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“I remember it like it was yesterday. The entire city just shrunk.”

Within mere seconds, more than 200,000 people were killed, and 1.5 million were displaced from their homes.  Buildings were completely destroyed. Phone connections were down. The scene was, in short, total devastation. It was January 12, 2010—five years ago today—when a magnitude 7.0 earthquake rocked Port-au-Prince and forever changed Haiti.

This earthquake would have been calamitous and overwhelming anywhere, but in Haiti—a poor country with weak building infrastructure—it hit at the heart, in the populous capital city, creating a massive urban disaster.

USAID’s Haiti Earthquake Disaster Assistance Response Team Leader Tim Callaghan and USAID Administrator Raj Shah during the 2010 response.  / USAID.

USAID’s Haiti Earthquake Disaster Assistance Response Team Leader Tim Callaghan and USAID Administrator Raj Shah during the 2010 response. / USAID.

As Team Leader for USAID’s Disaster Assistance Response Team (DART), I deployed in the first 24 hours and witnessed firsthand the perfect storm of challenging response issues: no communication as all phone connections were down; 1.5 million people were instantly displaced, with no shelter; in seconds, children were orphaned; Haitian Government officials and local disaster responders were affected themselves; transportation was severely hampered by the rubble; there was a myriad of health and nutrition concerns; and death was everywhere.

USAID-supported programs helped remove more than 50% of the total rubble cleared by the international community. / U.S. Navy, Chief Mass Communication Specialist Robert J. Fluegel

USAID-supported programs helped remove more than 50% of the total rubble cleared by the international community. / U.S. Navy, Chief Mass Communication Specialist Robert J. Fluegel

Rubble literally filled the streets. We found out later that the earthquake had generated enough rubble to fill dump trucks lined up from Maine to Florida twice. On the ground, this meant major obstacles to delivering life-saving assistance. It also required our DART to have a large urban-search-and-rescue (USAR) component with over 500 USAR members at its peak. These teams worked tirelessly, crawling through broken buildings, to find and save people who were trapped inside. One of my proudest memories was being on site early one morning around 3 a.m. to see our USAR teams pull people out of the wreckage. It is something I will never forget.

Members of the Los Angeles County Fire Department Search and Rescue Team rescue a Haitian woman from a collapsed building in downtown Port-au-Prince. The woman had been trapped in the building for five days without food or water. / U.S. Navy, Mass Communication Specialist 2nd Class Justin Stumberg

Members of the Los Angeles County Fire Department Search and Rescue Team rescue a Haitian woman from a collapsed building in downtown Port-au-Prince. The woman had been trapped in the building for five days without food or water. / U.S. Navy, Mass Communication Specialist 2nd Class Justin Stumberg

In addition to so many Haitian lives tragically taken on that day, several American colleagues from the U.S. Embassy also perished—the first time I had ever worked on a disaster response where this was the case.

Yet it’s during times like the Haiti earthquake that I am so vividly inspired by the mandate of the office I work for—USAID’s Office of U.S. Foreign Disaster Assistance—which is to save lives and alleviate human suffering. The DART did that in Haiti five years ago, rapidly providing humanitarian assistance and care to those in need. I was honored to manage a team of dedicated people who worked 20-hour days for weeks on end in grueling conditions.

Looking back, I also will never forget the incredible resilience and strength of the Haitian people. They lost so much, and yet were willing to roll up their sleeves amid all the tragedy to work with us in every way possible to build back their lives. The people of Ravine Pintade—one of the hardest hit areas—joined us and our partners Global Communities and Project Concern International to transform their devastated neighborhood into a model community.

Since 2010, USAID has continued to work together with the people of Haiti and their local and national governments traversing the long road from recovery to development and helping mitigate the damage of future crises. We’ve increased communities’ disaster resilience through preparedness and response planning, support to emergency operations centers and evacuation shelters, and small-scale infrastructure projects like retaining walls and drainage systems. We’ve also helped improve local capacity by training locals to handle disaster response efforts—everything from preparing first responders to designating leadership roles to managing relief supplies.

Haiti is vulnerable to many disasters including earthquakes, hurricanes, and flooding; but through these disaster risk reduction efforts, USAID is helping Haiti become more capable of preparing and responding to whatever disaster may strike next.

ABOUT THE AUTHOR

Tim Callaghan is the Senior Regional Advisor for Latin America and the Caribbean for USAID’s Office of U.S. Foreign Disaster Assistance. During the 2010 Haiti earthquake response, Callaghan served as USAID’s Disaster Assistance Response Team Leader.

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Lessons Learned a Decade after the Indian Ocean Tsunami

Ten years ago today, the Indian Ocean tsunami roared across more than 3,000 miles and a dozen countries from Southeast Asia to Africa, killing 200,000 people and leaving 40,000 missing. I remember watching the news from my parents’ kitchen, in the aftermath of Christmas, as hour by hour the enormity of the disaster registered on the world.  And it was Aceh, a conflict affected province of Indonesia, that suffered the greatest impact, accounting for nearly half of the total casualties.

Eight days later, I was in Aceh.   I will never forget the surreal sights and stench of such massive destruction.  In a humid heat, bodies were still trapped beneath towers of debris and piled along the road.  Boats were in trees and houses were upended.  Survivors and humanitarian workers alike had a dazed look.

The December 2004 Indian Ocean tsunami was one of the worst natural disasters in recorded history, destroying lives, homes, and livelihoods. In the disaster’s immediate aftermath, USAID provided emergency support in the form of food, shelter, water, sanitation, and medical supplies. In the years that followed, USAID has continued to work alongside survivors to help affected communities rebuild and create jobs.

The December 2004 Indian Ocean tsunami was one of the worst natural disasters in recorded history, destroying lives, homes, and livelihoods. In the disaster’s immediate aftermath, USAID provided emergency support in the form of food, shelter, water, sanitation, and medical supplies. In the years that followed, USAID has continued to work alongside survivors to help affected communities rebuild and create jobs. / USAID

In the face of this utter tragedy, the world mobilized to save lives and reconstruct.  The tsunami generated an unprecedented outpouring of support from the international community. Indonesia received more than $7 billion in aid, the most generous response ever to a natural disaster.  In three years, Indonesia built new airports, roads, schools, and over 130,000 new homes.

