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Archives for Asia

USAID Swears in First Mission Director to Burma in 24 Years

August 29, 2012, was a momentous occasion for USAID as Chris Milligan, amid an overflowing crowd of friends, supporters and high-level dignitaries, including Ambassador Than Swe and Special Representative and Policy Coordinator for Burma Patrick Murphy, was sworn in as the Agency’s first mission director to Burma since 1988.

USAID Administrator Dr. Rajiv Shah, right, administers the oath of office to Chris Milligan. Photo Credit: Patricia Adams/USAID

“The challenge before us—and before Chris—is not only to build a Mission from the ground up, but to help the Burmese people and government seize these opportunities and capture the potential of this moment in their history,” said USAID Administrator Dr. Rajiv Shah, who administered the oath of office.

Milligan will lead the newly re-established USAID mission at a critical time in the evolving relationship between the United States and Burma.  Murphy said, “We have today, I think, the culmination of the Obama Administration’s experiment when it comes to this country. Just a few short years ago, we decided to embark on a path of engagement to bring dialogue and diplomacy to several decades of isolation.”  Secretary Clinton announced the re-establishment of the USAID mission in Burma April 4, 2012, as part of the U.S. Government’s continuing commitment to support the Burmese people and governmental efforts toward reform and democracy.

Ambassador Swe thanked the American people and government for their support, which he said is “of vital importance for my country’s reform.”  Noting the challenges and the potential of his country, he expressed the Burmese people’s appreciation to USAID and the American people, and their eagerness to move forward, telling Milligan, “If you work together with our people, nothing is impossible.”

As Dr. Shah noted, the standing-room-only audience of colleagues, family, and Burma experts not only demonstrated the great interest in Burma and USAID’s new presence there, but it also highlighted the loyalty and friendships that Milligan has garnered in his career at USAID spanning more than two decades.

Assistant Administrator for Asia Nisha Biswal said that the United States is at a “new place” in its relationship with Burma, adding, “It is my privilege and delight to have Chris Milligan lead that effort on behalf of USAID.”

Chris Milligan delivers remarks following his swearing-in as mission director to Burma. Photo Credit: Patricia Adams/USAID

Milligan expressed gratitude for his appointment and stressed the value of American overseas assistance: “Development is about expanding opportunity—the opportunity to live a life free from fear, to have basic needs met, and to pursue a better future for ourselves our families and our communities.”

Milligan also reflected on the important historical moment of his appointment and the challenges facing the country, saying: “The country I’m going to is in the process of a remarkable transition.  The world wants to see this transition happen. […]  We will work in partnership and we will follow principles.  We think carefully about what we do. [..]  We will balance urgency and diligence.”

Led by Milligan, the new USAID mission will build up a team in country, including more technical experts, which will enable USAID to more effectively engage with partners, oversee programs, coordinate with other donors, and directly benefit the Burmese people.

A Relay Race to Save Lives During Bandhs

Bandhs, or general strikes, have become such recurrent events in Nepal that even as people complain about them, they are resigned to them.  During a bandh, markets and offices are closed and public transportation is halted, bringing life to a standstill.  Anyone venturing out in a vehicle during a bandh would risk broken windows, punctured tires, or even having their vehicle set on fire at the hands of bandh enforcers.

Because bandhs generally last only for a day or two, Nepalis usually take them in stride, but in April 2012, Nepal’s Far Western Region underwent a bandh that lasted for 32 days.  For the more than 5,000 people living with HIV in the region, this was a life-threatening situation—particularly as nearly half of them are dependent on anti-retroviral therapy (ART).

ART is a complex treatment involving multiple medications that need to be taken at the same time every day over the long term.  With local transportation halted, people in remote areas had no access to government-run ART centers.

That’s where the USAID-funded Saath-Saath Project stepped in.

The Saath-Saath Project, which has been providing support to people living with HIV through community and home-based care (CHBC) providers (PDF), was aware that these individuals would soon run out of their regular supply of medicine due to the prolonged bandh.

