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Bill Berger: “There is no book on responding to this Ebola crisis… we’re writing it now.”

Morgana Wingard This is the fifth blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
General Darryl Williams, Bill Berger, and U.S. Ambasador to Liberia Deborah Malac.

General Darryl Williams, DART Team Leader Bill Berger, and U.S. Ambasador to Liberia Deborah Malac. / Natalie Hawwa, USAID

“There is no book on responding to this Ebola crisis… we’re writing it now,” says Bill Berger, Team Leader for the Ebola Disaster Assistance Response Team (DART) in West Africa.

A seasoned disaster expert, Bill has responded to more than 30 large-scale emergencies across the globe and led several DARTs for USAID’s Office of U.S. Foreign Disaster Assistance.

But how exactly are Bill and his team fighting this unprecedented Ebola epidemic?

“Day by day, pushing at a maximum speed on all fronts,” he says, and with every ounce of compassion and disaster knowledge they have.

As the DART Team Leader, Bill strategizes alongside the local governments and U.S. Ambassadors in the affected countries, the United Nations and NGO partners on the ground to mount the most effective aid effort possible. With Ebola, there are many complex technical pieces that need to come together to help save lives.

“We know the basic things that need to happen, such as building treatment centers, training health care workers, providing testing capabilities and coordination — but we also have a real opportunity here to transfer that capacity and boost national health care systems in West Africa.”

The DART is working across the region in Guinea, Liberia and Sierra Leone – each a unique country with its own dynamic for responding to Ebola. While there are challenges of navigating unknown territory for this unprecedented crisis, Bill draws strength from having the opportunity to help those affected by this tragedy. He’s also inspired by his team and the chance they have to contribute to such a critical and historic global issue together.

“Every DART is like living a full lifetime; you have many experiences and feelings in a short period, with so much confronting you daily,” he says. “Working with others during a crisis brings about wonderful and special bonds.”

Bill jokes that the DART will be giving each other the ‘Ebola bump’ — the new West African greeting of hitting elbows, adopted in lieu of a handshake due to the ‘no touch’ atmosphere — for years to come.

“Our DART is a very special group of dedicated people bringing in every piece needed for this Ebola response. It’s a great gift to lead this team.”

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

First Look at a New Hospital for Ebola Aid Workers: 10 Photos You’ve Never Seen

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.

HARBEL, Liberia—”Where have you done this before?” USAID Administrator Raj Shah asked on October 15, as he stepped through the taupe colored tent flap into the new 25-bed critical care hospital being built to treat all health care and aid workers who fall ill to Ebola. “Nowhere, sir. No one has,” replied an army engineer.

Historically, mobile medical units like this one provide versatile trauma care for military operations. In this case, the Department of Defense (DoD) and the U.S. Public Health Service (USPHS) customized the Monrovia Medical Unit to treat highly contagious Ebola patients.

Once complete, the hospital will be operated and staffed by a team of 65 specialized officers from the USPHS Commissioned Corps – an elite uniformed service with more than 6,800 full-time, highly qualified public health professionals, serving the most underserved and vulnerable populations domestically and abroad.

The Commissioned Corps will deploy clinicians, administrators, and support staff to Liberia to treat health care workers with Ebola, and to continue efforts by USAID, DoD and international partners to build capacity for additional care in Liberia.

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The new 25-bed critical care hospital being built in Harbel, Liberia to treat health care and aid workers who fall ill to Ebola. The new hospital is expected to be online in early November.


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Rear Admiral Scott Giberson (Acting U.S. Deputy Surgeon General and Commander of the USPHS Commissioned Corps Ebola Response) gives USAID Administrator Raj Shah a tour of the new 25-bed critical care hospital for all health workers who fall ill with Ebola while on the frontlines of the epidemic in Liberia on October 15, 2014.  


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Colonel Joann Frye, nurse, Officer in Charge, U.S. Air Force Air Combat Command 633rd IPTS and USAID Administrator Raj Shah inside the new hospital.


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Tents are connected by a covered passageway inside the “Hot Zone.”  Soon the only people inside this area will be health workers either as patients or suited up in personal protective equipment.


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Inside one of the patient wings of a new critical care hospital being built by the U.S. Department of Defense and the U.S. Public Health Service in Harbel, Liberia.


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The new hospital’s supply room.


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CAPT Ed Dieser (Engineer, USPHS Commissioned Corps Safety/Facilities Officer) gives USAID Administrator Raj Shah a tour of the new 25-bed critical care hospital for health workers who fall ill to Ebola while on the front lines of the outbreak in Liberia.