USAID was front and center in the response, deploying a multi-country Disaster Assistance Response Team to the most affected areas immediately following the tsunami. USAID’s Office of U.S. Foreign Disaster Assistance and Food for Peace provided more than $96 million in emergency support in the form of food, shelter, water, sanitation, and medical supplies. In the immediate aftermath USAID airlifted 20,000 kitchen sets, 20,000 mosquito nets, 8,400 ten-liter water containers, 2,000 hygiene kits, 230 rolls of plastic sheeting, and two 12,000-liter water bladders. Partners built or rehabilitated more than 1,600 water systems in villages throughout Aceh, benefitting more than 77,000 people. Repaired sewages systems and sanitation facilities improved hygiene conditions for over 90,000 people. In the years that followed, USAID has continued to work alongside survivors to help affected communities rebuild and create jobs.

So what have we learned since 2005? Below are six lessons that inform the way we respond to disasters a decade after the Indian Ocean tsunami:

1. Early Warning Leads to Early Action

Although there was a lag of several hours between the earthquake and the tsunami, almost all of the victims of the Indian Ocean tsunami were taken by surprise, because there were no early detection or early warning systems in place.   In the aftermath of the tsunami, USAID provided $16.6 million to support the development of the Indian Ocean Tsunami Warning System (IOTWS), an integrated early warning and mitigation system that allows countries in the Indian Ocean region to detect and prepare for tsunamis and other coastal hazards. When the Banda Aceh earthquake struck in 2012, the IOTWS system successfully alerted communities across the Indian Ocean and millions of people were able to move away from the coastline.  As a result of these and other early warning efforts, countries and communities, USAID and its development partners are better prepared to respond and mitigate the impact of disasters before they strike.

In addition to aiding recovery and reconstruction, USAID has supported the development of a tsunami warning system in the Indian Ocean region to help governments detect and prepare for tsunamis in the future. / USAID

In addition to aiding recovery and reconstruction, USAID has supported the development of a tsunami warning system in the Indian Ocean region to help governments detect and prepare for tsunamis in the future. / USAID

2. Effective Civil-Military Cooperation is Essential

More than 15,000 U.S. soldiers participated in Operation Unified Assistance, the U.S. military’s response to the Indian Ocean tsunami.  Without the unique strategic and tactical lift capabilities of the military, we would not have reached remote places with life-saving supplies as quickly.  Yet, civil-military coordination was a major challenge, with 17 militaries and hundreds of international NGOs responding.  Over the past decade, UN agencies, donors, relief organizations, and the U.S. and other militaries have learned to coordinate more effectively on disaster responses, from the 2010 earthquake in Haiti to last year’s typhoon in the Philippines. USAID’s Office of Foreign Disaster Assistance is the designated U.S. government lead agency in disasters and has worked closely with the military and other U.S. government agencies to create a more seamless system for calling forward needed capabilities. In the current Ebola crisis, USAID and the U.S. military are working hand in glove to sustain an agile and effective response to one of the most complex emergencies of our time.

3. Focus on Jumpstarting Economies

In Aceh, Indonesia, USAID, in partnership with Chevron developed and hosted three-month vocational courses for hundreds of young people from the region, like Junaidi and Syahrizal (pictured). Courses ranged from welding and masonry to bookkeeping and automobile repair. These courses gave graduates the skills they needed to rebuild their communities, and also improved their ability to find jobs with higher wages. / USAID

In Aceh, Indonesia, USAID, in partnership with Chevron developed and hosted three-month vocational courses for hundreds of young people from the region, like Junaidi and Syahrizal (pictured). Courses ranged from welding and masonry to bookkeeping and automobile repair. These courses gave graduates the skills they needed to rebuild their communities, and also improved their ability to find jobs with higher wages. / USAID

In Indonesia, the 2004 tsunami completely razed coastal towns like Banda Aceh, but left others further from the shore untouched. The massive outpouring of aid in the aftermath of the tsunami provided life-saving relief to devastated communities, but also threatened to create a second crisis by smothering local markets that remained active across the country. The tsunami helped catalyze a greater understanding of the power of pivoting quickly from delivering commodities to a focus on using cash for work and other strategies to revive local markets.  USAID supported cash-for-work recovery projects that employed 70,000 people, and helped finance the construction of 278 fishing boats to revive Aceh’s fishing industry. In partnership with Chevron, USAID also developed and hosted three-month vocational courses for hundreds of young people in Aceh, like Junaidi and Syahrizal (pictured above). In the decade since the tsunami, the humanitarian community has increasingly recognized the value of cash-based approaches to emergency responses. USAID has continued to be a trailblazer in these efforts, using mobile e-payments and harnessing public-private partnerships to help jumpstart economies after a crisis, including in the aftermath of Typhoon Haiyan.

4. Give Cash, not Goods

The second stop on my 2005 trip was Sri Lanka, where I encountered a depot of donated goods—a new shipment of bikinis, ties and other donations clearly ill-suited to meet the needs of ordinary people trying to survive the aftermath of the tsunami. The outpouring of generosity after the Indian Ocean tsunami was truly impressive and unprecedented. However, it also led to massive “goodwill dumping,” as well-meaning people flooded the region with unnecessary goods that overwhelmed transit points and ended up as trash. As this experience and many other disasters have illustrated, donating cash instead of goods is always the best option, allowing victims to get the quickest access to basic items in local markets

5. Disasters Can Spur Conflict Resolution

The Indian Ocean tsunami caused massive social upheaval, uprooting the lives and livelihoods of hundreds of thousands of people.  Sinhalese and Tamil communities came together in Sri Lanka around the common enemy of a natural disaster.  In Sri Lanka, I saw an Office of Transition Initiatives program that brought together Sinhalese and Tamil youth to work side by side to clean the debris and rebuild their communities. And, recognizing that their own people needed to rebuild not fight, the Free Aceh movement signed a peace deal with the Indonesian government in August 2005. Indonesia’s experience sparks important lessons for how— if given the right circumstances and leaders willing to put their people first— disaster response can catalyze opportunities for peace and inclusive governance.

