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An IPES-Food report warns that workers in the global food system face high exploitation in keeping the world fed. Credit: Busani Bafana/IPS

By Busani Bafana
BULAWAYO, Oct 6 2026 (IPS)

A new report reveals widespread labour exploitation among food system workers, warning that keeping the world fed comes at the cost of human dignity.

More than 1.4 billion people work in the food industry – the largest employer in the world – and are the most abused, according to a report, Food Work: The workers behind our food and the exploitation they face, published this week by the International Panel of Experts on Sustainable Food Systems (IPES-Food).

The global food system exploits more workers than any other economic sector, and the report notes that this exploitation is not accidental but rather ingrained in a business model that keeps labour cheap while maximising profits.

Abuse All Round

“Often hidden from view, food workers face low pay, wage theft, forced labour, human trafficking, discrimination, sexual violence, dangerous working conditions, and exclusion from social safety nets,” the report found.

“From farmworkers, fishers, and slaughterhouse staff to delivery drivers, restaurant and supermarket employees, and domestic workers, labour abuse is rife at every link in the food chain.”

The report highlighted that migrants, women, refugees, and racialised workers are funnelled into the worst conditions, where speaking up risks job loss, deportation and blacklisting.

IPES-Food co-chair Olivier De Schutter said what was most surprising about the findings of the report was the deep hypocrisy of governments concerning migrant farmworkers. With many countries relying heavily on migrant labour, especially for fruit and vegetable production, as witnessed during the Covid-19 pandemic, governments often grant migrant workers short-term, seasonal stays.

“These workers are routinely subject to forms of exploitation and abuse that would be unimaginable if they were natives – housed in poor conditions, paid poverty wages, and working in often dangerous conditions,” said Olivier De Schutter, a former UN Special Rapporteur on the right to food.

De Schutter argued that because migrant workers were considered unskilled, they were treated like second-class workers and that they had no or minimal connections to the communities in countries that host them; they barely complained in cases of abuse.

This practice is a form of trafficking in human beings, except that it’s legal and officially encouraged, De Schutter told IPS.

According to the UN’s Food and Agriculture Organisation (FAO), the gross value of global agricultural production is estimated at just over $5 trillion, while the World Bank estimates agricultural value-added at about $3.2 trillion.

The global food system is valued at more than $8 trillion, yet those who produce and market the food survive on poverty wages, which calls for a change.

De Schutter identified three mutually reinforcing challenges which include loopholes in the current legislation which does not apply minimum wage or on working hours, poor law enforcement and the difficulty of organising workers where unions are discouraged or even repressed.

“Governments routinely take the position that, where workers are informal, labour legislation does not apply, and labour inspectorates have no role to play,” he said, describing this situation as absurd.

‘It’s like saying that if you don’t have a driver’s licence, you can ignore the traffic rules. In fact, international human rights law requires that basic labour legislation be extended to informal workers and that incentives be given to employers to register their workers to ensure informality does not pay and that formalisation instead be rewarded.”

IPES-Food co-chair Olivier De Schutter. Credit: IPES-Food

Systemic Exploitation

“Unfair employment arrangements, off-the-books work, and lack of basic job security all combine to entrench worker vulnerability,” he said. “Governments directly enable this abuse through legal carve-outs that explicitly exempt food and farm workers from basic protections on wages, workplace safety, and union rights.”

The report highlighted that even where protective laws exist, weak public enforcement and pervasive informal employment leave millions of workers unprotected.

Migrant workers are essential to today’s food systems, yet they face some of the highest rates of workplace abuse, wage theft, forced labour, injury, and death, the report noted.

Worsening Conditions

Compounding these structural abuses, a dangerous convergence of emerging forces was making food work increasingly hazardous and exploitative.

“Climate change is becoming a workers’ rights crisis,” said Mamadou Goïta, IPES-Food panel expert. “Farmworkers already face poverty wages, toxic pesticides, and gruelling conditions. Now climate change is turning up the heat and making their work even more dangerous.”

Goïta said governments were still failing to guarantee workers even basic, lifesaving protections like shade, rest, and drinking water.

“The people producing our food should not have to risk their health or their lives to earn a living,” said Goïta.

The impacts of extreme heat and drought are usually measured in lost crops and harvests. But the human toll on the world’s 928 million agricultural workers was also mounting, with heat stress being the most common health threat facing farmworkers, the report noted.

The consequences of health threats include dizziness, vomiting, and exhaustion from heat stroke and kidney disease. In the US, farmworkers were 35 times more likely to die from heat stress than other workers.

Agricultural regions across Africa, the Americas, and southern Europe now experience up to 50 more days of dangerous heat each year than in the 1970s. In Africa, 93% of workers were exposed to dangerous heat, most of whom work in food systems, said the report.

The report warned that while climate change was exposing workers to extreme heat, severe weather and toxic wildfire smoke, corporate power was suppressing wages, undermining collective bargaining, and shifting risks onto workers, which meant prioritising shareholder returns over decent work.

“At the cutting edge, digital technologies are creating new frontiers of exploitation: gig-based platform work, automation, algorithmic management, and workplace surveillance are isolating workers, intensifying productivity pressures, increasing injury rates, and eroding worker bargaining power,” said the report.

Organise or Agonise

But workers are fighting back. They are forming unions and cooperatives, staging strikes, litigating for rights, and building alliances to demand comprehensive labour standards that recognise their worth and dignity.

The report shows that comprehensive labour standards, living wages, and the right to collective bargaining can shift the world’s largest workforce from the food system’s most invisible victims to resilience.

The report emphasised that in achieving lasting transformation in the food systems industry, there must be a strong policy and power shift across five key priorities. These include building the power of workers by strengthening trade unions and expanding collective bargaining. In addition, legal carve-outs for food and farm workers must be eliminated and equal rights for migrant workers guaranteed.

Policies that criminalise migrants must be scrapped, while employer-tied visa schemes must be dismantled to guarantee equal labour rights and social protections regardless of status, the report said, urging for a curtailment of corporate power so that companies are held accountable for labour abuses throughout their supply chains.

“The people who feed the world deserve safe, fairly paid, and dignified work,” said the report. “Food systems must never depend on low wages, hazardous conditions, or invisible labour. Achieving this requires changing who holds power, who profits, and who bears the costs.”

IPS UN Bureau Report

 

 

 

 

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A reflection on kinship, memory, and what the Earth has always been trying to tell us.

By James Alix Michel
VICTORIA, Seychelles, Oct 6 2026 (IPS)

One night, many years ago now, on a remote beach in the outer islands of Seychelles, I sat in the darkness and watched a green turtle come ashore. She had waited for the heat of the day to leave the sand. Under a sky crowded with stars, she hauled herself slowly above the tideline, dug with a patience no human hand could match, and laid her eggs. Then, in the small hours, she turned back toward the water. She did not hurry. She paused once, as though listening, and then made her slow, unhesitating way down the sand, back to a home older than any I could imagine.

James Alix Michel

I have thought of her many times since. Not because there was anything unusual in what she did – her kind have been coming ashore to nest for more than a hundred million years – but because of what her calm dignity revealed, by contrast, about us. She belonged. She did not need to prove it. She had not spent her night wondering whether the sea would consent to receive her.

We, the human beings watching from the shore, are the ones who wonder.

