Leaders gather in Cape Town for WEF on Africa

first_img1 June 2015The World Economic Forum’s 25th meeting in Africa, with the theme Then and Now: Reimagining Africa’s Future, takes place in Cape Town from 3 to 5 June.It will be the largest ever in the region, with more than 1 250 leaders from business, politics, academia, civil society and the media attending.The record levels of participation could be seen to reflect an optimism in the economic prospects of the region, according to the World Economic Forum (WEF), as well as an unprecedented commitment across all stakeholder groups to pursue public-private co-operation as a means of tackling the considerable challenges the region still faces.More than 90 senior government officials will attend and 83 leading international companies will be represented. “As befits Africa’s youthful population,” said the WEF, “the meeting will also boast a record 200 young leaders, drawn from the forum’s community of Global Shapers and Forum of Young Global Leaders, as well as the highest proportion of women leaders – at 270 woman leaders 25.8% – than ever before. In total, over 75 countries will be represented.”Lessons of the pastSpeaking on the eve of the gathering, Elsie Kanza, the head of Africa, World Economic Forum, said: “The occasion of our 25th meeting allows us an opportunity to see how far Africa has come economically, socially and politically since 1990. However, what this meeting is really about is looking forward, to see how we can channel the lessons of the past with the creativity, innovation and resourcefulness that comes from all stakeholders working together to solve Africa’s challenges in the present and future.”The WEF’s first meeting on Africa took place in October 1990.This year, the programme is built upon the three pillars: enabling markets, marshalling resources and inspiring creativity. It will feature high-level sessions on critical subjects such as migration, combating terrorism and harnessing Africa’s informal economy.Alongside the meeting, the Grow Africa Investment Forum, which runs from 2 to 4 June, will bring together leaders engaged in the forum-led Grow Africa food security initiative. Another high-level summit will take place focused on mobilising financing for cross-border infrastructure.There will also be several innovations, among them Community Conversations. These will be public debates based on the forum’s popular Davos Open Forum format, in which young people from the city are invited to interact with meeting participants on the key subjects of entrepreneurism and leadership.The meeting will also, for the first time, webcast press conferences and issue briefings live, enabling the public to submit questions on important issues facing Africa’s future.FDI leaderSpeaking at a media briefing in Johannesburg on Friday ahead of the summit, Minister in the Presidency Jeff Radebe said South Africa as a foreign direct investment destination was regarded as one of the best on the continent.“South Africa remains the most diverse economy on the continent – providing a supportive regulatory framework, a well-developed infrastructure network, a world- class financial hub and world-class services for business opportunities.”According to the United Nations Conference on Trade and Development, South Africa remained the top foreign direct investment destination in Africa during 2013, significantly increasing foreign direct investment inflows from $4.6-billion (R56.28- billion) in 2012 to $8.1-billion in 2013, mostly in green field’s investments.Radebe said South Africa continued to make strides in improving the ease of doing business.“South Africa, if compared to other Brics [Brazil, Russia, India, China and South Africa] nations, comes first in the five of the 10 criteria the World Bank uses to assess ease of doing business – starting a business, dealing with construction permits, getting credit, protecting investors and paying taxes,” he said.Convened for regional and global leaders from business, government and civil society, the forum will take stock of progress made over the last 25 years, share insights on the present landscape and identify innovative approaches to accelerate inclusive growth while bring about sustainable development in the future.SAinfo reporterlast_img read more