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

Paloma and Alisha: The Information Gurus Behind the U.S. Ebola Response

Morgana Wingard This is the fourth blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
U.S. Information Officers Paloma Clohossey and Alisha McMichael, left to right.

U.S. Information Officers Paloma Clohossey and Alisha McMichael, left to right.

Though Alisha McMichael and  Paloma Clohossey’s jobs on the Ebola Disaster Assistance Response Team (DART) aren’t as high profile as the health care workers who suit up in protective gear everyday, one could argue that their role is just as vital to the U.S. response.

“Alisha and Paloma bring all the threads of the operation together for reporting and information collection — they know the ins and the outs of the response as a whole,” said Bill Berger, the Ebola Disaster Assistance Response Team Leader.

They are the DART’s Information Officers – also known as ‘IOs.’: the information gurus who compile, collate and verify all the information about the U.S. Government’s Ebola response efforts and the crisis at large. After absorbing every last detail and fact, they distribute them to team members on the ground and back to Washington, D.C. so that everyone is on the same page and has the correct information they need, when they need it.

In a disaster response environment – especially one like the Ebola epidemic, where everyday the international community is navigating new territory – information is critical. Alisha and Paloma constantly take in and filter information to ensure they’re up to date on the latest — no easy feat given the ever-evolving situation as the crisis progresses and the U.S. response gains momentum.

In fact, Alisha has been dubbed the DART’s ‘sync-master,’ responsible for tracking daily the progress of Ebola treatment units, community care centers, trainings for health care workers, burial teams, airlifts of relief supplies, and other response efforts – following the military’s Sync Matrix model. Meanwhile, Paloma writes daily updates about the situation on the ground to inform Washington and communicate key gaps, challenges and successes.

Being a DART IO requires a lot of attention to detail and long days, but working 24/7 doesn’t get them down.

“The best part by far,” says Paloma, “is getting to have the opportunity to do work that feels meaningful. I’ve been given a chance to contribute to something that I believe in.”

Adds Alisha, “This is a great team, and I know everyone gives their best everyday. That feels good.”

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

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“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

Livestock Production: Empowering Women in Ethiopia

For some, Ethiopia conjures images of famine and extreme poverty. I see a completely different picture.

Ethiopia is a country rich in opportunity and resources, composed of hardworking men and women with innovative ideas and entrepreneurial spirits. However, agricultural technology and best business practices are not widely available or utilized. Women are also not fully empowered to make financial decisions for their families and struggle to own land or access credit.  Ethiopia’s dairy sector is dominated by smallholder farmers caring for dairy cows. Processing milk is traditionally viewed as women’s work.

Recently, Ethiopian women have turned this traditional role into an economic opportunity based on the training and financial assistance provided by USAID. Livestock fattening and dairy production are areas that employ women. However, in most parts of Ethiopia, a lack of training and knowledge has prevented women from taking on leadership roles.

Yeshi, a professional milkmaid, milks cows for households throughout Bishoftu twice a day—early in the morning and again at night. / CNFA

Yeshi, a professional milkmaid, milks cows for households throughout Bishoftu twice a day—early in the morning and again at night. / CNFA

As part of the U.S. Government’s Feed the Future initiative, the USAID Agricultural Growth Program-Livestock Market Development project seeks to improve nutrition and boost incomes, through training and investments in commodities like dairy, meat, and live animals. The project targets both men and women, with specific interventions to integrate women entrepreneurs into the broader livestock value chain. For example, the project developed a specific female entrepreneur training package designed to enhance the business capacity of women. Moreover, to better facilitate the participation of women in the offered technical trainings, the project provides innovative daycare services for the children of women participants.

One of the project’s key objectives is to strengthen local Ethiopian organizations and help them build effective, long-term partnerships. In June 2013, USAID signed an agreement with Project Mercy; a local, faith-based not-for-profit relief and development agency established by Marta Gabre-Tsadick, the first woman senator of Ethiopia. Through the agreement, USAID is assisting with an innovative cattle cross-breeding program. The local cattle – when crossed with Jersey breed bulls, create offspring that are up to ten times more productive. The project specifically assisted input suppliers’ import of Jersey Cattle inputs to Ethiopia.

Every morning, farmers drop off milk collected from their dairy cows at one of three collection centers for Ruth and Hirut Dairy in Cha Cha, Amhara, Ethiopia. / CNFA

Every morning, farmers drop off milk collected from their dairy cows at one of three collection centers for Ruth and Hirut Dairy in Cha Cha, Amhara, Ethiopia. / CNFA

A year and a half into its five-year time frame, this project is achieving significant results To empower women, the projecthas launched various training and technical assistance programs, including a leadership program and grants for female entrepreneurs. More than 100 rural women were trained in entrepreneurship and leadership during one 2013 session. These women now serve as business role models in livestock market development in their communities.

