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Saving a Leg and a Life in Rif Damascus

An Arabic translation is available.

As part of the $385 million in U.S. government humanitarian assistance for the people of Syria, USAID is supporting more than 110 field hospitals, medical clinics and medical points across Syria that have saved countless lives.

Hajji Rajaa is a 69-year old grandmother who lives on her own in Rif Damascus. As she was traveling to buy groceries for her family, she was hit in the knee by sniper fire.

A doctor tends to Hajji Rajaa’s leg in a clinic in Rif Damascus, Syria. Photo credit: USAID Partner

Once the scene was deemed safe, bystanders transported Hajji Rajaa to a nearby USAID-funded field hospital. The medical team quickly determined the extent of the damage, thankful the bullet had not hit the femoral artery.

Doctors removed the bullet and treated her wound, but Hajji Rajaa required daily care to ensure her wound was healing properly.  Though she wanted to recover at home with her family nearby, she was unable to travel to the field hospital due to the nature of her injury. The doctors, supported by USAID, decided to take turns visiting Hajji Rajaa every day to change her dressings and check the wound.

On their last visit to Hajji Rajaa, she told the head doctor that she wanted to thank him, his team at the field hospital, and the donors who provide the aid for the support that they offered her. She knew that without proper medical care, she would have lost her leg.

Thanks to the assistance provided by USAID, Hajji Rajaa will fully recover and be able to continue helping her children and grandchildren.

USAID medical programs in Syria provide medical supplies and equipment, pay doctors’ salaries, and train additional first responders and medical staff. Our medical teams have treated hundreds of thousands of patients, including performing nearly 35,000 surgeries.

Every day U.S. humanitarian aid is saving lives in Syria. Learn more.

Photo of the Week: President Obama Visits West Bank

On March 21, President Barack Obama joined President Abbas of the Palestinian Authority in Ramallah, West Bank to deliver remarks to the Palestinian people. The President remarked, “I was last here five years ago, and it’s a pleasure to be back — to see the progress that’s happened since my last visit, but also to bear witness to the enduring challenges to peace and security that so many Palestinians seek. I’ve returned to the West Bank because the United States is deeply committed to the creation of an independent and sovereign state of Palestine.” He added that “young Palestinians and young Israelis… deserve a better future than one that is continually defined by conflict.” During his trip, the President visited with some children at a USAID-funded center. Photo is from Muhannad Mansour from the Al Bireh Youth Development and Resource Center.

View photos from the President’s trip to the Middle East.

Learn more about USAID’s work in the West Bank and Gaza. Follow USAID West Bank/Gaza on Facebook and Twitter (@USAIDWBG).

INFOGRAPHIC: USAID Forward Progress Report

We have accomplished a lot over the last few years: increasing our funding to local organizations, companies, and institutions by more than 50%; leveraging $525 million in private capital through our Development Credit Authority last year alone; and creating a worldwide network of seven development innovation labs. We invite you to take a look and share with your friends who might be interested in our new model of development that puts us on a path to deliver more innovative and sustainable results. And if you’d like to learn more, please take a look at the USAID Forward Report that we released last week, as well as Administrator Shah’s remarks.

Water Projects as part of the Middle East Regional Cooperation Program (Part 4)

Note: This is the fourth post in a 4-part series. Read part onepart two and part three.

USAID’s Middle East Regional Cooperation (MERC) Program promotes cooperation between the Arab and Israeli scientific communities through joint research projects addressing common development problems. The program was established in 1981 to facilitate research cooperation between Egyptian and Israeli scientists, and was subsequently expanded to include Jordan, Lebanon, Morocco, Tunisia, and the West Bank and Gaza.

Today, active projects involve more than 400 Arab and Israeli scientists, engineers, students and technicians at 50 institutions in seven Middle Eastern countries.  New project proposals which seek out sustainable solutions to regional development challenges are accepted every year. Working together, these scientists have led innovation in agriculture, environment, water resources and health.

A Moroccan farmer makes use of a USAID SMS advisory service to plan irrigation for his crops. Photo credit: USAID

Given the region’s water shortages and the regional nature of water challenges, the water sector is an important component of MERC’s research portfolio.  Because agriculture consumes a large amount of the region’s freshwater resources, MERC projects seek to increase the use of treated wastewater as appropriate in agriculture, minimize water demand in existing crops, and identify new crop varieties that are resistant to drought and salinity.

