Commission last month granted Elon Musk’s SpaceX permission to launch 4,425 satellites that will provide affordable high speed broadband internet to consumers.

The Starlink network will be accessible in the US and around the world – including in areas where the internet is currently unavailable or unreliable.

SpaceX isn’t the only company investing in global internet infrastructure. Facebook, Google and Microsoft all have various projects underway to deliver high speed connectivity to remote and rural areas.

It’s all part of a trend of private companies attempting to breach the digital divide and wage a battle for the global internet.




Read more:
Connecting everyone to the internet won’t solve the world’s development problems


But entrusting market forces to build critical internet resources and infrastructure is problematic. These companies aren’t obligated to operate in the interest of consumers. In some cases their practices could serve to further entrench the existing digital divide.

Half the world’s population can’t access the internet

The internet is embedded in social, personal and economic life across the developed world.

But access varies significantly between industrialised nations that boast high per capita incomes, and developing nations with largely poor, rural populations.

For example, 94% of South Korean adults and 93% of Australian adults have access to the internet, compared with just 22% of Indians and 15% of Pakistanis.

https://datawrapper.dwcdn.net/1U1a3/1/

As society becomes increasingly dependent on the internet, nations and communities need equal access. Otherwise legacy inequalities will become further entrenched and new divides will emerge, potentially creating a “permanent underclass”.

Tech giants battle it out

The tech giants have been investing heavily in critical infrastructure in recent years.

Google owns the FASTER trans-Pacific undersea cable link, which has carried data (at 60 terabits per second) between the US, Japan and Taiwan since 2016. Meanwhile, the Microsoft and Facebook funded MAREA trans-Atlantic cable has connected the US to southern Europe (at 160 terabits per second) since in 2017.

New investments centre on atmospheric, stratospheric and satellite delivery strategies.

Along with SpaceX’s constellation of small satellites, Facebook’s internet.org uses atmospheric drones to deliver internet to rural and remote areas. Google’s Project Loon uses high altitude navigable balloons for the same purpose.

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The privatisation of a public good is problematic

Private investors who build infrastructure are driven by commercial imperatives rather than a need to deliver social benefits. And that dynamic can entrench and exacerbate existing – and create new – digital, social and economic divides.

This can be innocuous enough, such as when the company that makes League of Legends built its own internet network to ensure its players weren’t upset by slow speeds.

But it’s more of a problem when faster connections can tilt investment and trading playing fields in favour of those with access, leaving ordinary investors out in the cold.




Read more:
How the internet is failing to drive economic development where promised


Facebook’s Free Basics is a program that aims to provide cheap internet services to consumers in developing countries. It currently operates in 63 developing nations.

Critics say the service is a blatant a strategy to extend Facebook’s global dominance to the developing world. It’s also been accused of violating net neutrality by strictly controlling participating sites to eliminate Facebook’s competitors.

Technology is not neutral

Privately owned and operated internet infrastructure can also become a means of social control.

Termination of internet services is a notorious tactic used by authoritarian regimes to repress dissent by disrupting communication and censoring information. But private entities may also exercise control over infrastructure outside of government regulation.

For example, when WikiLeaks published government correspondence in 2010, Amazon and AnyDNS withdrew the services that maintained the Wikileaks website. Mastercard, Paypal and VISA terminated services through which the organisation received funding for its activities.

These companies were not acting under government direction, citing violations of their Acceptable Use policies to justify their decisions. Harvard professor Yochai Benckler said at the time:

Commercial owners of the critical infrastructures of the networked environment can deny service to controversial speakers, and some appear to be willing to do so at a mere whiff of public controversy.

SpaceX must meet a host of technical conditions before Starlink can be activated. But we shouldn’t assume that providing internet access to developing countries will lead to an ecosystem from which economic or social benefits will flow.

The ConversationWhen the logic of corporate capitalism dominates the provision of internet services, there’s no guarantee that the internet’s founding principles – an egalitarian tool where users share information for the greater good – will be upheld.

Claudio Bozzi, Lecturer in Law, Deakin University

This article was originally published on The Conversation. Read the original article.