This, I have come to believe, is the deepest source of the trouble we now find ourselves in. Not our tools, not our economies, not even our numbers, though all of these press hard upon the living world. The deepest source is an older mistake: the unexamined assumption that we stand outside nature, deciding its fate. That the Earth is a stage and we are its principal players, and that everything else, the reef, the forest, the migrating whale, the green turtle, is scenery, resource, or backdrop.

The truth is far more humbling. We are not the authors of nature. We are its late arrivals.

Consider the arithmetic of belonging. The Earth is some four and a half billion years old. Life appeared here almost four billion years ago. Coral reefs were already ancient when the dinosaurs walked. Forests had been breathing for hundreds of millions of years before the first upright ape rose on the savannah. The calcium in our teeth, the iron in our blood, the carbon that composes almost everything we are, was forged in stars that lived and died long before this planet existed. To imagine ourselves separate from nature is not merely a philosophical mistake. It is a physical impossibility.

We Seychellois have a particular reason to understand this, for we are late arrivals twice over. Our granite islands are among the oldest islands on Earth, the only oceanic islands made of granite: fragments of the ancient supercontinent of Gondwana, left behind in the middle of the ocean when India drifted away some sixty-five million years ago. For almost all of that immense time, no human foot touched them. The turtles came, and the seabirds, and the giant tortoises. We came only in 1770, when a small party of Europeans, Africans and Indians stepped ashore on Sainte Anne. Others followed, from Africa, from India, from China, from Europe, some by choice and many, let us never forget, in chains. From that meeting of peoples, in scarcely two and a half centuries, a nation was born.

And something remarkable happened. A people with no ancestral memory of these islands learned, within a few generations, to belong to them. Our grandparents learned to read the sea as others read books. They gave thanks to the ocean before setting out and again on returning, and spoke of it as one speaks of a mother. Their kinship was not inherited; it was learned. That, to me, is among the most hopeful facts I know: belonging can be learned.

There is a school of thought, gathering strength in our time, that invites the whole of humanity to learn it too. Some call it biocentrism, the recognition that life in all its forms carries moral weight. Others call it deep ecology, the insistence that the human being is one strand in a vast web, not the loom on which the web is woven. The American conservationist Aldo Leopold put it most simply, many decades ago: we must learn to think “like a mountain.” The names matter less than the instinct behind them: that the living world is not a possession, and that our first duty to it is not extraction but attention.

This is why the environmental struggle feels to me, at its deepest level, like a spiritual struggle as much as an economic one. The numbers we use to measure our crisis are necessary and true, but they cannot on their own move the human heart. What moves the heart is the recognition that we are kin to what we are losing. That the coral bleaching in a lagoon is not a distant statistic but family. That the night sky above the nesting beach is not decoration but a memory of our own origin.

I do not offer this as sentiment. I offer it as strategy. For decades we have tried to persuade humanity to protect the Earth by appealing to self-interest. The argument is true, but it has not been sufficient. Self-interest is a thin thread from which to hang the future of a planet. What is needed now is the older and stronger thread of kinship. And kinship, once acted upon, is answered. On Aldabra, where green turtles were once taken in great numbers, decades of patient protection have allowed the nesting population to multiply several times over. The sea, it seems, is ready to forgive us, if we are ready to belong.

James Alix Michel, is Former President of the Republic of Seychelles

IPS UN Bureau

 

 

 

 

Excerpt:

A reflection on kinship, memory, and what the Earth has always been trying to tell us.

Une fillette d'environ dix ans a été retrouvée morte, dimanche 4 octobre 2026, dans un puisard à ciel ouvert au quartier Swinrou-Kpassagambou, dans le troisième arrondissement de Parakou.

Disparue du domicile familial quelques heures plus tôt, une fillette d'environ dix ans a été retrouvée au fond du puisard dimanche 4 septembre 2026.

Son corps a été découvert aux environs de 19h30, à Swinrou-Kpassagambou, un quartier du troisième arrondissement de Parakou, selon Fraternité fm.

La fillette a été inhumée lundi 5 octobre.

La police a ouvert une enquête pour déterminer les circonstances exactes du drame.

Sur les lieux, lundi, au lendemain de l'accident, le puisard ne semblait pas encore bénéficier d'un dispositif de sécurisation suffisamment rassurant. Des enfants continuaient par ailleurs à fréquenter et à jouer dans les environs. La situation suscite des inquiétudes dans le quartier.

M. M.

Un homme interpellé la veille pour des faits présumés de vol a été retrouvé mort, lundi 5 octobre 2026, dans les locaux du commissariat central de Tchaourou, dans le Borgou.

Un homme placé en garde à vue après son interpellation dimanche 4 octobre a été retrouvé mort au petit matin de ce lundi 5 octobre 2026 dans les locaux du commissariat central de Tchaourou.

D'après des informations rapportées par Le Parakois, recoupées auprès de plusieurs sources, l'intéressé avait été arrêté dans le cadre d'une affaire présumée de vol avant d'être conduit au commissariat. Il se trouvait encore dans les locaux de l'unité de police lorsqu'il a été découvert sans vie.

Les premières informations font état d'une mort par pendaison. Les circonstances exactes du drame ne sont pas encore connues.

M. M.

Le Bénin relance le dossier de la restitution de ses biens culturels conservés en France. À l'occasion de son entretien officiel avec Emmanuel Macron, lundi 5 octobre 2026 à l'Élysée, le chef de l'État béninois, Romuald Wadagni, a sollicité le retour de 35 biens culturels emportés durant la période coloniale.

Vers la restitution de plusieurs autres biens culturels au Bénin. Le sujet était au cœur du tête-à-tête entre les présidents Romuald Wadagni et Emmanuel Macron à l'Elysée ce lundi 5 octobre 2026.
Parmi les pièces concernées, figure la statue du dieu Gou, divinité associée au fer et à la guerre. Pillée en 1892 lors de la conquête du royaume du Dahomey, l'œuvre est aujourd'hui conservée au musée du Louvre. Sa restitution avait déjà été demandée par le Bénin en 2016, sous la présidence de Patrice Talon.
La nouvelle demande porte également sur un plateau de divination en bois sculpté, dérobé au XIXe siècle et conservé au musée du quai Branly. Le trône du roi Toffa de Porto-Novo, également conservé dans ce musée parisien, figure lui aussi parmi les biens dont Cotonou demande le rapatriement.

Un nouveau cadre juridique en France
Ces démarches interviennent dans un contexte juridique désormais plus favorable aux demandes de restitution. La France a promulgué, le 9 mai 2026, une loi relative à la restitution des biens culturels ayant fait l'objet d'une appropriation illicite. Le texte prévoit notamment des procédures permettant la sortie de biens culturels du domaine public afin de les restituer aux États qui en font la demande, sous certaines conditions.
La loi s'applique également aux demandes de restitution qui étaient déjà en cours d'examen au moment de sa publication. Elle prévoit par ailleurs un suivi parlementaire des demandes adressées à la France ainsi qu'un renforcement de la coopération culturelle, scientifique et muséographique avec les États demandeurs.
Cette nouvelle étape s'inscrit dans le prolongement de la restitution, en novembre 2021, de 26 trésors royaux d'Abomey au Bénin. Parmi ces pièces figuraient notamment des statues anthropomorphes des rois Ghézo et Béhanzin ainsi que plusieurs trônes royaux.
Avec cette nouvelle demande, le Bénin poursuit ainsi ses démarches en vue de récupérer d'autres éléments de son patrimoine conservés dans les collections publiques françaises.