For example, MERC programs explore the use of wetlands and membrane-based filters for the effective and efficient re-use of reclaimed water in agriculture. Its programs model crops’ abilities to make use of low-quality water, seek the optimal amount of water plants need, and develop protocols for the safe and effective use of reclaimed water. They identify and optimize high-value traditional and specialty crops suitable to arid climates and saline soils, such as potato varieties adapted to saline soils and water, and virus-resistant tomato lines.

As do USAID’s other water projects around the region, MERC’s water portfolio makes use of cutting-edge science, technology and innovation in improving the impact and sustainability of its initiatives.  One new project, for example, brings together Israeli and Palestinian scientists to look at the interaction between coastal aquifers and the Mediterranean under changing conditions. The scientists are developing empirical, quantitative estimates of seawater intrusion and freshwater outflow along the coast in and near Gaza. They will subsequently provide policy makers with recommendations about how best to manage these aquifers.

The re-use of wastewater is a growing practice in the region. Another MERC project studies the hormonal health hazards related to this re-use, the effectiveness of new wastewater treatment plants in removing hormonal pollutants, and the cost-effectiveness of new treatment alternatives. Project leader Alon Tal from Ben-Gurion University, who works with Israeli and Palestinian scientists from Bethlehem University and other groups to implement the project, commented, “I think this is going to take to the next level what we know about streams.”

Today, at a time of rapid change in the Arab world, MERC continues to bring together Arab and Israeli scientists and students to create and share solutions to regional development challenges like water while promoting a peaceful exchange between neighbors.

Read other blog posts in this series:

Latin America’s Slums and TB

In the slums of Latin America, 117 million people live in poverty. The region’s megacities, including Mexico City, Sao Paulo, Bogota, Rio de Janeiro, and Lima, generate over-crowded living conditions without access to clean water or electricity, poor nutritional status, and often lack of basic health services.  These marginalized populations are made up of the poor, the homeless, and vulnerable indigenous groups that have migrated to the city in search of a better life; they are the urban poor of Latin America.

The combination of these social determinants generates a breeding ground for tuberculosis (TB).

A woman and child receive TB treatment. Photo credit: USAID

Around the world, tuberculosis rates are often high in urban areas and in the Americas it is no exception. Twenty-five percent of Peru’s urban poor live in Lima-Callao, which reports 60% of the tuberculosis cases for the entire country and 85% of drug-resistant tuberculosis cases which is difficult and costly to treat.

As populations continue to explode throughout the region, health conditions will continue to worsen if they are not addressed, particularly in slums.  In 2011, 30,000 people died of tuberculosis in the Americas and there were 268,000 new reported cases. Worldwide, 1.4 million lost their fight against the disease. Tuberculosis, once thought an old disease, is the new emerging problem for the most vulnerable.

Tuberculosis has been used as a prime example of a “social disease” because it finds its nest among the poor and marginalized. The control of tuberculosis in cities requires social, economic, and environmental interventions to improve living conditions and increase access to health services. USAID has funded the Pan American Health Organization (PAHO) to tackle this concentrated epidemic in key cities across the Americas.

PAHO currently works with municipalities in Sao Paulo, Brazil; Bogota, Colombia; and Lima, Peru to improve their tuberculosis programs that service the urban poor. The successes from these cities will be shared with Mexico City, Guayaquil, and other megacities in Latin America and around the world.

As urbanization rates continue to increase, so are the chances of tuberculosis among the urban poor. Tuberculosis is contagious but also curable; acting now while the epidemic is concentrated will help avoid astronomical costs for treatment and keep the region healthy.

USAID in the Middle East: using data to improve regional water management (Part 3)

Note: This is the third post in a 4-part series. Read part onepart two and part four.

USAID has supported Egypt’s water sector – including its water and wastewater utilities – for more than three decades. Much of Egypt’s water and wastewater infrastructure built since the early 1980s – including treatment plants and water distribution networks – has been developed with U.S. assistance. Before USAID’s involvement, water and sanitation services were unevenly provided by a mix of municipal services providers and regional authorities. In 1975, for example, 70 percent of Egyptians had access to piped water; today, nearly 100 percent do. Accurate and consistent data were rare. Data aggregated nationally were difficult to verify. As elsewhere in the region, U.S. assistance strives to make available accurate data and decision-support systems to improve water-related decision-making.