6. Build Resilience

Most importantly, we know that tsunamis, typhoons, droughts and other shocks will continue to batter communities, hitting the most vulnerable the hardest.  Since 2011, USAID has been at the forefront of a global conversation on building resilience.  We know that all our development gains can be wiped out in an instance if households, communities, countries and regions are not better able to adapt, prepare, and recover from the shocks we know will continue to occur. That is why in partnership with the Rockefeller Foundation and Swedish sida, we launched the Global Resilience Partnership, which will drive evidence-based investments and innovations that enable cities, communities, and households to better manage and adapt to inevitable shocks.

ABOUT THE AUTHOR

Nancy Lindborg is the USAID Assistant Administrator for the Bureau for Democracy, Conflict and Humanitarian Assistance. Follow her @nancylindborg

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Building Ebola Treatment Units to Foster Hope, Healing in Liberia

Liberian Vice President Joseph Boakai, middle, gets a tour of the U.S.-built Tubmanburg Ebola treatment unit from USAID partner International Organization for Migration, which will be running the facility / Carol Han, USAID/OFDA

Liberian Vice President Joseph Boakai, middle, gets a tour of the U.S.-built Tubmanburg Ebola treatment unit from USAID partner International Organization for Migration, which will be running the facility / Carol Han, USAID/OFDA

In the Bomi Hills northwest of Monrovia, in an area that used to be the region’s iron and diamond mining center, it’s hard to miss the new “precious resource” that has become critical to Liberia’s fight against Ebola.

Four stark white tents gleam in the sun, the most prominent part of the new Ebola treatment unit (ETU) in Tubmanburg, which is the first ETU to be built and staffed by the United States in Liberia.

Liberian Army Capt. Glee Dilliard Dada led a team of Liberian soldiers who worked closely with the U.S. military to build the facility. Despite the rain, heat and construction setbacks, the Ebola treatment unit was built in 35 days / Carol Han, USAID/OFDA

Liberian Army Capt. Glee Dilliard Dada led a team of Liberian soldiers who worked closely with the U.S. military to build the facility. Despite the rain, heat and construction setbacks, the Ebola treatment unit was built in 35 days / Carol Han, USAID/OFDA

Construction on the 2-acre site was overseen by the U.S. Defense Department in close partnership with the Armed Forces of Liberia. More than 60 people had to overcome the rain, heat, poor roads and supply shortages to build the site in 35 days, completing the ETU earlier this month.

“Especially in this time of national crisis, it has been rewarding to be out here and assisting,” said Armed Forces of Liberia Capt. Glee Dilliard Dada, who supervised the Liberian military construction crew. “I am very overwhelmed with a lot of pride. In a month’s time we did all of this.”

The Ebola treatment unit (ETU) in Tubmanburg is the first ETU to be built and staffed by the United States in Liberia / Carol Han, USAID/OFDA

The Ebola treatment unit (ETU) in Tubmanburg is the first ETU to be built and staffed by the United States in Liberia / Carol Han, USAID/OFDA

USAID Disaster Assistance Response Team leader Bill Berger called the ETU an extraordinary effort, saying, “It took strong partnership to build this ETU. It will also take strong partnership to provide care to patients.”

USAID partner the International Organization of Migration, or IOM, has stepped forward to manage the ETU under the leadership of the Liberian Ministry of Health and Social Welfare. For the past two weeks, IOM’s medical team—made up of local and international health care workers—received rigorous training on Ebola patient care, safety protocols and ETU management.

Within the 2-acre site is a changing area where local and international staff with the International Organization for Migration will be donning googles and other protective equipment to care for patients. / Carol Han, USAID/OFDA

Within the 2-acre site is a changing area where local and international staff with the International Organization for Migration will be donning goggles and other protective equipment to care for patients. / Carol Han, USAID/OFDA

More than 120 members of IOM’s team are now prepared to care for patients. Tejanie Golafaley, a local resident and Ebola survivor, is especially eager to speak to patients at the ETU about his experience beating the disease.

“When I got Ebola, people didn’t want to come around me. I was stigmatized by Ebola,” Golafaley said. “The best thing I can do is talk to [patients] …. I’m going to tell them I’m a survivor. I want to give them hope.”

Tejanie Golafaley, an Ebola survivor, saw it as his personal mission to work at the USAID-supported Ebola treatment unit in Tubmanburg. “I want to explain my story to patients [so that] they can start to take courage.” / Carol Han, USAID/OFDA

Tejanie Golafaley, an Ebola survivor, saw it as his personal mission to work at the USAID-supported Ebola treatment unit in Tubmanburg. “I want to explain my story to patients [so that] they can start to take courage.” / Carol Han, USAID/OFDA

ABOUT THE AUTHOR

Carol Han is the Press Officer for USAID’s Ebola Disaster Assistance Response Team [DART], which is overseeing the U.S. Ebola response efforts in West Africa. The DART includes staff from across the government, including USAID’s Office of U.S. Foreign Disaster Assistance, the U.S. Centers for Disease Control and Prevention, and the Departments of Defense and Health and Human Services.

One Year Later—the Road to Resilience After Typhoon Haiyan

The United States is providing more than $47 million in humanitarian aid to help the people of the Philippines in the wake of Typhoon Haiyan. This photo was taken in hard-hit Tacloban, Nov. 18, 2013. At least 200,000 people affected by Typhoon Haiyan in the Philippine city of Tacloban and six surrounding districts are now receiving clean water for cooking and drinking, as the first water treatment plant came back to full operating capacity /  IOM/J. Lowry

The United States is providing more than $47 million in humanitarian aid to help the people of the Philippines in the wake of Typhoon Haiyan. This photo was taken in hard-hit Tacloban, Nov. 18, 2013. At least 200,000 people affected by Typhoon Haiyan in the Philippine city of Tacloban and six surrounding districts are now receiving clean water for cooking and drinking, as the first water treatment plant came back to full operating capacity / IOM/J. Lowry

This week a year ago, I was in the Philippines, flying with the USAID Disaster Assistance Response Team in a C-130 to Tacloban in the wake of Typhoon Haiyan (known locally as Yolanda). The strongest storm in recorded history, Haiyan hit on Nov. 8, killing more than 6,000 people, displacing 4.1 million, and affecting 16 million in total—about 14 percent of the country’s total population. Flying into Tacloban, I saw a flattened landscape littered with what looked like matchsticks—the splintered remains of homes, businesses and millions of coconut trees. The damage was immense.