Tropical Cyclone Debbie has blown a hole in the winter vegetable supply


Ian Sinclair, University of Sydney; Brent Jacobs, University of Technology Sydney; Laura Wynne, University of Technology Sydney, and Rachel Carey, University of Melbourne

Cyclone Debbie, which lashed the Queensland coast a week ago, has hit farmers hard in the area around Bowen – a crucial supplier of vegetables to Sydney, Melbourne and much of eastern Australia. The Conversation

With the Queensland Farmers’ Federation estimating the damage at more than A$100 million and winter crop losses at 20%, the event looks set to affect the cost and availability of fresh food for millions of Australians. Growers are reportedly forecasting a price spike in May, when the damaged crops were scheduled to have arrived on shelves.

The incident also raises broader questions about the resilience of Australia’s fresh vegetable supply, much of which comes from a relatively small number of areas that are under pressure from climate and land use change.

In 2011 the Bowen area produced 33% of Australia’s fresh beans, 46% of capsicum and 23% of fresh tomatoes, making it the country’s largest producer of beans and capsicums, and number two in fresh tomatoes.

The region also produces a significant amount of chillies, corn, cucumbers, eggplant, pumpkin, zucchini and squash, and is a key production area for mangoes and melons.

Coastal Queensland’s vegetable regions are among the highest-producing in the country, especially for perishable vegetables. The Whitsunday region around Bowen, and the area around Bundaberg further south are each responsible for around 13% of the national perishable vegetable supply.

As the chart below shows, vegetable production is highly concentrated in particular regions, typically on the fringes of large cities. These “peri-urban” regions, when added to the two major growing areas in coastal Queensland, account for about 75% of Australia’s perishable vegetables.

Proportion of State Perishable Vegetable Production by weight.
ABS 7121.0 Agricultural Commodities Australia, 2010-11

Australia’s climate variability means that most fresh produce can be grown domestically. The seasonable variability allows production to move from the south to the north in the winter, when the Bundaberg and Bowen areas produce most of the winter vegetables consumed in Brisbane, Sydney and Melbourne. The Bowen Gumlu Growers Association estimates that during the spring growing season in September—October, the region produces 90% of Australia’s fresh tomatoes and 95% of capsicums.

Besides damaging crops, Cyclone Debbie has also destroyed many growers’ packing and cool storage sheds. The cost of rebuilding this infrastructure may be too much for many farmers, and the waterlogged soils are also set to make planting the next crop more difficult.

The recovery of production in these areas is crucial for the supply. Growers who have lost their May crop will first have to wait until the paddocks dry out, then source new seedlings and plant them. It could be weeks until crops can be replanted, and storage and processing facilities replaced.

The Queensland government has announced natural disaster relief funding, including concessional loans of up to A$250,000 and essential working capital loans of up to A$100,000, to help farmers replant and rebuild.

Meanwhile, consumers of fresh vegetables in Sydney and Melbourne and many other places are likely to find themselves paying more until the shortfall can be replaced.

Fresh food for growing cities

Australia’s cities are growing rapidly, along with those of many other countries. The United Nations has predicted that by 2050 about 87% of the world’s population will live in cities. This urban expansion is putting ever more pressure on peri-urban food bowls.

Food production is also under pressure from climate change, raising the risk of future food shocks and price spikes in the wake of disasters such as cyclones. Meanwhile, the desire for semi-rural lifestyles is also conflicting with the use of land for farming (see Sydney’s Food Futures and Foodprint Melbourne for more).

These pressures mean that Australia’s cities need to make their food systems more resilient, so that they can withstand food shocks more easily, and recover more quickly.

Key features of a resilient food system are likely to include:

  • geographic diversity in production, which spreads the risk of crop damage from extreme weather events across a number of different production areas;

  • more local food production, to reduce transportation and storage costs and avoid over-reliance on particular regions;

  • a diverse, healthy and innovative farming community;

  • greater consumer awareness of the importance of seasonal and locally produced food;

  • recycling of urban waste and water for use on farms, to reduce the use of fresh water and fertilisers;

  • the capacity to import food from overseas to meet shortfalls in domestic supply;

  • increased use of protected cropping systems such as greenhouses, which are better able to withstand adverse weather.