What I Am Thinking About Now

first_imgSegmentation by Generation: Every generation looks at the next couple generations and decides that “these damn kids” are different, that they don’t share the same values, and that they’re making a mess of things. The Millennials all got awards at the end of soccer season, even when they lost. They don’t care about money, and they are never going to leave their parents’ houses. They’re way too open-minded. We’ll see. One thing is for certain, the generations before them won’t understand them. It’s a rite of passage. My bet is that they won’t be all that different, but they will feel the same way about their children and grandchildren.A Lot of Research Isn’t Useful. Yet.: I love it that we can do fMRI imaging of brains. I am certain there are great insights being discovered every day. But they are absolutely meaningless in practice. There is nothing neuroscience has taught us that is applicable when you are sitting in front of another human being that human evolution didn’t already provide. You want to know how to tell if someone is lying based on the latest brain research? You already know when someone is lying, don’t you? Your gut tells you. This will, however, change. We are going to figure out what we are figuring out, and it will be useful.It’s the Creative’s World (You’re Just Living In It): Everything that can be done by a robot or a computer eventually will be. That means the future is going to be owned–even more than it is now–by the creative class. The people who are going to be in greatest demand are people who can create, people with imaginations, people who can produce new works. Also, people who know how to work with their hands, craftsmen. Some of the first craftsmen are going to make individual works using new technologies, like 3D printing. You are going to pay for things that were not mass produced.Fragmentation: We used to have three television channels. Everyone had a common set of experiences because of that box. We had a few channels on FM Radio, and the powers-that-be (or powers-that-were, more accurately) used to determine what music we listened to. We had common experiences. Big stars were made. Now, everybody has access to the tools to create and distribute. This has resulted in serious fragmentation. We no longer share the cultural experiences that television, radio, movies and entertainment provided. There are no great acts.Polarization: More and more, people are being polarized by their political beliefs. The discourse is coarser. Things that should unite us divide us because the political parties and their staunchest supporters frame every issue with the sole intention of reaching some segment of the population they believe necessary by demonizing someone or something else. Politicians no longer stand for anything. Instead, they just oppose things. They don’t have a vision of their own. They just oppose the other side’s vision, which doesn’t really exist anyway.last_img read more

Odisha comes up with a flood atlas, aided by satellite imagery

first_imgOdisha has come out with a unique flood hazard atlas on the basis of historic flood inundation captured through satellite imagery over the period from 2001 to 2018, which is expected to help the State manage floods more efficiently.The National Remote Sensing Centre (NRSC) of the Indian Space Research Organisation (ISRO), Hyderabad had taken the study on flood hazard zonation for Odisha. The atlas was released by Chief Minister Naveen Patnaik at the State-level Natural Calamity Meeting here on Saturday.Vast areas of the State are inundated when there is flooding every year in major rivers, namely, the Mahanadi, Brahmani, Baitarani, Subarnarekha and Rushikulya. Some of the rivers like, the Vamsadhara and Budhabalanga, also cause flash floods due to instant run-off from their hilly catchments. According to Bishnupada Sethi, Managing Director, Odisha State Disaster Management Authority (OSDMA), damages due to floods are caused mainly by the Mahanadi, the Brahmani and the Baitarani, which have a common delta where floodwaters intermingle, and, when in spate simultaneously, wreak considerable havoc. The entire coastal belt is prone to storm surges, which is usually accompanied by heavy rainfall, thus making the estuary region vulnerable to both storm surges and river flooding. Few districts in the western and southern part of Odisha are prone to flash floods, he pointed out.The NRSC analysis says about 8.96% (13.96 lakh hectares) of land in Odisha was affected by floods during 2001-2018. Out of total flood-affected area (13.96 lakh hectares), about 2.81 lakh hectares of land falls under high (inundated seven-nine times) to very high (inundated 10-14 times) flood hazard categories. Eight out of 30 districts such as Bhadrak, Kendrapara, Jagatsinghapur, Balasore, Puri, Jajpur, Khordha and Cuttack districts are more flood-affected districts. As high as 77% of Bhadrak and 70% of the Kendrapara district have been categorised as flood hazard.According to P. G. Diwakar, Director of Earth Observation, Application and Disaster Management Support Programme Office of ISRO, “A large number of satellite images acquired over 18 years (2001-2018) were used. All satellite data sets were analysed and flood layers were extracted. All the flood layers corresponding to a year are combined as one inundation layer, so that this layer represents the maximum flooded area in one year.”‘Useful resource’“All such combined flood layers for 18 years were integrated into flood hazard layer representing the observed flood-inundated areas with different frequencies. This layer was integrated with the digital database layers of Odisha,” said Dr. Diwakar. The atlas would serve as a useful resource of information for policy makers, planners and civil society groups, said Chief Secretary A. P. Padhi.last_img read more