USAID's community and home-based care team travels to visit people living with HIV at their homes in the Far Western Region of Nepal. Photo: USAID

So the Saath-Saath Project, its local NGO partner Asha Kiran Pratisthan, CHBC team members, and Seti Zonal Hospital joined hands on an innovative solution: they would distribute supplies using a method similar to a relay race.

They started by mapping the location of all HIV-positive individuals needing ART.  Then they began delivering medicines to these individuals, carrying banners that read “Delivering Essential ARV Medicine to People Living with HIV.”  The CHBC team members traveled by bicycle, motorcycle, and even on foot—some travelling more than 35 kilometers through difficult terrain—to deliver the needed medicine.

“I was stopped a couple of times by bandh enforcers, but after seeing the medicine inside my bag, they even apologized and let me go,” said Chhabilal Khadka, one of the CHBC team members and an HIV patient himself.  “In the end, the relief I could see on the clients’ faces gave me a sense of pride and fulfillment at having saved lives.”

Workers trained through USAID's Community and Home-Based Care Program provide care and support services and replenish essential medicines for individuals with HIV in the Far Western Region of Nepal. Photo: USAID

“My medicine had run out.  I was sharing another HIV patient’s supply and when that started running out, we began to panic,” said an HIV patient in the Kailali district, who declined to provide his name due to privacy concerns.  “But the CHBC team came to my aid in the nick of time.  I am forever thankful to these dedicated people for going through such risk and trouble to ensure the well-being of people like us.”

 

USAID’s efforts to reduce HIV in Nepal began in 1993 and have since contributed extensively to the Government of Nepal’s national HIV response.  Today, Nepal is emerging as one of the few countries that have made remarkable progress in meeting the United Nations Millennium Development Goals, including combating HIV/AIDS.

Secretary Clinton Glimpses Legacy of Vietnam War-era Bombs in Laos

Secretary of State Hillary Clinton made a brief visit to Laos last month, making her the highest serving U.S. Government official to visit the country since 1955.  As part of her visit, she took a tour of a visitor center in the capital Vientiane established by the Cooperative Orthotic and Prosthetic Enterprise (COPE), an organization partially funded by USAID that is the only provider of prosthetic and orthotic devices in the country and assists survivors of cluster bombs left over from the Vietnam War.

COPE staff told Secretary Clinton about the on-going effects of the U.S.-made and deployed bombs during the Vietnam War that fell over Laos, where approximately 100 people a year continue to be injured or killed by those bombs and thousands more lives are disrupted by their presence, according to the organization. Secretary Clinton studied a map of U.S. Air Force bombing missions covering one third of the country with red dots, each signifying a bombing mission over a period of nine years.

COPE introduced her to the work it is doing to support cluster bomb survivors and people with physical disabilities with physical rehabilitation as the only provider of these services working with the Lao government. USAID’s Leahy Fund for War Victims supports a training program to develop the orthotic technology that helps COPE’s clients.

Secretary Clinton was introduced to Phongsavath, a 20-year old cluster bomb survivor who told her how he lost his hands and eyesight in an explosion four years ago.  During their conversation, Phongsavath said he was lucky to have COPE assist him, but many survivors are not as fortunate and have not received any assistance.  Secretary Clinton said the U.S. needs to work more with the Lao government to address this Vietnam War legacy and make sure that legacy comes to a safe end.

COPE supports the development of physical rehabilitation services through the five Lao government-owned rehabilitation centres across the country. A significant number of people assisted through COPE were injured by the unexploded ordinance that littered around one third of the country at the end of the Vietnam War. The COPE Visitor Centre hosts a permanent exhibition on the impact of unexploded ordinance on the Lao population.

Before leaving, the Secretary signed the center’s visitor book: “Thank you for all you do to help so many and I pledge the United States will support COPE and the Lao people and government to overcome the legacies of the past.”

 

Timor-Leste Administers Own Elections

On July 7, I went to the polls—along with my fellow citizens of Timor-Leste—to participate in a notable election:  not only did we elect a new parliament for the second time in our young country’s history, but we also voted in general elections that for the first time were managed and run entirely by Timorese institutions. As was widely anticipated, the elections were peaceful and the turnout was high, at about 75 percent.

