Update: Nigeria’s COVID-19 Death Toll Hits 200

The death toll from covid-19 in Nigeria has risen to 200, according to the latest figures released by the Nigeria centre for disease control (NCDC), which also announced 284 new infections of the virus, bringing the total number of positive cases to 6,677 and 1,840 discharged.
The new infections are in 12 states and the federal capital territory, with Lagos having the largest number of 199 cases

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When Universal Credit and benefits will change in 2020 and how you’ll be affected – Kent Live

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The General Election result meant a lot of things but it also ensured the continuation of Universal Credit.

Campaigners had been hoping for an end to the controversial scheme, with  Labour promising to scrap Universal Credit  altogether.

However, there will still be a number of changes to the benefits system this year – some of which will be good news for claimants, reports BirminghamLive .

Here’s the timetable of what will be happening – see how it will affect you.

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1. April 2020 – End of benefit freeze

The end to the benefit freeze would mean Universal Credit and other working age benefits rising by 1.7 per cent from April 2020.

The freeze was brought in by the Tories and came into effect from April 2016. It has meant that most benefits and tax credits have not gone up in line with inflation for four years.

Other benefits that have been frozen but are now set to rise are Employment and Support Allowance (ESA), income support, housing benefit, child tax credits, working tax credits and child benefit.

Adam Corlett

The increase means someone on £1,000 a month in benefits will get an extra £17, equivalent to £204 over a year. Those receiving £500 a month get an extra £8.50.

But according to think-tank the Resolution Foundation, families will still be hundreds of pounds a year worse off due to the past five years of bills rising while benefits have remained at the same level.

The Resolution Foundation’s Adam Corlett said: “While the benefit freeze is over, its impact is here to stay with a lower income couple with kids £580 a year worse off as a result.”

2. April 2020 – Pension changes

The Government also said the state pension – which has not been frozen – will increase by 3.9 per cent.

This is expected to be announced in the Budget.

It means retired Brits are in line for £5.05 a week extra on the ‘old’ basic state pension and £6.60 a week on the ‘new’ state pension.

bank accounts

The bad news is that the  adult dependency payment is being stopped  in April, which could mean thousands of pensions cut by £70 a week.

In addition, the qualifying age for men and women will rise to 66 in October 2020.

It means anyone born after October 5, 1954, will have a state pension age of at least 66.

And there will be further rises too. The Conservatives have set out plans to increase the state pension age to 67 by 2028 and 68 by 2039.

3. April 2020 – Disability benefit changes

The Scottish Government is taking on responsibility for disability benefits from April 1 and will implement changes after that.

In summer 2020, Social Security Scotland will open to claims for the brand new Disability Assistance for Children and Young People, which is Scotland’s replacement for Child Disability Living Allowance.

By the end of 2020, Social Security Scotland will also open to claims for the new Disability Assistance for Older People. This is the Scottish replacement for Attendance Allowance and is for people over the state pension age who need someone to help look after them because of a disability or long-term illness.

Also by the end of 2020, children who receive the highest care component of Disability Assistance will be entitled to Winter Heating Assistance.

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Further changes will come in 2021, including PIP being replaced by Disability Assistance for Working Age People and Carer’s Allowance being replaced by Carer’s Assistance.

Social Security Secretary Shirley-Anne Somerville says the system will have a redesigned application process and significantly fewer face to face assessments.

There will be rolling awards with no set end points and those with fluctuating health conditions will not face additional reviews due to changes in their needs.

She said: ““Since the Social Security Act was passed by the Scottish Parliament in June [2018], progress has been swift.

““Our next priority is delivering payments for disabled people, as this is where we can make the most meaningful difference for the largest number of people.

“We have a duty to quickly reform the parts of the current system which cause stress, anxiety and pain. And I have been moved by the personal stories I have heard, many of which criticise the penalising assessment process.”

Around half a million cases – the equivalent of around 10 per cent of people in Scotland – will transfer from DWP to Social Security Scotland in 2020.

Ms Somerville added: “This is not simply a case of turning off one switch and turning on another. For the first time in its history, our agency will be making regular payments, direct to people’s bank accounts and our systems need to work seamlessly with those of the DWP.

“It is therefore essential we have a system that is fully operational for those making new claims and ensure we protect everyone and their payments as their cases are transferred – that is what those who rely on social security support have told us they want. We must work to a timetable that reflects the importance of moving quickly but not putting people’s payments at risk.”

During the transfer no-one will have to reapply for benefits, no claims will be reassessed and payments will be protected.

She added: “The timetable I have set out is ambitious but realistic and at all points protects people and their payments. I have seen the mess the DWP has made when transferring people to PIP and introducing Universal Credit, and we will not make the same mistakes.    

“There is much hard work to be done but the prize is great – a social security system with dignity, fairness and respect at its heart and which works for the people of Scotland.”

4. June 2020 – TV licence changes

Free TV Licences, funded by the Government, for all those aged 75 and over will come to an end in June. So you can get a free licence up to May 31, 2020.

From June 1, a new scheme means you can only carry on getting a free licence if you – or your partner – are receiving Pension Credit.

If not, you’ll have to fork out the cost of a TV licence – which is £154.50 per year for a colour TV, and £52 for black and white. You can choose to pay monthly (£12.87 a month), quarterly (£39.87 every three months) or yearly.

Brits

So it’s worth checking if you can get Pension Credit to avoid the licence fee.

Pension Credit is a top-up benefit payment available if you or your partner have reached state pension age, or if one of you is getting housing benefit for people over pension age. You get more if you’re responsible for a child or young person who lives with you and is under the age of 20.

There are two elements to Pension Credit. Guarantee Credit tops up your weekly income if it’s below £167.25 (for single people) or £255.25 (for couples), while Savings Credit is an extra payment for people who saved some money towards their retirement and is up to £13.73 for single people and up to £15.35 for couples.

The Pension Service helpline is available on 0800 731 0469. Call Monday to Friday, 8am to 8pm. Calls to 0800 numbers are free.

5.  July 2020 – Universal Credit transition protection extended

From July 22, claimants are to get an additional two weeks of income-related Jobseekers Allowance, income-related Employment and Support Allowance, or Income Support if they receive one of these benefits when moving across to Universal Credit.

Universal Credit is intended to replace six existing benefits in total.

People are transferred on to UC if their circumstances change – such as moving home or having a child. This is called natural migration.

Everyone else on the six old benefits will have to move across in a managed migration scheme by the DWP that is set to be completed by December 2023 and is currently being tried out in Harrogate from July 2019 to July 2020.

Normally, existing benefits are terminated when a Universal Credit claim begins but the Government has amended the rules to allows a “two-week run-on” of the three benefits named above.

6. September 2020 – Universal Credit change for self employed

The DWP works out Universal Credit for self-employed people using what’s called a Minimum Income Floor (MIF).

This is roughly equivalent to the national minimum wage for each hour the claimant is expected to work.

It can mean Universal Credit is calculated on a higher level of earnings than you were actually paid.

However, this Minimum Income Floor is not applied to those who started a business within the past 12 months .

And from September 2020, this 12-month exclusion period will also not apply to “those who are naturally migrated in self-employment and all those existing UC claimants who become new gainfully self-employed.”

‘Naturally migrated’ means switched across to Universal Credit because of a change in circumstances.

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The Bolton Bucket List – 40 things you must experience while in the town – Manchester Evening News

There’s loads of things to experience in Bolton – but how many have you actually done?

Steeped in heritage and culture both historical and modern, there’s plenty of offerings for all tastes, whether you’re local or just visiting.

We’ve put together a list of 40 things to tick off in and around Bolton to get you started on your way to experiencing the best of the borough.

Some might seem obvious, others you might never have heard of, but all are entirely worth a mention.

Special thanks to the ‘I belong to Bolton’ Facebook group who helped with their suggestions.

How many can you cross off our ultimate Bolton Bucket List?

Watch Bolton Wanderers play at home

Art Gallery

They may be some way off the heights reached during the Sam Allardyce era, but Bolton is still immensely proud of its football club.

Four time FA Cup winners and one of the founder members of the Football League, Wanderers is a club steeped in history.

Now in League One, times have been tough for the club in recent years – but a visit to the University of Bolton Stadium is something all Boltonians must experience at least once.

Shop until you drop at Middlebrook

The UK’s largest retail and leisure park has plenty of things to do on a day out.

Whether it is taking in the shops, dining at one of the many restaurants, a trip to the cinema or bowling alley, it’s a popular spot for many Boltonians.

Dine at Britain’s best curry house

Benjamin Disraeli

Hot Chilli, in Bromley Cross, scooped the champion of champions award at the Asian Restaurant & Takeaway Awards in October.

The restaurant, which has been open since 2011, specialises in eastern Indian cuisine and boasts an extensive menu for all tastes.

Pull off into paradise

Bolton Museum

When Phoenix Nights, a sitcom set in a working men’s club in Bolton, first aired in the early 2000s it became a major national success and catapulted many of its stars on to bigger and better things.

Bringing us iconic characters such as Brian Potter, Jerry St. Clair and doormen Max and Paddy, the show is still quoted by many to this day.

Fans can actually pay a visit to the Phoenix Club, which is in fact St Gregory’s Social Club in Farnworth, and guided tours are available upon request.

Try a pint at one of the town’s many breweries

Bolton is awash with great breweries at the moment and beer lovers certainly don’t have a shortage of options to choose from.

Two of the finest are Northern Monkey and Bank Top, both of which have opened their own tap rooms in the town, while honourable mentions also go out to Blackedge Brewing Company and Rivington Brewing Company.

Enjoy a hike up the Pike

Bowling

For many families, an Easter hike up Rivington Pike is an annual tradition.

Hundreds of keen walkers clamber up to the summit, which stands at 1,191 feet, where they are rewarded with spectacular views across Bolton and the West Pennine Moors.

But the views are best enjoyed on a quieter day, away from the crowds. It’s an ideal spot to escape from the hustle and bustle of daily life.

Sample local delicacies at Ye Olde Pastie Shoppe

Bolton is blessed with several great bakeries, but a trip to this family-run shop is a must for anyone visiting the town.

Dating back to 1898, Ye Olde Pastie Shoppe has been serving generations of families from its modestly-sized shop on Churchgate.

TripAdvisor users even rate it as the best bakery in Greater Manchester. High praise indeed.

Try the Bolton institution that is Carrs Pasties

Another of Bolton’s finest pasty institutions, Carrs’ products can be found right across the town.

But for the proper experience, you need to visit one of their three shops dotted around the borough.

The family-run bakery counts radio presenter Chris Evans among its admirers; the former Top Gear host has rated their pasties among the finest in the country.

Take part in the Ironman. Or maybe just watch.

Easter

Bolton has played host to the biggest Ironman race in the UK 11 times now.

Thousands of entrants descend on the town’s streets each year to take on a gruelling course involving a 2.4 mile swim, 112 mile bike ride and a marathon.

If you aren’t quite in shape to take part, you could always join the thousands of others who turn out to line the streets and cheer on those who are.

Last year, a 5k night run was introduced on the Friday, while athletic youngsters can also join in an Ironkids event.

Learn about the history of steam

Bolton Steam Museum boasts one of Britain’s largest collection of working steam mill engines.

The volunteer-run museum delves into the area’s industrial heritage through the engines, which powered Bolton’s mills and helped transform it into the town it is today.

Take a stroll around Jumbles Country Park

Extraordinaire

Situated about four miles to the north of the town centre, the woodland trail and reservoir is a popular spot for dog walkers and those out for an afternoon stroll.

A sailing club is also based at the reservoir and hosts regular training days and races.

Boasting picturesque views, there are worse ways to spend a Sunday afternoon than paying a visit to Jumbles.

Shop at Bolton Market

Bolton’s market tradition stretches back hundreds of years to 1251 when the town was granted a charter by King Henry III.

Centuries later, the town’s market continues to thrive, although the range of products on offer has come a long way.

The market moved to its current base in Ashburner Street during the 1930s and boasts hundreds of stalls selling everything from fresh fish to cotton reels.

Try some African cuisine at Nkono

One of Bolton Market’s most popular traders is Nkono, a Cameroonian street food stall.

Finding it is no issue as the voice of its larger life than life owner, Alain Job, can often be heard booming through the indoor market hall as he entertains customers.

Nkono opened back in 2014 and quickly became a hit. With a range of exotic dishes, many of which are accompanied by jollof rice and sweet dumplings, it soon established itself as one of the town’s best eateries.

If you’re feeling especially experimental, why not try one of their goat curries?

Learn about the history of Turton Tower

Henry III

Set in relaxing woodlands on the edge of a popular walking area, the distinctive 15th century English country house has fascinating period rooms displaying a huge collection of decorative woodwork, paintings and furniture – all re-telling the lives of the families who lived there.

Dig for hidden gems at X Records

An institution in the town since the 1980s, this record shop serves as a treasure trove for Bolton’s music lovers.

Head down to its Bridge Street base and get lost in its vast collection of records. You might even find yourself a bargain.

Spend an afternoon with family at Moss Bank Park

Kazer

A sprawling park with a large play area including a sand pit area for children, the park is an ideal destination for a family afternoon out.

While the much-loved children’s zoo and tropical butterfly house are no more, there are plenty of other attractions to keep kids entertained including a mini steam train, crazy golf and fairground rides.

