As part of a three country trip to Asia, USAID Deputy Administrator Donald Steinberg attended the Annual Meeting of the Asian Development Bank in Manila, participating in the Development Partners Session. In the Philippines, he visited several USAID programs, including the launch of the Partnership for Growth Cities Development Initiative, the issuance of land titles to several Batangas residents, and the signing of the Bilateral Agreement with the Philippine government. Deputy Administrator Steinberg’s visit to Danang, Vietnam highlighted the USG’s commitment to remediation of Agent Orange dioxins, an important step in mending the painful legacy between our two countries. During a short stay in Japan, he engaged with experts at the Japan Institute of International Affairs on “The critical importance of U.S. – Japan development cooperation and the post-Busan development landscape.”
Archives for Asia
One of the leading causes of illness in the Philippines is diarrhea. It kills more than 27 Filipino children under 5 each day, and poor sanitation costs the Philippine economy nearly $2 billion each year. I was reminded of these staggering figures as I journeyed six hours north of Manila to San Fernando City, La Union, to inaugurate a new sewtage treatment facility supported by USAID.
As a native of the San Fernando City area, I have seen its transformation from a quiet municipality to a booming metropolis that has become the seat of national government agencies in the region. It is also a center of trade, commerce, and financial and educational institutions.
Unfortunately, rapid urbanization has taken a toll on the city’s sanitation management capacity. To address this problem, USAID partnered with Rotary International and the city government to construct a septage treatment facility that will improve sanitation services by treating the waste from all the septic tanks in the city.
The facility is one of the five projects undertaken by USAID and Rotary International under the Water Alliance Program. USAID and Rotary International together contributed a total of approximately $300,000 to cover both facility construction and technical assistance, while an additional $660,000 was put up by the city government.
The nearly 180,000 residents of San Fernando City will benefit from a cleaner, healthier environment as a result of this city-wide system. The project is also an excellent demonstration of how partnerships between government and non-governmental organizations can yield positive results. Collaborations such as this maximize the impact and sustainability of our programs in the communities that we serve.
USAID has partnered in the Philippines with local, provincial, and national governments; civil society; and the private sector to improve natural resource management. USAID has improved access to clean water and sanitation for 1.2 million Filipinos since 2005, and has protected and conserved over 1 million hectares of forest lands and coastal areas since 2004. We look forward to our continued work with our development partners as we strive to create a healthier environment conducive to sustained and inclusive growth.
Farmer-returnees empowered to develop livelihoods, support their families, and participate positively in their communities.
Recently, I visited one of the agriculture programs supported by USAID in the northern region of Sri Lanka where the most intense fighting took place between the Sri Lankan security forces and the Liberation Tigers of Tamil Eelam (LTTE). More than two years later, the destruction from the last military offensive was still palpable. As we made the long drive north from the capital city of Colombo to meet our beneficiaries, we knew we had arrived in Mullaitivu when the landscape changed. The unpaved, bumpy road into the town was lined with bullet-ridden and bombed out buildings.
For over twenty years, Sri Lanka was entangled in a brutal civil war between the Government of Sri Lanka and LTTE. The conflict saw widespread destruction of property, the planting of millions of landmines, and the displacement of hundreds of thousands of civilians in Northern Sri Lanka. An estimated 70,000 people were killed in the violence. In May 2009, the Sri Lanka military declared victory after crushing the last resistance of the LTTE.
In Northern Sri Lanka, the final military offensive resulted in nearly 300,000 Internally Displaced Persons (IDPs) who were confined to closed camps. Not only were the entire communities of Kilinochchi and Mullaitivu displaced during the final stages of the conflict, they lost all of their productive assets, most homes were destroyed, many family members perished, and anything of value was looted.
In 2010, a year after the military defeat of the LTTE, the government began the resettlement of the IDPs in Kilinochchi and parts of Mullaitivu known as the Vanni. With little advance notice, hundreds of families were returned to their villages. But their homes were destroyed and their lands decimated during the fighting. Over 80 percent of the returnees were farmers, and their only means of livelihood was agriculture. With an urgent need to provide assistance to help resettle the IDPs and restart their livelihoods, the U.S. Agency for International Development (USAID) provided resources through its Complex Crises Fund (CCF) to support a one-year program implemented by the U.N. Food and Agriculture Organization.