F. A. A.

La Loterie Nationale du Bénin vous donne les résultats du TIERCE / QUARTE/QUINTE+ DU LUNDI 05 OCTOBRE 2026

Arrivée de la course : 03-07-09-13-11
Tous Partants

TIERCE
Gain dans l'Ordre : NEANT (00)
Gain dans le Désordre : 21.300 FCFA (33)

QUARTE
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Gain dans le Désordre : 86.800 FCFA (06)

QUINTE+
Gain dans l'Ordre : NEANT (00)
Gain dans le Désordre : 43.800 FCFA (08)
Bonus : 7.500 FCFA (31)

PARI SIMPLE / PARI COUPLE
03 Gagnant : 3.500 FCFA (02)
03 Placé : 1.000 FCFA (02)
07 Placé : NEANT (00)
09 Placé : 1.000 FCFA (03)
03-07 Gagnant : NEANT (00)
03-07 Placé : 52.500 FCFA (01)
03-09 Placé : 3.250 FCFA (16)
07-09 Placé : 2.750 FCFA (19)

MASSE PARTAGÉE : 1.975.350 FCFA

MONTANT DU JACKPOT DU VENDREDI 09 OCTOBRE 2026 : 755.221 FCFA

MONTANT DE LA TIRELIRE DU MARDI 27 OCTOBRE 2026 : NEANT

CAGNOTTE « 4+1 » ORDRE DU SAMEDI 10 OCTOBRE 2026 : 1.522.267 FCFA

https://www.facebook.com/100069272119664/posts/1408984648087259/?app=fbl

DIGITAL 20H : Avez-vous tenté votre chance ?

Le tirage DIGITAL 20H N°239 a livré son verdict !

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Après plusieurs jours de perturbations, la plateforme MonEntreprise.bj est de nouveau accessible. L'APIEx prévient toutefois d'un possible allongement des délais de traitement des dossiers.

La plateforme MonEntreprise.bj fonctionne à nouveau après les difficultés techniques enregistrées ces derniers jours. L'Agence de Promotion des Investissements et des Exportations (APIEx) annonce la reprise du traitement des formalités et invite les usagers à poursuivre leurs démarches en ligne.

Cette remise en service devrait toutefois s'accompagner de délais supplémentaires. Les dossiers qui étaient en attente pendant la période de perturbation devront être régularisés, tandis que de nouvelles demandes continueront d'affluer. L'APIEx explique que ce volume à résorber pourrait ralentir temporairement le traitement des dossiers.

L'agence assure que ses équipes restent mobilisées pour rétablir un fonctionnement normal du service. Elle présente par ailleurs ses excuses aux usagers pour les désagréments liés à l'interruption et les remercie pour leur patience.

Pour toute demande d'information ou d'assistance, les usagers peuvent contacter la hotline de l'APIEx au +229 01 52 83 66 66.

M. M.

OECD PISA education performance: change in scores between 2009 to 2025, and 2025 scores.

By Isabel Ortiz and Antonia Wulff
BRUSSELS / GENEVA, Oct 5 2026 (IPS)

The results of the OECD PISA 2025 report point to the marked deterioration of results in countries whose education systems were once considered exemplary. PISA assesses how students aged 15 apply skills in reading, mathematics, and science to real-life situations, and the latest report contains the lowest averages ever measured in all three subjects across the OECD (as illustrated in the graph above). Public debate has rushed to blame the use of AI and social media, but the deterioration long predates them. In many countries, this decline has unfolded alongside years of austerity cuts and growing pressures on public education systems, including public spending, teacher pay and working conditions, staffing and the capacity of schools to provide quality education.

Isabel Ortiz

These austerity cuts and cost-containment reforms started after the 2008 financial crisis, when governments mobilized emergency support for the financial sector, in loans, capital and guarantees, equivalent to around half of national income in the advanced G20 economies. This unprecedented bailout left public treasuries depleted, and the costs of adjustment were then thrust upon populations: from 2010, governments turned to austerity reforms or fiscal consolidation, cutting education budgets alongside other public services.

Austerity reforms in education include reduced public budgets, wage restraint for teachers and school staff, recruitment freezes, staff reductions, heavier workloads, and the privatization and commercialization of education. Fiscal consolidation led half of OECD countries to cut or freeze teachers’ salaries after 2010; between 2008 and 2012 teachers’ real wages fell in 16 of the 30 countries for which data is available, and by more than a quarter in Greece. Finland cut 1.5 billion euros from education during 2011 to 2018, and – among many other damaging cuts – closed and merged schools. In the United States, spending per pupil fell roughly 7% after the financial crisis, and rigorous research shows these cuts lowered test scores and college attendance.

Antonia Wulff

The teaching profession has not recovered. In 13 OECD countries and economies, primary teachers were earning less in real terms in 2024 than in 2015. The share of students in schools whose principals report that teacher shortages hinder instruction jumped from 26% in 2018 to 47% in 2022, and stood at around 40% in the 2025 assessment. This trend was concentrated in public schools, including those that serve disadvantaged populations. The latest data shows the continuing scale of the problem – only 28.8% of OECD students study in schools where principals reported no teacher shortages. The OECD’s own teacher survey finds that 17% of teachers intend to leave the profession within five years, rising to around half of young teachers in some European countries. Globally, 44 million additional teachers are needed in primary and secondary education alone by 2030, more than half of them simply to replace teachers leaving the workforce.

Privatization and commercialization compound the damage. More than 350 million primary and secondary students worldwide are enrolled in private institutions, and the enrolment share of government-funded private schools has risen since 2000 in many countries. UNESCO’s global review is blunt: the apparent superior performance of private schools is largely attributable to the socio-economic advantages of the student population.

These trends reflect political choices: what governments choose to fund and what they choose to cut. When education systems are asked to do more with less, the consequences are felt in classrooms. Fewer teachers, heavier workloads, weaker pay and conditions, and less capacity to provide every child with a quality public education. The question is not whether we can afford to reverse this decline but whether governments are prepared to prioritize the investment that public education requires.

The money was never missing, it is a question of priorities. Governments mobilized US$10 trillion to rescue banks in 2009, and in the four years since the invasion of Ukraine, the world has spent more than $10 trillion on the military, with NATO members each pledging to spend 5% of GDP on this by 2035, exceeding the share that most devote to education. Today, debt-service payments exceed education expenditure in Colombia, Costa Rica, Hungary, Mexico, Poland and Türkiye, among other countries, meaning again that governments are prioritizing paying off private creditors, banks and defense over children. New revenues are within reach: from progressive taxation, taxing windfall profits (e.g. from oil) to a 2% minimum tax on the wealth of billionaires which would raise $2.5 trillion over a decade. The G20 has, meanwhile, already committed to cooperating on taxing the super-rich.

Austerity was a policy choice and so are public services for people’s prosperity. Through sustained investment in public education, decent pay for qualified teachers, and equitable learning conditions, OECD countries could once again set the example and invest in educating their children to expand opportunity for the next generation.

Isabel Ortiz, Director, Global Social Justice, was Director at the International Labor Organization (ILO) and UNICEF, and a senior official at the UN and the Asian Development Bank.

Antonia Wulff, Director of Research, Policy, and Advocacy, Education International.