NSW Footy Facilities Fund open for applications

first_imgMinister for Sport and Recreation, Stuart Ayres and the National Rugby League have announced the New South Wales Footy Facilities Fund, which is open for applications until Sunday, 9 January 2015. Funding is available for projects throughout New South Wales. “This program is a terrific initiative of the National Rugby League (NRL) and the New South Wales Government that will help fund grassroots footy clubs in local and regional New South Wales,” Mr Ayres said. “The program aims to improve facilities for a variety of benefits including increasing participation, safety and security, environmental sustainability, social inclusion and building strong communities.” The main objectives of the Footy Facilities Fund are to: –        increase regular and on-going participation opportunities in Rugby League –       improve the standard of Rugby League grounds and facilities Additionally, applications can be strengthened by addressing one or more of the following: –       improve safety at sport and recreation facilities (e.g. upgrade of field to provide a safer playing field, access pathways for players, disability ramps) –       increase the security at sport and recreation facilities (e.g. installation of fencing) –       remove barriers to promote inclusion in Rugby League (e.g. upgrade of amenities to increase female participation, provision of disability access, upgrade of referee amenities) –       develop environmentally sustainable sport and recreation facilities (e.g. installation of drainage, rainwater tank, upgrade lighting for environmental impact) –       build strong communities NRL Head of Football, Todd Greenberg said grassroots facilities were crucial to the success of Rugby League. “Every parent wants their children to play footy at safe, secure and high quality venues,” he said. “This program not only improves facilities at local footy clubs but it provides the services needed to enable more youngsters, particularly those with disabilities, to be part of our game.”“And that is crucial because there is a place in rugby league for everyone,” Mr Greenberg concluded. Touch Football affiliates in New South Wales are also eligible to apply. For more information and to apply, visit www.dsr.nsw.gov.au/grants or phone (02) 13 13 02.  Related Files141110_nsw_footy_facilities_fund_open_for_applications-pdfRelated LinksFooty Facilities Fundlast_img read more

Ola cabs banned in Karnataka for 6 months

first_imgBENGALURU: App-based cab aggregator Ola cannot run taxis and autos in Karnataka for the next six months, the state transport department has said in a notification. The licence has been suspended for “operating bike taxis” without permission, which were already banned in the state since the last one year. “Karnataka transport department has suspended the license of Ola Cabs across the state for six months. Licence has been cancelled for operating bike taxis without permission and not replying to the notices of transport department,” the transport department said in the notice issued in Kannadda on March 18. Also Read – Uddhav bats for ‘Sena CM’The notification came to the light today as the cab-aggregator issued a statement on the suspension of license saying it is “evaluating the options to find an amicable solution wherein hundreds of thousands of driver-partners in the state of Karnataka can continue to work and serve the mobility needs of our citizens.” In January, Ola started running bike taxis in certain pockets of Bengaluru – but the cab aggregator says this was purely a “beta pilot” project in a bid to gather data for when the state’s policy allowed bike taxis. Also Read – Farooq demands unconditional release of all detainees in J&KA showcause notice was then issued by the state to which Ola responded, requesting permission for a four-month pilot project. Ola said the services were by stopped February-end. Right now, there is no two-wheeler taxi policy in Karnataka. Calling the notification “unfortunate”, the company today said it is working closely with the authorities on the issue. “Ola is a law-abiding company that has always worked with the Government to develop livelihoods, improve mobility, and enable a new technology industry,” the statement read. “Despite other companies continuing to operate illegally, Ola halted our bike taxi experiment weeks ago, instead seeking the state’s cooperation to develop a legal framework for a pilot that will continue to take advantage of emerging opportunities in the mobility economy,” it said.last_img read more