My country’s independent conduct of free and fair elections demonstrated our government’s commitment to further consolidating our still-young, but vibrant democracy. I am proud that Timor-Leste was able to achieve this milestone just 10 years after the restoration of its independence.

As a Foreign Service National working with USAID, I am also proud about what this election demonstrates about USAID’s efforts to promote sustainability and local ownership in our programs. For the past 10 years, USAID has laid the groundwork for this day by supporting Timor-Leste in developing robust democratic institutions and processes. That work paid off on July 7.

Several Timorese institutions deserve credit for the successful Election Day—namely, the National Electoral Commission and the Technical Secretarial for Elections Administration, which administered the electoral processes. The National Police maintained security and tranquility not only on Election Day, but also during the periods before and after the election.

Although the elections were administered without international assistance, the Timorese government and public did welcome international observers. USAID funded a team of 20 international observers who covered every district throughout the country. Through the International Republican Institute (IRI), we also provided training to 1,700 domestic observers—members of a local non-governmental organization, the Observatorio da Igreja Para Os Assuntos Socials (OIPAS)—who were successfully deployed to every polling station across the country.

Before the election, USAID funded civic and voter education activities that familiarized voters with the elections procedures and processes and helped them to better understand the different platforms and programs proposed by the parties and coalitions competing in the election. And three weeks before the election, USAID deployed a separate team of observers to assess the pre-election atmosphere.

Timor-Leste’s successful elections are indeed a feather in the cap of my country. They are also a great example of what happens when USAID’s development programs work as they should, by strengthening the ability of local actors to carry out important work on their own for the long term.

Thinking Across Borders in Southeast Asia

Earlier this month, I traveled to Cambodia to join Secretary Clinton at the Lower Mekong Initiative (LMI) Ministerial meetings where we launched “LMI 2020” – a deepening of the United States’ commitment to  Southeast Asia through a set of new activities aimed at strengthening regional coordination on development challenges facing the Lower Mekong region. 

“LMI 2020” seeks to advance knowledge and understanding of the environmental and health implications of economic and infrastructure development along the Mekong River, one of the most bio-diverse fresh-water ecosystems on the planet, as well as to strengthen the capacity and coordination of government, civil society and academic/research institutions in the region on these issues.  These new assistance programs support the LMI pillars of environment, education, health and connectivity which are co-chaired respectively by Viet Nam, Thailand, Cambodia and Laos.  But one of the most exciting outcomes was the formal welcome of Burma as a full participant in the Lower Mekong Initiative and the adoption of a fifth pillar on Agriculture and Food Security that Burma will co-chair.

The Lower Mekong Initiative was launched in 2009 as a framework for addressing the transnational challenges posed by infrastructure development along the Mekong River and a way to share information and analysis and to improve coordination amongst the countries in the region as well as donors.  Hence a parallel effort, bringing together the “Friends of the Lower Mekong” (FLM) around the table with the Mekong countries, has also become a critical way of aligning programs and policies.  I was struck by how far our partnerships under the LMI framework have progressed in the three years since it was launched. LMI partners now regularly discuss challenges with each other, at the highest political levels as well as in technical working group meetings, on issues such as the impact of proposed hydropower projects on the main stem of the Mekong River, or the need to coordinate to fight emerging pandemic threats.

After several days of productive meetings in Phnom Penh surrounding the U.S.-ASEAN Ministerial meetings, I then traveled to Siem Reap  to participate in  the Lower Mekong Gender Equality and Women’s Empowerment Policy Dialogue, which USAID co-hosted along with the State Department and the Royal Government of Cambodia’s Ministry of Women’s Affairs to highlight the role of women in the fostering sustainable development in the Mekong region. Secretary Clinton gave an inspiring speech on women’s rights as workers and the need to ensure opportunities for all girls and women. USAID has committed to support women leaders in the region to build a network to address critical transnational issues, such as environmental resources management.  Listening to the dynamic and vibrant women participants at the conference, it was clear to me that the potential in the region to achieve inclusive and sustainable growth could not be achieved without the full and active participation of women.

