Inflammatory Breast Cancer - Fact Sheet

23.12.19

What is inflammatory breast cancer?
Inflammatory breast cancer is a rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast. This type of breast cancer is called “inflammatory” because the breast often looks swollen and red, or inflamed.

Inflammatory breast cancer is rare, accounting for 1 to 5 percent of all breast cancers diagnosed in the United States. Most inflammatory breast cancers are invasive ductal carcinomas, which means they developed from cells that line the milk ducts of the breast and then spread beyond the ducts. 
Inflammatory breast cancer progresses rapidly, often in a matter of weeks or months. At diagnosis, inflammatory breast cancer is either stage III or IV disease, depending on whether cancer cells have spread only to nearby lymph nodes or to other tissues as well. 

Additional features of inflammatory breast cancer include the following:

  • Compared with other types of breast cancer, inflammatory breast cancer tends to be diagnosed at younger ages.
  • Inflammatory breast cancer is more common and diagnosed at younger ages in African American women than in white women.
  • Inflammatory breast tumors are frequently hormone receptor negative, which means they cannot be treated with hormone therapies, such as tamoxifen, that interfere with the growth of cancer cells fueled by estrogen.
  • Inflammatory breast cancer is more common in obese women than in women of normal weight. 

Like other types of breast cancer, inflammatory breast cancer can occur in men, but usually at an older age than in women.

What are the symptoms of inflammatory breast cancer?
Symptoms of inflammatory breast cancer include swelling (edema) and redness (erythema) that affect a third or more of the breast. The skin of the breast may also appear pink, reddish purple, or bruised. In addition, the skin may have ridges or appear pitted, like the skin of an orange (called peau d’orange). These symptoms are caused by the buildup of fluid (lymph) in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.
Other symptoms of inflammatory breast cancer include a rapid increase in breast size; sensations of heaviness, burning, or tenderness in the breast; or a nipple that is inverted (facing inward). Swollen lymph nodes may also be present under the arm, near the collarbone, or both.

It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.
How is inflammatory breast cancer diagnosed?

Inflammatory breast cancer can be difficult to diagnose. Often, there is no lump that can be felt during a physical exam or seen in a screening mammogram. In addition, most women diagnosed with inflammatory breast cancer have dense breast tissue, which makes cancer detection in a screening mammogram more difficult. Also, because inflammatory breast cancer is so aggressive, it can arise between scheduled screening mammograms and progress quickly. The symptoms of inflammatory breast cancer may be mistaken for those of mastitis, which is an infection of the breast, or another form of locally advanced breast cancer.

To help prevent delays in diagnosis and in choosing the best course of treatment, an international panel of experts published guidelines on how doctors can diagnose and stage inflammatory breast cancer correctly. Their recommendations are summarized below.
Minimum criteria for a diagnosis of inflammatory breast cancer include the following:

  • A rapid onset of erythema (redness), edema (swelling), and a peau d’orange appearance (ridged or pitted skin) and/or abnormal breast warmth, with or without a lump that can be felt.
  • The above-mentioned symptoms have been present for less than 6 months.
  • The erythema covers at least a third of the breast.
  • Initial biopsy samples from the affected breast show invasive carcinoma.

Further examination of tissue from the affected breast should include testing to see if the cancer cells have hormone receptors (estrogen and progesterone receptors) or if they have greater than normal amounts of the HER2 gene and/or the HER2 protein (HER2-positive breast cancer).
Imaging and staging tests include the following:

  • A diagnostic mammogram and an ultrasound of the breast and regional (nearby) lymph nodes
  • A PET scan or a CT scan and a bone scan to see if the cancer has spread to other parts of the body

Proper diagnosis and staging of inflammatory breast cancer helps doctors develop the best treatment plan and estimate the likely outcome of the disease. Patients diagnosed with inflammatory breast cancer may want to consult a doctor who specializes in this disease.
How is inflammatory breast cancer treated?