The Philippine Government estimates the typhoon caused $12.7 billion in losses. More than a million homes were damaged or destroyed, and 33 million coconut trees, a source of income for many Filipinos, were wiped out. As the average growth span of a coconut tree is 12 years, the storm essentially wiped out a decade of livelihoods for many Filipino families.

USAID Assistant Administrator Nancy Lindborg greets a man at the Tacloban airport who is set to board a flight to Manila, Nov. 19, 2013 / USAID

USAID Assistant Administrator Nancy Lindborg greets a man at the Tacloban airport who is set to board a flight to Manila, Nov. 19, 2013 / USAID

While we have seen enormous progress by the Philippines to build back better, including plans to move 1 million people away from the coast, many of the 4 million people displaced by the storm are still living in temporary shelters. The Philippines continues to lose up to $5 billion, or 2 percent of its gross domestic product, each year to recurring natural disasters.

The Philippines’ steady but tough recovery one year after Haiyan underscores the importance of investing in resilience—of helping people, communities, countries and systems survive and recover from acute shocks and stresses.

Far from being an isolated incident, Haiyan is part of a litany of natural disasters that are coming faster and harder each year thanks to climate change. Research suggests that, as our oceans become warmer, the severity of storms will inevitably increase. The number of reported disasters has already nearly tripled since 1980, and the cost of those disasters is up 300 percent, to $200 billion every year.

As Haiyan illustrates, when disaster strikes, the most vulnerable populations are the hardest hit, often without a chance to recover before the next shock hits them. Many of the communities affected by Haiyan already had poor infrastructure, which was devastated by the storm.

We know that droughts, typhoons and other disasters will continue to happen. By investing in resilience, USAID has pledged to help the world’s most vulnerable get ahead of these recurring shocks. We have changed the way we do business to help communities adapt, mitigate and manage the risks that will inevitably come. These efforts include bringing our humanitarian and development teams together to integrate, layer and sequence our relief and development resources around the shared aim of reducing persistent emergencies by addressing underlying vulnerabilities.

Caption: Boxes of relief kits from USAID sit outside the heavily damaged Tacloban airport, Nov. 19, 2013 / IOM/J. Lowry

Boxes of relief kits from USAID sit outside the heavily damaged Tacloban airport, Nov. 19, 2013 / IOM/J. Lowry

Climate change adaptation is critical to mitigating the impact of disasters like Haiyan, and USAID is investing in these efforts. We are part of the Urban Climate Change Resilience Trust Fund, a $140 million partnership with the Department for International Development and the Rockefeller Foundation targeting infrastructure projects in Asian cities. We also launched the Pacific American Climate Fund, a $24 million program that provides grants to help communities adapt to the impacts of climate change.

In the aftermath of Haiyan, our humanitarian assistance of over $90 million helped the Philippines not only bounce back, but rebuild livelihoods and build up stronger systems to weather future shocks. Our Office of U.S. Foreign Disaster Assistance deployed people before the storm hit so we were prepared to provide immediate assistance to help save lives. We quickly turned our cash assistance programs into cash-for-work and cash-for-training activities, including emergency employment programs that engaged 118,000 people in essential reconstruction efforts to clear debris, repair more than 1,500 kilometers of roads, and restore services in 560 schools, 220 rural health care centers and more than 30 hospitals.

We also provided skills training and micro-enterprise and small business support to the most vulnerable populations, particularly small-scale coconut farmers.USAID joined together with Procter & Gamble and Coca-Cola to help revive economic activity and livelihoods in Leyte, the province worst hit by the typhoon. These efforts helped restore damaged or destroyed sari-sari stores (small community stores) in public markets, and jump-start business by providing store owners access to micro-financing loans.

And we continue to seek the best ideas for building resilience in advance of a crisis. USAID joined forces with the Rockefeller Foundation and Swedish International Development Cooperation Agency earlier this fall to launch the Global Resilience Partnership, which aims to catalyze innovation and scale what is already working in resilience efforts by bringing in new actors, including the private sector and academia. With an initial investment of $150 million from the three partners, the Partnership will help to drive evidence-based investments that enable cities, communities and households to better manage and adapt to inevitable shocks.

The Partnership’s first activity is the Global Resilience Challenge, a call for the creation of teams from all sectors to come together to produce locally driven, high-impact solutions to resilience challenges (application deadline: Nov. 30). Our focus will be in the Sahel, the Horn of Africa, and South and Southeast Asia—areas with high resilience needs.

Through the Partnership, we seek to create a community of practice to strengthen resilience globally. In the face of shocks and stresses caused by epidemics, fragility and our planet’s changing climate, we need all-in ideas and solutions. The Partnership is an important effort to learn from disasters like Haiyan, build preparedness for the future, and help the world’s most vulnerable get on a solid path toward development.

ABOUT THE AUTHOR

Nancy Lindborg is the USAID Assistant Administrator for the Bureau for Democracy, Conflict and Humanitarian Assistance. Follow here @nancylindborg

“I’ve Never Had a Job Like This”: Life Inside an Ebola Treatment Unit

Morgana Wingard This blog is part of our Daily Dispatches series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight on Ebola. Her photo series and blogs from the team offer unique angles into the many facets of the Ebola story – from life inside a treatment center, to profiles of the health care workers battling Ebola from the front lines, to the many ways the epidemic is impacting the health, economy and future of the nation.

SUAKOKO, Liberia—”It becomes day-to-day life. You get into your PPE [personal protective equipment] and you go in every day and you feel safe,” explains Audrey Rangel – a nurse at the Bong County Ebola treatment unit run by International Medical Corps with support and funding from USAID.