Feed the animals at Smithills Open Farm

Smithills has a wide range of animals from pigs and cows to snakes and owls.

As well as families, large groups of children visit from schools and nurseries with some coming from miles away to say hello, feed and cuddle the animals.

Children get the chance to feed the lambs and there are plenty of other hands on opportunities with snakes and chicks.

The venue also offers tractor rides, on toy ones as well as the real thing, and donkey rides too.

With bouncy castles, a sand pit and adventure playground it’s a popular place for day visits and children’s birthday parties.

Check out the town’s street art

Moss Bank Park

Some spectacular murals have sprouted up around Bolton over the last year or so.

The local artist behind them is Kazer, a joiner by trade who got into graffiti-style art after watching a series of YouTube.

You’ll find some of his eye-catching designs adorning the walls of several of the town’s pubs, including the Sweet Green Tavern, The Greyhound, and The Beer School in Westhoughton.

Enjoy a tour of Smithills Hall

Nkono

Set in restored formal gardens and a 2,000 acre estate leading to the West Pennine Moors, the beautiful old hall is an architectural gem dating back to the 14th century.

Travel in time through medieval, Tudor and Victorian rooms or enjoy the various walks on offer in the splendid surrounding countryside.

Sample a local delicacy at Rice n Three

The phenomenon that is rice and three has spread right across Greater Manchester since its creation at some point in the 1980s.

A base of rice topped with a choice of three curries, it’s affordable, filling and homely, making it the fast food go-to for many.

Rice and three’s origins are uncertain, but Bolton may well lay claim to it.

The Essa family bought the Northern Quarter’s This and That in the 1980s after coming to Manchester from Uganda claim rice and three as their creation.

They later sold the cafe and took the idea to Bolton, where they have since opened two restaurants, in Bradshawgate and Deane Road.

Is it really the original rice and three? Maybe. Is it tasty? Most definitely. It’s affordable too – one meat, two veg and rice costs just £5.00.

Visit the shops at Market Place

one of the founder members

Originally designed and opened in 1855, the Bolton Market Hall was said to be ‘the largest covered market in the kingdom’.

It was reopened as Market Place Shopping Centre by Queen Elizabeth ll in 1988 and has undergone a £25 million refurbishment transforming it into the town centre’s shopping heart.

Some of the biggest high street names can be found there, including Debenhams, Next, H&M and Zara.

Enjoy an evening in The Vaults

Prime Minister

The Vaults dining and leisure venue opened below Market Place back in 2016 and has fast become the go-to socialising spot for many Bolton families.

Based in the renovated Victorian vaults, which are part of the original market halls, several restaurant chains can be found there, including Nandos and Prezzo.

Watch a film at the Light Cinema

One of just a handful across the UK, the town centre venue was opened by independent cinema chain The Light back in 2016.

Dubbed ‘sociable cinema’, the whole experience is a little more laid back than your standard cinema trip, with reclining seats, and you can even have a drink from the bar in there too.

Learn from the top chefs at food and drink festival

Queen

Taking place across the August bank holiday weekend, the annual event is one of the biggest food and drink events in the north west.

Some of the world’s best-known celebrity chefs have appeared at the event to entertain crowds with cookery demos and book signings in recent years, with James Martin even hailing it the best festival of its kind in the UK.

There are markets aplenty too, with the streets around Victoria Square and Le Mans Crescent packed with street food stalls (including Thai, toasties, Polish BBQs, Italian desserts, Green meze, and Yorkshire pudding wraps) and produce to take away with you.

Visit Barrow Bridge

A picturesque model village to the north of Moss Bank Park, Barrow Bridge was created during the Industrial Revolution to house workers at nearby mills.

The cotton mills have long since gone, but the quaint cottages remain. The charming village is a haven of tranquility and is a perfect spot for a Sunday afternoon stroll.

Explore the town’s paranormal activity

Bolton is apparently a hotbed for paranormal activity. 

Ghost Walker Extraordinaire Flecky Bennett offers a number of ghost walks throughout the town, which are part history, part theatre and part paranormal. 

Covering haunted bookshops and pubs, as well as the Bolton Massacre, all the stories you hear are based on real people and actual events.

Unlock the mysteries of Ancient Egypt

retail

Bolton’s connection to Ancient Egypt is little-known, but its collection of treasures is one of the country’s finest.

Bolton Museum’s multi-million pound Egyptology gallery reopened last year following a £3.8 million refurbishment and more than 275,000 have stepped back into the land of the Pharoahs since then.

Rivington Pike

One of the oldest pubs in Britain, Ye Olde Man & Scythe is thought to have been built in Churchgate some time before 1251.

But its place in the town’s history was cemented in 1651 when the Earl of Derby, James Stanley, was executed outside the pub for his part in the Bolton Massacre, which led to the death of 1,600 people.

The royalist spent the final hours of his life in the pub, which his family owned at the time, and it still contains the chair he supposedly sat on before being taken outside to be beheaded.

His spirit is also said to linger in the pub and has seen it named one of the country’s most haunted.

Catch a show at The Albert Halls

Samuel Crompton

Located within Bolton Town Hall, the 670-theatre is a popular spot for families looking to enjoy a pre-Christmas pantomime.

The iconic building is perhaps best known as the setting for Peter Kay’s stand-up DVD, ‘Live At The Bolton Albert Halls’, which was filmed there in 2003.

A recent refurbishment included the addition of a new restaurant run by Michelin-starred chef Paul Heathcote, which has promised to champion ‘proper northern, old-fashioned food’.

Visit Hall i’th’ Wood Museum

Originally built as a half-timbered hall in the 15th century, this handsome building was owned by wealthy yeomen and merchants.

Later rented out, it was home to a young Samuel Crompton whose Spinning Mule invention revolutionised the cotton industry. Links with Crompton remain in its interactive museum.

Take a stroll around Queens Park

street food stalls

Just north east of the town centre, this Victorian park is a peaceful haven away from the hustle and bustle.

For generations, it has been a place where Bolton families have gone to play, relax, have a picnic and feed the ducks.

Opened in 1866 by the Earl of Bradford, it has undergone a £4.3 million refurbishment in recent years.

It now boasts a children’s play area, a cafe, as well a series of grade II listed statues, including one of the former prime minister Benjamin Disraeli.

Spend an idyllic afternoon at Turton and Entwistle Reservoir

Sweet Green Tavern

This breathtaking beautyspot, tucked away down quiet country lanes on the moors north of Bolton, is the perfect spot for an afternoon walk.

A path runs around the edge of the reservoir, while other trails lead off into the surrounding woods.

The reservoir contains almost 3,4 million litres of water and, with along with nearby Wayoh Reservoir, provides about 50% of Bolton’s drinking water.

Grab a scoop at Holden’s Ice Cream

With flavours including Vimto, Uncle Joe’s Mint Balls, Eccles Cake and Manchester Tart, there are plenty of reasons to venture out to Edgworth for a scoop of this home made ice cream.

Known locally for their special family recipe they have been making their ice cream in the same premises since the 1930s.

Rock out at The Alma Inn

This Bradshawgate pub is a haven for lovers of rock, punk and metal music and hosts live gigs every weekend.

The 250-capacity venue is usually crammed with loyal regulars trying to catch the next big upcoming bands.

It’s reputation isn’t a secret, though. In 2015, it was shortlisted as one one of Britain’s best small music venues by music magazine NME.

Catch a show at The Octagon Theatre

Top Gear

The theatre is currently undergoing a major makeover, but is expected to throw open its doors again in the summer.

Dominic Monaghan and Sue Johnston are among the famous names to have trod the boards at the celebrated venue.

A diverse range of events are held throughout the year, ranging from classic and contemporary plays to musicals and festive productions for youngsters.

Fish and chips at Olympus

A popular pre-theatre spot, the town centre chippy is often ranked among Bolton’s best and has been attracting visitors from across the North West for more than 30 years.

The family run restaurant offers great fish and chip meals and has seating for more than 200 people, as well as a takeaway next door.

Tackle Go Ape in Rivington

Explore the forest canopy via a treetop rope course on the outskirts of Bolton.

The Go Ape adventure is a must-go attraction for a thrilling day out.

It’s a hit with adrenaline lovers as they embark on the challenging course featuring 13-metre-high platforms.

So get your trainers on and be prepared for the thrill of your life.

See the sights on a night out in Bradshawgate

Bolton’s nightlife comes in for a fair bit of stick, but it is still a good place to let your hair down.

Many bars and clubs can be found off Bradshawgate, which comes to life as revellers descend on the town centre on a Friday and Saturday evening.

Pay homage to Fred Dibnah

Victoria Square

One of Bolton’s most famous sons, the celebrity steeplejack found national fame through his BBC programmes celebrating Britain’s industrial heritage and the golden age of steam.

Following Fred’s death, his grade II listed former home was converted into a heritage centre so that fans could see his tools and machinery.

It closed in 2018 and the property is currently up for auction, but Fred’s legacy is still preserved in his hometown where a statue of him takes pride of place in the town centre.

Marvel at Le Mans Crescent

Art Gallery

The jewel in Bolton town centre’s crown, Le Mans Crescent is an architectural triumph on par with anywhere else in the North West

The grade II listed crescent is currently home to Bolton Museum, Art Gallery, Central Library and Aquarium, while plans are afoot to transform the former magistrates’ court into a luxury boutique hotel.

In recent years it has also proved a popular filming location for television dramas, including Peaky Blinders and Bancroft.

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UK’s coronavirus death toll rises by 684 to 3,605 in biggest jump yet – Mirror Online

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The UK’s coronavirus death toll has soared to 3,605 after 684 patients died in just 24 hours – the biggest single day increase yet.

The figure does not include people who have died at home. The previous total stood at 2,921 deaths.

The number of confirmed cases has increased to 38,168 after 4,450 more people tested positive.

Most of the deaths have been in England (3,244), followed by Scotland (172), Wales (141) and Northern Ireland (48).

Two NHS nurses, who were both mothers in their 30s with three young children, are among the latest patients to die after battling Covid-19 in hospital.

The grim news came as Health Secretary Matt Hancock, who is back at work after battling the virus, said the Government expects the virus to peak in Britain in the next few weeks and Prime Minister Boris Johnson, who is still infected with Covid-19 and isolating, urged people to stick with social distancing in a bid to flatten the curve.

Have you been affected by coronavirus? Email webnews@mirror.co.uk.

Aimee O'Rourke

The Department of Health said: “As of 9am on 3 April 2020, 173,784 people have been tested, of which 38,168 were confirmed positive.

“As of 5pm on 2 April 2020, of those hospitalised in the UK who tested positive for coronavirus, 3,605 have died.”

Public Health England said 11,764 tests were carried out on Thursday in England, while testing capacity for inpatient care in the country currently stands at 12,799 tests per day.

Two NHS nurses were among the latest patients to die.

BBC Radio 4

Mum-of-three Areema Nasreen, 36, was in intensive care on a ventilator after testing positive for the virus.

She worked at Walsall Manor Hospital in the West Midlands.

In Kent, Aimee O’Rourke, 38, died at the Queen Elizabeth The Queen Mother Hospital in Margate, where she worked.

The mum-of-three was hailed as a “brave angel” as her family said in a tribute: “Aimee was a beautiful woman and a valued NHS nurse.”

Boris Johnson

More than 10,000 tests carried out

Friday’s figures from the Department of Health show that for the second day running more than 10,000 new people were tested in the UK for coronavirus.

A total of 10,590 new people were reported as being tested in the 24 hours to 9am April 3.

The equivalent figure for April 2 was 10,215.

The total number of people in the UK tested since the outbreak began is now 173,784.

This is the equivalent of around 261 people in every 100,000, or 0.3% of the population.

The number of coronavirus-related hospital deaths reported by the Department of Health stood at 3,605 as of 5pm April 2.

It took 19 days for this number to pass 300. It has taken further 11 days to pass 3,000.

Meanwhile, the number of confirmed cases of coronavirus in the UK has taken two weeks to go from just under 4,000 (3,983 as of 9am March 20) to just under 40,000 (38,168 as of 9am April 3).

Commenting on the death of Ms Nasreen, Mr Hancock said: “I pay tribute to the NHS staff who’ve died serving the NHS, serving the nation.

“It shows the incredible bravery of every member of the NHS who goes into work knowing that these dangers are there.

“I think it is a testament to every doctor and nurse and paramedic and other health professional who is working in the NHS in these difficult times.

“And I think the whole nation is grateful.”

About 35,000 front-line NHS staff are not currently in work due to coronavirus, said Mr Hancock.

He said testing figures for health staff “should” rise to thousands a day in the next few weeks.

The Government has set a goal of testing 100,000 people a day across the whole of the UK by the end of April following widespread criticism of its testing strategy.

The Prime Minister’s spokesman said the 5,000-plus NHS staff who had been tested had mainly been tested at new testing sites.

Health Secretary

A total of 172 patients have died in Scotland after testing positive for coronavirus, up by 46 from 126 on Thursday.

3,001 people have now tested positive for the virus in Scotland, up from 2,602 the day before.

Officials said 176 people are in intensive care with coronavirus or coronavirus symptoms, and increase of 14 on Thursday.

First Minister Nicola Sturgeon warned: “I want to be very clear that nothing I have seen gives me any basis whatsoever for predicting the virus will peak as early as a week’s time here in Scotland.”