Women thieves strike at SE Delhi banks, get captured on CCTV

first_imgNew Delhi: A group of 4 woman in their mid twenties are active in South East Delhi region which are striking at potential customers at various banks. They choose their target and slowly surround him pretending to be customers themselves.To avoid any suspicion they also carry a baby in their arms which distracts the attention of the target who has no idea that the other three are blocking the view of the others in the bank while one of them is slowly cutting the money bag with a sharp blade and stealing the money the target has brought to deposit in the bank. Also Read – After eight years, businessman arrested for kidnap & murderThe case came to light when Amin Akhter in his mid 60s went to Indian bank in Jamia to deposit 30 thousand rupees in cash in the afternoon. Within moments he was targeted by a group of 4 women in their mid 20s. “First two woman surrounded me followed by two more. One of them aslo carried a baby i their arms. I thought tehy are also customers of the bank. I had no idea that they are thieves and are piercing the bag in which i carried money. My jute handbag had two sharp cuts and all the money was taken,” Akhter said. Also Read – Two brothers held for snatchingsAkhter, retired from Jamia Milia islamia university the approachd the Jamia Nagar Police station. A police team tehn visited the Indian bank and collected the CCTV footage in which a group of 4 women were seen surrounding Akhter. “The group of women were well dressed and no one could suspect them that they are thieves carrying blades to cut open the money bag or purse. Since one doesn’t suspect and think their standing close as mere coincidence they easily rob the money. The bank should also keep a check who enters the bank,” Amin Akhter said. Police has formed teams to identify the accused women. CCTV footage is being examined and cops are checking if the group of women identities with any gang with the similar modus operandi. Some sophisticated groups of thieves do target customers in various banks and dupe the of their money either by offering some help of simply cutting open the money bag.last_img read more

Meghalaya mine disaster: Consent letters for calling off search operation filed in SC

first_imgShillong: The Meghalaya government has filed an affidavit in the Supreme Court stating that the families of the victims, who were trapped inside a coal mine in December and are untraced till now, have consented to call off search operations, Deputy Chief Minister Prestone Tynsong said Thursday.On the morning of December 13, a group of 16 miners went missing after water from Lytein river gushed into an illegal rat-hole coal mine in Lumthari village of East Jaintia Hills district in the state. Also Read – 2019 most peaceful festive season for J&K: Jitendra SinghOnly two bodies have been retrieved so far in the five-month-long search operation by teams of various agencies, including the NDRF, the Indian Navy and the Army. On January 28, the apex court had asked the Centre and the Meghalaya government to continue their multi-agency operations to trace the miners. “We have filed an affidavit in the Supreme Court informing that the family members of the miners have given their consent to call off the search and rescue operations. We are waiting for directions from the Supreme Court on the matter,” Tynsong said. In the affidavit, the government has attached the written consent received from the family members of the miners, he said. Also Read – Personal life needs to be respected: Cong on reports of Rahul’s visit abroadDistrict Deputy Commissioner of East Jaintia Hills F M Dopth had submitted the letters to the state government on April 16, citing that the operation be called off as there had been no tangible result. Dopth, on his part, clarified that there was no reduction in the water level in the main shaft, where the miners were trapped, even after discharge of several crore litres of water. Until Tuesday, submersible pumps were engaged in flushing out water from the 370-foot-deep mine, which is interconnected with eight other abandoned mines, he said. “The operations came to a halt yesterday (Wednesday) as the Lytein river is in spate following incessant rainfall in the region,” the official explained. Last month, an interim relief package of Rs 3 lakh was paid to the miners’ family members, who claimed that the amount was too meagre for their sustenance.last_img read more

Mediaset España has pulled its channels from Telef

first_imgMediaset España has pulled its channels from Telefónica’s Yomvi OTT platform to focus on its own MiTele platform.The move means that commercial channels Telecinco and Cuatro will no longer be available on the Telefónica platform.According to La Vanguardia newspaper, the decision to withdraw from Yomvi reflects a deteriorating relationship between the two groups, with Telefónica taking a decision not to use the services of Mediaset’s advertising arm Publiespaña for its Movistar+ service and introducing its own new flagship channel brand Canal #0 on Yomvi.Mediaset’s withdrawal from Yomvi also coincides with the launch on the platform of Discovery Channel and public broadcaster TVE’s kids channel Clan.last_img