For more information, see the fact sheets on LMIthe Asia Pacific Strategic Engagement Initiative (APSEI) and more at http://www.state.gov/r/pa/prs/ps/2012/index.htm

SMARTgirl Empowers Women in Cambodia

Originally posted to the FHI360 blog.  

Earlier this month, U.S. Ambassador at Large for Global Women’s Issues, Melanne Verveer, joined Assistant Administrator for Asia, Nisha Biswal for a special visit to the SMARTgirl project in Cambodia, a USAID funded project led by FHI 360. SMARTgirl aims to prevent and mitigate the impact of HIV and improve the sexual and reproductive health of entertainment workers, many of whom are sex workers. There are an estimated 35,000 entertainment workers in Cambodia, working at night clubs, bars, massage parlors, karaoke clubs (KTV), restaurants, beer gardens, as well as on the street. Prevalence of HIV is as high as 14 percent, among some groups of entertainment workers.

SMARTgirl stands apart from other programming among entertainment workers in Cambodia because of its positive, non-stigmatizing approach. It combines evidence-based interventions with the strong SMARTgirl brand, which empowers women to protect their health and well-being. SMARTgirl reaches nearly half of all EWs in Cambodia in their workplace, because it treats them respectfully, recognizes what is important to them and improves health-seeking behavior by raising self-esteem.

SMARTgirl is one of a number of projects that validates what the international community and national leaders have been emphasizing for more than a decade— that empowering women and girls are vital components of human development. Since coming into office, U.S. Secretary of State, Hillary Clinton, as well as Ambassador Verveer, have continually underscored the importance of integrating these issues into Department of State foreign policy objectives.

During Secretary Clinton’s recent ASEAN development meeting in Phnom Penh, she was influential in integrating gender equality and women’s empowerment into the Lower Mekong Initiative agenda. In a statement, she emphasized the importance of reproductive rights for achieving gender equality; an area that the innovative FHI 360 SMARTgirl program has been integrating into its HIV mitigation program:

“Reproductive rights are among the most basic of human rights. … Millions of women and young people in developing countries don’t have access to information to plan their family. They don’t have health services and modern methods of contraception. This is not only a violation of their right…it’s also a question of equity as women everywhere should have the same ability to determine this fundamental part of their lives.”

As this short video on SMARTgirl reveals, the women in the program feel inspired, often for the first time. They see themselves as “smart girls”– women who are empowered to change their lives, and educate others about health issues and rights.

Says Kheng, “Before I became a SMARTgirl leader, I used to face issues on my own, … but we have the right to help each other and we have to participate in the community where we live.”

From the Field: Imams Encourage TB Treatment in Tajikistan

As a community health specialist with USAID’s Quality Health Care Project in Dushanbe, Tajikistan, I educate community members, medical workers, patients, and their families about tuberculosis (TB) diagnosis, treatment, and infection control.  My job involves being constantly available and responsive to the needs of patients and their families, and I tend to work unusual hours in order to fit into their schedules.  Still, I was a bit surprised when I received a call from Safarov Khudodod in the middle of the night last month.  Khudodod is an imam, a religious leader at his mosque, and he was so excited about a TB testing referral he made after his sermon that he couldn’t wait until the morning to share it with me.

“I heard the man coughing and approached him to ask him about his symptoms.  I encouraged him to get tested.  He just reported back to me that he tested positive for TB and will begin treatment immediately,” he said.

Imams in Tajikistan play a major role in the lives of their congregations.  They lead ceremonies such as weddings and funerals and provide religious advice to those seeking it.  USAID is working with religious leaders in Tajikistan to inform them about the causes and treatment of TB.  USAID workshops are helping participants like Imam Khudodod to encourage known TB patients in their communities to get treatment and teach them how to avoid transmitting the disease to others.  I meet with workshop participants several times a year to help them complete self-designed outreach plans.  The 62 people we’ve trained have already reached approximately 20,000 community members.

Before he attended USAID’s TB workshop, Imam Khudodod told us he knew very little about TB.  “Before, we thought that TB was a genetic disease, but now we know it isn’t.  Many people in my community think that TB isn’t curable, so they don’t get treatment.  I share information about TB at all of my meetings with my congregation, even at weddings and births.  I have already reached out to over 5,000 people.”