IPS UN Bureau

 

 

 

 

Excerpt:

Decline blamed on AI and social media but was triggered much earlier by austerity reforms and budget cuts.

Social Democratic Party leader Magdalena Andersson speaks at the Social Democrats’ election night party in Stockholm on 13 September 2026. Credit: Jonas Ekstromer/TT News Agency/AFP

By Andrew Firmin
LONDON, Oct 5 2026 (IPS)

Four years ago, Sweden’s far right became the power behind a right-wing government. This time, it expected further gains and cabinet seats. But voters turned against it. In the 13 September general election, support for the far-right Sweden Democrats fell for the for the first time in the party’s history. Four days later, Prime Minister Ulf Kristersson resigned, leaving the way clear for the centre-left Social Democrats to negotiate a coalition. But the Sweden Democrats’ defeat will prove hollow if the next government maintains the hostility towards migrants that has come to characterise Sweden’s politics.

The Sweden Democrats originated in the country’s violent neo-Nazi movement. Established parties long refused to cooperate, but the centre-right Moderate Party broke the firewall in 2019, when it announced it was willing to work with it. In the 2022 election, the Sweden Democrats came second with 20.5 per cent of the vote. The Moderate Party came third but was able to form a minority government. The Sweden Democrats didn’t receive cabinet seats, but entered into a formal agreement with the governing parties, which relied on its votes.

Having brought the Sweden Democrats into the political mainstream, Kristersson went further in April, when he said his aim was to form a majority government with the Sweden Democrats and promised them cabinet posts, potentially giving them control of immigration policies. The announcement made clear how central to Swedish politics the Sweden Democrats had become.

Hostility written into law

The Sweden Democrats framed its hostility towards migrants as a defence of the country’s envied living standards, underpinned by its extensive social welfare system. This time it promised to ‘make Sweden Sweden again’, in a campaign marked by instances of blatant Islamophobia.

Sweden saw a sharp increase in the number of asylum seekers and migrants in 2010, particularly from war-torn Syria. Political parties and media have repeatedly blamed migrants for crime and economic and social problems.

As the Sweden Democrats picked up electoral support, established parties adopted increasingly anti-migrant policies to try to see off the political threat. The same thing has happened in other European countries, with the same effect. Mainstream parties legitimised the anti-migrant agenda and brought the far-right challenger into the political mainstream, while voters tended to prefer the original to the copy. In Sweden, conditions for migrants have worsened under successive governments.

Restrictive policies preceded the 2022 government, but intensified under it. Ahead of the election, the government passed a new set of anti-migrant laws. These removed any route to permanent residency for people with asylum status, offering only temporary residency permits. They introduced a broadly defined ‘good behaviour’ clause that allows authorities to refuse residency permits for non-criminal offences and revoke permits already granted.

On top of this, what’s commonly called the ‘snitch law’ obliges some categories of public employees to report people they suspect of being undocumented migrants. This may deter migrants from using essential public services, such as healthcare, for fear of being reported. Because the law is broad and vague, it will also encourage self-censorship, as migrants may feel less able to take part in protests or speak out online. This effectively creates a two-tier system for civic freedoms and risks introducing a default racial profiling system. Troublingly, other EU countries are reportedly watching how Sweden’s hostile new laws play out, with a view to copying them.

A fragmented result

Crime and migration were campaign issues, but didn’t dominate the debate, as voters also focused heavily on the economy, education and healthcare. After many years at the top of the agenda, migration may be receding as a political issue, revealing the Sweden Democrats as having little else to offer. The party’s four four years of sustaining a government also made it harder to run an anti-establishment campaign, while a scandal linking a party official to Russia may also have cost it.

Results point to a further political fragmentation. The Social Democrats also lost seats, recording its lowest vote share in over a century, while smaller parties gained support, with the Green and Left parties particularly attracting young voters.

The two major political blocs are holding coalition negotiations. Neither faces an easy task. A four-party coalition led by the Social Democrats would command 176 seats, just above the 175 needed for a majority, while a four-party coalition on the right would claim only 173. But significant policy differences mean agreement can’t be taken for granted. Determination to keep the Sweden Democrats out may galvanise the four into an agreement but may not be enough to sustain it in the long term.

Even if the Social Democrats prevail, a significant change of direction on migrants’ rights is unlikely. The party has expressed support for many recent anti-migrant policies. The political rhetoric may soften, but the situation could mirror that of neighbouring Denmark, where the Social Democrats, having long adopted anti-migrant policies, retained power in the March election despite having its worst result in over 120 years.

A chance to change course

Progressive voices urgently need to start making a more positive case that tells human stories and asserts the human rights of migrants, and that builds understanding of the causes of migration and appreciation of the benefits migrants can bring, from the public service jobs Sweden’s social welfare service relies on to the economic contributions migrants make.

Sweden’s civil society must be heard. Civil society organisations are providing practical help to migrants and going to the courts and European bodies to challenge the worst impacts of regressive laws. They know what’s needed to curb the hostility, make Swedish society fairer and restore the country’s hard-earned global reputation as a human rights champion.

The Sweden Democrats’ loss of support shows there’s nothing inevitable or unstoppable about the rise of the far right. If Sweden’s next government listens to civil society instead of continuing to imitate the far right, it has a chance to show Europe that it’s possible to roll back the far right’s agenda.

Andrew Firmin is CIVICUS Editor-in-Chief, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

For interviews or more information, please contact research@civicus.org

 

 

 

 

A community health worker examines a pregnant woman inside her home while family members look on, highlighting the growing challenges mothers face as extreme heat and climate-related pressures strain access to healthcare in vulnerable communities. Credit: Wellcome

By Umar Manzoor Shah
SUVA, Fiji & SRINAGAR, India, Oct 5 2026 (IPS)

Extreme heat is increasingly threatening pregnant women and newborn babies around the world, with almost all maternal health professionals surveyed across five continents saying they have cared for women or infants whose health was affected by high temperatures.

The findings, released as climate ministers gathered in the Pacific ahead of the COP31 climate summit, provide an extremely distressing picture of how global heating is affecting maternity wards, delivery rooms and newborn-care units.

A survey of 1,001 healthcare professionals in Australia, Brazil, India, the United Kingdom and Zimbabwe found that 98 percent had personally cared for a pregnant woman whose health they believed was adversely affected by extreme heat.

Some 99 percent said they had cared for a foetus or newborn whose health, in their professional judgment, had been affected by extreme heat.

Almost three-quarters, 73%, said heat-related cases or complications affecting pregnant women had increased over the previous five years. The proportion rose to 76% when health workers were asked about complications involving foetal health, childbirth or newborn babies.

The survey was commissioned by the global health foundation Wellcome and conducted among obstetricians, gynaecologists, doctors, midwives, nurses and other maternal-health professionals between September 17 and October 1.

The findings were released in Fiji at the launch of Birthright, a global campaign seeking greater protection for pregnant women, babies and healthcare workers as temperatures rise.

Speaking at the event, United Nations Climate Change Executive Secretary Simon Stiell said climate change was creating a new and potentially deadly risk around pregnancy and childbirth.

“The picture is clear and very disturbing: as extreme heat worsens, pregnancy and birth are now a new faultline in the global climate crisis, and one which is potentially fatal,” Stiell said.

“This faultline must not become another deep chasm of climate-driven suffering, inequality and injustice.”

The survey offers detailed evidence of what healthcare professionals say they are already witnessing.