Hirut Yohannes embodies the entrepreneurial spirit I see in so many Ethiopian women. In 2008, she launched Rut and Hirut Dairy, a milk processing company located in Cha Cha, Amhara, just outside Addis Ababa. After some initial successes, she wanted to expand her company’s operations but needed guidance. Hirut approached USAID for support and was trained in production and marketing of quality products. She learned to make higher quality gouda and mozzarella cheese, flavored yogurt, cream cheese, and several other types of cheese. USAID also assisted Hirut to introduce packaging for fluid milk products.

Following support from the project, Rut and Hirut Dairy saw an almost immediate 50 percent increase in sales, which enabled Hirut to increase the volume of milk she purchases from farmers and to increase its sale price by 12 percent per liter. Hirut now provides market access for more farmers in her area and has plans to establish new milk collection centers to further expand her business.  With higher quality products, she has increased her income and profitability and is now able to service the bank loan that she had accessed to originally establish her milk processing facility.

Extreme poverty is still a serious problem in many parts of Ethiopia. Projects like this, however, are providing sustainable solutions to some of the most intractable issues that Ethiopians face. Successful women entrepreneurs serve as role models for other women who see little opportunity to improve their family’s income. While the role models are the ones that inspire other women to initiate and expand their livestock businesses, USAID provides essential training and support to help their endeavors succeed.

ABOUT THE AUTHOR

Dr. Yirgalem Gebremeskel is a Livestock Program Specialist Economic Growth and Transformation Office, USAID Ethiopia

The Digital Development Opportunity

Bangladeshi farmer Jalal Kha talks over a mobile phone as he works in his paddy field. / AFP, Farjana K. Godhuly

Bangladeshi farmer Jalal Kha talks over a mobile phone as he works in his paddy field. / AFP, Farjana K. Godhuly

At last month’s Frontiers in Development Forum, we welcomed some of the world’s brightest minds and boldest leaders to discuss how to best partner to end extreme poverty. We not only heard from leaders like Tanzanian President Jakaya Kikwete and Secretary of State John Kerry, but also from innovators who are creating mobile apps to fight human trafficking and using 3-D printers to build prosthetic hands in the field. It was a recognition that we live in a unique moment, one where new technologies and partnerships are redefining what is possible.

Above all, the Forum was a reminder that—as we near the 2015 deadline of the Millennium Development Goals—we must accelerate progress. For our Agency, new technologies and partnerships have created unprecedented opportunities to end extreme poverty and promote resilient, democratic societies.

From GPS to Skype to e-tablets, new innovations are fundamentally changing the way we communicate, work, learn, share and interact. Almost two decades ago, we launched the Leland Initiative, an effort to expand access to information and communication technology in more than 20 African countries. To build on this legacy, we teamed up with the U.K., Google.org, and the Omidyar Network to establish the Alliance for Affordable Internet. Since then, the Alliance has grown to more than 65 members, from Facebook to the Government of Mozambique. Together, they are building global consensus around a set of policy and regulatory recommendations that will lower the cost of internet access—unlocking new opportunities for doctors, entrepreneurs, and local leaders across the developing world.

Much of this progress won’t happen at a desktop; it’ll happen in the palms of billions of hands. Today, farmers are using mobile payments apps to send payments and receive loans; entrepreneurs are selling their goods on the global marketplace; and health workers are treating more patients, at less cost, and without expensive equipment.

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A mobile money user in the Philippines checks her balance on her phone. / USAID, Brooke Patterson

We’re also tapping into affordable, game-changing technologies with the potential to transform the way we work. In Uganda, we’re using mTrac, a tool that enables local health workers to send the government reports via SMS. Recently, the Ministry of Health used mTrac to survey 10,000 health workers on whether their health unit had a fridge that kept perishable drugs and vaccines cold.

The survey cost just $150 and took less than three days—providing the Ministry of Health with information from 1,862 health facilities. As a result, we learned that only about 70 percent of them have working fridges to store life-saving treatments. As Uganda ramped up its national campaign to eradicate polio, it used this information to target the most vulnerable populations and protect more children.

Technology we often take for granted is creating monumental changes in developing economies. In Senegal, rice millers buy expensive Asian imports, while local rice farmers are unable to sell their crops. To build up local supply chains and improve the quality of harvests, we are helping farmers share information through Excel and Dropbox. With this information in hand, rice millers can monitor local crops, schedule shipments in advance, and collect payments online. With 30 farming networks involved to date, this project is helping tens of thousands of smallholder farmers boost their sales and reach new customers.