Two recent studies of food production around Sydney and Melbourne provide examples of a range of mechanisms and policies for increasing the resilience of the food systems of Australian cities.

Our food system has served us well until now, but land use pressures and climate change will make it harder in future. When a cyclone can knock out a major production region overnight, with knock-on effects for Australian consumers, this points to a lack of resilience in Australia’s fresh vegetable supply.

Ian Sinclair, PhD Candidate. Contested Landscapes – Managing the Tensions between Land Use Planning in Strategic Agricultural Regions on Australia’s Eastern Seaboard., University of Sydney; Brent Jacobs, Research Director, Institute for Sustainable Futures, University of Technology Sydney; Laura Wynne, Senior Research Consultant, Institute for Sustainable Futures, University of Technology Sydney, and Rachel Carey, Research Fellow, University of Melbourne

This article was originally published on The Conversation. Read the original article.

Egyptian Couple Shot by Muslim Extremists Undaunted in Ministry


Left for dead, Christians offer to drop charges if allowed to construct church building.

CAIRO, Egypt, June 9 (CDN) — Rasha Samir was sure her husband, Ephraim Shehata, was dead.

He was covered with blood, had two bullets inside him and was lying facedown in the dust of a dirt road. Samir was lying on top of him doing her best to shelter him from the onslaught of approaching gunmen.

With arms outstretched, the men surrounded Samir and Shehata and pumped off round after round at the couple. Seconds before, Samir could hear her husband mumbling Bible verses. But one bullet had pierced his neck, and now he wasn’t moving. In a blind terror, Samir tried desperately to stop her panicked breathing and convincingly lie still, hoping the gunmen would go away.

Finally, the gunfire stopped and one of the men spoke. “Let’s go. They’re dead.”

 

‘Break the Hearts’

On the afternoon of Feb. 27, lay pastor Shehata and his wife Samir were ambushed on a desolate street by a group of Islamic gunmen outside the village of Teleda in Upper Egypt.

The attack was meant to “break the hearts of the Christians” in the area, Samir said.

The attackers shot Shehata twice, once in the stomach through the back, and once in the neck. They shot Samir in the arm. Both survived the attack, but Shehata is still in the midst of a difficult recovery. The shooters have since been arrested and are in jail awaiting trial. A trial cannot begin until Shehata has recovered enough to attend court proceedings.

Despite this trauma, being left with debilitating injuries, more than 85,000 Egyptian pounds (US$14,855) in medical bills and possible long-term unemployment, Shehata is willing to drop all criminal charges against his attackers – and avoid what could be a very embarrassing trial for the nation – if the government will stop blocking Shehata from constructing a church building.

Before Shehata was shot, one of the attackers pushed him off his motorcycle and told him he was going to teach him a lesson about “running around” or being an active Christian.

Because of his ministry, the 34-year-old Shehata, a Coptic Orthodox Christian, was arguably the most visible Christian in his community. When he wasn’t working as a lab technician or attending legal classes at a local college, he was going door-to-door among Christians to encourage them in any way he could. He also ran a community center and medical clinic out of a converted two-bedroom apartment. His main goal, he said, was to “help Christians be strong in their faith.”

The center, open now for five years, provided much-needed basic medical services for surrounding residents for free, irrespective of their religion. The center also provided sewing training and a worksite for Christian women so they could gain extra income. Before the center was open in its present location, he ran similar services out of a relative’s apartment.

“We teach them something that can help them with the future, and when they get married they can have some way to work and it will help them get money for their families,” Shehata said.

Additionally, the center was used to teach hygiene and sanitation basics to area residents, a vital service to a community that uses well water that is often polluted or full of diseases. Along with these services, Shehata and his wife ran several development projects, repairing the roofs of shelters for poor people, installing plumbing, toilets and electrical systems. The center also distributed free food to the elderly and the infirm.

