Regional issues frustrate Nairobi’s foreign strategy

Significance The trip comes shortly after the International Court of Justice (ICJ) ruled that Somalia can pursue a claim against Kenya over a maritime boundary dispute. The ruling was the latest in a series of foreign relations defeats that have called into question the effectiveness of President Uhuru Kenyatta’s foreign policy. Kenya focuses on building regional support for its military action in Somalia and promoting regional integration through large-scale integration projects, while diversifying its portfolio of international partners and marshalling African criticism of perceived Western hypocrisy. However, a series of challenges, including a fatal attack on the military in Somalia and failure to secure the chair of the African Union (AU) Commission, have undermined confidence in the competence of the Kenyatta government on the international stage. Impacts Fears about corruption and political instability discourage regional neighbours from implementing touted infrastructure plans. Kenya will vigorously pursue the maritime border case as it has already granted hydrocarbon exploration and exploitation rights. Regional security considerations may shift as the military effort in Somalia winds down.

FORGETTING APARTHEID: HISTORY, CULTURE AND THE BODY OF A NUN

ABSTRACTIn 1952, the African National Congress (ANC) initiated its Defiance Campaign, opposing apartheid laws through organized civil disobedience and African nationalism. On Sunday 9 November, the city of East London became a site of political mobilization when 1,500 Xhosa-speaking ANC sympathizers peacefully protested in Bantu Square, the hub of a township named Duncan Village. Police arrived and fired on the crowd, igniting ‘spontaneous riots’. An Afrikaner salesman and an Irish nun were killed in the ensuing unrest. Rumours circulated that a mob ate the white woman; troop reinforcements then fanned into the township to wage a retaliatory war, shooting and bayoneting their victims. Upwards of 200 Africans may have died but only nine fatalities were recorded. If the revised toll is credible, the bloodshed exceeds that of Sharpeville, the worst one-day massacre in apartheid South Africa. Oral sources explain why the slaughter in Duncan Village is not widely known. Township residents secretly carted the dead to rural graves, fearing to report their losses as people mourned the tragic slaying of the nun named Sister Aidan. Today, ANC rulers of East London seem content to silence the memory of a mass killing reputedly spawned by chaos and cannibalism. At the centre of this incident is Sr Aidan's mutilation for the purpose of makingmuthi, a shocking incident that dominates the story of violence on Black Sunday. Using archival documents and oral histories, and incorporating the methodologies of Jennifer Cole, Donald Donham and Veena Das, this article reconstructs a narrative of ‘critical events’ surrounding the nun'smuthimurder. The scrutinized witness testimonies relay how township residents framed their fierce encounters with a symbolic (white person) and ubiquitous (militarized police) enemy. Oral sources reject the notion that an aimless ‘riot’ occurred on 9 November. Instead, they reflect on cultural enactments of purposeful violence through scripted assaults andmuthiritual. Ultimately, they view the fatal attack on Sr Aidan as an evolving customary act of defensive retribution and symbolic warning, submerging truths in apartheid and hindering reconciliations in democracy.

Effects of mouse predation on burrowing petrel chicks at Gough Island

Since 2004 there has been mounting evidence of the severe impact of introduced house mice (Mus musculusL.) killing chicks of burrow-nesting petrels at Gough Island. We monitored seven species of burrow-nesting petrels in 2014 using a combination of infra-red video cameras augmented by burrowscope nest inspections. All seven camera-monitored Atlantic petrel (Pterodroma incertaSchlegel) chicks were killed by mice within hours of hatching (average 7.2±4.0 hours) with an 87% chick failure rate (n=83 hatchlings). Several grey petrel (Procellaria cinereaGmelin) chicks were found with mouse wounds and 60% of chicks failed (n=35 hatchlings). Video surveillance revealed one (of seven nests filmed) fatal attack on a great shearwater (Puffinus gravisO’Reilly) chick and two (of nine) on soft-plumaged petrel (Pterodroma mollisGould) chicks. Mice killed the chicks of the recently discovered summer-breeding MacGillivray’s prion (Pachyptila macgillivrayiMathews), with a chick mortality rate of 82% in 2013/14 and 100% in 2014/15. The closely-related broad-billed prion (P. vittataForster) breeds in late winter and also had a chick mortality rate of 100% in 2014. The results provide further evidence of the dire situation for seabirds nesting on Gough Island and the urgent need for mouse eradication.

The national review of asthma deaths: what did we learn and what needs to change?

Key pointsThe 2014 UK National Review of Asthma Deaths identified potentially preventable factors in two-thirds of the medical records of cases scrutinised45% of people who died from asthma did not call for or receive medical assistance in their final fatal attackOverall asthma management, acute and chronic, in primary and secondary care was judged to be good in less than one-fifth of those who diedThere was a failure by doctors and nurses to identify and act on risk factors for asthma attacks and asthma deathThe rationale for diagnosing asthma was not evident in a considerable number of cases, and there were inaccuracies related to the completion of medical certificates of the cause of death in over half of the cases considered for the UK National Review of Asthma DeathsEducational aimsTo increase awareness of some of the findings of the recent UK National Review of Asthma Deaths and previous similar studiesTo emphasise the need for accurate diagnosis of asthma, and of the requirements for completion of medical certificates of the cause of deathTo consider areas for improving asthma care and prevention of attacks and avoidable deathsSummaryDespite the development and publication of evidence-based asthma guidelines nearly three decades ago, potentially preventable factors are repeatedly identified in studies of the care provided for patients who die from asthma. The UK National Review of Asthma Deaths (NRAD), a confidential enquiry, was no exception: major preventable factors were identified in two-thirds of asthma deaths. Most of these factors, such as inappropriate prescription and failure to provide patients with personal asthma action plans (PAAPs), could possibly have been prevented had asthma guidelines been implemented.NRAD involved in-depth scrutiny by clinicians of the asthma care for 276 people who were classified with asthma as the underlying cause of death in real-life. A striking finding was that a third of these patients did not actually die from asthma, and many had no recorded rationale for an asthma diagnosis.The apparent complacency with respect to asthma care, highlighted in NRAD, serves as a wake-up call for health professionals, patients and their carers to take asthma more seriously. Based on the NRAD evidence, the report made 19 recommendations for change. The author has selected six areas related to the NRAD findings for discussion and provides suggestions for change in the provision of asthma care. The six areas are: systems for provision and optimisation of asthma care, diagnosis, identifying risk, implementation of guidelines, improved patient education and self-management, and improved quality of completion of medical certificates of the cause of death.