We’re not creating technology for technology’s sake. There are too many apps that might look sleek, but are not transformative for the people who use them. That’s why we have helped publish a set of guidelines on best practices for development programs that utilize technology.

We call these principles the Greentree Consensus, and they are built on earlier sets of principles that draw on the insight of more than 300 NGOs with expertise in the field. Representing our commitment not only to innovation, but sustainable results, we’re thrilled to be launching these principles in partnership with over a dozen donors and multilaterals, including the Bill & Melinda Gates Foundation, UNICEF, the Swedish International Development Cooperation Agency, the United Nations Development Program and the World Food Program.

This is just the beginning of a conversation. We must do more to take these insights into action.  Over the next year, we want to hear from the development community about your experiences in bringing technology to tackle development challenges—from promoting media freedom to solving water shortages. With our Agency’s new U.S. Global Development Lab at the center of this effort, we’ll be able to create, test, and scale breakthrough solutions like never before. In doing so, we can make strides towards a day when extreme poverty—like cassette tapes and dial-up internet—is a thing of the past.

ABOUT THE AUTHOR

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

Justin Pendarvis: “We have to demystify Ebola. It’s not a superhuman and magical thing.”

Morgana Wingard This is the third blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
Justin-Pendarvis

Justin Pendarvis: “We have to demystify Ebola. It’s not a superhuman and magical thing.”

Before the United States deployed an Ebola Disaster Assistance Response Team (DART), there was Justin Pendarvis. As one of the Public Health Advisors at USAID’s Office of U.S. Foreign Disaster Assistance, Justin was the first disaster expert tapped to travel to West Africa and assess the growing Ebola situation for USAID.

In early July, Justin traveled to Guinea – home of the epidemic’s ‘patient zero.’ His mission: to observe and gauge the growing outbreak, understand the coordination at play for the response, and identify key challenges.

In Guinea he observed the protocols required to run an Ebola treatment unit (ETU) at one of Medecins sans Frontieres’ first facilities – an intense operation out of the capital city, Conakry. The following week he headed to Sierra Leone where frightening narratives were emerging from Kenema, one of the country’s largest towns hit hard by the virus.

“People were working around the clock, but more Ebola cases kept popping up,” recalls Justin. Health care workers were also falling ill.

By the time Justin landed in Liberia a week later it was clear that a significant amount of resources were needed to support West Africa and help save lives. Weak public health systems fell prey to the disease, and more help was needed. With key insight provided by Justin, USAID stood up the Ebola Disaster Assistance Response Team (DART) – the team of roughly 30 people from across the U.S. Government leading and coordinating the U.S. Ebola response.

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Patients wait outside the JFK Ebola treatment unit in Monrovia, Liberia on September 15, 2014.


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An Ebola patient rests on his bed inside the patient area at the Ebola treatment unit at Island Clinic September 22, 2014 in Monrovia. With the help of USAID, the Government of Liberia and the World Health Organization opened the facility on September 21. Within one day it was filled to capacity with more than 100 patients. USAID provided generators and other supplies to equip the facility with life saving care.


Since then there has been an “evolution of thought,” says Justin, as everyday USAID, alongside the affected countries and international community continue to learn how best to respond to this unprecedented crisis and fight the world’s largest Ebola outbreak in history.

In Liberia’s capital Monrovia, most residents know somebody who has been affected by the epidemic. Justin, like many West Africans, finds Ebola and this humanitarian response to be very personal. He first arrived in Liberia in 2009 and considers it his second home. His first three-and-a-half years in country were spent working with a Liberian NGO to strengthen and rebuild the country’s health infrastructure — systems that had been destroyed by decades of brutal civil war. But progress was being made.

Five years ago, only 11 percent of women in Liberia were delivering babies at health clinics, putting most — those delivering at home often in unsanitary conditions –  at great risk for complications and death. Liberia had one of the globe’s highest maternal mortality rates.

Fast forward to last year, where more than half of Liberian women were safely delivering at hospitals and clinics – a significant health breakthrough.Although maternal mortality is still high, the numbers have started to fall.

Today, in the face of Ebola, any woman who comes to a hospital to deliver her baby and is bleeding becomes untouchable. Staff hesitate to provide medical care due to fear and risk of  contracting the virus, which is transmitted through contact with infected bodily fluids.

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Midwives at John F. Kennedy hospital now wear extra protective gear when they go to work because of fears of the spread of Ebola.


“We have to demystify Ebola, it’s not a superhuman and magical thing. We know how to control it, and we know how to keep people safe – but there is a crippling fear.”

