YEMEN: People struggling with drought on Socotra Island [Archives:2007/1092/Health]

October 8 2007

Socotra, a small group of Yemeni islands in the Indian Ocean close to the Horn of Africa – and in broad bio-geographical terms closely linked with Africa – has been hit by a severe drought. It started about two months ago, causing a water shortage and the deaths of hundreds of animals, say government officials.

The last time the main island's 45,000 inhabitants experienced serious drought was in 1999. Their livestock died in their thousands as grass and bushes withered in the sun in what at the time was the worst drought in living memory.

This time drought has spread to the western, eastern and middle parts of the island.

Ahmed al-Awadi, director-general of Hadibo, Socotra's capital, told IRIN that people in the affected areas were living in miserable conditions and their livestock had been dying as a result of the drought.

According to al-Awadi, a tanker of water could cost 60,000 Yemeni riyals (about US$300), which Socotri people say they cannot afford. “Our capabilities are very weak. We need water tankers to bring water to the affected areas. The army has helped people get water in some areas,” al-Awadi said.

The head of the environmental protection authority (a government body) in Socotra, Salem Ali, told IRIN sheep and cattle had been dying because of lack of water and grazing areas. “There is no exact figure on the number of deaths of animals, but it could run into the hundreds,” he said.

The inhabitants of these areas were very poor and preoccupied with their animals on whom they depended for their living. Many had left their homes in search of better places for themselves and their animals, Ali said.

However, environmentalists say that if livestock are allowed to survive droughts through the provision of water and imported fodder, the present fragile equilibrium between vegetation, man and livestock will be destroyed very quickly.

Rainwater harvesting, storage

Southern and northern parts of the main island get water from cisterns in the valleys and a network of pipes. People in western and eastern parts of the island build ponds to collect rain water. While some of the ponds are six metres long, four metres wide and three metres deep, others are larger. Several families share a single pond.

“But water saved in ponds can dry up in a month. This year the ponds dried up by the beginning of July after the May rains,” Ali said.

Most of the ponds are not clean as they are not covered. “The water in these ponds can cause diseases such as diarrhoea because it contains parasites,” he said. Dysentery is common on the island and often essential drugs are not available.

Malaria is also widespread partly as a result of mosquitoes breeding in the ponds. Fresh water ponds have also formed because of leaking water pipes and this has also contributed to an increase of mosquitoes.

Sources of income

Socotra's inhabitants depend on fishing, livestock and to some extent tourism as sources of income. The coastal area is inhabited by fishermen mostly of African origin while the `wadis' (dried-up river valleys) and mountain regions are populated by people of Arab descent. Health services, education, access to sustainable livelihoods and clean water are weak.

The island has no agricultural crops because of the harsh climate, though small-scale production of fruit and vegetables, including dates, cow peas, finger millet and sweet potatoes, is possible.

Food, mostly wheat and flour, come from other parts of Yemen by air or sea, as a result of which prices are the highest in the country.

“The situation is horrifying. A sack of wheat can cost 8,000 Yemeni riyals ($40) while in other provinces it sells for 5,000 riyals ($25),” said al-Awadi, attributing this to the high cost of transporting food to the island.

Source: IRIN

By Barron H. Lerner

The cyclist Lance Armstrong recently celebrated an anniversary. It has been ten years since he was diagnosed with metastatic testicular cancer, which his doctors believed would kill him.

Based on his inspiring story and his efforts to publicize the disease, Armstrong has become an anti-cancer crusader. But on examining his foundation's website ( and his writings, a nagging question remains: Did the same tenacity that enabled Armstrong to win seven Tour de France bicycle races help cure his cancer? Armstrong is careful not to equate cycling with cancer, but he)and his legions of fans)often cannot help but do so. Such a connection may be highly misleading.

By his early twenties, Armstrong was becoming a force in the racing world, but all was not well. In 1996, at age 25, Armstrong developed fatigue, testicular pain and a bloody cough.

Doctors diagnosed him with testicular cancer. More distressingly, Armstrong's cancer was far-advanced, having spread to his lungs, abdomen and brain. He was given roughly a 40% chance of survival, which was probably an overestimate. One doctor told Armstrong's mother that her son would die.

After undergoing surgery to remove his cancerous testicle, Armstrong became “a student of cancer.” He was treated at Indiana University, perhaps America's leading center for testicular cancer.

Armstrong chose Indiana because its oncologists said they could treat him without bleomycin, a type of chemotherapy that would have damaged his lungs and ended his cycling career if he survived. They removed his brain tumors with surgery instead of radiation, which might have caused balance problems.

But the doctors made no bones about what Armstrong was to receive: extremely caustic drugs that would make him sick as a dog. Armstrong later wrote that “by the fourth cycle [of chemotherapy], I was in the fetal position, retching around the clock.”

Armstrong's cancer responded extremely well. He then underwent extensive rehabilitation, gradually regaining strength and confidence. By 1998, he was again riding his bicycle.

The illness changed Armstrong's body. When he resumed serious training, he was leaner and more muscular. In addition to the emotional advantage that Armstrong believed that cancer gave him, his new body also made him a more effective cyclist.

In 1999, less than three years after his diagnosis, Armstrong won his first Tour de France. Six more followed, making him the greatest cyclist in history.

For his part, Armstrong has tried to steer clear of facile associations between his Tour de France triumphs and his recovery from cancer. “Good, strong people get cancer,” he has written, “and they do all the right things to beat it, and they still die.” Perhaps he was a racing hero, Armstrong has stated, but “it wasn't heroic to survive cancer.” Even though he participated in his care and had excellent doctors, his survival was “more a matter of blind luck.”

Still, at times, Armstrong seems to slip into the sort of language he wishes to avoid. At the close of his second book, Armstrong summarized his history with cancer as: “I got treated, I fought like hell, and I got better.” A quotation on his foundation's website reads “When I was sick, I didn't want to die. When I race I don't want to lose. Dying and losing, it's the same thing.”

More worrisome is the adoption of the same reasoning by those who hear Armstrong's story. “Lance refused to become a statistic and instead rallied and became cancer's worst enemy,” wrote a reviewer of his first book. “He refused to give in and chose to fight the disease with all he had.” An Internet biography states that “with the same fierce focus he brings to competition,” Armstrong “tackled his illness and won.”

To some people, Armstrong has become a symbol for the notion that anything is possible. “Lance beat cancer and then he went on to win 5 Tour de Frances,” a computer programmer wrote on his blog in 2003. “That pretty much means I can overcome whatever ills I have in my life so I can keep going after that.”

The trouble is that data about the “will to live” among cancer patients are not so rosy. One 1989 study showed that women with metastatic breast cancer who attended support groups survived longer, but these results have not been duplicated. A recent study showed that a positive attitude did not lengthen the lives of lung cancer patients. Anecdotally, clinicians can recall “fighters” with cancer who die and others who “give up” but live.

This is a sobering message for Armstrong's many fans. After all, we all want to think that hard work always pays off. Unfortunately, in the world of cancer, this may not be so.

But Armstrong's legacy is about more than data. He has educated and provided inspiration to thousands, perhaps millions, of cancer patients and raised money that is being used to finding cures. Oh, and there are those seven bike races that he won.

Barron H. Lerner is Professor of Medicine and Public Health at Columbia University Medical Center. This essay draws on his new book, When Illness Goes Public: Celebrity Patients and How We Look at Medicine.

Copyright: Project Syndicate, 2007.