The center has been run by donations and nominal fees used to pay the rent for the apartment. Shehata has continued to run the programs as aggressively as he can, but he said that even before the shooting that the center was barely scraping by.

“We have no money to build or improve anything,” he said. “We have a safe, but no money to put in it.”

 

Tense Atmosphere

In the weeks before the shooting, Teleda and the surrounding villages were gripped with fear.

Christians in the community had been receiving death threats by phone after a Muslim man died during an attack on a Christian couple. On Feb. 2, a group of men in nearby Samalout tried to abduct a Coptic woman from a three-wheeled motorcycle her husband was driving. The husband, Zarif Elia, punched one of the attackers in the nose. The Muslim, Basem Abul-Eid, dropped dead on the spot.

Elia was arrested and charged with murder. An autopsy later revealed that the man died of a heart attack, but local Muslims were incensed.

Already in the spotlight for his ministry activities, Shehata heightened his profile when he warned government officials that Christians were going to be attacked, as they had been in Farshout and Nag Hammadi the previous month. He also gave an interview to a human rights activist that was posted on numerous Coptic websites. Because of this, government troops were deployed to the town, and extremists were unable to take revenge on local Christians – but only after almost the
entire Christian community was placed under house arrest.

“They chose me,” Shehata said, “Because they thought I was the one serving everybody, and I was the one who wrote the government telling them that Muslims were going to set fire to the Christian houses because of the death.”

Because of his busy schedule, Shehata and Samir, 27, were only able to spend Fridays and part of every Saturday together in a village in Samalut, where Shehata lives. Every Saturday after seeing Samir, Shehata would drive her back through Teleda to the village where she lives, close to her family. Samalut is a town approximately 105 kilometers (65 miles) south of Cairo.

On the afternoon of Feb. 27, Shehata and his wife were on a motorcycle on a desolate stretch of hard-packed dirt road. Other than a few scattered farming structures, there was nothing near the road but the Nile River on one side, and open fields dotted with palm trees on the other.

Shehata approached a torn-up section of the road and slowed down. A man walked up to the vehicle carrying a big wooden stick and forced him to stop. Shehata asked the man what was wrong, but he only pushed Shehata off the motorcycle and told him, “I’m going to stop you from running around,” Samir recounted.

Shehata asked the man to let Samir go. “Whatever you are going to do, do it to me,” he told the man.

The man didn’t listen and began hitting Shehata on the leg with the stick. As Shehata stumbled, Samir screamed for the man to leave them alone. The man lifted the stick again, clubbed Shehata once more on the leg and knocked him to the ground. As Shehata struggled to get up, the man took out a pistol, leveled it at Shehata’s back and squeezed the trigger.

Samir started praying and screaming Jesus’ name. The man turned toward her, raised the pistol once more, squeezed off another round, and shot Samir in the arm. Samir looked around and saw a few men running toward her, but her heart sank when she realized they had come not to help them but to join the assault.

Samir jumped on top of Shehata, rolled on to her back and started begging her attackers for their lives, but the men, now four in all, kept firing. Bullets were flying everywhere.

“I was scared. I thought I was going to die and that the angels were going to come and get our spirits,” Samir said. “I started praying, ‘Please God, forgive me, I’m a sinner and I am going to die.’”

Samir decided to play dead. She leaned back toward her husband, closed her eyes, went limp and tried to stop breathing. She said she felt that Shehata was dying underneath her.

“I could hear him saying some of the Scriptures, the one about the righteous thief [saying] ‘Remember me when you enter Paradise,’” she said. “Then a bullet went through his neck, and he stopped saying anything.”

Samir has no way of knowing how much time passed, but eventually the firing stopped. After she heard one of the shooters say, “Let’s go, they’re dead,” moments later she opened her eyes and the men were gone. When she lifted her head, she heard her husband moan.

 

Unlikely Survival

When Shehata arrived at the hospital, his doctors didn’t think he would survive. He had lost a tremendous amount of blood, a bullet had split his kidney in two, and the other bullet was lodged in his neck, leaving him partially paralyzed.