Tajikistan has the highest rate of TB incidence in Central Asia and one of the highest multi-drug resistant TB rates in the world.  Encouraging individuals to complete treatment and teaching them basic rules of infection control are key steps in eradicating TB in countries like Tajikistan.

Imam Khudodod is optimistic about the future of TB in his country:  “I think that the next generation will be healthy and will know about TB.”

Video of the Week: A Visit to Candlenut Farmers

This week’s video comes from our USAID Mission in Timor-Leste. USAID works with candlenut farmers and their communities to teach them how to increase yields and reach new markets.

An Oasis for New Moms

This blog post is published in conjunction with the Child Survival Call to Action, which was convened June 14-15 by the Governments of the United States, India, and Ethiopia, and is organized in close collaboration with UNICEF.

The new mothers I met at the Regional Maternity Hospital in Kyzylorda, a province in southern Kazakhstan, were as weathered as the salty desert earth all around us. Their young faces appeared determined but exhausted, hinting at the many hundreds of kilometers they had to travel to reach the hospital in time to give birth.

The newborns these mothers cradled in their arms weighed less than a handful of apples. This region historically has suffered from the country’s highest newborn mortality rates. Kyzylorda suffers from many unhealthy environmental factors, like the Aral Sea pollution crisis and toxic mining, which the local doctors tell us contributes to poor health outcomes for mothers and infants. Prematurity accounts for about 37 percent of newborn deaths worldwide.  Asphyxia and infections are other leading causes of newborn deaths.

If these babies had been born before 2008, they would probably not be alive today.  Before 2008, when USAID started helping the regional health department adopt World Health Organization (WHO) live birth criteria, these babies would not have received the life-saving interventions such as neonatal resuscitation that kept them alive in those precious hours after birth. In the four years since the Kyzylorda Oblast Health Department introduced neonatal care technology and adopted a 500 gram (1.1 pound) live birth definition, doctors here have saved around 200 babies’ lives. The WHO live birth criteria state that all babies showing any signs of life, such as muscle activity, a gasp for breath, or a heartbeat should be included as a live birth and provided with interventions to keep them alive. Under the Soviet-era definition, infants who were born before 28 weeks, weighing less than 1,000 grams, or measuring less than 35 centimeters, were not counted as live births if they died within seven days.

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Saving the Lives of Newborns in Indonesia

Dina, age 27, delivered her first baby Diandra at an Indonesian hospital in Central Java. Hospital staff kept Diandra away from her mother in the newborn care unit and fed her formula until they deemed Dina ready and strong enough to feed the baby. Diandra fell sick with severe diarrhea and died at the hospital ten short days later.

Each year, more than 80,000 newborn babies die in Indonesia within the first month of life from treatable conditions, the most common of which are prematurity, low birth weight, birth asphyxia, and neonatal sepsis.

“Every family has a sad story about a baby or mother they know who lost their life from complications during pregnancy, delivery or immediately after child birth. Many attribute the deaths to God’s will but with the right technology, equipment, and training for health care professionals, it can be stopped,” said Evodia Iswandi, Jhpiego deputy director for provincial operations in Indonesia. “Good hospital administration and policies can also go a long way to enable staff to work at their full technical capabilities.”

Through Expanding Maternal and Neonatal Survival (EMAS), a U.S. Agency for International Development (USAID) – funded program in Indonesia, local health care providers receive training from one of Indonesia’s premier maternal and child hospital and other organizations on best practices in neonatal and maternity emergency services. Hospitals and community health centers learn how to prevent and treat hemorrhaging, premature delivery, low birth weight, high blood pressure, birth asphyxia, and other causes of death. USAID’s EMAS program also helps reform Indonesia’s referral system so that mothers and babies get to the right place, at the right time, in order to receive the right medical treatment.

“USAID is partnering with Muhammadiyah, one of the largest and most respected Islamic organizations in Indonesia committed to diversity and pluralism, to save lives and sustain EMAS even after the program ends,” said USAID/Indonesia Mission Director Glenn Anders.

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