Inflammatory breast cancer is generally treated first with systemic chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy. This approach to treatment is called a multimodal approach. Studies have found that women with inflammatory breast cancer who are treated with a multimodal approach have better responses to therapy and longer survival. Treatments used in a multimodal approach may include those described below.

  • Neoadjuvant chemotherapy: This type of chemotherapy is given before surgery and usually includes both anthracycline and taxane drugs. Doctors generally recommend that at least six cycles of neoadjuvant chemotherapy be given over the course of 4 to 6 months before the tumor is removed, unless the disease continues to progress during this time and doctors decide that surgery should not be delayed.
  • Targeted therapy: Inflammatory breast cancers often produce greater than normal amounts of the HER2 protein, which means that drugs such as trastuzumab (Herceptin) that target this protein may be used to treat them. Anti-HER2 therapy can be given both as part of neoadjuvant therapy and after surgery (adjuvant therapy).
  • Hormone therapy: If the cells of a woman’s inflammatory breast cancer contain hormone receptors, hormone therapy is another treatment option. Drugs such as tamoxifen, which prevent estrogen from binding to its receptor, and aromatase inhibitors such as letrozole, which block the body’s ability to make estrogen, can cause estrogen-dependent cancer cells to stop growing and die.
  • Surgery: The standard surgery for inflammatory breast cancer is a modified radical mastectomy. This surgery involves removal of the entire affected breast and most or all of the lymph nodes under the adjacent arm. Often, the lining over the underlying chest muscles is also removed, but the chest muscles are preserved. Sometimes, however, the smaller chest muscle (pectoralis minor) may be removed, too.
  • Radiation therapy: Post-mastectomy radiation therapy to the chest wall under the breast that was removed is a standard part of multimodal therapy for inflammatory breast cancer. If a woman received trastuzumab before surgery, she may continue to receive it during postoperative radiation therapy. Breast reconstruction can be performed in women with inflammatory breast cancer, but, due to the importance of radiation therapy in treating this disease, experts generally recommend delayed reconstruction.
  • Adjuvant therapy: Adjuvant systemic therapy may be given after surgery to reduce the chance of cancer recurrence. This therapy may include additional chemotherapy, hormone therapy, targeted therapy (such as trastuzumab), or some combination of these treatments.

What is the prognosis of patients with inflammatory breast cancer?
The prognosis, or likely outcome, for a patient diagnosed with cancer is often viewed as the chance that the cancer will be treated successfully and that the patient will recover completely. Many factors can influence a cancer patient’s prognosis, including the type and location of the cancer, the stage of the disease, the patient’s age and overall general health, and the extent to which the patient’s disease responds to treatment.

Because inflammatory breast cancer usually develops quickly and spreads aggressively to other parts of the body, women diagnosed with this disease, in general, do not survive as long as women diagnosed with other types of breast cancer.

It is important to keep in mind, however, that survival statistics are based on large numbers of patients and that an individual woman’s prognosis could be better or worse, depending on her tumor characteristics and medical history. Women who have inflammatory breast cancer are encouraged to talk with their doctor about their prognosis, given their particular situation.

Ongoing research, especially at the molecular level, will increase our understanding of how inflammatory breast cancer begins and progresses. This knowledge should enable the development of new treatments and more accurate prognoses for women diagnosed with this disease. It is important, therefore, that women who are diagnosed with inflammatory breast cancer talk with their doctor about the option of participating in a clinical trial.
Selected References