The dollar index opened at 8292…and then moved si

first_img The dollar index opened at 82.92…and then moved sideways until shortly after 9:00 a.m. in London.  From there, it rose to its high of the day [83.13] around 8:30 a.m. in New York…and then it rolled over and headed south with some conviction.  The low tick [82.43] came shortly before 1:30 p.m. Eastern time…and from there it recovered a bit before trading sideways into the close.  The index finished down 35 basis points on the day, closing at 82.57. (Click on image to enlarge) What they show is the steady selling pressure that always exists [no matter what is going on in the real world] during the time between the London a.m. and p.m. fixes in gold…and the constant upward price pressure during the rest of the trading day. Not much happened during Far East and early London trading.  Prices are flat…and volumes are pretty light, with most of the volume of the high-frequency trading variety as usual.  The dollar index is down about 10 basis points as I hit the ‘send’ button on today’s column at 5:20 a.m. Eastern time. With today being Friday, I have no idea what to expect during the New York trading session, but I’ll be emotionally ready for any scenario that greets me when I switch my computer on later this morning. Before heading out the door today, I’d like to bring Casey Research’s Miller’s Money Forever newsletter to your attention.  The latest commentary is entitled Money Forever Retirement Plan…Social [In]Security…and you can read all about it at the link here…and it costs nothing to have a peek. Enjoy your weekend, or what’s left of it…and I’ll see you here tomorrow. The gold shares opened down a hair, but quickly rallied into positive territory…and stayed there for the remainder of the day.  The HUI finished up 1.03%. Silver was much more ‘volatile’ on Thursday…and had that surprise sell-off shortly after 10:00 a.m. in Hong Kong.  From that low, it rose back to almost unchanged by around 10:00 a.m. in London.  Then the silver price rolled over…hitting its low of the day [$28.47 spot] around 9:45 a.m. in New York…about twenty-five minutes after the Comex began to trade. From that low tick, the silver price rose quickly…and was capped around 10:00 a.m. Eastern as it made another assault on the $29 spot price mark.  The high tick at that point checked in at $29.01 spot. From that point, the price chopped sideways into the 5:15 p.m. Eastern time electronic close. Silver closed at $28.81 spot…down 11 cents from Wednesday.  Volume was very decent at around 45,000 contracts. Once again I have a lot of stories…and I’m never a happy camper when that’s the case…so do your best. They say that time is money. What they don’t say is that money may be running out of time. – Bill Gross Thursday was another day where not a lot happened in the grand scheme of things.  I asked Ted about the sell-offs yesterday…both in the Far East and London trading…and he said that the short-term price moves like these are pretty much all done by the high-frequency traders…and has nothing to do with supply and demand.  To attempt to read anything into this sort of price action was a mug’s game. Today we get the latest Commitment of Traders Report for positions held at the end of Comex trading at 1:30 p.m. on Tuesday.  Neither Ted nor myself are expecting big changes in the Commercial net short positions in either metal…but neither of us know for sure.  But whatever the numbers show, I’ll have all the gory details in tomorrow’s column. Despite Nick Laird’s computer problems, he was able to send me a couple of key charts that have graced this column a number of time during the last year or so…and one has to do with the gold price between the London a.m. fix…and the London p.m. fix.  What would have happened to your ‘investment’ if you were able to buy the London a.m. gold fix and sell the London p.m. gold fix.  The other chart is what would have happened if you’d bought the London p.m. fix and sold at the London a.m. fix the following morning.  The differences are quite spectacular…and should lay to rest the fact that the ‘fix’ has been in for gold ever since that last big run-up over thirty years ago. This is what Nick had to say when I asked about the scale on the ‘Y’ axis…was it in U.S. dollars? “It’s in dollars – but you need to understand how percentage advance/decline charts work before you go trumpeting that the price should be $37,020.27 or $12.38.  The plot is more indicative than definitive…and hence the right axis is in many ways moot…” “It’s the degree of move rather than the absolute value…and the degree of the move in one chart vs. the other [that] show[s] which way the forces are aligned.” Please note that the charts begin in 1970…so there is 42-plus years of data here. Sponsor Advertisement The 2 Energy Sectors You Should Invest in This Year Top energy analyst Marin Katusa, frequently featured in the financial media such as Forbes, Business News, Financial Sense News Hour, and the Al Korelin Show, says two highly undervalued energy sectors will provide windfalls for smart investors this year. Read his assessment, including which two energy sectors you should be bullish on for 2013… and which two you’d only lose money on. Click here for Marin’s free report, The 2013 Energy Forecast. (Click on image to enlarge) The silver stocks finished mixed…and Nick Laird’s Silver Sentiment Index closed close down 0.74% on the day.  Nick’s having some major issues at the moment, and is unable to update his Intraday silver chart…so here’s the ‘old’ one until he’s firing on all cylinders again. Short-term price moves like these are pretty much all done by the high-frequency traders It was another quiet trading day in the Far East…and during the first three hours of trading in London yesterday.  Then at 11:00 a.m. in London, the gold price came under some selling pressure.  The low of the day…$1,575.70 spot…came at 8:30 a.m. in New York, right on the button. From there it rallied to its high tick of the day, such as it was, and that occurred at 2:00 p.m. in the electronic market.  Kitco recorded that it as $1,594.50 spot. Gold closed down a bit from there at $1,590.30 spot…up $2.60 from Wednesday.   Net volume was similar to Tuesday’s and Wednesday’s volume…around 118,000 contracts. (Click on image to enlarge) The CME’s Daily Delivery Report showed that 125 gold and 3 silver contracts were posted for delivery on Monday within the Comex-approved depositories.  All 125 gold contracts came out of JPMorgan’s client account…and the biggest stopper by far was none other than Canada’s Bank of Nova Scotia.  The link to yesterday’s Issuers and Stoppers Report is here. For the second day in a row, there were no reported changes in either GLD or SLV. The U.S. Mint had a smallish sales report yesterday, as they only sold 110,000 silver eagles. Over at the Comex-approved depositories on Wednesday, they reported receiving 1,525,877 troy ounces of silver…and shipped 419,589 troy ounces of the stuff out the door.  The link to that activity is here.last_img read more