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A total of 24 patients have died after testing positive for coronavirus in Wales, bringing the total number of deaths in the country to 141, health officials said.

Public Health Wales said 345 new cases had tested positive for Covid-19, bringing the total number of confirmed cases in Wales to 2,466.

Dr Robin Howe, from Public Health Wales, said “345 new cases have tested positive for Covid-19 in Wales, bringing the total number of confirmed cases to 2,466, although the true number of cases is likely to be higher”.

Dr Howe added: “Twenty-four further deaths have been reported to us of people who had tested positive for Covid-19, taking the number of deaths in Wales to 141.

Louisa Jordan

“We offer our condolences to families and friends affected, and we ask those reporting on the situation to respect patient confidentiality.”

The Welsh Government will introduce a law compelling all employers to make sure their workers keep two metres apart, Wales’ First Minister has said.

Mark Drakeford said the social distancing legislation, the first in the UK, would require bosses to “put the needs of their workforce first” when it comes into force on Monday or Tuesday of next week.

The number of people who have died in Northern Ireland after contracting coronavirus has risen by 12 to 48, health officials said.

Testing has resulted in 130 new positive cases, bringing the total number of confirmed cases in the region to 904.

Manchester's Central Complex

In England, two siblings of Ismail Mohamed Abdulwahab, the 13-year-old London boy who died after testing positive for coronavirus, have also developed symptoms, according to a family friend who launched an online appeal.

The development means Ismail’s mother and six siblings are forced to self-isolate and cannot attend his funeral in Brixton on Friday, Mark Stephenson said.

Meanwhile, Prince Charles, who tested positive for coronavirus last month, officially opened the NHS Nightingale Hospital at the ExCeL centre in east London.

The Prince of Wales, 71, appeared via video-link from his Scottish home of Birkhall and spoke to those gathered at the entrance of the new temporary hospital.

He said: “It is without doubt a spectacular and almost unbelievable feat of work in every sense, from its speed of construction – in just nine days as we’ve heard – to its size and the skills of those who have created it.

Mark Stephenson

NHS Nightingale Hospital – the facts

The NHS Nightingale Hospital has been built in east London in the ExCel convention centre.

The facility will be used to treat Covid-19 patients transferred from intensive care units across London

Just one ward will need 200 members of staff

“An example, if ever one was needed, of how the impossible could be made possible and how we can achieve the unthinkable through human will and ingenuity.”

Charles added: “The creation of this hospital is above all the result of an extraordinary collaboration and partnership between NHS managers, the military and all those involved to create a centre on a scale that has never been seen before in the United Kingdom.

“To convert one of the largest national conference centres into a field hospital, starting with 500 beds with a potential of 4,000, is quite frankly incredible.”

The prince and Mr Hancock both recently ended self-isolation after contracting the virus and Charles commented on the fact they had recovered.

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He said: “Now I was one of the lucky ones to have Covid-19 relatively mildly and if I may say so I’m so glad to see the Secretary of State has also recovered, but for some it will be a much harder journey.”

Shortly after he spoke, Buckingham Palace confirmed the Queen has recorded a special broadcast on the coronavirus outbreak to be broadcast on Sunday night.

Previously, it was said that the 93-year-old monarch, who is isolating with Prince Philip, 98, at Windsor Castle, was preparing to make a televised address to calm the nation’s nerves, but was waiting for the “right moment” to address the country.

Mr Hancock, meanwhile, praised all those involved in the setting up of the hospital, adding the “extraordinary project”, the core of which was completed in just nine days, was a “testament to the work and the brilliance of the many people involved”.

Matt Hancock

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He also praised the NHS and the way its staff are dealing with the virus crisis.

The Health Secretary said: “In these troubled times with this invisible killer stalking the whole world, the fact that in this country we have the NHS is even more valuable than before.”

Asked about the number of ventilators currently in use and how many are expected to arrive next week, Mr Hancock said: “We’ve obviously got a big programme to ramp up the number of ventilators and we now have more ventilators than we had before.

“And we’re going to need them for this hospital and I’m just going to go and have a look at that now.”

Pressed for exact numbers, Mr Hancock did not respond.

Northern Ireland

Speaking on BBC Radio 4’s Today programme earlier, Mr Hancock said it is unclear whether he is now immune to Covid-19.

He described having coronavirus as a “pretty unpleasant experience” with an “incredibly” sore throat and a feeling of “having glass in my throat”.

He said he has lost half a stone in weight.

Prime Minister Boris Johnson remained in isolation in Downing Street after testing positive for the virus.

He was “feeling better” but still had a fever on Friday.

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In a video on social media, the Prime Minister urged the public to stick with social distancing and not be tempted to “hang out” in the warmer weather predicted for this weekend.

“In my own case, although I’m feeling better and I’ve done my seven days of isolation, alas I still have one of the symptoms, a minor symptom, I still still have a temperature,” he said.

“So, in accordance with government advice I must continue my self-isolation until that symptom itself goes.”

Mr Johnson said people must not be tempted to break social distancing rules as the weather warms up even if they were going “a bit stir crazy”

In England, more than 26.7 million units of personal protection equipment (PPE) were delivered to 281 NHS “trusts and providers” on Thursday, Downing Street confirmed.

Prime Minister

Mr Johnson’s spokesman said: “That included 7.8 million aprons, 1.7 million masks and 12.4 million gloves.”

It follows the new guidance issued by Public Health England about the level of protection health staff should wear depending on the patient situation.

There would be no new guidance published on the public wearing masks or face coverings when out of the house, said the spokesman.

The spokesman said “surveillance” of the population to determine the spread of coronavirus was ongoing, with 3,500 antibody tests carried out per week.

“This is a population surveillance programme which we have been carrying out since February,” said the spokesman.

“It is being done by Public Health England at their campus which is at Porton Down.

“We currently have capacity for 3,500 of these surveillance tests to be carried out this week which is enough for small-scale population sampling.”

Two newly-planned temporary hospital sites have been agreed at the University of the West of England and the Harrogate Convention Centre.

They will join other sites due to open at Birmingham’s National Exhibition Centre and Manchester’s Central Complex.

Construction of a temporary hospital called the NHS Louisa Jordan is underway in Glasgow.

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EBB 117 – The Evidence on Inducing for Due Dates – Evidence Based Birth®

person

Hi, everyone. On today’s podcast, we’re going to talk about the evidence on inducing labor for going past your due date.

Welcome to the Evidence Based Birth podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD and the founder of Evidence Based Birth. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details.

Hi, everyone. On today’s podcast, we’re going to talk about the evidence on inducing versus waiting for labor when you’re going past your due date. I’m going to be joined by Anna Bertone, MPH, our Research Editor at Evidence Based Birth to talk about this topic.

Before we get started, I have a quick announcement, and that is next week we are hosting free webinars for the public all about the Evidence Based Birth Childbirth Class. On Monday, March 2, we’ll host a special webinar just for parents. We’ll give you a peek behind the scenes at what it’s like to take our Evidence Based Birth Childbirth Class. Then on Tuesday, March 3, we’ll have a special webinar just for birth professionals to give you a tour of the Evidence Based Birth Childbirth Class so that you can decide if it’s something you’d like to recommend to your clients or not. You can register for these free webinars at evidencebasedbirth.com/childbirthclasswebinar. That’s all one word /childbirthclasswebinar.

All right, now back to the topic at hand, inducing labor for going past your due dates. Now before we begin, I do want to give a brief trigger warning. In our discussion about the research evidence on this topic, we will be talking about stillbirth and newborn death. So there has been a ton of new research on the evidence on induction versus waiting for labor when you go past your due date. So much research, in fact, that we have decided to separate our Signature Article on due dates into two separate articles.

So we still have the original article, The Evidence on Due Dates, which you can find at ebbirth.com/duedates. And although we updated that article a little bit, it’s remained very similar to previous additions. It talks about the length of a normal pregnancy, factors that can make you more or less likely to have a long pregnancy, et cetera. But then we separated out the research on induction into a new article that you can find at ebbirth.com/inducingduedates. This is a peer-reviewed article that covers all of the research on induction versus something called “expectant management” for going past your due date. And in today’s podcast, we’re going to update you on the latest info that we found for that article.

Just a heads up, we will not be covering the research evidence on inducing at 39 weeks. We already covered the ARRIVE study, a randomized trial that looked at induction versus expectant management for 39 weeks of pregnancy in episode 10 of the Evidence Based Birth podcasts. And just a tip, if you’re having trouble finding any of our earlier episodes of this podcast, iTunes has stopped showing the earliest podcasts, but they’re still out there and you can find them on Spotify and any other podcasting app. You can also find info about the ARRIVE study at ebbirth.com/arrive.

So we’re not going to talk about induction at 39 weeks. Instead, we’re going to be focusing on the evidence on induction versus waiting for labor once you reach 41 weeks. And to do so, we’re going to talk with our Research Editor, Anna. So welcome, Anna, to the Evidence Based Birth podcasts.

Anna Bertone:   Thank you! I’m glad to be on the podcast again.

So I want to start by explaining to our audience a little bit kind of about the background of why this topic is important. Inductions for non-medical reasons have been on the rise in the United States and all around the world for the past 30 years. And increasingly, more people who are pregnant are being induced for reaching their estimated due date. So we really want to cover the benefits and risks of elective induction for going past your estimated due date. And we’ll also talk about whether or not your goals and preferences for your birth matter, which of course they do, but that kind of plays a role as well.

So how often are people induced for going past their due date? Well, we don’t know for sure because this hasn’t been measured recently. But according to the 2013 Listening to Mothers III survey, which was now published about seven years ago, more than 4 out of 10 mothers in the U.S. said that their care provider tried to induce labor. Inducing labor for going past your due date was one of the most common reasons for an induction. Out of everyone who had an induction in this study, 44% said they were induced because their baby was full term and it was close to the due date. Another 18% said that they were induced because the healthcare provider was concerned that the mother was overdue.

The Centers for Disease Control in the U.S. also reported in 2018 that about 27% of people had their labor induced, but we think that number is probably low and that the percentage of people who have labor induced is under-reported in the Vital Statistics Program in the United States. So Anna, can you talk a little bit about why there’s so much controversy over this concept of electively inducing labor once you go past your due date?

Anna Bertone:   So why is there so much controversy about elective induction? Elective inductions by definition are labor inductions that do not have a clear medical reason for taking place. They occur for social reasons, like the provider wanting the mother to give birth before the provider goes out of town or for other non-medical reasons like the pregnancy getting uncomfortable and for the mother’s convenience. But there’s also a gray zone about what constitutes an elective induction. Many providers only consider an induction to be “elective” when the mother is healthy, pregnant with a single baby, and less than 41 weeks pregnant. The gray zone is that sometimes when the pregnancy goes past 41 weeks, some providers consider that to be a medically indicated induction rather than an elective induction. But in general, inductions are considered medically indicated when there are accepted medical problems or complications with the pregnancy that make it less safe to continue the pregnancy.

For many years, and I remember when I first entered the birth world in 2012, a lot of people talked about the fact that if you have an induction it doubles your chance of cesarean. And then all of a sudden there were people saying that wasn’t true. So can you talk a little bit about that controversy?

Anna Bertone:   So for many years, the common belief was that elective induction doubles the cesarean rate, especially in first-time mothers. But researchers nowadays consider those earlier studies to be flawed. In the earlier studies, what they would do is they would compare people assigned to elective induction to people who went into spontaneous labor. Nowadays, they don’t compare those two groups anymore. They compare people assigned to elective induction to the people assigned to what’s called expectant management, or in other words waiting for labor. And in that group, the person could either go into spontaneous labor or they could require an induction for medical reasons (so that would be a medically indicated induction), or they could choose elective induction further along in the pregnancy.

So that’s a subtle difference but an important one because in the earlier studies they compared elective induction to spontaneous labor. But you don’t have the choice to go into spontaneous labor today. Your choice is to be induced today or to wait for labor to start. And sometimes during that waiting period you might develop complications that require an induction, or you might change your mind and decide to have an elective induction, or you might go into spontaneous labor.

Anna Bertone:   Right. So nowadays, we compare a group assigned to elective induction to a group assigned to expectant management. One example of this was the ARRIVE trial.

The ARRIVE trial was a study comparing elective induction at 39 weeks versus expectant management. We’re not going to go into that trial in detail because we already covered it in detail in episode 10 of the Evidence Based Birth podcasts. But they actually found a lower risk of cesarean in the elective induction group. Researchers think that had to do with the fact that of the people in the expectant management group, more of them developed problems with blood pressure that required medical inductions and increased risk for complications. So again, that just kind of goes to show you that it does make a difference when you compare elective induction to expectant management.

Although, one thing you have to keep in mind with the ARRIVE study is that they had a very low cesarean rate in both groups compared to some settings. The cesarean rate was 19% in the elective induction group versus 22% in the expectant management group. So those research results cannot probably be generalized to settings with extremely high cesarean rates or high cesarean rates with inductions. We have some, for example, some professional members at Evidence Based Birth who talked to us about where they’re practicing and how high the cesarean rates are with the elective inductions there. So I think you have to be careful how you generalize or apply that data from the ARRIVE study, and we talk more about that in episode 10 of the podcast.