Established in 2010, the CCF was created as a flexible resource to enable the U.S. Government to respond quickly during critical windows of opportunity and/or unforeseen political, social, or economic challenges that threaten a country’s stability or help create the conditions necessary for longer-term development. Generally speaking, the CCF is contingent upon an unanticipated urgent need or a significant triggering event that requires an immediate, robust response. In Sri Lanka, the goal was to restart and restore livelihoods for these highly vulnerable returnee populations. The timing of the request was critical because the Maha (planting season) was within weeks.
The activity focused on resuming basic farming and agricultural production in order to maintain community stability during the resettlement process. As a result of USAID’s program, nearly 120,000 acres of rice paddy seed were planted in the Vanni region. The beneficiaries included approximately 68,000 people, of which approximately 25 percent were single female heads of household. The agriculture assistance was coupled with training sessions on how to care for livestock as well as harvesting and planting techniques. The district agrarian training centers were also refurbished to ensure a safe and suitable community meeting place.
The CCF resources accomplished far more than just agriculture production and crop yields. It provided the foundation for a disenfranchised and highly vulnerable population to restart their life.
One of the highlights of my recent trip through South Asia was returning to Sri Lanka. The entire journey through the subcontinent was intense, with meetings scheduled back-to-back from 7 A.M. well into the late evening, including working lunches and dinners. Yet despite the busy schedule, it was a wonderful opportunity to see up close both the immense challenges on the ground and just some of the ways USAID is addressing them.
Sri Lanka was more of a homecoming for me. I visited Sri Lanka in 1979 to attend a wedding of close friends – a British bride and Sinhala groom. Their close friends were Tamil, from the north, and we continued the celebrations in Jaffna, during my three-week sojourn to Sri Lanka. Jaffna was once the center of Tamil life, and full of excitement and prosperous. Since the civil war erupted in 1985, Jaffna sadly had been closed off to most foreigners.
During my recent visit, I was really looking forward to seeing a revived and rebuilt north. The government is rebuilding the infrastructure, but clearly nearly 30 years of war has left the population in the north severely traumatized. Most striking was the impact on the women and their families. Thousands of war widows are unable to reclaim family lands because they lack the documentation required to prove ownership. As a result, even if they find land to settle on, they are prohibited from farming because they lack title to the land. Poverty is extensive in these communities, and it impacts even male-headed families.
Although the government is providing jobs through infrastructure development, the jobs employ men imported from southern Sri Lanka, and not Tamils from the north. In addition, large contingents of military soldiers are now embedded in massive camps dotting the landscape. This has led to a breakdown in the social fabric, where survival requirements have pitted women-headed households with no employment opportunities against an influx of male soldiers and day laborers. As I met with villagers to discuss their plight, my visit to Sri Lanka some 35 years ago became a distant past, with the country I was seeing now bearing no relation to what I saw in1979.
USAID has run a number of programs in Sri Lanka to both address the direct humanitarian crisis of the displaced persons, as well as to foster long-term interethnic reconciliation and cooperation. In the past, we’ve supported efforts to counsel widows and children affected by the trauma of war.
One USAID project assisted such widows by providing chickens as a source for family consumption and for sale. Now we are part of a public private partnership with a garment company to deepen interpersonal bonds among workers from several ethnic groups on the factory floor as part of the interethnic reconciliation process.
I’m hoping programs like these continue to provide support and raise awareness over the continuing humanitarian situation in Sri Lanka, and particularly in the north. While I can’t return to 1979, I do hope one day to return to the lively and thriving Jaffna I remember.
At USAID-Supported Conference, Yemen’s Transitional Prime Minister Endorses Leadership Quota for Women
Joan Parker is President and Chief Executive Officer of Counterpart International.
History happens faster than you expect and is usually part of a chain of events. Monday, March 19, in a filled-to-capacity ballroom in a hotel in Sana’a, Yemen, I witnessed an important link in that historical chain.
At the National Women’s Conference, co-sponsored by USAID, Yemen’s transitional Prime Minister Mohammed Salim Basindwa pledged his support for a top demand from USAID-supported women’s organizations—a quota requiring at least 30 percent of high-ranking posts be held by females.
“I truly believe that if women rule the country, that it would be peaceful and prosperous,” Basindwa said. “Yemeni women are important factors in our development, and Yemen will prosper only if women are fully involved.”
Basindwa also focused on the significance of the conference, which drew nearly 1,000 women (and a handful of men). “Today’s gathering represents an unprecedented moment in Yemeni history,” he said. “Currently, Yemen is working to build its future. There is a need to have this conference.”