His heartbeat was so faint it couldn’t be detected. He was also riddled with a seemingly limitless supply of bullet fragments throughout his body.

Samir, though seriously injured, had fared much better than Shehata. The bullet went into her arm but otherwise left her uninjured. When she was shot, Samir was wearing a maternity coat. She wasn’t pregnant, but the couple had bought the coat in hopes she soon would be. Samir said she thinks the gunman who shot her thought he had hit her body, instead of just her arm.

The church leadership in Samalut was quickly informed about the shooting and summoned the best doctors they could, who quickly traveled to help Shehata and Samir. By chance, the hospital had a large supply of blood matching Shehata’s blood type because of an elective surgical procedure that was cancelled. The bullets were removed, and his kidney was repaired. The doctors however, were forced to leave many of the bullet fragments in Shehata’s body.

As difficult as it was to piece Shehata’s broken body back together, it paled in comparison with the recovery he had to suffer through. He endured multiple surgeries and was near death several times during his 70 days of hospitalization.

Early on, Shehata was struck with a massive infection. Also, because part of his internal tissue was cut off from its blood supply, it literally started to rot inside him. He began to swell and was in agony.

“I was screaming, and they brought the doctors,” Shehata said. The doctors decided to operate immediately.

When a surgeon removed one of the clamps holding Shehata’s abdomen together, the intense pressure popped off most of the other clamps. Surgeons removed some stomach tissue, part of his colon and more than a liter of infectious liquid.

Shehata could not eat normally and lost 35 kilograms (approximately 77 lbs.). He also couldn’t evacuate his bowels for at least 11 days, his wife said.

Despite the doctors’ best efforts, infections continued to rage through Shehata’s body, accompanied by alarming spikes in body temperature.

Eventually, doctors sent him to a hospital in Cairo, where he spent a week under treatment. A doctor there prescribed a different regimen of antibiotics that successfully fought the infection and returned Shehata’s body temperature to normal.

Shehata is recovering at home now, but he still has a host of medical problems. He has to take a massive amount of painkillers and is essentially bedridden. He cannot walk without assistance, is unable to move the fingers on his left hand and cannot eat solid food. In approximately two months he will undergo yet another surgery that, if all goes well, will allow him to use the bathroom normally.

“Even now I can’t walk properly, and I can’t lift my leg more than 10 or 20 centimeters. I need someone to help me just to pull up my underwear,” Shehata said. “I can move my arm, but I can’t move my fingers.”

Samir does not complain about her condition or that of Shehata. Instead, she sees the fact that she and her husband are even alive as a testament to God’s faithfulness. She said she thinks God allowed them to be struck with the bullets that injured them but pushed away the bullets that would have killed them.

“There were lots of bullets being shot, but they didn’t hit us, only three or four,” she said. “Where are the others?”

Even in the brutal process of recovery, Samir found cause for thanks. In the beginning, Shehata couldn’t move his left arm, but now he can. “Thank God and thank Jesus, it was His blessing to us,” Samir said. “We were kind of dead, now we are alive."

Still, Samir admits that sometimes her faith waivers. She is facing the possibility that Shehata might not work for some time, if ever. The couple owes the 85,000 Egyptian pounds (US$14,855) in medical bills, and continuing their ministry at the center and in the surrounding villages will be difficult at best.

“I am scared now, more so than during the shooting,” she said. “Ephraim said do not be afraid, it is supposed to make us stronger.”

So Samir prays for strength for her husband to heal and for patience. In the meantime, she said she looks forward to the day when the struggles from the shooting are over and she can look back and see how God used it to shape them.

“There is a great work the Lord is doing in our lives, we may not know what the reason is now, but maybe some day we will,” Samir said.

 

Government Opposition

For the past 10 years, Shehata has tried to erect a church building, or at a minimum a house, that he could use as a dedicated community center. But local Muslims and Egypt’s State Security Investigations (SSI) agency have blocked him every step of the way. He had, until the shooting happened, all but given up on constructing the church building.