Before landing at Roberts International Airport in Monrovia on September 8,  Audrey worked on a maternal, child health and nutrition program in Timor Leste. “I always wanted to do disaster relief work. The crisis started to take off. It was in the news a lot. People were talking about it. So I went online. I saw a position for an Ebola response nurse. To me it was just the right time. The description just kind of fit me. I was speaking with my husband and I was saying I can’t not do this. I can’t not do this…. They need people. There was an actual need for me. And I just kind of felt like the description was made for me. It was just perfect. I had to do it.”

The Bong County Ebola treatment unit where Audrey was stationed is a four hour bumpy journey from Monrovia. Bong has some of the highest rates of infection after Lofa and Montserrado Counties. Their two ambulances drive for hours every day to pick-up patients in remote locations like Bong Mines where they picked-up 18-year-old Cephas after his father carried him on his back for an hour to a location where the ambulance could reach him.

Audrey’s days are spent on the front lines of the Ebola response, suiting up in protective gear and caring for patients like Cephas. Even as she roots for survivors, she admits that it’s easy to get attached to her patients: “For some reason you’re sad to see them go.”

“It’s turned out to be an amazing, amazing experience. I wouldn’t take it back for anything.  I guess you can say it exceeded my non-expectations,” says Audrey.

To learn how qualified medical professionals can join the fight against Ebola, visit: www.usaid.gov/ebola/volunteers.

Watch Audrey’s Story

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. All this week she will be guest posting from USAID’s instagram

2014: A Year of Food Assistance

From the dusty plains of South Sudan to the tropics in the Philippines, the world saw a whirlwind of crises destroy lives, livelihoods and human dignity over the past year. Severe drought, ravaging conflict and powerful natural disasters devastated communities and pushed already vulnerable families into crisis, oftentimes lacking enough food. USAID, through its Office of Food For Peace, was there to provide emergency food assistance in those times of need. The face of hunger is changing and we have changed with it—by thinking outside the box and providing more innovative responses to reach families faster, cheaper and more effectively. Among the largest responses this year were Syria, South Sudan, the Philippines and Central African Republic. Keep reading to learn about a few of the innovations USAID used to deliver humanitarian assistance to those in need.

Syria

A boy purchases bread in Aleppo, Syria, using a food voucher he received from the World Food Program. / USAID Partner

A boy purchases bread in Aleppo, Syria, using a food voucher he received from the World Food Program. / USAID Partner

Violence in Syria escalated over the past year due to heavy fighting between the Islamic State of Iraq and Syria (ISIS) and opposition forces, increasing the number of displaced persons to more than 6.4 million. Over the past year, USAID and its partners supported food vouchers for refugee families enabling them to buy food in local markets. Bakeries inside Syria turned regionally purchased wheat into bread for hungry families, ensuring families had that most basic of staples in their daily diets. With this and other forms of assistance—including family-size food packs—USAID assisted partners in reaching nearly 5 million conflict-affected Syrians.

South Sudan

In South Sudan, clashes sparked by a political crisis in December 2013 spurred conflict through much of the country that eventually displaced more than 1.8 million people. Ongoing displacement prevented farmers from planting or harvesting their crops and led to emergency or crisis levels of food insecurity for 1.5 million people. Even before the crisis began, 40 percent of South Sudanese needed humanitarian assistance. In preparation for increasing 2014 needs, USAID shipped U.S. food to South Sudan that arrived in February.

By May, when United Nations officials alerted the world to the possibility of famine, USAID had already authorized the U.N. World Food Program’s (WFP’s) South Sudan program to fully utilize those resources for the emergency response. When on-the-ground distribution became unfeasible due to conflict and the rainy season that collectively made roads impassable, WFP started the very expensive alternative of delivering food aid by aircraft. As part of its response, USAID distributed regionally purchased ready-to-use specialized food products to prevent and treat acute malnutrition in children under the age of 5.

The situation in South Sudan was already dire, but has since spiraled downward to become the worst food security crisis in the world. As a result, USAID has tapped into a seldom-used special authority in the Farm Bill—the Bill Emerson Humanitarian Trust—to respond to extraordinary, unforeseen and expanding need with additional food aid. Shipments of more than 64,000 metric tons of U.S. food commodities purchased under this special authority are now on their way to Africa to help the South Sudanese people.

Food distribution in South Sudan. / World Food Program

Food distribution in South Sudan. / World Food Program

Philippines

In November 2013, Typhoon Haiyan swept into the Philippines and proved to be one of the most powerful storms ever recorded. The storm displaced over 14.1 million people and caused billions of dollars in damages to infrastructure and livelihoods. Within three weeks of its landfall, USAID provided WFP and the the Philippine Government with the tools needed to provide life saving food assistance to nearly 3 million people.

Through an innovative approach, USAID combined U.S. food—including pre-positioned meal-replacement bars from Miami and pre-positioned rice from Colombo, Sri Lanka—with cash-based assistance to meet urgent food needs. With the cash assistance, WFP purchased rice directly from the Government of the Philippines and airlifted high-energy biscuits from Dubai, including these items in family food packs distributed just five days after the typhoon. WFP also provided cash transfers to purchase basic food items in places where markets were functioning. Additional U.S. rice arrived in February to support food-for-assets activities, which focused on agricultural livelihoods restoration, and direct distribution to the most vulnerable households.

USAID distributes rice and high-energy biscuits to vulnerable families after Typhoon Haiyan. / World Food Program

USAID distributes rice and high-energy biscuits to vulnerable families after Typhoon Haiyan. / World Food Program

Central African Republic

Ongoing armed conflict and political instability in Central African Republic (CAR) since December 2012 has displaced over 490,000 people, created close to 418,000 refugees, and greatly exacerbated food insecurity. Due to heightened insecurities this year along the roads entering the country, USAID and WFP worked to expand the number of entry points into CAR and figure out creative ways to distribute food assistance to those in need, such as using airlifts and river barges.