Among pregnant women,

• 25% reported seeing muscle cramps or muscle aches that they believed extreme heat had contributed to or worsened
• 24% reported severe fatigue, sleep problems or a reduced ability among pregnant women to carry out daily activities
• 23% reported breathing difficulties or worsening respiratory symptoms
• 23 percent reported pregnancy complications requiring additional monitoring or treatment, while an equal proportion reported hypertensive disorders, including pre-eclampsia
• More than one in five reported mental distress, anxiety or stress linked to heat
• 21% said they had encountered severe maternal illness requiring medical attention or hospital care
• 20% reported dizziness, fainting or loss of consciousness, while 19 percent reported preterm contractions, labour or birth
• Nearly 18% said they had observed pregnancy loss or stillbirth in circumstances where, in their professional judgment, extreme heat had contributed to or worsened the problem.

The survey did not attempt to establish that heat alone caused individual complications. The responses provide information about the professional judgment and clinical experience of the healthcare workers questioned.

Protect Life at Its Most Fragile

The findings involving babies were similarly worrying.

• 36% of health professionals reported dehydration or heat-related illness among newborns during the pregnancy-related care they provided
• 34% reported low birth weight or restricted foetal growth
• 33% had observed breathing, feeding or temperature-regulation difficulties
• 28% said babies required additional monitoring, treatment or neonatal care, and a similar proportion reported preterm birth
• During the newborn period, 38% of respondents reported low birth weight or restricted growth
• 36% reported dehydration or heat-related illness, and another 36% reported breathing, feeding or problems regulating body temperature
• Almost 30% said heat-related conditions resulted in babies needing additional monitoring, treatment or neonatal care
• 9% percent reported stillbirth or neonatal death during the newborn period in cases where they believed extreme heat had contributed to or worsened the condition.

Stiell said the findings showed that rising temperatures could no longer be treated simply as an environmental issue.

“The climate policy process is measured in degrees, targets and finance,” he said. “But a deep test of climate action is far simpler: whether we protect life at its most fragile.”

He said the world was entering conditions for which many health systems had not been designed.

“We are in a new, hotter world, as the world continues to burn planet-heating fossil fuels, overwhelmingly in G20 economies,” Stiell said.

“The last eleven years smashed records.”

He said rising temperatures meant “rising danger in pregnancy”, citing evidence linking extreme heat to premature birth, stillbirth, low birth weight and maternal complications.

A healthcare worker cradles a newborn baby at a maternal health facility, illustrating frontline efforts to protect mothers and infants amid mounting concerns over the impact of extreme heat on pregnancy, childbirth and newborn health. Credit: Wellcome

No One Is Immune

The survey also revealed significant differences between countries.

Zimbabwean health workers were among those reporting the sharpest increases.

Eighty-five percent of respondents in Zimbabwe said heat-related cases or complications affecting pregnant women had increased during the previous five years. The figure was 79% in Australia, 74% in Brazil, 66% in the United Kingdom and 62% in India.

When respondents were asked about foetal or newborn health, 89% of Zimbabwean health professionals reported an increase in heat-related cases or complications. The corresponding figure was 79% in Brazil, 78% in Australia, 68% in the United Kingdom and 66% in India.

The results suggest that the effects are being felt across countries with very different climates, incomes and healthcare systems.

Concern was also widespread.

More than 92% of all respondents said they were concerned about the impact of extreme heat on the health and well-being of pregnant women in the areas where they worked and 90% expressed concern about foetal health during pregnancy and childbirth, as well as the health of babies during the newborn period.

Zimbabwe recorded some of the highest levels of concern, with 97% of respondents concerned about foetal and newborn health.

Stiell said no country or family could consider itself completely insulated from the risk.

“No one is immune,” he said. “But the risks and impacts are not shared equally.”

The survey showed that extreme heat was also disrupting the healthcare systems expected to protect women and infants.

• 29% of health workers said they had seen increased urgent or emergency presentations during extreme heat
• 28% reported difficulties safely storing or using medicines, supplies or medical equipment
• 27% said pregnant women and their families found it harder to travel to or access healthcare
• 25% reported increased demand for advice, monitoring or treatment, while another quarter reported staff illness, fatigue or a reduced ability to work safely
• 24% had experienced interruptions to electricity, water, cooling systems, medical equipment or other essential services
• A similar proportion reported healthcare services becoming overburdened or having insufficient capacity
• Nearly one-quarter said temperatures inside healthcare facilities had become unsafe or uncomfortable.

The findings highlight a basic problem in responding to extreme heat. Advising pregnant women to stay cool may be of little practical value when families lack air conditioning, cannot afford electricity, work outside, or live far from medical services.

“‘Staying cool’ is simply not an option when there is no cool place to go,” Stiell said.

“A safe birth is already too often shaped by geography, income and access to care. Without action, extreme heat will widen that injustice.”

The survey asked health professionals what most limited pregnant women’s ability to protect themselves and their babies.

• 26% cited limited awareness or understanding that extreme heat could affect health during pregnancy
• 24% cited the need to work outdoors or in hot conditions
• About 23% pointed to limited support from family or the wider community
• The same proportion cited limited access to cooling or air conditioning
• 23% identified the cost of electricity, water or other protective measures.

Other barriers included existing health conditions, inadequate access to safe drinking water, homes that were difficult to keep cool, lack of employer support and difficulties travelling to healthcare facilities.

Only 0.4 percent said no factors limited women’s ability to protect themselves from extreme heat.

Stiell said such conditions meant that climate change risk was increasingly intertwined with inequality.

“Someone working outdoors, living in unregulated housing, travelling far to a clinic, or relying on facilities without water, power or cooling, cannot be protected by advice alone,” he said.

Harm that is not counted is too easily ignored

For Pacific Island countries, the issue is particularly sensitive.

Many small island states have contributed only a tiny fraction of historic greenhouse gas emissions but face rising sea levels, intensifying storms, heat and pressure on food, water and health systems.

“Here in the Pacific, climate change is no abstraction,” Stiell said.

“It is felt in homes, villages, farms, fisheries and clinics, in journeys for care, and in the availability and cost of food, water, power and transport.”

The Fiji event was held as ministers and climate officials gathered for the pre-COP meeting hosted by Australia and Fiji from October 5 to 8.

The meeting is intended to advance negotiations ahead of COP31 in Antalya, Türkiye, and give greater prominence to Pacific Island perspectives and climate solutions. Tuvalu was hosting a leaders’ event as part of the Pacific meetings.

Despite the growing risks, the survey suggests many healthcare workers believe they need more support to respond effectively.

• An overwhelming 92% said they wanted additional training and resources to help pregnant women during periods of extreme heat.
• 55% said clearer national or international guidance on protecting pregnant women from extreme heat would help them perform their jobs better
• When asked what would most improve their ability to protect women and babies, 33% selected practical information and materials for pregnant women and families
• 31% called for improvements to buildings, cooling, ventilation, water or electricity
• 29% wanted stronger referral pathways and better coordination between health services
• A similar proportion called for improved data and surveillance on heat, pregnancy and newborn health, as well as better local heat alerts and communication
• 28% said more staff, time or funding during periods of extreme heat would help
• 28% called for greater community outreach to people who may otherwise be difficult for health services to reach.

Stiell urged governments to make maternal and newborn health an explicit part of national climate adaptation and heat-response strategies.