Which leads me to another point, and that is some cautions about the evidence. When I say generalize, that means taking research from a research study, and seeing if you can apply that to where people are giving birth in your community. So it’s important to understand that there are some major drawbacks to some of the research that we’re going to be talking about. Many of the studies are carried out in countries or time periods where there are low cesarean rates. So when that happens, when a study is carried out in a setting where culturally there’s low C-section rates, that might not apply to a hospital with high cesarean rates. If your hospital has high rates of “failed inductions” and strict time limits on the length of labor, then the evidence in these studies may not apply to you because induction might be more risky in your community hospital.

Also, another disclaimer about the evidence, in these trials, people are randomly assigned to induction or expectant management. And it’s important to remember that the people assigned to expectant management do not always go into labor spontaneously. There’s a mix of people in that group. Some of them do have a spontaneous labor. Others have an elective induction later on, and others have a medical induction for complications.

Also, you have to look at what they’re doing for fetal testing in the studies. In some studies there’s lots of fetal testing going on in the expectant management group. However, we’re going to talk about one of the studies where they were not doing any standard fetal monitoring during expected management. So those results might not apply to your community if your community does the fetal monitoring, and the study did not have fetal monitoring.

Finally, another disclaimer about the research evidence is that the induction protocols vary from study to study, and even within studies themselves. So knowing what the protocol was for induction in that study can be very helpful to decide if this is going to apply to your unique situation in your local community or not.

So with all of those disclaimers being said, there’s been quite a lot of new research in the past year about induction at 41 weeks. So Anna, can you talk about one of the most recent studies? Let’s talk about the INDEX trial from the Netherlands. There were two trials that came out in 2019, two large randomized control trials. Let’s talk about the INDEX one first.

Anna Bertone:   Sure. So the INDEX trial was from the Netherlands. INDEX stands for induction at 41 weeks, expectant management until 42 weeks. This was a large multicenter trial. It was conducted at 123 midwifery practices and 45 hospitals. Most of these pregnancies were managed by midwives.

…So this was the midwifery-led model of care-

Anna Bertone:   Exactly.

… which is very different than in the United States which is typically an obstetrician-led care model.

Anna Bertone:   The researchers randomly assigned a total of 1,801 pregnant people to either induction at 41 weeks and zero to one days or to wait for labor until 42 weeks and zero days, which is called expectant management. The reason they were able to conduct this study in the Netherlands and got ethical approval for it is because it was standard practice for them to not induce labor before 42 weeks with an uncomplicated pregnancy.

…Whereas in the U.S. it’s rare to see someone go to 42 weeks, in the Netherlands, they typically won’t induce you unless there’s medical reasons until you get to 42 weeks – 

Anna Bertone:   Exactly. So the mothers were enrolled in the study between 2012 and 2016. Everyone had to be healthy, and pregnant with single, head-down babies. The gestational ages were estimated with ultrasound before 16 weeks of pregnancy. They excluded people with a prior cesarean, with high blood pressure disorders, with expected problems with the baby’s growth, abnormal fetal heart rate, or known fetal malformations (congenital anomalies). In both groups, cervical ripening and induction methods depended on local protocol. It’s like what Rebecca was talking about earlier. There wasn’t a standard protocol to apply to both groups in this study when it came to cervical ripening and induction. It was based on local protocol. And this is an important weakness of the study because the providers might’ve managed labor inductions differently based on whether someone was being electively induced or was assigned to the expectant management group. It also limits the study’s generalizability, which means our ability to apply the results of this study to the population at large because providers don’t have an induction protocol that they can replicate.

…So we can learn from what happened in this study, but it’s difficult for us to apply it to across the board because there’s no specific induction protocol that could be followed – 

Anna Bertone:   Yeah. What happened was in the elective induction group, 29% of the participants went into labor before their induction and 71% were induced. Then in the expectant management group, 74% of the participants went into labor spontaneously before their planned induction and 26% were induced.

…And before we talk about how long the pregnancies were, I think it’s important for people to understand that when you have a randomized controlled trial like this the researchers do something called intent to treat analysis. So it doesn’t matter what type of birth they had, whether it was a spontaneous labor or a medical induction, the data were analyzed depending on which group you were originally assigned to. So if you were assigned to an elective induction but you happen to just quick go into labor on your own before the induction, you were still grouped with everyone in the elective induction group and vice versa. So that’s just an important distinction for people to understand. – 

Anna Bertone:   Yes. What happened with these results is that the median pregnancy was only two days shorter in the elective induction group compared to the expectant management group. This is interesting because they still found a difference between these two groups, but-

…And this is important because a lot of people ask us like, “Well, I only want to wait one more day, or two more days, or three or four more days,” but they’re saying by decreasing the length of the pregnancy by two days they found significant results. So what did they find in the INDEX trial? – 

Anna Bertone:   So for mothers, they found that there was no difference in the cesarean rates. This was taking place in a country with low cesarean rates. It was a midwifery model of care and the rates were very low in both groups (11%). 

They only had an 11% cesarean rate then?

Anna Bertone:   Yeah. They also had an outcome called a composite outcome, which is a combined outcome for mothers, and there was no difference in that measure either. They were looking for things like excessive bleeding after birth, manual removal of the placenta, severe tears, intensive care admission, and maternal death, and they didn’t find a difference in those things. There were no maternal deaths in either group. So as far as the bad outcomes for the mothers, there were about 11% to 14% in both groups, but not different.

…And what about for the babies then? – 

Anna Bertone:   And then for the babies, the babies in the elective induction group had a lower composite outcome rate. And in this composite outcome, what they were looking at was perinatal death, Apgar score less than seven at five minutes, low pH, meconium aspiration syndrome, nerve injury, brain bleeds, or admission to a NICU. And here they found a lower composite adverse outcome rate with the babies in the elective induction group (1.7% versus 3.1%). 

And why do they think that outcome was better with the elective induction group?

Anna Bertone:   They think that it was mostly due to the lower rate of Apgar scores less than seven at five minutes, and that probably contributed the most to having a lower adverse outcome rate with the babies in the elective induction group. The author’s note that there was no difference in rates of Apgar score less than four at five minutes, but they found that the combined outcome was still lower in the elective induction group if they used an Apgar score of less than four at five minutes and excluded fetal malformations. So basically, the babies in the elective induction group had better Apgar scores overall.

…And what about stillbirths? Because that’s like the main reason they’re doing these kinds of elective inductions, is to lower the risk of stillbirth. – 

Anna Bertone:   Yep. And they did not find a difference in stillbirth in this study. There was one stillbirth that occurred in the elective induction group. It was at 40 weeks and six days, before the mother was induced. Then, there were two stillbirths that occurred in the expectant management group while the mothers were waiting for labor.

Anna Bertone:   I looked for a few more details about those stillbirths because I was interested in that. Of the two stillbirths that occurred in the expectant management group, one was a small for gestational age baby at 41 weeks and three days to a first-time mother. The other one was to a mother with a prior birth, and that was at 41 weeks and four days. The mother’s placenta showed signs of infection (infection of the membranes). Then, the one stillbirth that occurred at in the elective induction group at 41 weeks was to an experienced mother (someone who had already had given birth before), and that was at 40 weeks and six days, and there was no explanation for that one. But with two versus one, they didn’t find a significant differences in stillbirths between those groups.

And what was the protocol for fetal monitoring in that study?

Anna Bertone:   There was no protocol for fetal monitoring. It depended on local guidelines, just like the induction and cervical ripening protocol. But the study authors say that fetal monitoring and assessment of amniotic fluid levels was typically done between 41 and 42 weeks. 

So how would you sum up the results of this INDEX study then?

Anna Bertone:   They found that elective induction at 41 weeks resulted in similar cesarean rates and less overall bad outcomes for babies compared to waiting for labor until 42 weeks. However, they say that the absolute risk of a bad outcome happening was low in both groups. It was 1.7% in the elective induction group versus 3.1% in the expectant management group (the group that waited until 42 weeks).

All right. Well, the next study we wanted to talk about was the SWEPIS trial from Sweden, also published in 2019, also coming out of Europe. It’s S-W-E-P-I-S, and it stands for the Swedish post-term induction study, or SWEPIS. It got a lot of media attention with headlines like … There was one that said, “Post-term pregnancy research canceled after six babies died.” And it is true that this study was ended early after deaths in the study. The researchers intended to enroll 10,000 mothers from multiple centers across Sweden, but they ended up stopping the study with about 1,380 people in each group after their data safety and monitoring board found a significant difference in perinatal death between the groups.

Data safety and monitoring boards are basically a board that keeps track of what’s going on in the study. They get interim reports. And if they see any concerning safety issues, they have the power to stop the studies. That’s a standard part of a lot of randomized controlled trials is to have one of these safety boards.

Similar to the INDEX trial in the Netherlands, in Sweden, labor is typically not induced before 42 weeks if you have an uncomplicated pregnancy. Also similar to the Netherlands, in Sweden, midwives manage most of the pregnancies and births. It’s a midwifery-led model of care.

The purpose of the SWEPIS study was to compare elective induction at 41 weeks and zero to two days versus expectant management and induction at 42 weeks and zero to one day if the mother hadn’t gone into labor by that point. The study was carried out in the years 2015 to 2018. The researchers enrolled healthy mothers with single babies in head-first position. They had accurate gestational ages. They excluded people with a prior cesarean, diabetes, and other complications such as high blood pressure, small for gestational age, or known fetal malformations.

There is a pretty low stillbirth rate in Sweden, so they thought they would need about 10,000 people to see a difference between groups, but they ended up not needing nearly that many people to find a difference in stillbirth rates. One of the big strengths of the SWEPIS trial is that in contrast to the INDEX trial, in the SWEPIS trial they defined an induction protocol and they used that same protocol with everyone in the elective induction group and everyone in the expected management group who had an induction. The protocol was basically if the mother’s cervix was already ripe, they simply broke her water and gave her oxytocin as needed by IV. If the mother’s cervix was not ripe or the baby’s head was not engaged, they used mechanical methods or Misoprostol, or prostaglandins, or oxytocin, but they did cervical ripening first.

In the elective induction group, most of the people were induced. 86% had their labor induced. 14% went into labor spontaneously before the induction. In the expectant management group, 67% of them went into labor spontaneously and 33% ended up with an induction. Similar to the INDEX trial, there was a really tiny difference in the length of pregnancy between groups. Pregnancy in the elective induction group was in general only three days shorter than pregnancy in the expectant management group, but yet they did go on to find significant differences.

So what the SWEPIS trial found was that for babies – this is why this study was stopped early – there were five stillbirths and one early newborn deaths in the expectant management group out of 1,379 participants for a death rate of 4.4 deaths per 1,000 women. There were zero deaths in the elective induction group out of 1,381 participants. All five stillbirths in the expectant management group happened between 41 weeks, two days and 41 weeks, six days. Three of the stillbirths had no known explanation. One was for a baby that was small for gestational age. The other was with a baby who had a heart defect. There was one newborn death that occurred four days after birth due to multiple organ failure in a baby that was large for gestational age.

The authors mentioned that when complications are present at the end of pregnancy, such as problems of the placenta, or the umbilical cord, or fetal growth, these problems may become increasingly important as each day of pregnancy progresses, which they believe is why they found a higher death rate with expectant management past 41 weeks.

Another key finding of the study was that all of these deaths occurred to first-time mothers, which suggests that 41-week induction may be especially beneficial for babies of first-time mothers. They found that it only took 230 inductions at 41 weeks to prevent one death for a baby, and this was a much lower number than previously thought. If you remember, though, as Anna was saying, the INDEX trial did not find a significant difference in death between the induction group and the expectant management group. We think the reason the SWEPIS study found a difference was because it was a larger study, it was better able to detect differences in rare outcomes like death. Also, with the SWEPIS study, there might not have been as good fetal monitoring. So it’s possible that the better fetal monitoring of participants between 41 weeks and 42 weeks in the INDEX trial might’ve been protective, leading to fewer perinatal deaths. We can’t be certain though because there were no fetal monitoring protocols in either trial.

Another thing to note is that participants in the SWEPIS expectant management group tended to give a birth a little later than the participants in the INDEX expectant management group. That might help explain the higher perinatal death rate in the expectant management group in SWEPIS. They did not find a difference in what they call the composite adverse perinatal outcome, which included death, low Apgar scores, low pH, brain bleeds, brain injury, seizures, and several other major complications, but there was that significant difference in perinatal death (either having a stillbirth or newborn death).

Also, the elective induction babies were less likely to have an admission to intensive care, 4% versus 5.9%. They had fewer cases of jaundice, 1.2% versus 2.3%, and fewer of them were big babies, 4.9% versus 8.3%.

For mothers, the outcomes were overall pretty good. There were no differences in cesarean rates similar to the other trial. The cesarean rate in this study in both groups was about 10% to 11%. More mothers in the elective induction group had an inflammation of the inner lining of the uterus called endometritis, 1.3% versus 0.4%. And on the other hand, more mothers in the expected management group developed high blood pressure, 3% versus 1.4%. They also interviewed the women in both groups and they found that the mothers in the expectant management group really struggled with negative thoughts. They described feeling in limbo while they waited to go into labor. So Anna, can you talk a little bit about the fetal monitoring in this study and how it may have differed from the other study?

