USAID Impact Photo Credit: USAID and Partners

Archives for Asia

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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Make Every Mother and Baby Count

In early May, we witnessed a spectacular commitment to “making every mother and baby count” here in Dhaka, Bangladesh.  The United States Agency for International Development (USAID), through their Maternal and Child Health Integrated Program, and in partnership with the Bangladesh Ministry of Health and Family Welfare (MOHFW), convened an important series of meetings focused on saving the lives of mother and their babies.  We wanted to tally for you the numbers that express just how much every mother and baby count:

  • Participation included more than 275 international maternal and newborn health professionals;
  • With over 29 countries represented;
  • Including over 100 individuals from Bangladesh.
  • But why?  Because just 1 maternal or child death is more than just a tragic occurrence. It affects the entire family, it affects social cohesion, and it dampens the economic growth of the countries. Data shows that after a mother dies there is an increased risk of death for surviving children.
  • Here in Bangladesh, about 20 women die every day from childbirth, about half of these due to 2 main causes, postpartum hemorrhage that is to say excessive bleeding and eclampsia (high blood pressure leading to convulsions). These are the very 2 factors that kill 50% of mothers in developing countries around the world.

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Video of the Week: Planting the Seed for Economic Growth

Ever wonder how Gladioli bulbs can help an estimated 1,000 families start earning their living and jumpstart a fledgling flower industry in Pakistan? USAID, through the Small Grants Program and the US Ambassador’s Fund, seeks to empower grassroots organizations and community groups working to strengthen civil society in Pakistan.

The U.S. Ambassador’s Fund provides small grants to improve basic economic or social conditions at the local community level. The Fund supports high-impact, quick-implementation activities, that can be completed within one year without requiring further funding.

On this occasion, we highlight one of the results of the U.S. Ambassador’s Fund in Rawalakot, known for its dire economic situation for the 540,000 residents who until recently only planted maize and wheat.

In a strategically located valley just 120 km from the twin cities of Rawalpindi and Islamabad, Rawalakot’s high elevation (1,615 m.) makes it ideal for growing gladioli bulbs which are increasingly becoming popular in major cities.

USAID financed the purchase of gladioli bulbs, training sessions for farmers, and consultations of an agricultural specialist to help the families grow the flowers correctly.  Thanks to the project, families have increased their revenues by over 70%, with women being the main beneficiaries of the project.  This project has enabled women to become salient participants in the flower industry and because of related activities involving the sale and distribution of the flower, it is estimated that many more families in surrounding communities will benefit greatly from this project.  As a result of the increase in income, families are now able to invest the money into their children’s education and household expenses.

Awarding Property Titles to Longtime Land Holders

I’ve long known that land titles mean empowerment for urban and rural poor, especially women, in developing countries.  Indeed, a paragraph in my “stump speech” notes that if women farmers could use their land as collateral to gain access to credit at the same rate as men, there would be a 30 percent increase in productivity, enough to feed 150 million people.  But during my visit to Batangas in the Philippines last week, the human dimension of this reality was brought home to me vividly.

USAID in the Philippines is working with national and local authorities and civil society on a project to bring to life the “Residential Free Patent Law.” That law provides expedited land titles to people who can show that they’ve long occupied their land.  In the Philippines, only about half of the estimated 22 million land parcels are titled.  Working with the Asia Foundation and the local Foundation for Economic Freedom (FEF), USAID is providing training and technical assistance to the Department of Environment and Natural Resources and local government units to speed the titling process.

Last Thursday, I took part in a ceremony where we awarded land titles to long-time occupants of land.  No, we didn’t get the attention that a similar ceremony in Colombia attracted several weeks ago, but then again, I’m not Barack Obama, and I wasn’t accompanied by musical superstar Shakira.  But still it was a remarkable program.

When I gave one woman her land title, she squeezed my hand and wouldn’t let go until she told me her story.  She said that she was 60 years old and had occupied her land for four decades.  Each day, she would wake up wondering if, by nightfall, she would be driven off her property by land-grabbers or government officials.  She couldn’t use her land to get a loan, and even if she could, she was afraid that improvements on her house or farm land would make it attractive to interlopers.  Holding up her new title, she said, “This magic paper changes everything for me, my children, and my grandchildren.” And then she started to cry tears of joy as her family came forward to embrace her.

Only time will tell if that woman’s future is as bright as she imagines.  But thanks in large part to mission director Gloria Steele, John Avila, the entire USAID mission, and our partners, this woman and thousands like her are empowered to seek a more secure and prosperous life.

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