Using a combination of U.S. and regionally available food, USAID reached over 1 million vulnerable, food insecure people—including both internally displaced persons and refugees.  Returnees in Chad, who fled CAR at the outbreak of violence, are using food vouchers to buy food available on local markets. As the conflict has raged on, decreased access to vulnerable populations has meant USAID and its partners have had to continually search for new and innovative ways to deliver life saving assistance.

Children carry vegetable oil provided by USAID in the Don Bosco camp for internally displaced persons in Bangui, CAR. / World Food Program

Children carry vegetable oil provided by USAID in the Don Bosco camp for internally displaced persons in Bangui, CAR. / World Food Program

ABOUT THE AUTHOR

Nina Rosenberg is an Information Officer in USAID’s Office of Food for Peace.

An Outsized Problem with a Small-sized Solution

In the lush countryside of Burundi, you wouldn’t expect there to be chronically high rates of malnutrition. But hidden behind the walls of a family’s house, poor feeding practices, compounded by large families with kids close in age, means malnutrition lurks. According to a 2013 IFPRI study, more than 73 percent of the population in Burundi is undernourished, and 58 percent of the population is stunted. These figures are staggering, given the population of Burundi is only 10 million.

That’s where USAID and partner UNICEF come in. Burundi is one of the first countries where U.S.-produced Ready-to-Use Therapeutic Food, or RUTF, is being used to treat acute malnutrition.

A child eats his ready-to-use therapeutic food to treat his malnutrition. / USAID, Katie McKenna

A child eats his ready-to-use therapeutic food to treat his malnutrition. / USAID, Katie McKenna

Why do these small packets make such a difference? Previously, kids with severe acute malnutrition (SAM) had to be treated at the hospital. This meant families’ staying weeks and weeks as the child recuperated. Now, with the advent of products like RUTF, children without any other health symptoms can be treated at home. Imagine you’re a small kid who is sick – which would you prefer? Being at a hospital for weeks at a time, or in the comfort of your own home? It’s a no brainer.

A new food assistance product for the Agency’s Office of Food for Peace, this product is a game changer for tackling severe acute malnutrition. Previously the Agency’s food assistance partners did not have capacity to purchase this product in the United States for food assistance programs because U.S. suppliers were not producing it. This meant only doing small scale interventions with locally purchased ready-to-use foods, or not being able to treat severe acute malnutrition at all through food assistance.

Starting in 2012, this changed. Currently USAID plans to meet at least 10 percent of UNICEF’s global need for RUTF, and has already provided this specialized product in 14 countries since 2012. In Burundi, RUTF is helping treat 16,500 severely acutely malnourished kids under 5 in nine provinces.

UNICEF staff are working tirelessly to ensure that the Ministry of Health of Burundi is able to treat severe acute malnutrition, and help mothers learn to treat it themselves at home. In villages across Burundi, every week women bring their children to the local health clinic for nutrition training, and to get their kids’ health assessed. In exchange, they receive a week’s supply of RUTF for their kids identified as severely acutely malnourished.

In Burundi, more than 73 percent of the population is undernourished, and 58 percent of the population is stunted. U.S.-produced Ready-to-Use Therapeutic Food is being used there to treat acute malnutrition. / USAID, Katie McKenna

In Burundi, more than 73 percent of the population is undernourished, and 58 percent of the population is stunted. U.S.-produced Ready-to-Use Therapeutic Food is being used there to treat acute malnutrition. / USAID, Katie McKenna

Elias Ndikumana, a father of three, has two children enrolled in treatment for severe acute malnutrition. Twins Alain Don Divin Igiraneza and Alain Bon Idée Ahishakiye, both 1.5 years old, were brought into the health center in Muyange colline, in Makamba Province,  when they started to show some of the telltale signs of being malnourished.

“The children were so weak when I brought them to the clinic. I was so worried about them,” said Ndikumana. For the last six weeks, they’ve been eating RUTF. “Now they’ve been eating the paste, they are livelier and getting healthier. I am so relieved.”

UNICEF and USAID are not stopping there. We are working to build the capacity of the Ministry of Health nutrition office to do outpatient care at the health center level and inpatient treatment of SAM at the hospital level. A first step is helping the government manage the supply chain for RUTF. With funding from both PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) and Food for Peace, warehouses to store the RUTF have been equipped to improve storage space and stock management.

Health workers, nurses and doctors, including those still in medical schools, are also being trained to recognize the signs of acute malnutrition and how to treat it so the problem can be tackled early on, and not once a child gets to a critical stage. It is hoped in the long run that the Ministry of Health will be able to tackle this persistent problem without outside assistance.

ABOUT THE AUTHOR

Jessica Hartl is lead Information Officer for the Office of Food for Peace. Follow Food for Peace @USAIDFFP

Reducing Disaster Risk for All Generations

Today is International Day for Disaster Reduction—a day to reflect on the importance of reducing disaster risks around the globe. This year we pay special attention to the global aging population and how we must include all generations in our disaster planning, preparedness and mitigation efforts.

According to the United Nations Department of Economic and Social Affairs, the population age 60 or over is the fastest growing demographic globally, and is expected to more than triple to nearly 3 billion by 2100, representing about 28 percent of the projected 10.9 billion people worldwide.

This trend points, in part, to the many successes of international development, which have helped people around the world achieve longer, healthier lives. It also points to our responsibility to ensure that this population is not ignored when we address disaster risks around the globe.

USAID works steadfastly with our partners to ensure that all of our programs are accessible and inclusive to all people, regardless of age. We recognize that older people may be “hidden” within disaster-affected populations and may face constraints in accessing humanitarian assistance, so we take extra steps to identify them during a disaster response, listen to their views and design targeted programs that meet their unique needs where necessary.

We recognize that having this large and growing population of experienced, knowledgeable leaders and volunteers represents an enormous opportunity for communities, especially in terms of improving safety through disaster preparedness.

Matilda Blake, 85, is a farmer as well as a stand-out participant in the USAID-supported HelpAge International disaster risk reduction program in Jamaica. / Jenny Anderson, HelpAge International

Matilda Blake, 85, is a farmer as well as a stand-out participant in the USAID-supported HelpAge International disaster risk reduction program in Jamaica. / Jenny Anderson, HelpAge International

Take 85-year-old Matilda Blake. She not only single-handedly manages her family farm in Jamaica, she is also a dynamic contributor in her community, serving as an emergency shelter manager when natural disasters threaten the island. She is an active participant in USAID-supported training sessions offered by our partner HelpAge International that help the community better prepare for future disasters.