Anna Bertone:   Sure. Fetal monitoring in this study was done per local guidelines. So there was no study protocol for fetal monitoring during the 41st week of pregnancy. However, the mothers recruited from one region of Sweden, called the Stockholm region, which made up about half the people in the study, had ultrasound measurements of their amniotic fluid volume and abdominal diameter at 41 weeks, whereas the people that came from the other areas of Sweden in the study did not receive these assessments regularly. None of the six deaths that occurred in this study occurred in the Stockholm region of Sweden where they received this type of fetal monitoring, which leaves us with the question of how important was this fetal monitoring. Could it have made the difference between the Stockholm region participants not experiencing fetal deaths whereas participants from other regions did?

Anna Bertone:   So that’s just an important thing to keep in mind with this study is that the fetal monitoring may have made a difference as far as the perinatal outcomes. It also means that the results of the SWEPIS study might not apply equally to mothers who receive fetal monitoring at the end of pregnancy, specifically during that 41st week of pregnancy which seems to be the really critical time period. Another thing, all of the perinatal deaths in this study occurred to first-time mothers, which tells us that the results might not apply equally to mothers who have already given birth before.

…So in the SWEPIS study, out of the mothers in the study who had already given birth before and were having a subsequent baby, none of them experienced this stillbirth or newborn death, correct?

Anna Bertone:   Correct. Yes.

Okay. So all of the perinatal deaths occurred to first-time mothers.

Anna Bertone:   And the first-time mothers, by the way, they only made up about half of the participants in the sample, so it was about a 50/50 split.

So all of the fetal and newborn deaths from this study came from first-time mothers who lived in the areas of Sweden that did not do any prescribed fetal monitoring during that 41st week of pregnancy.

Anna Bertone:   That’s my understanding. Correct.

Okay. So those are the two big randomized trials that came out in 2019. Before they were published, there was a 2018 Cochrane meta-analysis. Anna, I was wondering if you could talk a little bit about that. This study did not include the SWEPIS and the INDEX trials, but we still wanted to talk about it in our article. So can you explain to our listeners a little bit about this Cochrane review?

Anna Bertone:   Sure. There was a 2018 Cochrane review and meta-analysis by Middleton. Unlike these randomized control trials that we were just talking about, they didn’t focus specifically on the 41st week of pregnancy versus the 42nd week of pregnancy. It was much more broad than that. What they did was they looked at people who were electively induced at some point, and compared them to people who waited for labor to start on its own until some point. So there was a much more broad range of gestational ages there. But they included 30 randomized control trials with over 12,000 mothers, and they compared a policy of induction at or beyond term versus expectant management. All of the trials took place in Norway, China, Thailand, the U.S., Austria, Turkey, Canada, the UK, India, Tunisia, Finland, Spain, Sweden, and the Netherlands.

So it’s quite a global sample.

Anna Bertone:   Yes. But one study in this meta-analysis really dominated and accounted for about 75% of the data, and that was the Hannah post-term trial that I think Rebecca is going to be talking about soon. Because that one trial dominated this meta-analysis so much, most of the data was on giving birth at 41 weeks or later.

And they did not include the ARRIVE trial in this meta-analysis.

Anna Bertone:   Right. They didn’t include the ARRIVE, INDEX, or SWEPIS trials. So in its next update, it’s going to be updated with those three randomized control trials. But they did include 30 other randomized control trials. What they found was that a policy of induction at term or beyond term was linked to 67% fewer perinatal deaths compared to expectant management. So that was two deaths with induction at or beyond term versus 16 deaths in the people assigned to expected management.

Anna Bertone:   The Hannah post-term trial excluded deaths due to fetal malformations, but some of the smaller trials that were included in the Cochrane meta-analysis did not. So if we exclude the three deaths from severe fetal malformations, then the final count is one death in the induction group and 14 in the expectant management group. So it doesn’t change the results too much overall to exclude fetal malformations. Overall, they found that the number needed to treat was 426 people with induction at or beyond term to prevent one perinatal death. Specifically, there were fewer stillbirths with a policy of induction at or beyond term.

Which was a different number needed to treat than the SWEPIS trial, which found only took 230 inductions at 41 weeks to prevent one perinatal death.

Anna Bertone:   Yeah. I think part of the reason the SWEPIS trial was so groundbreaking and got so much media attention is because it did find a lower number needed to treat than had been found previously. So the absolute risk of perinatal death was 3.2 per 1,000 births with the policy of expected management versus 0.4 deaths per 1,000 births with the policy of induction at or beyond term. They found that a policy of induction was linked to slightly fewer cesareans compared to expectant management, 16.3% versus 18.4%.

Anna Bertone:   Fewer babies assigned to induction had Apgar scores less than seven at five minutes compared to those assigned to expectant management. They didn’t find any differences between the groups with the rate of forceps or vacuum assistance at birth, perinatal trauma, excessive bleeding after birth, total length of hospital stay for the mother, newborn intensive care admissions, or newborn trauma. The authors concluded that individualized counseling might help pregnant people choose between elective induction at or beyond term or continuing to wait for labor. They stress that providers should honor the values and preferences of the mothers.

We need more research to know who would or would not benefit from elective induction. And the optimal time for induction is still not clear from the research, which is what they said in 2018. I think Rebecca’s going to talk about the famous Hannah post-term study that accounted for 75% of the data in that meta-analysis.

Yeah, so we’re kind of working backwards through time. We started with the 2019 randomized trials, then the 2018 meta-analysis where they said the optimal time for induction is not clear, but they stated that before the two new randomized trials came out. Then even before then going back in time is the 1992 Hannah post-term study, which is one of the most important studies on inducing for going past your due date and it was the largest randomized trial ever done on this topic, larger even than INDEX or SWEPIS. And it controls most of the findings in that Cochrane meta-analysis that Anna just described.

So let’s look at what happened in this study because it plays so much of a role in the meta-analysis. It was carried out between the years 1985 and 1990 when a group of researchers enrolled 3,407 low-risk pregnant people from six different hospitals in Canada into the study. Women could be included if they were pregnant with a live single fetus, and they were excluded if they were already dilating, if they had a prior cesarean, pre-labor rupture membranes, or a medical reason for induction.

This study had a much different expectant management protocol than INDEX or SWEPIS because unlike those studies where the longest you would go was 42 weeks and zero to one or two days, in the Hannah post-term study, the people assigned expectant management were monitored for as long as 44 weeks pregnancy before they were induced, so up to a month past your due date, which is almost unheard of today. At around 41 weeks, people who agreed to be in the study were either randomly assigned to have an induction of labor or fetal monitoring with expectant management.

In the induction group, labor was induced within four days of entering the study, usually about 41 weeks and four days. If the cervix was not ripe and if the fetal heart rate was normal, they were given a prostaglandin E2 gel to ripen the cervix. They used a maximum of three doses of gel every six hours. If this did not induce labor or if they did not need the gel, people were given IV oxytocin, had their waters broken, or both. And they could not receive oxytocin until at least 12 hours after the last prostaglandin dose.

So one strength of this study is that it had a defined induction protocol that providers could replicate. But the big weakness of this study is that the expectant management group did not have that same induction protocol. In the monitored or expected management group, people were taught how to do kick counts every day and they had a non-stress tests three times per week. They also had their amniotic fluid levels checked by ultrasound two to three times per week. And labor was induced if there were concerning results in the non-stress test, or if there was low amniotic fluid, or if the mother developed complications, or if the person did not go into labor on their own by 44 weeks. And if doctors decided the baby needed to be born, mothers in expectant management group did not receive any cervical ripening. Instead, they either had their water broken and/or IV oxytocin, or they just went straight to a cesarean without labor. So Anna, do you want to talk a little bit about what the researchers found in the study?

Anna Bertone:   What the researchers found in the Hannah post-term study is that in the induction group, 66% of the people were induced and 34% went into labor on their own before induction. And in the expectant management group, 33% were induced and 67% went into labor on their own. There were two stillbirths in the group assigned to wait for labor and zero in the group assigned to induction. This difference was not considered to be statistically significant, which means we don’t know if it happened by chance or if it was a true difference between the groups. The more interesting outcome to look at with the Hannah post-term trial are the findings on cesarean rates because they differ depending on what numbers you look at. You can either look at the outcomes for the two original groups, which were the people randomly assigned to induction and then those assigned to expectant management, or you can look at the breakdown of what actually happened to the people in the two groups, in other words what happened to the people who were actually induced or who actually went into spontaneous labor.

Anna Bertone:   So what happened in the original randomly assigned groups? If you look at the two original groups, the overall cesarean rate was lower in the induction group. It was 21.2% versus 24.5%. That was even after taking into account factors like the mother’s age, whether or not it was her first baby, and cervical dilation at the time of study entry. Or you could look at what happened with the people who were actually induced or who actually went into labor on their own. And if you look at that, you see two very interesting things. You see that people who went into spontaneous labor, regardless of which group they were assigned to, they had a cesarean rate of only 25.7%. But if people in the monitoring group had an induction, their cesarean rate was much higher than all the other groups. It was 42%. The same was true for both first-time mothers and for mothers who had given birth before.

Anna Bertone:   So what does this mean? It means that only the people who were expectantly managed but then had an induction had a really high cesarean rate. The people who were expectantly managed and then went into labor spontaneously did not have a higher cesarean rate. One possible reason for this, for the highest cesarean rate seen in the people who were assigned to expectant management but then ended up getting an induction, is that the people in this group might’ve been higher risk to begin with since a medical complication could have led to their induction. The people that were assigned to expectant management and never developed a complication requiring an induction, those were the lower risk people, which means they were the ones less likely to end up giving birth by cesarean.

Anna Bertone:   Then, another important factor that I know Rebecca has discussed previously is that doctors might’ve been quicker to call for a cesarean when assisting the labors of people with medical inductions if their pregnancies were beyond 42 weeks. They may have been less patient waiting for labor.

…Or more easily worried about the course of the labor, big baby, etc. – 

Anna Bertone:   Yes. More worried.

So basically, it seems like from the Hannah post-term trial, one of the benefits of considering expectant management is that if you do have spontaneous labor, your chance of cesarean is pretty low. But the risk is that you’ll develop medical complications and need an induction, in which case an induction at 42 weeks is going to be riskier than an induction at 41 weeks. So what do you think? We have all this research from all over the world, from the Hannah post-term trial, to the 2018 meta-analysis, to two trials out in 2019. Do you still feel like routine induction at 41 weeks is still going to be controversial or not?

Anna Bertone:   I think it’s definitely still controversial, and I think everybody’s still processing the results from the INDEX trial and the SWEPIS trial. Rebecca and I reached out to Dr. Wennerholm who conducted the SWEPIS trial in Sweden, and she said she’s currently working on secondary analysis of the data. They’re talking about the economic implications of the findings in Sweden and what it means for Swedish national policy. So I think it’s still controversial. People are still talking about what to make of these findings.

Anna Bertone:   There was another systematic review from 2019 by Riedel. This one came out too early to include the SWEPIS and the INDEX trials, but it’s still interesting to look at. Because unlike the Middleton Cochrane review, these authors were specifically interested in induction during the 41st week of pregnancy versus during the 42nd week of pregnancy. So in their analysis, they restricted the studies only to people having a routine induction at 41 weeks and zero to six days versus routine induction at 42 weeks and zero to six days. If you remember, the Cochrane review was much broader than that. They also only looked at studies published within the last 20 years. They only looked at studies with low-risk participants, and they ended up with three observational studies, two randomized controlled trials, and two studies that they called “quasi experimental studies”, which they grouped with the randomized controlled trials even though these studies weren’t truly randomized.

Anna Bertone:   What they found was one perinatal death in the 41 week induction group and six deaths in the 42 week induction group. That was a rate of 0.4 versus 2.4 per 1,000. This finding was not statistically significant. In other words, we don’t have strong enough evidence that this couldn’t have happened by chance. These same studies, those two randomized controlled trials and the two quasi experimental studies, they showed no difference in cesarean rates between groups also. But the authors did report that one observational study found an increase in the cesarean rate with the 41 week induction group. So basically, they’re saying if you look much more narrowly at the evidence of induction during the 41st week versus the 42nd week, then there might not be a significant difference in the death rate.

But that Riedel study from 2019 is already outdated because that was before the two big randomized trials came out.

Anna Bertone:   Yes. We need to see a systematic review and meta-analysis that includes those two randomized controlled trials and see if that changes. These authors also expressed concerns about the cesarean rate possibly rising with 41-week induction because both the SWEPIS trial and the INDEX trial took place in countries with very low cesarean rates. So we just don’t really know at this point whether there would be a difference in cesarean rates if they took place in countries with higher rates of cesarean, such as the U.S.

Anna Bertone:   So I think it is still controversial. There’s also countries that are changing their policies about induction and going back and looking at whether that policy change led to any difference in outcomes. One such country is Denmark. They just published a study where they compared birth outcomes from 2000 to 2010 versus 2012 to 2016. And in that time period there was a change in policy from recommending induction at 42 weeks and zero days to 41 weeks and three to five days. They included over 150,000 births in the dataset. And when they looked back, they didn’t see any difference in stillbirths, or perinatal deaths, or low Apgar scores when they compared the period before versus after the policy change. The perinatal death rate was already declining before the policy change in 2011, and it just continued going down without any additional impact from the 2011 policy change. There was also no impact on the rate of Cesareans with the policy to switch from 42 weeks to 41 weeks.