Lindsay Bunker woke up from a nightmare The 32ye

first_imgLindsay Bunker woke up from a nightmare. The 32-year-old lives with her sixth-month-old daughter on the Lac Courte Oreilles Indian Reservation in northern Wisconsin. She’s struggled with addiction for over 10 years, mostly to heroin. Then came the nightmare: She dreamt two men were attacking her baby while she could think only about drugs.”In my mind I was thinking, ‘If I can just get one hit, if I can get one line, I can save her,'” she recalls, pausing before continuing, “I woke up and I was panicking. How can a mother think like that?”It was a wake-up call. Bunker says she realized in that moment that heroin was “evil” and she resolved to get into treatment. In a lot of rural America, that’s where the story could have ended. Many rural communities lack basic resources for substance abuse. There are fewer services available than in urban areas—as many as 82 percent of rural Americans may live in counties that lack detoxification services, for example. But Bunker was lucky. She found a community health center only about an hour from her home that recently expanded its addiction treatment services. The clinic, NorthLakes Community Clinic,serves Medicaid and Medicare patients, and offers sliding scale payments for those with low-income. It expanded its addiction recovery program with the help of state and federal grants targeting opioid use. Though rural communities across the country struggle with addiction, community health centers like this one are modeling an approach to managing — and funding — treatment programs.”We were seeing substance use disorders killing our community and we felt it was our job to step up,” says Reba Rice, the clinic’s CEO. “We feel that all of our patients and community members deserve a life worth living.”Not just opioidsRice says addiction has torn apart rural communities in Northern Wisconsin in the last five years or so, with an increase in crime, problems in schools, trauma in families. “It was amazing how many things we were seeing changed,” she says. “The way people looked at each other, the level people were willing to trust each other, and it was all about the changes that this disease makes on its victims”A recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health shows that opioid and other drug abuse is the top health concern for rural Americans. NorthLakes has long provided primary care, dental and behavioral health services for low-income residents in Ashland, Wisconsin, and in several nearby towns. But as the opioid addiction problem worsened, Rice says she felt a responsibility as a health care provider to do something about it. “We contributed to the problem so we needed to contribute to the solution,” she says.Rice says opioids were just part of the puzzle: meth and alcohol were huge problems too. In fact, meth use in Wisconsin it has grown by 250 percent in recent years, according to the FBI. But new funds were becoming available for opioid treatment so the clinic applied for those — and is using them to build a comprehensive addiction treatment program that addresses all the substances people there struggle with. To fund its expanded addiction treatment services, NorthLakes applied for and won a grant from the state of Wisconsin three years ago. It also got other federal grants intended for mental health and addiction. Central to their plan was hiring a physician who could lead the new program, and could prescribe the addiction treatment buprenorphine, known by the trade-name Suboxone. Suboxone treatment is one of the most effective ways to treat opioid addiction. But it is hard to find in rural areas, because only providers who’ve received special training are allowed to prescribe it. One 2015 study found that more than 80 percent of rural counties in the U.S. do not have a single physician able to prescribe it. NorthLakes found a physician who could prescribe it and more than that, who had a vision for a comprehensive addiction program. Building treatment capacityDr. Mark Lim says he is surprised he’s here in this 8,000 person port-town