  • Anderson WF, Schairer C, Chen BE, Hance KW, Levine PH. Epidemiology of inflammatory breast cancer (IBC). Breast Diseases 2005; 22:9-23. [PubMed Abstract]
  • Bertucci F, Ueno NT, Finetti P, et al. Gene expression profiles of inflammatory breast cancer: correlation with response to neoadjuvant chemotherapy and metastasis-free survival. Annals of Oncology 2014; 25(2):358-365. [PubMed Abstract]
  • Chang S, Parker SL, Pham T, Buzdar AU, Hursting SD. Inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program of the National Cancer Institute, 1975-1992. Cancer 1998; 82(12):2366-2372. [PubMed Abstract]
  • Dawood S, Cristofanilli M. Inflammatory breast cancer: what progress have we made? Oncology (Williston Park) 2011; 25(3):264-270, 273. [PubMed Abstract]
  • Dawood S, Merajver SD, Viens P, et al. International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment. Annals of Oncology 2011; 22(3):515-523. [PubMed Abstract]
  • Fouad TM, Kogawa T, Reuben JM, Ueno NT. The role of inflammation in inflammatory breast cancer. Advances in Experimental Medicine and Biology 2014; 816:53-73. [PubMed Abstract]
  • Hance KW, Anderson WF, Devesa SS, Young HA, Levine PH. Trends in inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program at the National Cancer Institute. Journal of the National Cancer Institute 2005; 97(13):966-975. [PubMed Abstract]
  • Li BD, Sicard MA, Ampil F, et al. Trimodal therapy for inflammatory breast cancer: a surgeon’s perspective. Oncology 2010;79(1-2):3-12. [PubMed Abstract]
  • Masuda H, Brewer TM, Liu DD, et al. Long-term treatment efficacy in primary inflammatory breast cancer by hormonal receptor- and HER2-defined subtypes. Annals of Oncology 2014; 25(2):384-91. [PubMed Abstract]
  • Merajver SD, Sabel MS. Inflammatory breast cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK, editors. Diseases of the Breast. 3rd ed. Philadelphia: Lippincott Williams and Wilkins, 2004.
  • Ries LAG, Young JL, Keel GE, et al (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. Bethesda, MD: NCI SEER Program; 2007. NIH Pub. No. 07-6215. Retrieved April 18, 2012.
  • Robertson FM, Bondy M, Yang W, et al. Inflammatory breast cancer: the disease, the biology, the treatment. CA: A Cancer Journal for Clinicians 2010; 60(6):351-375. [PubMed Abstract]
  • Rueth NM, Lin HY, Bedrosian I, et al. Underuse of trimodality treatment affects survival for patients with inflammatory breast cancer: an analysis of treatment and survival trends from the National Cancer Database. Journal of Clinical Oncology 2014; 32(19):2018-24. [PubMed Abstract]
  • Schairer C, Li Y, Frawley P, Graubard BI, et al. Risk factors for inflammatory breast cancer and other invasive breast cancers. Journal of the National Cancer Institute 2013; 105(18):1373-1384. [PubMed Abstract]
  • Tsai CJ, Li J, Gonzalez-Angulo AM, et al. Outcomes after multidisciplinary treatment of inflammatory breast cancer in the era of neoadjuvant HER2-directed therapy. American Journal of Clinical Oncology 2015; 38(3):242-247. [PubMed Abstract]
  • Van Laere SJ, Ueno NT, Finetti P, et al. Uncovering the molecular secrets of inflammatory breast cancer biology: an integrated analysis of three distinct affymetrix gene expression datasets. Clinical Cancer Research 2013; 19(17):4685-96. [PubMed Abstract]
  • Yamauchi H, Ueno NT. Targeted therapy in inflammatory breast cancer. Cancer 2010; 116(11 Suppl):2758-9. [PubMed Abstract]
  • Yamauchi H, Woodward WA, Valero V, et al. Inflammatory breast cancer: what we know and what we need to learn. The Oncologist 2012; 17(7):891-9. [PubMed Abstract]
  • SOURCE: Oncology Nurse Advisor; originally published by American National Cancer Institute

 

 

 

Fidelity Bank sets new record, nets 20% rise in 9months

30.10.19

FIDELITY Bank Plc has reported a growth of 20 per cent in profit after tax (PAT) to N21.5 billion for the nine months which ended September 30, 2019. This is an improvement its N17.9 billion recorded in the corresponding period of 2018.