“What is not named in a plan is too often not funded, not measured and not protected,” he said.

He outlined three priorities.

The first was to make pregnancy and newborn care part of national adaptation, health and extreme-heat planning.

That would require resilient clinics, dependable electricity and water supplies and properly trained health workers.

The second was to convert scientific evidence into direct protection, including improved guidance, professional training, heat alerts, safer medical facilities and health systems prepared before extreme weather strikes.

The third was better monitoring.

“Harm that is not counted is too easily ignored,” Stiell said.

“As temperatures rise, data must show where risks are growing, which interventions work, which communities are exposed, and where finance and technology support is needed.”

The survey found broad support among health workers for stronger policy action.

• 81% agreed that without further action, extreme heat would increasingly endanger maternal, foetal and newborn health during the next five years
• 82% said protecting pregnant women and babies from extreme heat should become a higher priority for health-system leaders and policymakers
• Another 82% agreed that better evidence on heat, pregnancy and newborn health would help drive effective action.

Stiell linked the issue to broader international climate finance negotiations.

He said commitments on adaptation finance agreed at COP30 in Brazil needed to be implemented and called for governments and the international financial system to help mobilise $1.3 trillion annually for developing nations.

“For small islands and other nations that did practically nothing to cause this climate crisis, it underscores the need for support at scale,” he said.

He also pointed to the Belém Gender Action Plan and Belém Adaptation Indicators as mechanisms that could help governments measure climate-related health risks and build more resilient health services.

Stiell praised Türkiye’s COP31 presidency and Australia, which is serving as President of Negotiations, for putting health on the agenda ahead of the Antalya summit.

For Stiell, the issue ultimately goes beyond climate-negotiating language.

“I am a parent, but I cannot pretend to know what it feels like to carry a pregnancy through those conditions,” he said.

“Mothers, midwives, doctors, nurses and families speak from lived experience. We should listen.”

The survey suggests those voices are already delivering a clear warning.

Pregnant women are struggling with heat exposure. Babies are requiring additional care. Health workers are seeing more complications. Facilities are facing pressure on electricity, water, medicines and staff. And many doctors, nurses and midwives say they lack the training and resources they need.

“Pregnancy should be a time of hope,” Stiell said. “But for millions, it is becoming a time of anxiety, as climate impacts fill everyday life with risk.”

He ended with an appeal for governments to treat protection of mothers and babies as a basic test of climate policy.

“A changing climate must never be accepted as a reason pregnancy and birth become less safe,” he said.

“A newborn’s healthy start must never depend on a family’s ability to escape the heat.”

“This work is urgent, deeply human, and we all share the responsibility to drive it forward together.”

IPS UN Bureau Report

 

 

 

 

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At the Africa Food Systems Forum in Kigali, Rwanda, experts explored how renewable energy can ease the burden on farmers. Here Shifra Ainomugisha poses beside a solar-powered irrigation system in Uganda. She was named the 2026 Commonwealth Young Person of the Year for the development of AI and solar-powered agricultural technologies. Credit: Solar Farm Uganda

By Farai Shawn Matiashe
KIGALI, Oct 2 2026 (IPS)

Post-harvest losses, particularly in rural areas, threaten the gains Africa is making in agricultural production and export capacity.

In Sub-Saharan Africa, up to 40% of farm produce is lost because of a lack of cold storage, according to industry players.

Highly perishable farm produce, like fruits and vegetables, can go as high as 70%.

With agriculture accounting for one-third of the Gross Domestic Product and employing over 60%, such a loss threatens jobs and the livelihoods of millions of people.

Farmers in Africa grapple with a lack of reliable refrigeration, an underdeveloped cold chain and unreliable power storage, leaving harvests to heat and spoilage.

Poor road networks and limited refrigerated transport options also worsen the situation. Farmers transport fruits long distances to processing centres under non-ideal conditions, resulting in losses.

Renewable Energy Offers an Opportunity

At the Africa Food Systems Forum in Kigali, Rwanda, experts are exploring how renewable energy can ease the burden on farmers who often turn to diesel generators to cool their farms’ fresh produce.

Olamide Niyi-Afuye, Chief Executive Officer at Africa Minigrid Developers Association (AMDA), an industry association working to improve the operating environment for mini-grids, said the biggest gap is not awareness but aggregation and intentional market design.

“We already see individual examples of mini-grids powering agro-processing, cold storage and other productive activities,” he said.

“The challenge is that these are still too often treated as individual projects rather than part of a scalable commercial model.”

Mugwe Manga, a Climate Finance Lead at Financial Sector Deepening Kenya (FSD Kenya), an independent trust supporting micro and small enterprises, said energy presents a tremendous opportunity for smallholder farmers to capture more value from what they produce.

“Solar, increasingly combined with battery energy storage, is particularly important because it is modular, increasingly affordable and can be deployed relatively quickly in rural areas,” he said.

“Solar-powered irrigation, cold storage, drying, milling, cooling and agro-processing can reduce post-harvest losses, increase productivity, improve product quality and allow farmers to sell into higher-value markets.”

Manga said energy can become an important enabler of both climate resilience and higher farmer incomes.

“The productive use of energy for cold storage, solar-pumped irrigation, and agro-processing is critical to value capture, climate resilience, and adaptation that will strengthen smallholder farmers,” he said.

Nigeria, one of Africa’s largest economies, lost between $2.3bn and $3.3bn to post-harvest inefficiencies in 2025, according to industry players.

The food wasted due to poor storage and transport networks amounted to up to 40 million metric tonnes.

South Africa loses an estimated 10.3 million tonnes of food annually, about 19% of its fresh produce, according to a 2021 report titled Waste Research Development and Innovation Roadmap Research.

Funding Cooperatives Is a Better Funding Model

Renewable energy offers reliable and accessible solutions to cold storage and processing problems in Africa, but funding remains a major challenge.

Though prices of solar panels and batteries shipped from China have been declining in recent years, current prices remain high for many farmers, particularly smallholders in rural areas.

With low capital amid limited access to grants and loans, many cannot afford solar-powered agro-processing and cold storage facilities.

Experts said that clean energy is the cheapest technology to deploy when farmers work together.

“Due to the capital expenditure of some of these, it is important for farmers to organise themselves and come together as a collective in order to take advantage of economies of scale and the power of aggregation that can use energy for all, as opposed to rolling out these solutions to individual smallholders that may not be cost-effective,” said Manga.

Niyi-Afuye said there is a need to bring energy developers and agribusinesses together much earlier, aggregate demand across agricultural value chains, and structure projects around credible productive loads from the outset.

“The opportunity is to stop treating energy and food systems as two separate investment cases and start building bankable opportunities at the intersection of both,” he said.

Manga said one of the key lessons from distributed energy is that the economics are often stronger when players move away from financing individual assets for individual farmers and instead aggregate demand.

“Farmers can organise through cooperatives, producer organisations, aggregators or rural enterprises and invest in shared infrastructure that serves many producers,” he said.

“This creates economies of scale, improves asset utilisation and creates a stronger and more predictable revenue base.”

Manga said aggregation also makes these projects more attractive to financiers by reducing transaction costs and perceived risk.

“Rather than lending against hundreds of individual smallholders, investors can finance a productive asset with an identifiable operator, clear cash flows and an aggregated customer base,” he said.