Stanford Bentley, 84, contributes his energy and experience to disaster preparedness actions in Jamaica while also learning new ways to protect his crops from extreme weather. / Jenny Anderson, HelpAge International

Stanford Bentley, 84, contributes his energy and experience to disaster preparedness actions in Jamaica while also learning new ways to protect his crops from extreme weather. / Jenny Anderson, HelpAge International

Stanford Bentley, an 84-year-old Jamaican farmer, also benefits from HelpAge’s training, learning new ways to protect his crops and livestock from extreme weather, while contributing his own energy, insight and experience to disaster preparedness actions in his community. By ensuring that older people’s knowledge and experience is used to its full potential during the planning and preparedness phase, their specific needs will be capably met when a disaster strikes.

Vietnam Red Cross and local volunteers organize an evacuation of older community members during a flood simulation drill. / Brian Heidel, USAID

Vietnam Red Cross and local volunteers organize an evacuation of older community members during a flood simulation drill. / Brian Heidel, USAID

In Vietnam, USAID has partnered with the American Red Cross to train hundreds of Vietnam Red Cross staff members and community leaders in disaster and risk management. Just as they do in the United States, these Red Cross staff and volunteers in Vietnam respond to disasters that impact their country. They also help people of all generations to prepare for and manage disaster risk. The Vietnam Red Cross uses an intergenerational approach, connecting primary school students, teachers of all ages and older people with information about disaster risk reduction, community resources and practical skills training. By including people of all ages, the program builds and reinforces a culture of safety throughout all generations in society.

These are just two examples that highlight the many contributions of older people. They illustrate how all generations can learn from and support one another, not only once a disaster has occurred, but also before a disaster by working together to reduce risk and prepare for disasters.

USAID has a proud tradition of standing up for the inclusion of older people when providing humanitarian assistance. We are also committed, in both policy and in practice, to helping reduce disaster risk for all generations in all our programs worldwide. On this International Day for Disaster Reduction, we stand together with all of the hardworking people— young and old—who are helping make their homes, neighborhoods, farms, cities, states, and countries safer, secure, and more resilient places for current and future generations.

ABOUT THE AUTHOR

Laura Powers is Senior Humanitarian Advisor and Sara Westrick Schomig is Special Projects Advisor for USAID’s Office of U.S. Foreign Disaster Assistance

A Grand Challenge to Help Health Care Workers Fight Ebola

Health care workers put on Personal protective equipment (PPE) before going into the hot zone at Island Clinic in Monrovia, Liberia on Sept 22 2014. / Morgana Wingard, USAID

Health care workers put on personal protective equipment (PPE) before going into the hot zone at Island Clinic in Monrovia, Liberia on Sept. 22 2014. / Morgana Wingard, USAID

Today, West Africa faces the largest Ebola epidemic in history. Markets are empty. Schools are closed. Friends greet each other from a distance. As President Obama said yesterday at the United Nations:

“Ebola is a horrific disease. It’s wiping out entire families. It has turned simple acts of love and comfort and kindness — like holding a sick friend’s hand, or embracing a dying child — into potentially fatal acts. If ever there were a public health emergency deserving an urgent, strong and coordinated international response, this is it.”

From Guinea to Liberia to Sierra Leone, the alarm has been sounded, and United States is mobilizing a global response. We know how to stop this epidemic, but it will take ingenuity, speed, and cooperation. That is why President Obama announced a new Grand Challenge for Development to generate pioneering solutions that help health care workers provide better care in the midst of the epidemic.

“I’m pleased to announce a new effort to help health workers respond to diseases like Ebola. As many of you know firsthand, the protective gear that health workers wear can get incredibly hot, especially in humid environments. So today, we’re issuing a challenge to the inventors and entrepreneurs and businesses of the world to design better protective solutions for our health workers… And our goal is to get them to the field in a matter of months, to help the people working in West Africa right now.  We can do this.”

Every day, courageous men and women are performing critical tasks that save lives and prevent the spread of the virus. Personal protective equipment (PPE)—the suits, masks and gloves the health care worker wears—is their primary protection, but it is also the greatest source of stress. In these hot and uncomfortable suits, health workers must administer to the patients and remove contaminated materials.

Health workers in personal protective equipment (PPE) wait to enter the hot zone at Island Clinic in Monrovia, Liberia on Sept 22. 2014. PPE is their primary protection, but it is also the greatest source of stress. / Morgana Wingard, USAID

Health workers in personal protective equipment (PPE) wait to enter the hot zone at Island Clinic in Monrovia, Liberia on Sept 22. 2014. PPE is their primary protection, but it is also the greatest source of stress. / Morgana Wingard, USAID

Announced at the Global Health Security Summit in Washington, D.C., this Grand Challenge for Development will unite the global community in the quest for ingenious ideas that deliver practical and cost-effective innovations in a matter of months, not years.

We need new ideas to help ensure that treatment sites, communal transport units, and burial sites do not become infection sources. We need new solutions that strengthen the safety and increase the comfort of the suits, from improving fabric design to measuring a health worker’s temperature and heart rate.

We need new ways to simplify clinical processes, including point-of-care diagnostics. And we need new tools that continue to create a safer clinical environment, including improving infection control and waste disposal. Taken together, these innovations will enable health workers to provide better care for those who are suffering.

Together with our international partners, we will translate the expertise and ingenuity of scientists, innovators, engineers, and students from across the globe into real solutions. With your bold thinking and engagement, we can give health workers the tools they need to win this fight.

To get involved, please visit: http://www.usaid.gov/grandchallenges/ebola

 

ABOUT THE AUTHOR

Dr. Rajiv Shah is USAID Administrator. He tweets from @rajshah

Powering The Ebola Response: Monrovia’s Island Clinic

Morgana Wingard This is the first blog in our Daily Dispatches series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight on Ebola. Her photo series and blogs from the team will offer unique angles into the many facets of the Ebola story – from life inside a treatment center, to profiles of the health care workers battling Ebola from the front lines, to the many ways the epidemic is impacting the health, economy and future of the nation.