The bank’s unaudited results shows gross earnings of N161 billion in 2019, an increase of 15 per cent. Net interest income rose to N58.2 billion from N58.1 billion in 2018. Similarly, fees and commission income increased from N15.1 billion to N19.2 billion. The bank ended the period with profit before tax of N23 billion, showing an increase of 15 per cent, while PAT grew faster by 20 per cent to N21.5 billion, from N17.9 billion.

Similarly, total assets of the bank grew by 14.6 per cent to N1.971 trillion, from N1.719 trillion in the same period under review. Total deposit, which signifies customers’ confidence, increased by 14.0 per cent to close at N1.116 trillion from N979.4 billion in 2018.

An elated Managing Director and Chief Executive Officer of the Bank, Mr. Nnamdi Okonkwo, said he expected a further improvement in the last quarter of the year.

“We look forward to sustaining the momentum in fourth quarter 2019 and achieving our set targets for 2019 financial year.” According to him, retail banking continued to deliver impressive results as savings deposits increased by 9.2 per cent to N248.9 billion, noting that the bank was on course to achieving the sixth consecutive year of double-digit savings growth.

“Savings deposits now accounts for about 22.3 per cent of total deposits, an attestation of our increasing market share in the retail segment,” Okonkwo said

He explained further that the growth in deposits was further complemented by the bank’s digital banking drive which he noted has resulted in having over 46.4 per cent of its customers enrolled on the mobile/internet banking products and recording over 82.0 per cent of total transactions on digital platforms.

“Digital banking continued to gain traction driven by the bank’s new initiatives in the retail lending and increased cross-selling of our digital banking products,” he added.

The banks’ non-performing loans (NPLs) ratio improved to 4.8 per cent from 5.7 percent in the 2018FY while absolute NPL declined by 4.9 per cent in the third quarter (Q3) 2019, compared to second (Q2) 2019.

He said all other regulatory ratios remained above the required thresholds with Capital Adequacy Ratio (CAR) at 16.4 per cent and Liquidity Ratio at 32.6 per cent.

Fidelity Bank is a full-fledged commercial bank operating in Nigeria with over five million customers who are serviced across its 250 business offices and various digital banking channels.

The bank is focused on select corporate banking sectors as well as Micro Small and Medium Enterprises (MSMEs). It currently drives its retail banking businesses through structured robust digital banking channels.

 

 

Situation worsens as Cameroon jails Anglophone separatist leader

28.08.19

SITUATION in central African country of Cameroon plummets resulting from recent jail terms handed down to members of the country’s Anglophone separatist movement.

According to Reuters, Cameroonian security forces moved same Tuesday to quell uprisings in two prisons by inmates protesting the government's crackdown on the Anglophone separatist movement and poor conditions of incarceration.

Scores of people from English-speaking regions of the central African country have been arrested over the last two years during a conflict between the mostly French-speaking government and separatist rebels seeking to form an independent state called Ambazonia.

A Cameroonian security source confirmed to Reuters that a riot took place in the central prison of the capital Yaoundé and said several people were injured. Government spokespeople did not immediately respond to requests for comment.

Videos filmed by inmates and uploaded to Facebook showed protesters there crying "Ambazonia rising!" as they hurled debris at security forces inside the Kondengui prison in Yaoundé.

Loud crackles that sounded like gunfire could be heard in the background and fires could be seen burning in parts of the prison, sending thick plumes of smoke billowing into the air.

"Our brothers are slaughtered, children killed," said one unidentified man, speaking in English. "We are tired of being in prison. We want to go home," said another.

A second riot erupted in the prison in Buea, one of the main cities of the Anglophone Southwest region, a local journalist who was present said. The journalist, Kum Leonard, added that he had heard gunfire from the jail throughout the late afternoon.
Cameroon's state television channel CRTV reported that the inmates in Yaoundé were protesting conditions in the prison and had burned down the library and a workshop for female inmates.

The report said several prisoners had been injured and that the army and police were working to restore calm.

Cameroon's main opposition party, the Cameroon Renaissance Movement, said Tuesday it was worried it did not have any news about its members held in the prison, including its first vice president, who is being held in connection with a protest distinct from the separatist campaign.