on Lake Superior. He’d dreamed of living in a big city since he moved to the U.S. from the Philippines. When he got the call about the job, he was hesitant at first. “I didn’t know where that was on a map,” he recalls.But he saw this part of Wisconsin, where the death rate from drug and alcohol abuse is nearly twice as high as the state average, as a place where he could make a difference. Lim’s been board certified in addiction medicine since it was officially recognized as a subspecialty in 2016, but he’s been working in the field since about 10 years ago when he started working in an addiction practice in Maine. He took the Wisconsin job, with one stipulation: He would start a program to address addiction as a whole. His expertise would be just one part of the treatment approach.”If I’m just going to be the Suboxone doctor I’m not doing the full practice of addiction,” Lim says.Because while the medication can be effective for treating opioid use disorder, Lim says addiction is not just about opioids.”Opioids are big right now,” Lim says. “But you have to work with alcohol too. You have to work with marijuana too. You have to work with methamphetamine, cocaine.”Rice says she and Lim developed the program together with community partners including educators, law enforcement and tribal leadership. “We were successful because we had a vision for creating a program and so did he,” Rice says.While it’s rare to have a doctor who can prescribe Suboxone in a rural area like this one, Lim says only about 40 of his more than 200 patients take it. For the rest, his program relies on a combination of counseling, group therapy for addiction and underlying mental health issues, and case management. Staff help to remove barriers to being successful in recovery, helping patients with things like, transportation to the clinic, daycare for parents during therapy, and even job placements.This kind of recovery program that combines clinical and counseling services is exactly what rural communities need, says John Gale of the Maine Rural Health Research Center.”That’s exactly the way it should be done. Because most people with a substance use disorder have co-occurring mental health and substance use problems,” Gale says. “If we take care of [a patient’s] heroin problems and we don’t treat the underlying mental health and substance abuse problems, they’re going to go to go to alcohol, they’re going to do something else.”And while most of the attention and dollars are focused on opioid abuse right now, he says rural communities struggling to address addiction can use those resources to build a larger treatment capacity. “They can use [those resources] to say, ‘Wait a minute, let’s build a treatment capacity for other people,’ ” Gale says. “And they begin to create a community where you can treat all sorts of substance use disorders.”Lindsay Bunker gets a ride to and from the NorthLakes clinic from a medical transportation company — it’s about an hour’s drive each way from the reservation. The clinic has a baby sitter who looks after her daughter when Bunker is in appointments. She makes the trip nearly every day.”I love being here. I feel safe. I feel strong. I feel supported,” Bunker says.But she only sees Dr. Lim about once a week. Instead, like all of the patients here, she spends most of her time in one-on-one and group counseling sessions. There’s the early relapse prevention group (from which Bunker recently graduated), then there’s the relapse recovery group, the family group, the engaged-in-recovery group. There’ll be a trauma group soon as well. Bunker says those group sessions are really important in helping her stay in recovery.”I get cravings and the cravings are being taken away with that medicine [suboxone]. But being here with my peers, I love it. I really do,” Bunker says. And she says, recovery agrees with her. “I look good, I feel good, I’m taking care of my kid,” she says. “I’m doing very well.”Bram Sable-Smith (@besables) is a health reporter based in Madison, Wis. Copyright 2018 NPR. To see more, visit https://www.npr.org.last_img read more