In Egypt, a team using USAID’s Program Management Information System (PRISM) to monitor the status of 3,000 water and wastewater construction projects around the country validates system data with a site visit. Photo credit: USAID

The latest generation of USAID assistance works to ensure the sustainable stewardship of Egypt’s water infrastructure by emphasizing the management systems required to make the most of past infrastructure investments. With USAID assistance, major infrastructure investment and regulatory reform projects were launched, and the local water and wastewater departments were restructured and consolidated as operating subsidiaries of a national holding company. A key element in USAID’s approach is creating the systems to track and monitor data, and indicators to monitor service quality, the efficiency of water applications, and the cost-effectiveness of capital investments.

In Egypt, five national agencies are involved with construction and maintenance of water supply infrastructure. Until recently, there were no systems in place to track the thousands of construction projects underway nationwide at any given time. This inability to track and monitor construction progress led to poorly informed investment decisions and inadequate cost control. In 2006, the newly-installed minister overseeing these efforts requested U.S. assistance to establish a capital investment project tracking tool. Today, this system provides real-time summaries of over 3,000 construction projects underway, helping to prioritize investment decisions, quantify the expected impact, and justify and explain investment decisions.

Another USAID funded system provides a platform for tracking utility performance against key indicators for national- and regional-level managers. The system, installed in all 25 of Egypt’s water and wastewater companies, tracks a wide variety of data on a quarterly basis, including figures on utility finances, customer service, drinking water quality and efficiency of operations. The comprehensive and standardized set of indicators allows leadership to review performance, make accurate comparisons across utilities and detect inefficiencies. Mohamed Hassan, executive director of the Egyptian Water Regulatory Association, credits the USAID system for “allowing the water sector regulator to track the performance of water and wastewater utilities and customer-based level of service indicators, and assisting in tariff and licensing decisions.”

Today, a range of USAID systems and tools are being used by sector officials, making use of American technical expertise to improve local water management. Using these and other management tools, USAID is helping monitor performance, prioritize and track investments, and effectively make the case for water and wastewater investments.

 

Read other blog posts in this series:

USAID in the Middle East: Famine Early Warning Systems Network (Part 2)

Note: This is the second post in a 4-part series. Read part onepart three and part four.

A map of cultivation areas made by the FEWS NET famine early warning project helps decision makers adapt to and mitigate climate change.

In arid parts of the Middle East and North Africa, famine and climate-related food shortages remain critical development concerns. In sub-Saharan Africa, after devastating famines in the 1980s, USAID created the Famine Early Warning Systems Network – FEWS NET –to monitor and predict developments that affect food security. The system has been serving the region ever since. Among its accomplishments, FEWS NET is known for pioneering the application of satellite remote sensing and models to track and predict climate-sensitive aspects of food security.

There is a powerful interdependence between water availability and agriculture, health, nutrition, and political and economic development. In Yemen, for example, variable rainfall has decreased crop production, food prices are rising, and declining GDP growth and security diminish the population’s ability to obtain adequate nutrition. Today, more than 10 million Yemenis face food insecurity, as do 8 million citizens of Sudan and South Sudan. In Sudan, rainfall has declined by 20 percent since the mid-1970s, with acute impacts for pastoral communities reliant on rainfall for crop production.

Without a stable and sufficient food supply, little other development is possible. Climate change threatens to further destabilize the situation, and recent changes in weather patterns and rainfall have already exacerbated regional water resource management problems. Rain-fed agricultural productivity is particularly vulnerable to shifts in precipitation patterns. Resilience to climate change is critical to ensuring that broad-based development priorities can be met. As Jose Graziano Da Silva, director-general of the U.N. Food and Agriculture Organization, puts it, “there is no food security without water security.”

FEWS NET staff collaborates with U.S. Government agencies, national government ministries and international partners to collect data and produce objective, forward-looking analyses on more than 30 of the world’s most food-insecure countries. FEWS NET helps guide adaptation efforts by providing high quality analyses of recently observed climate trends.

The importance of early warning is critical. With adequate lead time, governments, development agencies and citizens have the opportunity to plan for and mitigate the impact of climate developments. FEWS NET provides continuous monitoring of weather, climate, agricultural production, prices, trade and other factors, and thus can predict and plan for emerging problems. Pioneering in its analytical approach, FEWS NET forecasts the most likely climate patterns up to six months in advance. To help government decision-makers and relief agencies plan for food emergencies, FEWS NET publishes monthly reports on current and projected food insecurity, up-to-the-minute alerts on emerging or likely crises, and specialized reports on weather hazards, crops, market prices and food assistance at www.fews.net.