Justin says that many of the challenges in responding to the Ebola crisis are fighting that exact fear, and arming West Africans with knowledge to understand the virus and learn how to weave protective measures into their daily life and cultural traditions.

As USAID continues to work toward bringing more Ebola treatment units online, the DART is also prioritizing messaging campaigns that educate communities on how to protect themselves. These efforts have already proven to be life-saving.

“Liberia is definitely a special place to me. I feel lucky to be in a position where I can hopefully contribute, and am proud of the momentum we’re now seeing – it’s this impact and the collective commitment alongside the Liberian people to fight Ebola that drives me forward every day.”

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Natalie Hawwa is a USAID Press Officer for the Disaster Assistance Response Team on the ground in Monrovia, Liberia

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

Standing with Civil Society

In an effort to advance the Stand for Civil Society call to action, launched in September 2013, the President reminded us at this year’s United Nations General Assembly that “it is our obligation as free peoples, as free nations, to stand with the courageous citizens and brave civil society groups who are working for equality and opportunity and justice and human dignity all over the world.”

He referenced a newly issued Presidential Memorandum that directs U.S. agencies abroad to support civil society in several ways and announced a groundbreaking USAID initiative, in collaboration with the Sweden International Development Agency (SIDA) and the Aga Khan Foundation, to establish Regional Civil Society Innovation Centers that build connections among civil society organizations by providing resources, tools, and knowledge.

Civil society plays an important role in building stable, robust democracies and in protecting the rights of marginalized populations. At the same time, it remains an easy target for governments resistant to change. USAID has become increasingly concerned in recent years as governments adopt more laws that restrict activities of civil society and continue to harass, detain and imprison civil society activists. Tom Carothers of the Carnegie Endowment describes this closing space phenomenon as the “new normal,” which is why the President’s call to action is both timely and necessary.

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By engaging youth in the process of governance, we build a solid foundation for future leaders and contribute to establishing a stable and prosperous future for their countries. / Global Communities

Last month in Jakarta, Indonesia, I attended the Asia Civil Society Experience Summit (CSES), co-hosted by USAID, where the role of civil society and the backlash from numerous governments was the subject of much discussion. At the end of the Asia CSES, the participating activists issued a statement, which called upon Asian civil society, Asian governments and the international community to:

  • Build an enabling environment for civil society;
  • Promote innovative partnerships with diverse actors and change agents:
  • Leverage information and communication technologies to build and strengthen local and regional networks;
  • Explore innovative means to provide technical, institutional and financial support to civil society; and
  • Build and strengthen civil society transparency, accountability and effective governance.

The statement closed with a plea for “donors, governments, and international community to ensure continued financial and political commitment to civil society, particularly in closing and closed environments.”

Having travelled to Jakarta from Sri Lanka, I understood well the tensions and challenges that USAID faces in these environments. Sri Lanka was once a robust democracy but then suffered 25 years of brutal civil war. In the aftermath of the conflict, the government has sought to restrict NGOs they view as “political” by intimidating activists and imposing arduous legal regulations.

USAID’s response applies our three-pronged “prevention, adaptation, and support” approach in closing spaces: prevent the introduction of restrictive legislation; adapt to government efforts that make our existing operations difficult; and commit to continued support, financial or otherwise, for organizations that work in development, reconciliation and human rights.

In Sri Lanka today, many of the organizations that USAID supports are leading the effort to counter government plans to adopt a restrictive NGO law and to highlight concerns about security force intimidation that is affecting their operations. We are also funding programs that work with CSOs to ensure that they can continue serving their communities and advocating for human rights, even as government intimidation increases. And, we intend on continuing to support civil society, even after we transition in 2017 from a full mission to a limited presence country status program.

In Cambodia, USAID’s Development Innovations lab is connecting civil society, technology and social enterprises to provide physical space, expertise and catalytic programming to a number of groups and initiatives. The lab is involved in several activities, including teaching girls to utilize computer code in preparation for an international competition and assisting agriculture organizations to develop better monitoring apps. Via another project in Cambodia, USAID is funding the creation of mobile phone apps that allow Cambodians to read, text and chat in Khmer, their national language, as well as in Cham, the minority language.

The U.S. is the largest supporter of civil society in the world, having invested more than $2.7 billion to strengthen civil society since 2010.

As we continue to face grave challenges around the world, USAID will ensure that, when it comes to civil society, our financial investments are matched by our political commitments, and that we utilize both our presence in the field and technological innovations to support inclusive and accountable democracies that advance freedom, dignity and development.

ABOUT THE AUTHOR

Larry Garber is a Senior Advisor in the Bureau for Policy, Planning and Learning

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

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