MONROVIA, Liberia—One of the saddest things about the Ebola outbreak in Liberia is the inability for many patients to get treatment. In Dolo Town recently, I watched a father carry his ailing son in a wheelbarrow to the clinic for treatment, but they did not have the capacity to help. He had been calling the government hotline for four days to no avail. A team of NGO workers proceeded to call the hotline again and a personal ambulance, but they also couldn’t get any help. All the treatment centers were full. In the end, the clinic sent him and his son home along with two other patients. Different versions of the same story have repeated across Monrovia for weeks. Liberians, trying to do the right thing, called the hotline and drove their loved ones to the hospital only to be denied entrance.

A father is devastated in Dolo Town after he was unable to get his son into an Ebola Treatment Unit (ETU) . It’s unclear whether he has Ebola as he can’t get to a facility for testing -- an all too common problem. The U.S. Government is helping build and staff several new facilities in Liberia. / Morgana Wingard

A father is devastated in Dolo Town after he was unable to get his son into an Ebola Treatment Unit (ETU) . It’s unclear whether he has Ebola as he can’t get to a facility for testing — an all too common problem. The U.S. Government is helping build and staff several new facilities in Liberia. / Morgana Wingard

After hearing too many of these stories as I have documented the unfolding Ebola crisis over past weeks, the opening of another Ebola treatment unit (ETU) was a huge relief. With the help of USAID, the Liberian Government and the WHO opened the 100-bed facility on Sunday, September 21. To power the treatment center, USAID provided two generators, amongst other supplies. These generators are vital to the functioning of the clinic by providing power for lights, pumps for water, and washing machines to clean scrubs worn by health care workers under their personal protective equipment (PPEs).

Miata, a nurse we met, said all the health care workers ran from nearby Redemption Hospital, the largest government-run hospital in Liberia, at first. A doctor and several nurses on staff became infected with Ebola and died as the outbreak was beginning in Liberia. But when a team of Ugandan health care workers arrived in Liberia who had fought previous Ebola outbreaks in their own country, they called them together for a training workshop.

“That workshop inspired me to come back. If we don’t help the patients, who will?” Now, she is not afraid because she can cover herself with personal protective equipment before she enters the “hot zone” to provide food for patients fighting the Ebola virus. This new Island Clinic facility is helping. But many more beds and qualified health care workers are needed to meet the needs of growing numbers of patients.

Qualified health care workers’ interested in volunteering can go to http://www.usaid.gov/ebola/volunteers for information.

Here are some shots I took on our trip to Island Clinic on Monday.

The entrance for health care workers going into Island Clinic

The entrance for health care workers going into Island Clinic, a new Ebola Treatment Unit that opened in Monrovia, Liberia on Sept. 21, 2014 and within one day, reached capacity. The building was a Doctors without Borders hospital during Liberia’s Civil War. It was neglected for several years until the government, with help from the World Health Organization, transformed it into a 100-bed clinic in response to the surge of patients needing care due to the Ebola crisis that is hitting Liberia especially hard. Many people are calling the battle against the Ebola epidemic a “biological war” and now these same facilities that were used during the country’s long Civil War are finding a new use as Liberia struggles to contain the crisis. USAID has provided two generators to the facility which are providing power for lights, pumps for water, and washing machines to clean scrubs worn by health care workers under their personal protective equipment.


A family waits at the entrance to the Island Clinic in Monrovia, Liberia

A family waits at the entrance to Island Clinic in Monrovia, Liberia, which was opened by the World Health Organization and the Liberian Ministry of Health in response to the surge of patients needing an Ebola Treatment Unit. Here, a health worker in protective gear tells the family to wait on the side as they open the doors for an ambulance to exit the facility. Before the facility opened on September 21, ambulances and patients arrived at the gates waiting to be admitted. Just a day after opening, the clinic is already at capacity. USAID has provided two generators and other supplies to equip the facility with life-saving care.


Health care workers put on personal protective equipment before going into the hot zone at the Island Clinic in Monrovia

Health care workers put on personal protective equipment before going into the hot zone at Island Clinic, in Monrovia, Liberia on Sept. 22, 2014. The 100-bed clinic opened on Sept. 21, and within one day it is already at capacity after approximately 100 Ebola patients were moved from the nearby Redemption Hospital and ambulances brought other Ebola-stricken patients from the community. There are still more patients on the way. The facility was set up by the World Health Organization and Liberia’s Ministry of Health in response to the surge of patients needing an Ebola Treatment Unit. USAID has provided two generators and other supplies the facility.


Hygienists at the ebola treatment unit at Island Clinic in Monrovia wash health workers' scrubs

Hygienists at the ebola treatment unit at Island Clinic in Monrovia wash health workers’ scrubs, a vital part of the operation at the new clinic, which opened September 21, 2014. Health workers at the clinic must follow extensive protocol to protect themselves. All scrubs worn under their personal protective equipment and shoes must be washed thoroughly in chlorine water and then with soap. While we were at Island clinic, one of the health workers told me why she was working here: “If we don’t help the patients, who will?” She said she is not afraid because she can cover herself with personal protective equipment before she enters the “hot zone” to provide food for patients fighting the Ebola virus.


A patient lies in a bed at the newly opened Island Clinic in Monrovia

A patient lies in a bed at the newly opened Island Clinic in Monrovia, Liberia on Sept. 22, 2014. The patient is getting an intravenous treatment – a crucial part of treatment for Ebola because the virus quickly dehydrates those it infects. However, using IV is also considered risky for health workers if they do not take proper precautions and not all treatment centers are using them. At the Island Clinic, a concrete wall and glass window offers those outside the clinica sobering view into the patient area. While I am standing less than a foot from this man, the perception is that I’m peering into a restricted and isolated world.

(All photos by Morgana Wingard)


ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. All this week she will be guest posting from USAID’s instagram

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