Amnesty International called for an investigation into reports that security forces fired live ammunition in the prison and said authorities should address overcrowding.

Tuesday’s Jailing
AFP reported that a military court in the country on Tuesday August 20 handed a life sentence to the head of the country’s Anglophone separatist movement, Julius Sisiku Ayuk Tabe, in a move that analysts said could inflame the 22-month-old revolt.
Ayuk Tabe, a charismatic leader widely deemed as a moderate in the separatist movement, was convicted with nine others of charges including “terrorism and secession”, the state’s lawyer, Martin Luther Achet, told AFP. They were given life terms.
The sentences were confirmed by a lawyer for the separatists, Joseph Fru, who added the 10 had also been fined 250 billion CFA francs ($422 million, 381 million euros).

Fru condemned what he called a “parody of justice” and said the defendants refused to recognise the right of the military tribunal in Yaoundé to try them. Their lawyers have yet to say whether they will file an appeal.
Ayuk Tabe, a 54-year-old computer engineer by training, is the first self-proclaimed president of “Ambazonia” — a breakaway state declared in October 2017 in two English-speaking regions of the central African country.
The government responded with a military crackdown. Attacks by both sides have left 1,850 dead, according to the International Crisis Group (ICG) think tank, while the UN says 530,000 people have fled their homes.

Colonial legacy 
English-speakers account for about a fifth of Cameroon’s population of 24 million, who are majority French-speaking.
Anglophones are mainly concentrated in two western areas, the Northwest Region and the Southwest Region, that were incorporated into the French-speaking state after the colonial era in Africa wound down six decades ago.

Anglophones have chafed for years at perceived discrimination in education, law and economic opportunities at the hands of the francophone majority.

Ayuk Tabe is part of the political branch of the separatist group that supports dialogue with 86-year-old President Paul Biya, who has been in power for 36 years.

But the influence of moderates waned in 2017 as Biya rejected demands for autonomy and radicals in the movement gained the ascendant.

Worsening Cisis 
In January 2018, Ayuk Tabe was arrested with 46 other separatists in the Nigerian capital Abuja.
They were then handed over to Cameroon, and the trial of Ayuk Tabe and the nine others began in late December. In March this year, the extradition was ruled illegal by a Nigerian court.

In late May, Ayuk Tabe said he was willing to take part in talks with the government, provided this took place abroad and the government released all people who had been detained since the start of the Anglophone crisis.

But Tuesday’s sentencing could crush any chance of dialogue, analysts said.

A specialist at the ICG said the move “risks worsening the security situation in the Anglophone zone in the coming weeks.”
“It could radicalise part of the separatists who had been seeing a sign of hope in the fact that the leaders had not yet been sentenced.”

Cameroon’s main opposition part, the Social Democratic Front (SDF), which is opposed to Anglophone secession, also said the sentence worsened the breakaway crisis.

“Ayuk Tabe has much clout among Anglophones. His sentencing will make the resolution of this crisis more complicated,” its spokesman, Denis Nkenlemo, told AFP.

“This decision is an act of provocation which once more proves that the government isn’t ready for dialogue… and is driving us straight into the wall.”

The unrest has crippled the economy of the Northwest and Southwest Regions and had a knock-on effect across the country.
More than one in six people in Cameroon — 4.3 million — need humanitarian aid, an increase of 30 percent from 2018, according to UN aid officials.

World Report 2019 by Human Rights Watch
Cameroon, a country previously known for its stability, faced violence and serious human rights abuses in 2018. The country endured abusive military operations against a secessionist insurgency in two Anglophone regions, attacks by the Islamic militant group, Boko Haram, in the Far North, and a worsening humanitarian crisis. President Paul Biya, 85, won a seventh seven-year term on October 7.  