Niyi-Afuye said the better model is to aggregate projects into investable portfolios, combine commercial capital with appropriate credit enhancement and risk-sharing mechanisms, and increase access to patient, local-currency financing.

“Financing infrastructure in dollars while the underlying customers earn in Nigerian Naira or Kenyan shillings creates a structural mismatch,” he said.

Pratik Patel, Bureau Chief for East and Southern Africa at AfriCatalyist, a global development advisory firm headquartered in Senegal, said a public-private-producer partnership is the model that can make renewables affordable.

“Instead of a cold storage facility or cold chain operator trying to stand alone as a single commercial enterprise, it’s embedded in a collective plan that covers the full journey from farm to table, production, aggregation through farmer cooperatives, storage, processing, and market access, with clear roles and coordination at each stage,” he said.

He said the approach matters for financing because it gives investors what a standalone facility cannot, such as a defined use case, identified long-term clients, and a credible route to market.

“When responsibility for each link in the chain is assigned to the actor best suited to manage it, the plan becomes legible and de-risked, which is what ultimately builds investor confidence,” he said.

IPS UN Bureau Report

 

 

 

 

Shehnaz Ali from Rahim Yar Khan, Pakistan, has been living with a fistula for 16 years. Credit: Zofeen T. Ebrahim/IPS

By Zofeen Ebrahim
KARACHI, Pakistan, Oct 2 2026 (IPS)

“You’re living a life drained of joy,” is how Shehnaz Sher Ali describes her “perpetually wet and stinky” existence. “I wouldn’t wish it on my worst enemy,” says the 35-year-old, who travelled by bus for more than 12 hours with her husband from their village in Rahim Yar Khan, Punjab, changing diapers whenever possible to keep the smell from reaching the fellow passengers.

For 16 years, she had lived with urine dribbling, unaware that it was treatable with a relatively simple surgical procedure.

She developed an iatrogenic fistula—caused by a surgical injury during a Caesarean section—and is among the estimated two million women living with untreated obstetric fistula worldwide.

Shehnaz got married at the age of 18 and conceived soon after. At full term, her obstetrician suspected a complication for which she underwent a Caesarean section, but the baby was stillborn. The doctor then told the young couple she would not be able to conceive again.

That was not all. She soon realized she was leaking urine.

The doctor assured her it would stop within weeks. It never did, despite three months in hospital trying to repair the leak.

“After spending so much on my operation, being told I could never have children, and then living with the urine leakage, my husband divorced me. I was damaged goods, a liability, and he didn’t want to spend any more money on me.”

She returned to her parents’ home and, a few years later, married Ali, twice her age and already married with three daughters.

“He knew about my condition but married me because he needed someone to care for his paralyzed wife and their three daughters.”

But now, her life is beginning to change.

Fistula Ward at Kooh Goth Hospital, where cats are allowed to roam free. Credit: Zofeen T. Ebrahim/IPS

Center of Hope

She is being treated at the best facility for treatment of fistula—the Koohi Goth Women’s Hospital (KGWH), run by the Zafar and Atia Foundation Charitable Trust (supported by numerous Pakistanis both abroad and within the country), in Karachi’s Landhi neighborhood.

“A relative found out about it a month back, and my husband brought me to it immediately,” she said.

Dr. Shershah Syed, who founded KGWH, was Pakistan’s first gynaecologist and obstetrician to train in genital tract fistula (both rectovaginal and vesicovaginal fistula) repair. He describes these as among the “worst and most devastating childbirth injuries” a woman can endure.

In 1993, Syed trained at Addis Ababa Fistula Hospital under renowned surgeons Dr. Reginald Hamlin and his wife, Dr. Catherine Hamlin, who provided free obstetric fistula repair in Ethiopia. Two years later, as medical superintendent of the government-run Sobhraj Maternity Hospital, he began actively repairing fistulas.

Since KGWH began operations in 2007, it has treated “more than 3,200 women and trained 30 master trainers,” said Dr. Sajjad Ahmed Siddiqui, its fistula project manager.

In 2025, UNFPA’s Asia-Pacific office designated KGWH a Regional Center of Excellence for fistula care after it trained surgeons from Bangladesh, Nepal, and Afghanistan. It was already the national referral and surgical training hub.

“We want to treat 800 women annually while providing psychosocial support, literacy, and skills training to help them reintegrate and become economically empowered,” says Dr. Jameel Ahmed, sexual and reproductive health specialist at UNFPA Pakistan. “But with global funding constraints and rising iatrogenic fistula cases, we are unsure how much reintegration support we can provide.”

KGWH’s work has also extended beyond its walls.

Syed, who is a medical advisor to the Fistula Foundation, organizes free surgical camps with the help of trained surgeons in remote Sindh government hospitals, bringing treatment to women from nearby villages.

In January, he travelled to Kabul with four female surgeons, where they set up a fistula repair camp and provided refresher training to Afghan female surgeons.

“In five days, the women surgeons repaired 20 fistulas,” said Syed. “There is a great need there, but with relations between the two countries at their lowest, it is difficult for us.”

Before the Taliban takeover, 30 to 35 women from remote provinces of Afghanistan would travel to Pakistan each year for treatment. That has now ended.

Today, there are 11 fistula repair centers across Pakistan equipped with 88 trained surgeons, and in the last decade, these centers have treated over 7,800 women for fistula.

Globally, about 50,000–100,000 new cases of vesicovaginal fistula occur each year, with 80% in developing countries, mainly in Asia and Africa, according to UNFPA. “In Pakistan, we estimate that up to 5,000 cases of fistula occur annually; iatrogenic fistula is one type,” explained Ahmed.

Back in 2007, when UNFPA began addressing obstetric fistula caused by obstructed labor in Pakistan through the Pakistan National Forum on Women’s Health, it believed that improved reproductive healthcare and more facility-based births would help reduce the incidence of this devastating condition.

Some Progress, But Not Enough

“To some extent, there have been significant improvements in maternal mortality and morbidity since then,” said Ahmed.

The progress is reflected in World Health Organization figures: Pakistan’s maternal mortality ratio fell from 276 deaths per 100,000 live births in 2006 to 155 in 2024. Neonatal mortality declined from 52 to 37.6 deaths per 1,000 live births over the same period, while the stillbirth rate fell from 39.8 per 1,000 births in 2000 to 27.5 in 2024.

But Syed remains unimpressed. Despite these gains, the toll is still “not acceptable” to him. Every day, 675 babies die before reaching one month of age, and 27 mothers die from preventable complications, amounting to more than 246,300 newborn and 9,800 maternal deaths a year. Pakistan also records more than 190,000 stillbirths annually, WHO figures show.

All these put Pakistan’s achievement of SDG 3—which deals with sexual and reproductive health—at risk.

And there is another worrying development.

As Pakistan made progress in tackling obstetric fistula, another form was emerging—one caused not by obstructed labor but by medical intervention itself. “We observed women developing fistulas following Caesarean sections or hysterectomies in health facilities—iatrogenic,” said Ahmed.

Syed is particularly concerned about this kind. “In most childbirth cases, I find surgical intervention unnecessary. Too often, the decision to intervene is a ‘personal’ one, driven by greed and ‘ease’ rather than ethics.”

“We have irrefutable proof that most of the injuries happen due to surgical error during C-sections, hysterectomies, or repair of ruptured uterus and bladder,” says Siddiqui.