“This is the Yemeni spring,” declared Yemen’s Human Rights Minister, Horia Mashur. “In this Yemeni spring, women are leaders.” Mashur recalled how women took to the streets a year earlier in uprisings that resulted in a presidential election on February 17, ushering in what is expected to be a new democratic era for Yemen.
“Discrimination has prevented women from achieving high posts in the government,” Mashur said. She is one of only three women who hold high-level national posts; there is one other woman in the Cabinet and one woman among the 301 elected legislators in Parliament.
USAID’s Responsive Governance Project, which Counterpart International is implementing, co-sponsored the conference along with Yemen’s Human Rights Ministry and the National Women’s Committee. The conference is a key step toward a soon-to-be-announced public policy dialogue among the government, civil society, and the private sector, which will include gender issues.
Conferees debated draft positions, including access to education and maternal health services, banning childhood marriage, and eliminating discriminatory practices. A final document is expected later in April. Elizabeth Richard, Chargés d’Affaires at the U.S. Embassy in Yemen, delivered a speech with a quote from Secretary of State Hillary Clinton that tied the Yemeni spring to events in the rest of the world: “When women organize in large numbers, they galvanize opinion and help change the course of history,” said Richard.
In Sana’a, I could see and feel how they were rising to this unique moment in history.
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World TB Day has a special meaning for me, and it is not just because of my job as a USAID Health Officer in Kazakhstan. It is because every morning for the past four months I have taken a daily isoniazid pill to treat my latent tuberculosis.
Tuberculosis, or TB, is a contagious chronic bacterial infection that is spread through the air and usually infects the lungs. More than 2 billion people—one-third of the world’s total population—are infected with TB bacilli, the microbes that cause TB, but do not show symptoms (latent TB). In the United States, between 10 and 15 million people are infected with latent TB. In other parts of the world, like in Central Asia, this number is much higher.
I found out that I had latent TB at the exam to get my first medical clearance as a foreign service officer. I suspect that I was exposed to TB while I was a volunteer in Indonesia years before. Although I was shocked and worried when I got the diagnosis, the nurse reassured me and explained that latent TB is widespread in many developing countries and that there are options for treatment. I was pregnant then so isoniazid treatment—what I’m taking now—was not an option.
I learned soon after I was diagnosed with latent TB that anyone—grandparents, fathers, mothers, and children—can be exposed and infected. In the three minutes that it will take you to read this blog post, nine people will have died from TB. Although my chance of becoming sick with active TB in my lifetime is only 1 in 10, I felt that it was important to mitigate this risk and undergo the six-month treatment regimen. Every year, approximately 2 million people die from TB.
Compared with the experience of a typical TB patient in Central Asia, the past four months have been incredibly easy for me. In Kazakhstan, for example, a patient with active TB is required to be hospitalized in a TB treatment facility for a minimum of two months even if she is no longer contagious after a short period of treatment. She is not allowed to go to work or see her family and often faces tremendous stigma and discrimination if people find out she has TB. Moreover, poor infection control practices in TB facilities greatly increase the risk that patients will be exposed to and contract either drug-sensitive TB or, worse, multi-drug resistant TB (MDR TB). MDR-TB is a form of TB that does not respond to standard first-line TB treatment, making the treatment longer, more costly, and more likely to result in serious adverse effects. Since TB is contagious and someone with active TB can infect an average of 10 to 15 people a year, infection control is critical to protect both patients and health care providers.
MDR-TB can also caused by failure to complete the standard course of TB treatment. If I were a TB patient in Central Asia, after months in a TB hospital, I would be required to visit a health facility every day for at least seven months to take TB drugs as part of directly observed therapy. The health facility is sometimes located far away from the patient’s home. Given these challenges, it is no wonder that patient adherence rates to treatment can be as low as 25 percent in some places in Central Asia.
On World TB Day, I am heartened by the work that USAID has been doing in Central Asia to reduce the spread of this terrible disease. Across the region, we are working with governments, the Global Fund to Fight AIDS, TB, and Malaria, and other international partners to focus our efforts in three areas. First, we are reducing the time that patients are required to stay in TB facilities by improving outpatient TB treatment in order to prevent hospital-based transmission of MDR TB and increase treatment adherence. We also are introducing new diagnostic technologies that can diagnose MDR TB within a few hours as opposed to a few weeks, which will expedite their care plan , as well as to help reduce the time that undiagnosed MDR TB patients are potentially exposing others, both in the community and in health care facilities. Finally, we are supporting an intensive program to build the skills of health providers, communities, and patients to understand and address the treatment and care of people with TB and MDR TB.