Anna Bertone:   That’s just an example of how this is still controversial. Countries are implementing new policies, and Sweden and the Netherlands may implement new policies based on the INDEX and the SWEPIS studies. Then they’ll probably conduct a study the same way that Denmark did to see if that policy change had any real impact on the population.

I think it’s important to mention, though, that with the Denmark national policy, they switched from 42 weeks and zero days to 41 weeks and three to five days, and that might not have been early enough to make an impact on the stillbirth rate because the studies that we were looking at from 2019, SWEPIS and INDEX, were looking at inductions happening at 41 weeks and zero to one or two days and it was that couple of days difference that made the difference between low stillbirth rate and a higher stillbirth rate.

Anna Bertone:   Right. Exactly. I think that future researchers shouldn’t group 41 weeks and zero to six days together in one grouping because there seems to be differences between the earlier part of the 41st week and the later part of the 41st week because, like you said, SWEPIS and INDEX found that waiting even just two or three days make a difference in outcomes during that week.

So let’s just sum up the pros and cons of induction at 41 weeks versus continuing to wait for labor since that’s what we have the bulk of the evidence on now. I would say that the research shows that the pros of inducing labor at 41 weeks include a lower risk of stillbirth, especially among those with risk factors for stillbirths such as being pregnant with your first baby. In our article, we have a table of the pros and cons. The absolute risk of stillbirth is 4 out of 10,000 pregnancies at 39 weeks, 7 out of 10,000 pregnancies at 40 weeks, 17 out of 10,000 pregnancies at 41 weeks, and 32 stillbirths out of 10,000 pregnancies at 42 weeks. Research also shows a lower risk of the baby receiving intensive care with an elective induction at 41 weeks, lower risk of the baby having jaundice, lower risk of the baby being large for gestational age, and lower risk of needing a cesarean, although that finding may depend on your practice setting. There is a lower risk of mother developing a high blood pressure disorder. at the end of pregnancy. And for some people, they may find an elective induction at 41 weeks convenient and it could help them end an uncomfortable pregnancy.

Also, in our article, we reference one study that found some cognitive benefits for babies. It suggests that the cognitive benefits for the baby from the mom remaining pregnant appear to increase until about 40 to 41 weeks after which there’s no cognitive benefits to the baby’s brain development for continuing to remain pregnant. So Anna, can you share the cons of elective induction at 41 weeks?

Anna Bertone:   Yeah. One of the cons of being induced at 41 weeks instead of continuing to wait and see if you go into labor is the potential for medicalization of birth. One example of this is continuous fetal monitoring may occur if you have the induction, whereas you might not get continuous fetal monitoring if you go into labor on your own spontaneously during that 41st week. 

Anna Bertone:   Another con would be a potential for failed induction leading to a cesarean. That also depends a lot on your practice setting. Another con is the potential for uterine tachysystole, which is defined as more than five contractions in 10 minutes averaged over 30-minute window. There’s a potential increase in the risk of uterine rupture with medical induction. That is especially important among people with a previous cesarean having a VBAC.

Anna Bertone:   Another con is missing the hormonal benefits of spontaneous labor. Another con is increased risk of mother getting inflammation of the inner lining of the uterus, endometritis. One study found that as a possible risk of induction 41 weeks. Then, lastly, medically-induced contractions might increase pain and make epidural use more likely.

We also have a section in the article where we talk about whether there are any benefits to going past your due date. That table we just took you through was comparing the benefits and risks of elective induction. In terms of benefits of going past your due date, one of the major benefits of awaiting for spontaneous labor are the hormonal benefits, which Anna briefly mentioned. In our article, we link to the book Hormonal Physiology of Childbearing by Dr. Sarah Buckley, which talks about the physiologic understandings and the physiology of spontaneous labor. So that is something to keep in mind, and that’s one reason why some people prefer to wait for spontaneous labor. So Anna, if someone wants to wait for labor to begin on its own and they’re talking with their care provider about expectant management, what’s kind of the bottom line about that?

Anna Bertone:   I think the bottom line about that is it all needs to be very individualized. When someone goes past their estimated due date, they could talk to their care provider about the benefits and the risks of elective induction versus continuing to wait for labor and how those benefits and risks apply to them personally. Most research articles and guidelines say that because there are benefits and risks to both options, the pregnant person’s values, goals, and preferences should play a part in the decision-making process.

Anna Bertone:   It’s important for expectant families to be aware of the growing research evidence showing that there could be worse health outcomes for those who wait for labor after 41 weeks of pregnancy instead of being induced at 41 weeks, especially among first-time mothers and those with additional risk factors for stillbirth. But ultimately, after receiving accurate evidence-based information and having conversations with their care providers, pregnant people have the right to decide whether they prefer to induce labor or wait for spontaneous labor with appropriate fetal monitoring.

I want to also let people know about a couple more resources that are in this article at evidencebasedbirth.com/inducingduedates. We have a section all about how people and their care providers can talk about the risk of stillbirth with some sample scripts that healthcare providers can use when they’re talking about risks of stillbirth. We also have links to different guidelines from different organizations about induction at 41 weeks. Then we also have our section called The Bottom Line. So what would you say are some of the bottom lines, Anna, about elective induction at 41 weeks and zero to two days?

Anna Bertone:   I think the bottom line is that elective induction at 41 weeks and zero to two days could help to reduce stillbirths and poor health outcomes for babies without increasing harm, like the risk of Cesarean for mothers. We’re getting that from those two large randomized controlled trials published in 2019 that both found benefits to elective induction at 41 weeks instead of continuing to wait for labor until 42 weeks. One of those studies, as we mentioned, found less perinatal death with 41 week induction and the other found fewer poor health outcomes for babies like intensive care unit admission and low Apgar scores with 41 week induction. Neither of those trials found an increase in the risk of Cesarean during birth with 41 induction compared to continuing to wait for labor until 42 weeks. However, both of those trials took place in countries that follow the midwifery model of care and the overall Cesarean rates were very low. So I think it remains to be seen how that will translate into countries like the U.S. that have higher Cesarean rates. 

So I hope you all found this podcast helpful in looking at the recent research on induction at 41 weeks versus expectant management. Make sure you check out the blog article that goes along with this podcast episode for all of the resources, links, research references. We also have a free one-page handout you can download that summarizes the results of this research. Just go to evidencebasedbirth.com/inducingduedates to download that new article. Thank you so much, Anna, for joining us to help our listeners understand the evidence.

Anna Bertone:   Happy to do it, Rebecca. Thank you.

Today’s podcast was brought to you by the PDF library inside the Evidence Based Birth Professional Membership. The free articles that we provide to the public at evidencebasedbirth.com and this free podcast as well as other resources are supported by our Professional Membership program. Everyone who joins our professional membership gets access to a library with all our printer-friendly PDFs. Each signature article that we publish online has been turned into a professionally-designed, easy-to-print PDF so that our members can print and share evidence-based info with their clients, other parents, or other professionals. To learn how you can become a member today, visit ebbirth.com/membership.

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Church and State in Montenegro: between National(istic) and Imperial Policies | Political Theology Network

A crisis is brewing in the tiny ex-Yugoslav country of Montenegro. There are massive street protests, attacks on priests, and fights in the Parliament. Various domestic, regional, and international actors, interests and policies are at stake here, giving us the opportunity to learn important lessons about national (and nationalistic) ideological projects, and the role of religion and international (also imperial) aspirations in their creation. And yet, mainstream Western media has shown little interest in the matter. One can speculate why.

The Government of Montenegro proposed new legislation on religious organizations called “The Law on the Freedom of Religion,” which was approved by the Parliament on December 27, 2019.  A draft version of the document is available from the website of the Ministry for Human and Minority Rights, both in the local language and in English. The legislation generated significant controversy due to its treatment of religious organizations, their internal procedures, as well as their property.

Article 4 specifies that:

“Prior to the appointment, i.e. announcement of the appointment if the highest religious leaders, a religious community shall confidentially notify the Government of Montenegro (hereinafter: the Government) about that.”

Article 16, § 1 requires that the application for registration of a religious community shall contain:

“The name of the religious community, which must be different from names of other religious communities and must not contain the official name of other state and its features”

For many, the most problematic article is 52, found under the
section “Transitional and Final Provisions”:

“Religious facilities and land used by the religious communities in the territory of Montenegro and for which is found to have been built or obtained from public resources of the state or have been in state ownership until 1 December 1918, as the cultural heritage of Montenegro, shall be the property of the state. Religious facilities for which if found to have been built on the territory of Montenegro from joint investments of the citizens until 1 December 1918, shall be the property of the state.”

The law caused an outrage among the members of the Orthodox Church
in Montenegro. Let me sketch some of the background which will, hopefully,
render the current crisis more intelligible.

There are four Orthodox dioceses (belonging to the Serbian
Orthodox Church, i.e. Patriarchate of Peć) whose territory is fully or in part
located on the territory of Montenegro. The Orthodox Church (i.e. these four dioceses)
is, by far, the largest religious organization in the country.

The majority of both the clergy and laity view the new legislation as a purposeful targeting of the Church by the Government. They interpret Article 16, § 1 as specifically crafted against the Orthodox Church, as the above-mentioned dioceses in Montenegro belong to the Serbian Orthodox Church. However, the Article 52 appears to be a much more serious threat. Many these churches and monasteries are centuries old, predating even the formation of the modern state of Montenegro. If enacted, Article 52 could lead to the confiscation of Church property and its sacral objects.

Why would the government do this? Why would it go against the Church,
in a country where a significant majority of the population considers itself
Orthodox? This is where things get complicated.

Arguably the chief political authority in Montenegro, over the
past three decades, has been Milo Đukanović. He assumed the office of prime
minister in 1991, and has been in power ever since, performing the roles of
prime minister and president interchangeably (with a couple of years of break,
2006-2008, and 2010-2012). This style of rule brings to mind rulers in other
parts of Europe who have de facto been chief figures in the political
life of their countries for long periods of time, regardless of the name of the
office they would hold in a given moment. Not all long-lasting autocrats are
the same though: There are those who “we” (in the West) do not like very much,
since they refuse to obey us (branded as “evil autocrats”), and there are “our
kind of guys,” who are submissive enough to the Western political and economic
centers (branded as “democratic rulers”). Milo Đukanović, of course, belongs to
the latter group. During his pontificate the country joined the NATO alliance (in
2017), and he has successfully resisted a stronger Russian influence in the
country.

Đukanović, once upon a time, was loyal to Serbian president
Slobodan Milošević, and his allies in Montenegro. However, he switched sides just
in time, and his chief project became an independent Montenegro (proclaimed in
2006) and close cooperation with Western governments, military, and
multinational corporations. This where problems with the Serbian Orthodox
Church in Montenegro begin, in particular with the most prominent figure of
Montenegrin religious life—Metropolitan Amfilohije (Radović). At times partners,
at other times in conflict, this turbulent relationship between the politician
and the metropolitan has ended up, as of now, in an open battle.

Đukanović’s vision of independent Montenegro and the new
Montenegrin identity also includes the vision of an autocephalous (“self-governed”)
“Montenegrin church” which would be loyal (some would suggest obedient as a much better word choice) to the State (i.e., his regime). Amfilohije and
other bishops do not seem to share the same vision. For them, there is no conflict
between an “authentic” Montenegrin identity and Serbian identity, and therefore
no problem with the Orthodox Church in Montenegro being part of the Serbian
Orthodox Church. (Nota bene, many figures and structures within the Serbian
Orthodox Church are by no means innocent in the political games that have been
played in the region, particularly when it comes to Serbian nationalism and the
policies of various autocrats from Belgrade, but that is a topic for another analysis.)

To foster a new Montenegrin identity, Đukanović’s regime started
to promote “Montenegrin Orthodox Church” as an “autocephalous” organization,
headed by the colorful figure of Miraš Dedejić. According to some sources, Dedejić
used to be an admirer of Slobodan Milošević and his policies. He had also been a
priest of the Ecumenical Patriarchate until he was excommunicated by Patriarch
Bartholomew. This organization is not recognized by any of the canonical
Orthodox Churches. Even Đukanović’s support has not been full or unconditional.
One is tempted to say that its purpose has primarily been to put pressure on Amfilohije
to follow the “right path.”  

This is how one can understand the recent actions, at least in one
of their complex and intertwined dimensions: Just as the Ukrainian political
leadership was advancing the (formerly) uncanonical church structures and their
autocephaly in the hope that it would strengthen Ukrainian national identity, as
well as the political elite who championed the project, Montenegrin leadership
might hope that promoting one group, which would be loyal to one political
project and obedient to the political authorities (Amfilohije has not proven
himself in that role), would lead to the recognition of autocephaly of that
group, with same or similar political results. Probably working out of these
hopes, the regime has, then, threatened the confiscation of Church property of
the “disloyal” Church, which is quietly accepted (if not blessed) by the
Western political centers. The trade seems straight-forward, based on a
widely-practiced strategy: “We” (political/economic centers in the West) will
turn a blind eye to violence, undemocratic policies, the autocratic style of
rule, breach of various rights, and so forth, and “you” (local political
elites) will ensure that the (military, economic, political) interests of those
centers are protected and advanced locally.

An obstacle in the case of Montenegro (unlike in the case of
Ukraine) is the fact that the Ecumenical Patriarchate does not seem willing to intervene
to support the formation of a new autocephalous Church, which would advance the
local national identity, being closely connected to the State. Not yet at least,
and not with Miraš’s team as a new autocephalous
church. It seems that there is awareness that right now there are no credible
candidates in Montenegro who would be willing to lead a potential autocephalous
church, neither there is popular support for such project.