UNFPA has found that a staggering 70% of fistula cases in Pakistan result from surgical injuries. “We tried to plug one hole two decades back, through improved facility-based births, and realized there was a bigger one at hand that happened in facilities that needed to be plugged now,” said Ahmed.

Dr. Pushpa Srichand, 75, has spent more than five decades as a gynaecologist and has treated some 2,200 fistula patients in hospitals, along with countless more at free surgical camps. “It is a disease of the poor; I promised myself I would never charge these women,” she said. Even after retiring from government service and joining Isra University, she made free fistula treatment a condition of her appointment.

A recent seven-year prospective study by Isra University found a 56% rise in iatrogenic fistula among gynaecological patients between 2017 and 2024. Of the 2,190 women treated for obstetric and other gynaecological complications, some 1,358 had iatrogenic fistula.

“This is a huge and extremely concerning number,” said Srichand, sharing her findings at a UNFPA national consultation that brought together regulators, medical bodies, and provincial health officials to discuss the rise in iatrogenic fistula and ways to prevent it.

Earlier research points to a similar pattern. A two-year study at Lady Willingdon Hospital, Lahore, from January 2007 to December 2008, found that 54% (33 of 61) of referred fistula cases were iatrogenic. A 2004 report from the same hospital, by contrast, found that 79% of fistulas were obstetric. The 2008 study concluded that “gynaecological surgery is being performed by untrained hands in the periphery.”

Another study at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, covering almost 12 years to June 2018, also found a rising trend in iatrogenic urogenital fistula. It concluded that the trend underscored the need for better safety standards in both obstetric and gynecological surgery.

The same was concluded at the UNFPA consultation, where doctors largely blamed inexperienced and unskilled practitioners.

“They make wrong diagnoses, perform faulty surgeries, and leave patients with lifelong complications,” Syed told IPS on the sidelines of the event.

“A C-section, for instance, is a relatively straightforward procedure,” he pointed out, but in incompetent hands, even this can go terribly wrong. “It requires a very special kind of negligent expertise to get this wrong,” he said sarcastically. He also blamed the superiors for the errors of their juniors. “They never taught their juniors properly, and many C-sections and even normal births are carried out by those without adequate training, resulting in these grave mistakes that women suffer lifelong. The worst part is there is no accountability.”

For women like Shehnaz, such medical errors are not simply complications—they can reshape an entire life.

For years, she saw her suffering as punishment for some inexplicable sin. The treatment, she says, is “Allah telling me that I have finally atoned for it.”

“When I go home, the first thing I will do is cook a large pot of biryani and distribute it among the poor, in gratitude to Allah for giving me a second life,” says Shehnaz, her face beaming after her first successful operation.

Dr. Sana Ashfaque, who carried out an “extremely complicated, four-hour-long surgery” to repair Shehnaz’s holes, is hopeful she has plugged the leak for good. “But we will keep her for another two weeks just to be sure everything is in place; she’s come from far and it may not have been easy for her to come back to us.”

After 16 years of waiting, four hours was a small price to pay for a second life.

Note: This article is brought to you by IPS Noram in collaboration with INPS Japan and Soka Gakkai International in consultative status with ECOSOC.

IPS UN Bureau Report

 

 

 

 

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By CIVICUS
Oct 2 2026 (IPS)

 
CIVICUS discusses life as a refugee with an exiled Sudanese civil society activist who has asked to remain anonymous for security reasons.

Over three years into Sudan’s war, millions of people have been displaced, both within the country and beyond its borders, and the numbers keep rising. Fighting continues to force civilians from their homes, while those who reach neighbouring countries struggle to find safety and stability. Civil society warns that, despite the scale of the suffering, Sudan’s crisis isn’t receiving the international attention it deserves. Exiles document violations and advocate for democracy and peace.

What drew you to human rights activism, and how has exile changed it?

The gender-based injustice women face in our societies drew me to human rights work. From childhood, I objected to the unequal treatment of girls and boys and the stereotypes that painted women as less capable. I rebelled against this system, seeking out books, stories and real-life experiences that showed women’s capabilities and potential.

Activism in exile, particularly during wartime, brings unending and unexpected risks and challenges. At times, it feels like you are fighting to survive. You carry the trauma of war and the guilt of being safe while your family and community remain in danger. Many human rights defenders lack the basic resources to survive.

In exile, I have moved from a radical stance to one focused on reform, having learned that dogmatism, hostility and refusal to listen can lead to violence and grave human rights violations. I have become more deliberate in my judgements, with a stronger desire to understand the other side.

How has Sudanese civil society adapted since the war began?

Sudanese civil society has shown remarkable resilience. People mobilised to confront the war and the collapse of state institutions. Within hours, young people and volunteers were helping the wounded, homes became field clinics and communities shared their resources.

As the war continued, many civil society organisations relocated abroad. One of the most remarkable aspects of the Sudanese experience has been the emergence of numerous additional human rights, humanitarian, women’s and youth organisations in host countries. They have maintained links with activists inside Sudan, monitored human rights and documented violations, provided humanitarian assistance, advocated for peace, promoted dialogue and countered hate speech.

Civil society’s work, inside Sudan and abroad, is one of the few sources of hope for peace in the country.

What barriers do Sudanese civil society activists and organisations face in exile?

Refugees face insecurity and a rising wave of xenophobia in host countries, and many feel unwelcome, or even blamed for seeking safety in a country where they are made to feel they don’t belong. Many also face movement restrictions, difficulties renewing residency documents and the constant risk of deportation.

On top of this, activists carry the added burden of propaganda that portrays them as fugitives or foreign agents. We must confront the abuses we document while also countering division, hatred, intolerance and racism.

Civil society organisations abroad also face economic, legal and security restrictions. Many struggle to register legally, open bank accounts, access funding or obtain permits.

Compounding all this are the limited international support and the sense that global decision-makers, and even international human rights organisations, don’t prioritise our concerns. This can leave you feeling that you simply don’t matter.

What needs to change to stop displacement silencing activists and refugees in general?

The global system often seems designed to protect the strong while weakening the vulnerable. In Africa and across the global south, we seek to change this, yet we remain constrained by the structures and assumptions of the system. We need to see difference as a source of diversity rather than division, share responsibility for resources and security, and protect everyone’s rights to life, development, dignity and freedom.

As a Sudanese refugee and human rights defender, I strongly support the Borderless Africa campaign, led by the pan-African civil society movement Africans Rising, which calls for visa-free travel and a single continental passport across Africa. It reflects the need to move beyond borders and put humanity and fundamental rights first.

It’s shocking to be forced into silence about crimes you have witnessed simply because you are a refugee. Governments, civil society and activists must dismantle the legal and logistical barriers that leave refugees unable to access basic rights.

CIVICUS interviews a wide range of civil society activists, experts and leaders to gather diverse perspectives on civil society action and current issues for publication on its CIVICUS Lens platform. The views expressed in interviews are the interviewees’ and do not necessarily reflect those of CIVICUS. Publication does not imply endorsement of interviewees or the organisations they represent.

SEE ALSO
Sudan: ‘Crossing a border doesn’t automatically mean you’re safe’ CIVICUS Lens | Interview with Rawia Saad 09.Sep.2026
Sudan: blood on the hands of foreign powers CIVICUS Lens 04.Sep.2026
Sudan in crisis: mass killings continue while the world looks away CIVICUS Lens 23.Dec.2025