In the South West and North West, government security forces have committed extrajudicial executions, burned property, carried out arbitrary arrests, and tortured detainees. A Human Rights Watch report documented a range of abuses by both sides in the Anglophone regions, including arson attacks on homes and schools. According to the International Crisis Group, government forces and armed separatists killed over 420 civilians in the regions since the crisis escalated in 2017. 
The humanitarian consequences of the Boko Haram attacks and separatist insurgency are of growing concern. As of November, the United Nations estimated that more than 244,000 civilians were displaced in the Far North and  437,500 in the Anglophone North West and South West regions. About 32,600 Cameroonians found refuge in Nigeria. Also, Cameroon has continued to forcibly return Nigerian asylum seekers, fleeing Boko Haram attacks in northeastern Nigeria.

While the government maintained it did not tolerate serious crimes committed by security forces, it failed to demonstrate progress in investigating and punishing them.

On October 22, Cameroon’s Constitutional Council validated Paul Biya’s reelection, with 71.28 percent of the votes. The council’s decision was immediately contested by one of Biya’s rivals, Maurice Kamto, who claimed the results had been altered. In early November, dozens of pro-Kamto protesters were arrested in Bafoussam, Western region. Biya was sworn-in for a seventh term as president on November 6.

Abuses on Both Sides
In the Anglophone North West and South West regions, the absence of a genuine political process to address decades-old grievances against the Biya government contributed to the radicalization of the discourse and tactics of Anglophone activists. Since mid-2017, Anglophone separatists have attacked government institutions and threatened, kidnapped, and killed civilians perceived to side with the government.

In 2016 and 2017, government security forces used excessive force against largely peaceful demonstrations organized by members of the country’s Anglophone minority who were calling for increased autonomy for their region. During demonstrations in late 2017, government forces used live ammunition, including from helicopters, against demonstrators and bystanders, killing at least a dozen people and injuring scores. Some individuals detained in the context of the demonstrations were subjected to torture and ill-treatment.

In October 2017, separatist leaders unilaterally declared independence of the North West and South West regions, and the formation of a new nation, Ambazonia. The following month, President Biya announced that Cameroon was under attack from terrorists and vowed to “eradicate these criminals.” The pace and scale of separatists’ attacks against security forces, government workers, and state institutions increased, especially following the arrest and deportation of 47 suspected secessionist activists from Nigeria in January 2018. 

Violations by Government Forces
Human Rights Watch found that government forces responded to the growing separatist insurgency by carrying out abusive security operations against communities suspected of supporting secessionist groups. Security forces committed extrajudicial executions, used excessive force against civilians, tortured and abused suspected separatists and other detainees, and burned homes and other property in scores of villages.

During attacks documented by Human Rights Watch, security forces allegedly shot and killed over a dozen civilians, including at least seven people whom witnesses said had intellectual, psychosocial or physical disabilities, who did not flee because they were unable or refused to. At least four older women died, burned alive, after security forces set their homes on fire.

Human Rights Watch also documented three cases where security forces detained people suspected of supporting the secessionist cause, and then tortured and killed them in detention. In a fourth case, Human Rights Watch analyzed evidence of torture filmed by perpetrators, who appear to be gendarmes. On September 24 and 27, a total of nine men were allegedly executed by security forces in the town of Buea, according to videos reviewed by Human Rights Watch and a report by theCentre for Human Rights and Democracy in Africa, a local nongovernmental organization (NGO).

Abuses by Armed Separatists
To enforce boycotts of schools following protests by Anglophone teachers against perceived discrimination by the Francophone-dominated national government, separatist groups attacked and burned dozens of schools, threatened teachers, students and parents, kidnapped principals and violently attacked teachers and students. In March, people believed to be armed separatists attacked a high school dormitory in Widikum, North West region, and shot dead Emmanuel Galega, a student. 

The pressure tactics forced the majority of schools to close during the 2016-2017 academic year, and as of May 2018 an estimated 42,500 children were still out of school, according to UN Office for Humanitarian Affairs (OCHA). Most schools did not re-open in 2018.  