For those less familiar with Orthodox ecclesiology, it is worth noting that in Orthodoxy there is no equivalent role to the one of the Roman pontiff. Orthodox ecclesiology has advanced the principle of conciliarity instead of the (universal) primacy of power of one ecclesiastical/imperial center. This does not mean, of course, that there have been no attempts of ecclesiastical seats to assume such power. Indeed, just as the seat of Rome infused the universalist aspirations to power into the emptied shell of the Western (Roman) Empire, so the bishops of “New Rome” (Constantinople) have occasionally aspired to assume both universal ecclesial, and even political authority (at times when the Empire was weakened). This universalism is reflected also in the title of the bishop/patriarch of Constantinople – “Ecumenical” – as the authority of this episcopal seat, as well as the authority of the (Roman) emperor, should ideally stretch over the entire oikoumene (inhabited world). What one can see, based on the recent actions of the Ecumenical Patriarchate, is the (renewed) aspiration to usurp a position within the Orthodox world which would be, in some aspects at least, comparable to the position which the Roman pontiff gradually acquired in the West. This, predictably, provokes a lot of criticism.

The entire episode can thus be understood as yet another example of how the whole concept of autocephaly, the way it is generally understood and practiced in “Orthodox countries” nowadays, is highly problematic. If autocephaly is understood as something “naturally” linked to national/ethnic identities (and/or nation states), it is both theologically unacceptable and very harmful to the body of the Church in long term. Serious Orthodox ecclesiology does not operate with the concept of “national Churches,” although it has been widely (and mistakenly) used both in the public discourse and, sometimes, in academia. Local Churches (i.e. dioceses) are organized as administrative regional ecclesiastical unites, that gather the faithful of a certain territory (for the sake of serving the Liturgy) regardless of their ethnicity, nationality, gender, class, race, etc. The predominant culture or customs have always been embraced in the Orthodox tradition, leaving a trace on how the service is conducted, which language is spoken, etc. However, the identity of the Church is not derived from the ethnic, national or other identities of the majority population of a certain territory, but from the Eucharist as the icon of the Kingdom of God. This is why an autocephalous Church makes sense as a self-governing administrative organization of dioceses of a certain region, having one of the local bishops as their own “head” (having the title of metropolitan, archbishop, pope or patriarch), but not as a “national” institution, or a Church of certain ethnic group (which, following Orthodox ecclesiology, amounts to nothing less than a heresy).

In practice, however, just as local ecclesiastical and political
elites are eager to exploit the (seriously flawed) understanding of autocephaly
as “national institutions,” for the sake of their own power struggles, so is
the Ecumenical Patriarchate. (Neo)imperial policies of ecclesiastical centers
(in this case of Phanar) can thus be very similar to the (neo)imperial policies
of States; both try to manipulate local nationalisms to their own advantage.
Therefore, if they serve the (neo)imperial agendas of “New Rome,” local
nationalisms and local “national” churches will be blessed. If they don’t,
local nationalisms and their cravings for autocephaly will be condemned in the
name of (neo)imperial “universalisms.”

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Citizen Journalists Who Exposed Beijing’s Lies In Wuhan Have Suddenly Vanished

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Citizen Journalists Who Exposed Beijing’s Lies In Wuhan Have Suddenly Vanished

As we reported late Thursday evening, the death toll from the viral outbreak on mainland China has surpassed 600. With global markets once again in the red, Bloomberg reports that Beijing has silenced two of the citizen journalists responsible for much of the horrifying footage seeping onto western social media.

As BBG’s reporter explains, Chinese citizen journalists Chen Qiushi and Fang Bin have effectively been “the world’s eyes and ears” inside Wuhan (much of the film produced by American news organizations has consisted of drone footage). In recent days, SCMP and other news organizations reporting on the ground and publishing in English have warned that Beijing has stepped up efforts to censor Chinese social media after allowing citizens to vent their frustrations and share news without the usual scrutiny.

On Wednesday, China said its censors would conduct “targeted supervision” on the largest social media platforms including Weibo, Tencent’s WeChat and ByteDance’s Douyin. All in an effort to mask the dystopian nightmare that life in cities like Wuhan has become.

But that brief period of informational amnesty is now over, apparently. Fang posted a dramatic video on Friday showing him being forcibly detained and dragged off to a ‘quarantine’. He was detained over a video showing corpses piled up in a Wuhan hospital. However, he has already been released.

Chen, meanwhile, seems to have vanished without a trace, and is believed to still be in government detention. We shared one of Chen’s more alarming videos documenting the severe medical supply shortages and outnumbered medical personnel fighting a ‘losing battle’ against the outbreak.

The crackdown on these journalists comes amid an outpouring of public anger over the death of a doctor who was wrongly victimized by police after attempting to warn the public about the outbreak. Beijing tried to cover up the death, denying it to the western press before the local hospital confirmed.

The videos supplied by the two citizen journos have circulated most freely on twitter, which is where most in-the-know Chinese go for their latest information about the outbreak. Many “hop” the “great firewall” via a VPN.

“There’s a lot more activity happening on Twitter compared with Weibo and WeChat,” said Maya Wang, senior China researcher at Human Rights Watch. There has been a Chinese community on Jack Dorsey’s short-message platform since before President Xi Jinping rose to power, she added, but the recent crackdown has weakened that social circle.

Chen has now been missing for more than 24 hours, according to several friends in contact with BBG News.

Chen has been out of contact for a prolonged period of time. His friends posted a message on his Twitter account saying he has been unreachable since 7 p.m. local time on Thursday. In a texted interview, Bloomberg News’s last question to Chen was whether he was concerned about his safety as he’s among the few people reporting the situation on the front lines.

It’s all part of the great crackdown that Beijing is enforcing, even as the WHO continues to praise the Communist Party for its ‘transparency’.

“After lifting the lid briefly to give the press and social media some freedom,” said Wang about China’s ruling Communist Party, the regime “is now reinstating its control over social media, fearing it could lead to a wider-spread panic.”

With a little luck, the world might soon learn Chen’s whereabouts. Then again, there’s always the chance that he’s never heard from again.


Tyler Durden

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Facebook Appoints Derya Matraş as Regional Director For Africa

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Social media giant, Facebook has appointed Derya Matraş as its Regional Director for the Africa, Middle East and Turkey.

This new appointment comes quite early in 2020 and according to Facebook, Derya will be charged with leading the platform to serve Facebook’s businesses and communities in the region.

@Facebook Middle East has just appointed their new Regional Director, Derya Matras. https://t.co/WYYL0Gjh8E

— CommunicateOnline (@CommunicateME)

This is because the regions, Middle East, Africa and Turkey, are an important market for Facebook and it is important that the company’s impact on the region increases.

The fast-growing Middle East, Africa and Turkey region is an important market for Facebook. Derya’s wealth of experience in emerging markets and her pioneering spirit will help us further drive impact and value in this uniquely diverse region, while maintaining our mission of bringing people together and building communities.

Derya holds a BsC in Electronics Engineering from Bogazici University, Instanbul, Turkey as well as an MBA from Columbia Business School. Prior to this recent appointment, Derya was the Country Director for Facebook in Turkey charged with the role of driving growth for brands, agencies and the digital ecosystem.

Facebook Appoints Derya Matraş as Regional Director For Africa, Middle East and Turkey
Derya Matraş, the New Regional Director for Facebook

Before Facebook, she has worked in executive roles at various companies. One of them is McKinsey and Company where she served as an management consultant. She was also vice president of the largest media conglomerate in Turkey, Dogan Media Group.

She’s expected to bring her wealth of experience to her new role as Regional Director where she will lead the company’s charge to grow its economic and social impact across the regions.

Speaking on her appointment, Derya Matraş reiterated Facebook’s commitment to supporting the millions of businesses in the region that rely on its services.

“As a woman leader, I am very proud to be appointed to this region where diversity is of crucial importance, and I am looking forward to continuing to drive our significant economic and social value contribution,” she says.

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Death, Diarrhea and Late Night Sackings: The Inside Story of an Unfolding Staff Nightmare at UBA and Dangote

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Last November, thousands of Lagosians including hundreds of UBA Bank employees attended what was billed as the ‘party of the year’ at the Lekki Special Events Centre on Admiralty Way.

The UBA RedTV Rave had everyone from Wizkid to Olamide to Jidenna to Burna Boy thrilling the festive crowd as UBA chairman Tony Elumelu and CEO Kennedy Uzoka mingled with the artists and guests.

On the surface, this was the best of times, as a bank that was clearly in rude health celebrated a successful year with thousands of employees, friends and family. The bank had also recently concluded a recruitment exercise that would add nearly 4,000 new employees to its staff strength, so the year ahead looked to be a promising one for most employees present. 

Unknown to them, while senior executives danced with Wizkid in the VIP area, one of the most brutal staff layoffs in Nigerian banking history was just around the corner. They partied well into the night and then showed up for work the following week as usual. A week went by. Two weeks. Four weeks. Then right at the start of the new year – a shocker.

Closed at 5.30PM, Terminated at 10.30PM

Ifunanya (name has been changed) was asked to wait behind at work on Friday January 3. As a 12-year UBA veteran including a long stint in her role as a Branch Operations Manager at a branch in Ojodu, Lagos, this was not an unusual request to receive. She was even used to working weekends so that the ATMs could remain functional and she could troubleshoot other onsite customer-facing issues. This time however, was different. 

Along with other staff members at the branch, she was asked to wait for a board meeting. By 10.30PM, the assembled staff were informed that their services were no longer required. They were then told verbally to write out their resignation letters on the spot and leave voluntarily or be forced out. At this point, her security pass was taken, and along with the other affected staff, her profile was unceremoniously deactivated from the bank’s internal system. She was reminded to drop her work ID on the way out, and thus ended a 12-year association with the bank.

When a relative of hers reached out to tell the story, he was keen to make the point that she was not an agency employee, but a full UBA employee on a monthly salary of N153,000. He could not understand why the bank would treat her that way. I heard similar stories from two other sources who insisted that they were coerced into resigning after being told that their services were no longer required right at the start of the new year.

Shocking and callous as these stories may have sounded, one of the first things you are taught in any professional journalism program is to always balance the story. So I sought an alternate account of what transpired, with the goal of putting the picture together to tell a complete story. There were conflicting accounts of the events of January 3 flying around, with some accounts describing a recruitment and promotion exercise without mentioning any firings, while others reported a purported “restructuring” at UBA, which is a well-known euphemism for “mass sack.”

I managed to establish contact with a current senior employee at UBA who asked to remain anonymous because he is not authorised to speak about such matters. This was his account of what happened at UBA bank at the start of this year:

“Usually when anyone joins UBA with a Bachelor’s degree, they are put on a GT1 level (N80,000). After one year, they are promoted to GT2 (N100,000), then after another year ET1 (N140,000) which is where a lot of people get stuck on. If you are lucky, you get to ET2 (N165,000). So what UBA did was to meld those 4 levels into one (ET) so any one who was on GT1 and GT2 gets automatically promoted to ET2. Those that were on ET1 and ET2 got promoted to SET (Senior Executive Trainee). 

So it was a promotion of sorts, but honestly it was long overdue because compared to other banks, N80,000 for entry level staff is quite low. About the layoffs: I only know 4 people personally who got affected. The people affected were on manager grades and worked at the head office, they all reportedly got 6 months arrears.”

According to this source, he was not personally aware of the fate of any branch staff or what he termed ‘OND staff.’ He did however say that in his opinion, the bank handled the situation poorly and that Nigeria does need stronger labour laws to protect young graduates fresh out of school from exploitation for cheap labor at the hands of corporates like UBA. He also mentioned that he knows current UBA staff have not had a salary increase in ten years – a remarkable situation for workers in a country whose currency has declined 195 percent over the same period.

As it later emerged, more than 2,000 staff were affected by the shocking late-night cull at UBA. It also became increasingly clear that the firings had nothing to do with a harsh operating environment or decreased profitability. The bank which had brought together Nigeria’s most expensive music stars to perform at its end of year shindig was anything but struggling – it actually hired more people than if fired. What the sackings did though, was clear out a number of people in roles that the bank considered obsolete, particularly within branch operations.

It can definitely be argued that such restructuring is inevitable in the face of rapidly changing technology, which is hardly a terrible thing. What is also true however, is that the bank that paid huge sums of money to bring Burna Boy and Jidenna to an annual vanity event that adds nothing to its bottom line could also afford to retrain its redundant staff to fit into new roles –  instead of just sacking them and instantly bringing in thousands of readymade replacements.

Yet again, the actions of a Nigerian corporate made the point that Nigerian labour law, in addition to be being poorly enforced is also woefully inadequate and unfit for purpose. If after 12 years of useful service to a bank, Ifunanya could be dumped out onto the street without even a few hours of notice – and no regulatory action was forthcoming – then clearly, Nigerian employees working for Nigerian companies have a problem on their hands.

As much as the UBA situation made that point, nothing could have prepared me for what I was about to unearth about another Nigerian corporate behemoth.