On numerous occasions, Shehata has been stopped from holding group prayer meetings after people complained to the SSI. In one incident, a man paid by a land owner to watch a piece of property near the community center complained to the SSI that Shehata was holding prayer meetings at the facility. The SSI made Shehata sign papers stating he wouldn’t hold prayer meetings at the center.

At one time, Shehata had hoped to build a house to use as a community center on property that had been given to him for that purpose. Residents spread a rumor that he was actually erecting a church building, and police massed at the property to prevent him from doing any construction.

There is no church in the town where Shehata lives or in the surrounding villages. Shehata admits he would like to put up a church building on the donated property but says it is impossible, so he doesn’t even try.

In Egypt constructing or even repairing a church building can only be done after a complex government approval process. In effect, it makes it impossible to build a place for Christian worship. By comparison, the construction of mosques is encouraged through a system of subsidies.

“It is not allowed to build a church in Egypt,” Shehata said. “We can’t build a house. We can’t build a community center. And we can’t build a church.”

Because of this, Shehata and his wife organize transportation from surrounding villages to St. Mark’s Cathedral in Samalut for Friday services and sacraments. Because of the lack of transportation options, the congregants are forced to ride in a dozen open-top cattle cars.

“We take them not in proper cars or micro-buses, but trucks – the same trucks we use to move animals,” he said.

The trip is dangerous. A year ago a man fell out of one of the trucks onto the road and died. Shehata said bluntly that Christians are dying in Egypt because the government won’t allow them to construct church buildings.

“I feel upset about the man who died on the way going to church,” he said.

 

Church-for-Charges Swap

The shooters who attacked Shehata and Samir are in jail awaiting trial. The couple has identified each of the men, but even if they hadn’t, finding them for arrest was not a difficult task. The village the attackers came from erupted in celebration when they heard the pastor and his wife were dead.

Shehata now sees the shooting as a horrible incident that can be turned to the good of the believers he serves. He said he finds it particularly frustrating that numerous mosques have sprouted up in his community and surrounding areas during the 10 years he has been prevented from putting up a church building, or even a house. There are two mosques alone on the street of the man who died while being trucked to church services, he said.

Shehata has decided to forgo justice in pursuit of an opportunity to finally construct a church building. He has approached the SSI through church leaders, saying that if he is allowed to construct a church building, then he will take no part in the criminal prosecution of the shooters.

“I have told the security forces through the priests that I will drop the case if they can let us build the church on the piece of land,” he said.

The proposal isn’t without possibilities. His trial has the potential of being internationally embarrassing. It raises questions about fairness in Egyptian society during an upcoming presidential election that will be watched by the world.

Regardless of what happens, Shehata said all he wants is peace and for the rights of Christians to be respected. He said that in Egypt, Christians have less value than the “birds of the air” mentioned in the Bible. According to Luke 12:6, five sparrows sold for two pennies in ancient times.

“We are not to be killed like birds, slaughtered,” he said. “We are human.”

Report from Compass Direct News

Vietnamese Christian, Family, Forced into Hiding


Officials expel them from village; elsewhere, pastor dragged behind motorbike.

HO CHI MINH CITY, April 1 (CDN) — Suffering severe abuse from villagers and local Vietnamese officials, Hmong Christian Sung Cua Po fled into the forest with his family on March 19.

An expulsion order had been issued to his family, an area Christian leader said.

Since Compass reported on Jan. 18 that Po, who embraced Christianity in November, received some 70 blows to his head and back after local officials in northwest Vietnam’s Dien Bien Province arrested him on Dec. 1, 2009, he suffered physical attacks by police of Nam Son Commune on Feb. 10 and the confiscation of his motorbike.

The Christian leader said that police have threatened that if he did not recant they would beat him till only his tongue was intact.

Around the Lunar New Year in mid-February, Po had an altercation with his father over offerings to family ancestors. Hmong Christians see no continuity between the old worship of ancestral spirits and their new faith in Jesus; for them it a spiritual power encounter with no possibility of compromise, and Po held fast to his allegiance to Christ, refusing to sacrifice to his ancestors. 