The road south out of Dili climbs steadily, winding back and forth with spectacular switchbacks on a paved but narrow road, one of the few that crosses Timor-Leste, ultimately reaching the country’s south coast. I am told Timor-Leste is about the size of Connecticut – a state I have traversed many times in just a couple of hours. Here, a couple of hours might get you into the middle of the country, but certainly not all the way across. Of course, Connecticut doesn’t have Timor-Leste’s mountains; at nearly 10,000 feet above sea level, Mt. Ramelau towers over the country’s central highlands.
Despite the travel complications they create, it is these mountains that have put Timor-Leste on the map as one of the top coffee-producing nations in the world. The high elevation, sloping terrain, and regular rainfall make it a near-perfect coffee-growing area—the Timor hybrid coffee produces a delicious brew. As a result, coffee now accounts for 90 percent of all non-petroleum exports for this small island nation, and most of it is bought by Starbucks.
As we rose through the lush, verdant countryside, we quickly reached coffee plots right alongside the road. My guide and teacher was Bency Issacs, the senior technical advisor for USAID’s coffee and agriculture rehabilitation project, run by the U.S.-based National Cooperative Business Association. The project helps more than 23,000 farm families, about 15 percent of Timor-Leste’s population.
Phil Carroll is the Senior Policy Communications Associate at USAID partner organization PATH. He spent two weeks in India last fall visiting PATH programs related to maternal and child health, tuberculosis, immunizations, and safe water and diarrheal disease. Originally posted at the Global Health Technologies Coalition Blog.
India is a country that changes dramatically from place to place, something I experienced firsthand while on a two week trip there this past fall. One day I was listening in on a mothers’ group meeting in one of the poorest villages in Uttar Pradesh state, and less than 24 hours later I was standing in one of the world’s most technologically advanced airports in Hyderabad—often referred to as the ‘Silicon Valley’ of India. It was during this leg of my journey where I was further convinced of the need for sustained investment in research and development.
In a laboratory on the outskirts of the city, I met a handful of Indian doctors and researchers who are doing some pretty amazing, albeit subtle, things in health. Thanks to a small, less than $100,000, investment by the US Agency for International Development (USAID), the Blue Peter Public Health & Research Centre upgraded its tuberculosis (TB) lab to a higher level of biosafety. Improvements like better equipment and infrastructure and enhanced safety measures have enabled researchers here to diagnose a case of multi-drug resistant tuberculosis (MDR-TB) in a matter of days, a process that used to take the same team several months.
This is significant for a host of reasons. Diagnosing TB on the early side can help get patients on treatment faster, thereby reducing further deterioration of their lungs and other organs and ultimately save their lives. Catching TB early on can also curtail the spread of this incredibly contagious disease to others. India, which has the highest incidence of TB in the world, and 20 percent of the world’s burden, needs these sorts of advancements now more than ever. Currently, the government of India, as part of its National TB program, is only reaching 25 percent of MDR-TB patients with diagnosis. However, by 2013, it is aiming for 100 percent coverage, or around 2 million TB patients.
In Kathmandu, Nepal’s Prime Minister, Dr. Babarum Bhattarai, said at an event at his offices that “I am very pleased with the return of the Peace Corps to Nepal. From the early 60s, thousands of volunteers have served in districts all across this country. I remember in much of the 60s and 70s the volunteers were a big source of teachers for subjects like math and science. I am very glad that with USAID’s assistance, the volunteers are coming back one more time to help with agriculture and health. Those are areas that need help, and I welcome the decision to redeploy the Peace Corps.”
Among those volunteers who served in Nepal include William Douglass, who now works with USAID. “Serving as a Peace Corps Volunteer in Nepal 45 years ago gave me unique opportunities to meet and work with a wide range of Nepalese villagers, urban dwellers and government officials throughout the country. I came away from Nepal with a strong appreciation for the people and the culture, and together with my wife who was also a volunteer, have taken many opportunities to return. During two assignments in the USAID mission in the 1980s and the 1990s, I was able to promote and support Peace Corps and USAID collaboration on Nepal Government projects. I and the many other former volunteers, including a number working with or for USAID, welcome this renewed collaboration to support Nepal’s development efforts after many years of conflict.”