Diarrhea in India, Death in Ibeju-Lekki: The Unbelievable Story of Dangote Refinery

While senior executives at UBA House were going over the finer points of their plan to log 2,000 employees out of their work systems and force them to resign on the spot, a different level of labour exploitation was entering its fourth year about 73KM east of the Marina. There, at the site of the Dangote Refinery at the Free Trade Zone in Ibeju-Lekki, Lagos, the refinery was taking delivery of the world’s largest crude oil refining tower.

While this was predictably being celebrated across local and foreign media as the start of a glorious new chapter in Nigeria’s industrial history, I was speaking to a whistleblower with close and detailed knowledge of the project. What he had to say about the refinery project, the Indian project managers, the company’s internal culture and its much-publicised trainee program left me absolutely floored. Naturally I reached out to Dangote Group for a comment, but at press time I have received no response or acknowledgment.

My source, whom I shall call “Mukhtar” worked in and around the refinery project between 2016 and 2018, and what I found most distressing amidst everything he said was the revelation that deaths due to onsite accidents are not just known to happen at the refinery site, but are effectively covered up by Dangote. This he said, is because the people who die are mostly site labourers who are hired through staffing agencies instead of directly. When they die, it becomes the staffing company’s problem and the Dangote brand distances itself from it – even though the site owner is legally responsible for all safety-related incidents onsite.

Something else that struck me was that he implied that – contrary to all its public posturing – the company actually has no intention of using Nigerian engineers to run the refinery anytime soon. The trainee program that sent dozens of Engineering graduates for a one-year training program in India? “Strictly PR,” he said.

Accidents
The first batch of Dangote Refinery trainees head off to India in March 2016

For full effect, I have decided to reproduce the full and unredacted transcript of our conversation instead of using quotes and reported speech. Here is the conversation below:

ME: When we started this conversation, you mentioned that Dangote Refinery is exempt from Nigerian labour laws. What were you referencing?

Mukhtar: Because the refinery is in the FTZ, it is not subject to certain laws like local content laws. As such, even mundane jobs are given to non-Nigerian companies. Even the refinery’s fence wall was handled by a Chinese company. This didn’t stop long stretches of the fence from collapsing sometime in 2017. The FTZ affects Labour laws too. The company is not really under any obligation to employ Nigerians. They do so mostly for PR. All key decision makers are Indians (say 98%).

ME: There have been several horror stories about Indian-run businesses in Nigeria. Was this one of them?

Mukhtar: Yes, the Indians are quite racist. Some even demand to be referred to as “master”. To be fair, when this is reported, the HR unit makes a show of cautioning them. But I dont think anyone has ever been dismissed for it or seriously punished. Most of workers who meet their death on site are labourers. So their names might be known to many staff. I’ll see what I can get. It happens. It’s kept under wraps but it happens.

ME: Now you mentioned onsite deaths earlier. I want to know all about this. Why haven’t we heard anything about this?

Mukhtar: The refinery site is not really the best place to work. Mortality rate on site is quite high. People falling from heights or getting crushed by heavy vehicles/machines is quite common. These numbers are not reported because most staff are contract staff (or outsourced) so the company gets to wash its hands off such cases. But safety on site is the ultimate responsibility of the owner of the project. The construction site has a board that is supposed to display the safety statistics but it is never displays the truth. According to that board, there has never been a fatality on site. But in reality, I think 2018 had about 5 fatalities between January and March. If I were to guess, I’d say there have been over 25 fatalities since construction started in 2016/17.

ME: Now you said earlier that the trainee program was a washout and a disappointment. Fill me in on that.

Mukhtar: I was one of the first batch of engineers sent to India for training in 2016. In my opinion, the whole scheme was either poorly thought out or the company was somehow compelled to do it, and did so for PR. Our salaries were being paid into our accounts in Nigeria, so we were using our debit cards to access our Nigerian accounts for expenses over there) Around July 2016 when the naira went from around 160 per dollar to nearly double that number, our spending power was effectively halved.

ME: I also remember that there was a forex shortage crisis in 2016 and Nigerian bank cards stopped working outside the country.

Mukhtar: So when the banks eventually stopped all cards from functioning abroad, we were stranded. The company resorted to selling us dollars or rupees at the black market rate.They deducted the money from our salaries. We had accommodation (two adults per room) and feeding (Indian food which many of us did not like). Some of had to buy intercontinental dishes regularly, because Indian food is really not nice if you’re not into many smelly spices. It was crazy. Meanwhile we were told categorically that we would have Nigerian food and Nigerian cooks. It was a blatant lie by the Indian HR director.

Also, no arrangement was made for our medical care. Those who fell ill had to treat themselves from their pockets. During the currency crisis, those who fell ill had to rely on the rest of us to put together our spare change to pay for their treatment. The company promised to refund medical expenses, but this shouldn’t have been the situation in the first place.

ME: Tell me about the training program. What was the course content and the experience like? Was it what you were expecting?

Mukhtar: The training itself was a mess too. We were supposed to be trained to operate the refinery (at the time, it was said that it will be completed by mid 2017), but we were sent to a design company. These (designing a refinery and operating it) are two very, very different things. The trainers did not want us there in the first place. It was not a part of their initial contract with Dangote. Plus, they didn’t know what to teach us because designers are not operators. They were confused, several times, they asked us what we wanted to learn. But we could not know what we wanted to learn cos we knew nothing about the entire business. In the end, they reluctantly settled for teaching us design (skills we were/are unlikely to use cos the refinery was already 90% designed). 

ME: If you say that the refinery was “already 90% designed,” and you were learning design in India, that sounds like your presence was superfluous. Was the company really serious about sending you to learn skills to run a refinery?

Mukhtar: Indians will run the refinery. It will take many many many years before that refinery will be populated by just Nigerians. It was strictly PR. Anyways, the training with that design company was suddenly terminated on December 31st. Apparently, Dangote had not paid them a dime for all the months were were being taught design. They didn’t want to send us back to Nigeria so they moved us to the Dangote office in India. The office housed the Indian engineers (around 150 – 200 in number) who were supervising the design work being done by the design company. Now, it is interesting that these guys were working and earning as expatriates within their own country.

But realising that the “training” was a blunder, the company sent back some engineers to train in an actual refinery. So what was supposed to be a 1 year training became 2 years.

ME: Since returning to Nigeria, is there anything else you have noticed about the project that worries or disturbs you?

Mukhtar: Yes. So we have only the refinery at the FTZ, but the company gets to import things meant for other branches of the company duty-free. As a matter of fact, with the Dangote jetty in place and a customs office right there, the company no longer needs to clear stuff at Apapa. Dangote empire effectively has its own customs and port, because we cannot assume that the custom officers stationed at Dangote’s jetty/FTZ are extremely meticulous in checking what comes in and goes out. Personally, I find this disturbing. No non-military entity should be able to import stuff that easily into any country. This is bigger than just skipping custom duty payment.

–Ends–

Between bank staff being fired at 10.30PM and refinery site labourers being killed by workplace accidents without accountability, the sheer grimness of the picture facing Nigerian workers comes into stark relief. It is afterall, an employer’s market, with several thousand qualified people jostling for every job opening, which creates the possibility and incentive to treat staff like battery animals.

Whether the Labour Ministry is willing or able to do anything about such blatant labour exploitation is anybody’s guess. Nigeria’s government is increasingly weak and unable to impose its will on the country even territorially. In the event that the government did take interest, there is a valid fear that it would go to the other extreme and adopt a lazy anti-business Hugo Chavez approach, as it so often does. The real solution if there is to be one, must come from Nigerian labour having a stronger bargaining position through an improved economy. Anything else as it stands, is little more than a sticking plaster.

As Mukhtar mentioned, even inside the ridiculous situation of being financially stranded in a foreign country at the behest of an irresponsible and insincere Nigerian corporate, the vast majority of the group chose to suffer in silence. They did so because spending a year abroad learning useless information, suffering deprivation and experiencing diarrhea after being forced to eat unfamiliar food was still preferable to whatever alternative was at home.

Ultimately, that is the biggest problem facing Nigerian labour. 

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How religion divides and under-develops Africa by Reno

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Reno Omokri
Reno Omokri

By Reno Omokri

Yesterday, I saw Nigerian Shiites demonstrating against the United States and President Donald Trump, and I groaned in my spirit. When will Africans become themselves and stop being remote controlled by foreign interests?

Most Africans think they chose their religions. Not true. As a matter of fact, the vast majority of Africans had their religions handed down to them by Europeans or Arabs. How do I mean?

Let us take Nigeria as a case study. Most Nigerians are either Christian, Muslims, or Catholics. Many of them will even die to defend their faiths. But how did they get these faiths?

Most Muslims in Northern Nigerian were born into Islam. Most Nigerian Muslims did not make a conscious decision to become Muslims. They just found themselves as Muslims and accepted it. But the historical fact is that most of their ancestors were CONQUERED into Islam, either by the Usman Dan Fodio jihad of 1804, or by the Kanem Bornu empire (one of the oldest empires on Earth), or by Arabs during the the Tran Saharan Slave Trade. This is a historical fact and I do not mean to upset my beloved Muslim followers.

At first they resisted. Then they were conquered. They were FORCED to accept Islam. Those who refused were killed, and the survivors, fearing a similar fate, accepted the new religion. Then they had children who knew nothing but Islam, and the rest is history.

Nigeria was colonised by Britain. Britain is OFFICIALLY a very staunch Protestant nation, with the Church of England (Anglican Church) as the OFFICIAL state church. Have Nigerians ever wondered why the British allowed Catholicism to flourish in Nigeria even when it was suppressed in Britain for centuries? Or why they did not allow Christian Missionaries into the North?

Other than the Binis and Itsekiri, who voluntarily accepted Catholicism in the 15th Century due to their trade with the Portuguese, Catholicism only gained ground in Nigeria, and especially amongst the Igbos of the East of Nigeria, in the 19th Century.

The British had a colonial policy of Divide and Rule. They did not allow Christian missionaries into Nigeria for love of Christianity or God, or Africans. It was a deliberate colonial policy to sow discord and division in Nigeria and their other colonial territories all over the world, and to keep nations, like Nigeria, ever subservient to Europe as a supplier of raw materials and human labour in times of war (Nigerians in their thousands fought for the British in both World Wars and were often used almost as cannon fodder) and in times of peace (Nigerians are a backbone of the health sector in both the UK and US. 77% of all Black doctors in America are Nigerian).

The British decided that Anglicanism snd other forms of Protestantism should thrive amongst the Yoruba and that Catholicism should thrive amongst the Igbo, and they refused to let Christian missionaries proselytise in the North to keep it Muslim, so that both the South and the North would be perpetually divided and check each other, and will never be able to unite against the colonialists.

Every missionary that came to Nigeria was licensed by the British. The Catholicism you see in Igboland today is the fruit of four Catholic missionaries who arrived Onitsha in 1885, as part of the Holy Ghost Fathers, led by a certain Reverend Father Lutz. In fact, the house where they first stayed was owned by the Royal Niger Company (which influenced the formation of the colonial Nigerian government, and even provided personnel for them. Lord Lugard was a staff of the Royal Niger Company).

Meanwhile, as they were promoting Catholicism in Eastern Nigeria, the British were promoting Protestantism in Western Nigeria, where Henry Townsend planted the first church in Badagry, in 1842. When the British rescued Samuel Ajayi Crowther from Fulani and Portuguese slavers, he was handed over to the Church Missionary Society (the proselytising mission of the Anglican Church), who educated him, and used him to extend Anglicanism amongst the Edekiri people. Ajayi Crowther eventually changed their name to Yoruba (a bastardisation of the Fulani word Yaribansa), because the British wanted a common identity for all Edekiri people.

That is how we come to have a Nigeria dominated by Muslims in the North, Anglicans and other Protestants in the West, and Catholicism in the East. It was not by chance. It was not by the choice of Nigerians. To the largest extent, with only very few exception, it is by design of external powers.

I urge Africans to think about their religions. Do not just accept your religion because of the accident of your birth. Your eternal soul is too valuable to be left to chance.

I use myself as an example. I was born to a Catholic mother and an Anglican father. While my mother schooled in Europe, I was anglicised by the rest of the family who were Anglican.

I remained an Anglican until I went to university. Free at last from my parents, I at first became a campus evangelist at the University of Benin in 1990 at the age of 16, until I left for another university and became an atheist at age 18, and began reading The Bible, and the Quran in other to know the true God.

May God bless my parents, they did not interfere. They did not force me to go to church. They left me to choose.

For one whole year, I did not believe in God, until after reading Scripture, the Quran and Dr. Yongi Cho’s (now David Yongi Cho) book, the Fourth Dimension, I found God by myself. Alone. Without the help of Arabs, or Europeans, or my parents. That is why today, NOTHING can shake my faith. I was not born as a Christ follower. I was CONVINCED into following Christ by Scripture and a personal experience with God and I was ordained as a pastor on January 15, 2012.

If all Africans can free their minds and choose their religion by themselves, Africans will stop being divided and fighting each other on the basis of religion and region, and we will no longer by the patsies of European and Arab nations, and Africa will be truly free to become the greatest continent on Planet Earth.

Reno Omokri

Gospeller. Deep Thinker. #1 Bestselling author of Facts Versus Fiction: The True Story of the Jonathan Years. Avid traveller. Hollywood Magazine Film Festival Humanitarian of the Year, 2019.

The post How religion divides and under-develops Africa by Reno appeared first on Vanguard News.

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