On Feb. 20, Nam Son district police were authorized by Dien Bien Dong district authorities to demolish Po’s house if deemed necessary. On Feb. 21, community members backed by police confiscated 40 sacks of paddy rice, the family’s one-year supply. The villagers also took all cooking and eating utensils from the family.

Pressure against Po, a member of the Sung clan that has long been resistant to Christianity, comes both from traditionalists in his ethnic community and the government, though the government officials have tried to hide their involvement. Primarily hostile toward the Po family have been Officer Hang Giang Chen of the Dien Bien district police and Officer Sung Boua Long of the Nam Son Commune police.

A source close to Po reported that local authorities and villagers tore down the family’s house on March 14. On March 19 the dispossessed Po couple fled into forest with their three children. Their relatives and community members say they do not know where they are. If previous experience holds true, they were likely given refuge by some of the many Christians in the region.

The same source reported that a foreign delegation visited the village on March 25 asking about Sung Cua Po. No Christians were allowed to meet the delegation. The source added that police had been there earlier to coach all villagers to say there was no government involvement in the mistreatment of the Po family and had issued dire threats for non-compliance.

Such antagonism has continued even though several western governments have raised the issue of the persecution of the Po family with high central government officials.

“The only conclusion one can draw,” said one knowledgeable Vietnam source, “is that the central government is either unwilling or unable to intervene and enforce the published national standards for religious tolerance.”

A Christian leader in the area told Compass yesterday that earlier this week authorities had burned 14 houses of Christians in another commune in Dien Bien Dong district, and that he was trying to arrange shelter for the affected families. The leader said the authorities of Dien Bien Dong district completely exempt themselves from Vietnam’s laws on religion and suffer no reprimand from above. 

After Po was first detained on Dec. 1, Dien Bien Dong District and Na Son Commune police and soldiers led by policeman Hang A Senh took him and his wife to the Na Son Commune People’s Committee office after police earlier incited local residents to abuse and stone them and other Christian families. After Po and his wife were beaten at 1 a.m. that night, he was fined 8 million dong (US$430) and a pig of at least 16 kilos.

Abuses Elsewhere

In Phu Yen Province in the south of Vietnam, religious intolerance was also on display as local police dragged a pastor behind a motorbike, Christian leaders reported.

Village police summoned Y Du, a 55-year-old pastor also from the Ede ethnic group, to a police station for questioning on Jan. 27. While driving his motorbike to the station, Pastor Du was stopped by village police who chained his hands together and then attached the chain by rope to his motorbike.

Christian sources said they forced Pastor Du to run behind the motorbike that they had commandeered, and he fell over many times, dragged along the ground. He was beaten and forced to keep running.

Local villagers at Hai Rieng witnessed what was happening and, fearing for the pastor’s life, shouted to the police to stop, the Christian leaders said. Du was then carried to the police station and was incarcerated in Phu Lam prison, Phu Lam district, Phu Yen Province. No formal charges were brought against him.

Local police subsequently visited his wife at their home, looking for evidence of illegal activity, Christian leaders reported. The officers said they suspected ties with organizers of demonstrations against confiscation of minority land and lack of religious freedom that were held six years ago.

Christian leaders said the police officers tried to bribe Pastor Du’s wife to renounce her Christian faith, saying, “If you renounce your faith, we will build you a new house and give you rice.” The family is poor and lives in a bamboo house. She replied, “I would rather die than renounce my faith.”

In mid-February, local police told Pastor Du’s wife that they could not find anything with which to charge her husband. But they said they continued to hold him because he refused to denounce the leader of a Bible school in Dak Lak Province, Pastor Mai Hong Sanh. Pastor Du was regularly beaten, Christians leaders reported.

Another evangelist, Pastor Y Co also from the Ede ethnic group, had also been held at Phu Lam prison, Phu Lam district, Phu Yen Province in the same conditions, they said. Pastor Du and Pastor Co had the opportunity to be released if they had signed "confessions," but they refused to do so, especially as they are not fluently literate in Vietnamese.

Both Pastor Du and Co are evangelists with the Vietnam Good News Mission Church.

Report from Compass Direct News