On April 30, Father William Neba, principal of St. Bede’s College, in Ashing near Belo, North West region, was reported abducted while celebrating mass with students. He was released two days later. The school suspended classes on the day of the abduction.  In September, unidentified gunmen attacked a girl’s school in Bafut, North West region, kidnapping five pupils and severely wounding the principal.

In September, the government endorsed the Safe Schools Declaration, an international political agreement to protect education during armed conflict.

On November 5, up to 78 schoolchildren were reportedly kidnapped in Bamenda, North West region, by unknown gunmen. They were released two days later.

Refugee Rights
Cameroon hosts more than 350,000 refugees and asylum seekers, including 260,000 from the Central African Republic and at least 90,000 from Nigeria. Despite its long history of hosting refugees, Cameroon has forcibly returned tens of thousands of Nigerian asylum seekers since 2015. A 2017 Human Rights Watch report documented how soldiers used violence and abuse, including torture, against asylum seekers in remote border regions. Authorities also imposed unlawful restrictions on movement in Cameroon’s only official camp for Nigerian refugees. In August 2018, the UN High Commissioner for Refugees reported that between January and July, Cameroon unlawfully returned at least 800 refugees and asylum seekers to Nigeria. 

Sexual Orientation and Gender Identity
Cameroon’s penal code punishes “sexual relations between persons of the same sex” with up to five years in prison. Police and gendarmes continued to carry out arrests and harassment of people they believe to be lesbian, gay, bisexual or transgender (LGBT). In April, police arrested four activists and a security guard at the office of AJO, an organization that works on HIV education with men who have sex with men (MSM), and other vulnerable groups. They spent a week in jail on spurious homosexuality charges before a lawyer secured their release. Cameroonian human rights organizations documented the arrest of at least 25 other men and at least two women on homosexuality charges in the first half of 2018. They also reported numerous cases of physical violence by private citizens targeting LGBT people.

Justice and Accountability
While the government has repeatedly promised to investigate crimes committed by security forces, it has not done so transparently or systematically.

Government officials told Human Rights Watch in June that while they conducted investigations, they did not want to make them public to avoid undermining the morale of government troops. However, the visible lack of accountability appears to have fueled abuses, like arson and torture, rather than ending them.

In July, the government finally granted access to ten Anglophone leaders who had been detained and deported from Nigeria to Cameroon in January. The individuals, held incommunicado for over six months, were permitted to meet their lawyers and the International Committee of the Red Cross.

The government dismissed video footage that emerged in July showing two women and two children being executed by men in uniform in Cameroon’s Far North as “fake news.” Only after an investigation conducted by Amnesty International demonstrated the killings took place in Cameroon did the government announce it had arrested six soldiers suspected of executing the civilians in the video.  

Key International Actors
France, the United States, and the United Kingdom are Cameroon’s principal partners, primarily in the context of the counter Boko Haram operations in the country’s Far North region. Both France and the US provide Cameroon with military and security assistance and training.

The US and the UK are the only close allies of Cameroon to have voiced public concern regarding the ongoing situation in the Anglophone regions. The US has continued to provide military aid to Cameroon.

In February, the European Union called for proportionate use of force and accountability for abuses in the Anglophone region.
In September 2018, as the pace and scope of abuses continued to escalate in Cameroon’s Anglophone regions, the UN and African Union issued a joint communiqué calling on the government to facilitate access to humanitarian and human rights organizations and engage in an inclusive dialogue to address the root causes of the crisis.

The UN Security Council in August expressed concern about the situation in Cameroon’s Anglophone regions.

 

 

 

Independence for Southern Cameroon

By Melvin Mekunye

11.07.18

 

IN the past sixteen months, concerned citizens of Southern Cameroon resident in Nigeria have continued to reawaken the region's agitation for sovereignty. While some of them staged a diplomatic protest in Abuja, Nigeria's capital; some others have continued to engage in diplomatic campaign capable of crippling the fragile economy of Cameroon.


“We want the restoration of Independence and Sovereignty of the Southern Cameroons (Ambazonia). The people of the Southern Cameroons feel, and rightly so, that they have reached the limit of trying to get the annexationist government of La République du Cameroun to resolve their crisis amicably through frank dialogue…Our population has become very restive and we call on the international community to hold the government of La République du Cameroun fully responsible for any outbreak of violence due to their continued provocation of our people and pillage of our resources...” said a communiqué presented to the media and signed by the trio of Sisiki Ayuk Tabe, Cornelius Kwanga and Fidelis Ndeh-Chein in Abuja.

Events in the country have overtaken the warning which is currently being implemented, albeit alleged killings by the military to put down protests.


The agitation is not new. There has been a recurrent cause for its continuation. Before the advent of the Portuguese traders to the Southern Cameroons; and the Fulani Islamists some centuries later to northern Cameroon, the political entity now referred as Southern Cameroons was believed to be the home of the Bantu people described by some African historians as industrious and friendly.

While other parts of Cameroon found freedom at Independence in 1961, it marked the beginning of political nuisances for the people of Southern Cameroons.

The current build up in Southern Cameroons resembles a great potential for another theatre of violent conflict as in some parts of Africa, thus requiring the international community to sincerely manage the situation. The agitators do not only accuse Yaoundé of marginalization but also of neglect and deprivation.

Reports said there had been “targeted killings” in the English-speaking region by the country's military which led the British Ambassador to the country Peter Barlerin, to condemn the alleged action. He was later summoned by the Cameroonian authorities for the criticism.

AFP reported in May that Cameroon's foreign ministry summoned the ambassador, who on May 18 alleged that government forces carried out targeted killings and other human right abuses against separatist militants.

There is the need for a civilized approach on the parts of the agitators, the government of Cameroon and the international community. There doesn't seem to be any man or group of people, who cries without a cause. It similarly goes that a man, who has repeatedly cried for help without neighbourly response or concern, becomes despondent, hardened and fiendish. This seems to have been a background to terrorism in the world today.

There is no basis justifying terror anywhere in the world, but sincerity and godliness demand sympathy with the psyche of a people, who felt cheated, humiliated and rebuffed; eventually resorted to arms. Pressure for violence may abet if they receive sympathy from a third party.

The people of Southern Cameroons, like any other oppressed group anywhere in the world, require attention.
Whereby a government through greed or political blindness is not able to orchestrate political harmony within its administration, it is expected that such regional or global bodies as African Union or the United Nations should maintain the position of a credible mediator.

Like African Union averted a loomed ulcerous armed conflict in The Gambia, the situation in Cameroon is begging an attention. If the agitation of the people of Southern Cameroons is allowed to develop to an advance armed struggle, the terror group Boko Haram menacing parts of Central and West Africa will receive additional fortress. The terror group is already in Cameroon.
In the same manner, governments of countries in Central and West Africa particularly Nigeria, Benin Republic, Cameroon, Niger and Tchad should ensure that local or national agitations do not develop into armed struggle, not by coercion but by diplomacy; otherwise the entire regions may become a large home to terror groups; worst than the situations in Syria and Afghanistan.

Southern Cameroonian political trouble which seems as old as colonialism and European impish distortion of the face of Africa should not be allowed to magnify African economic and political woes.

Perhaps, continued violence in the Cameroons could compound the various cases of displacement of persons and families in almost all the regions of Africa.

President Paul Biya should be assisted to end political and economic problems in Southern Cameroons. He has been wonderful in the fight against terrorism in the region, albeit his unacceptable dictatorship. The international community should assist him to avert the looming crisis in his country before it destroys economic and political gains in Cameroon, and the rest of central and West African countries.

The effect of such crisis on Nigeria and other neighbouring countries will be colossal. Apart from possible spill of terrorism, negative economic impact such as accommodating refugees may remain insolvable for decades.

It is therefore proactive that the UN and AU should give sincere and urgent attention to events in Cameroon as I call for total support for the recognition of the Republic of Ambazonia.

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