Programs like FEWS NET are putting to work leading American science and technology in support of effective regional water management and decision-making. “Much of the information that we rely on comes from FEWS NET,” says Abdoulaye Diop, director of the World Food Program in Malawi. “It is quite valuable…no one else on the ground can provide this type of information.”

Read other blog posts in this series:

Improving Tuberculosis Treatment for Children

David Greeley, Senior Vice President at TB Alliance. Photo credit: TB Alliance

World TB Day is Sunday, March 24. 

Fighting tuberculosis (TB) is extremely tough on any patient. Treatment consists of multiple pills each day over the course of at least six months. The medicines often have significant side effects and adhering to treatment often infringes on a patient’s ability to work and interact with his/her family. As prolonged and harsh as it sounds, that is actually the best case scenario for a TB patient. Those who contract or develop TB that is resistant to “first-line” treatments (the most commonly prescribed TB medicines) will be prescribed a still harsher combination of thousands of pills and shots—a draining course of treatment with greater side effects that can last as long as two years. And even then, a clean bill of health is far from guaranteed.

As grueling and debilitating as TB treatment may be for an adult, a child who is infected with TB will face an even rougher road. Treatments for children with TB are the same for children as they are for adults, but the recommended dosages are different. However, pediatric-appropriate versions of TB treatment remain absent from the marketplace. In 2010, WHO issued new guidelines for pediatric TB treatments, however, in the years since, child-friendly TB treatments in the correct dosages have not been produced. Parents or caregivers are left to split or crush adult pills for children, estimating the proper amount of medicine. If they guess wrong, children can be undertreated, resulting in poor outcomes and the development of drug-resistant forms of TB.

Furthermore, because treatments are designed for adults, none of the medicines used to treat children come in formulations that are easy for children to take. This means every dose becomes an adventure for the little ones and their caregivers—a struggle lasting as long as two years in attempt to cure the disease.

As a parent, I find it hard to understand how children with TB can be so neglected. Even among TB patients, who are underserved as a whole, children are particularly vulnerable and face the toughest road to cure when sick. But we’re going to change that! USAID is teaming up with TB Alliance, which is dedicated to the research and development of better TB drugs, to change course, help our children, and brighten the future prospects for the youngest TB patients.

In this new partnership, efforts will promote new understanding of the problem that can help lead to the sustainable supply of new TB drug formulations for children. And a stronger emphasis on patient care will help the world’s youngest TB patients comfortably and confidently survive one of the most persistent diseases ever known.

Greener Pastures in Crimea’s Future

For those of us who have always had it, access to clean water is something that is all too easy to take for granted. We turn on the tap, cook and bathe, and water our lawns and gardens, without ever thinking of the complexities that bring us our clean water.  Others must constantly think about clean water because they have never had access to piped-in clean water in their homes, and have always made do by carrying water from the local well.

In the former Soviet Union, some communities once had access to clean water, but are now suffering the effects of crumbling infrastructure and increasing water demands. Nowhere is this more true than in the small communities scattered across Ukraine’s Crimean Peninsula.

USAID will utilize the existing Soviet-era pump facility (background) in Pervimaysky to irrigate farm fields for a rural community of 300 persons. Photo credit: Jason Gilpin, USAID

Crimea is an attractive region, with a wide variety of ecosystems, rainfall, sunshine, land use and people. For two years as a Peace Corps volunteer, I lived in Sevastopol, a city located on the peninsula’s south-western tip, and often traveled throught small villages and towns in Crimea where Ukrainian NGO colleagues and other volunteers were based. I saw firsthand how many people in rural Crimea go days or even weeks without water, particularly in summer. In many villages, the public water system operates for one or two hours a day only on a few days a week. Even quick showers are a luxury and residents use the brief time the water system is functioning to quickly fill up as many empty plastic containers as possible in order to live through the dry period. Bottled water is expensive for the average Crimean villager, whose monthly income rarely exceeds $200. Crimea is also growing as a tourism destination, further burdening  the overwhelmed public water system during the summer season.

The problem with poor water availability isn’t caused by a lack of water in the region. While Crimea is a fairly dry place, averaging just over 15 inches of precipitation annually, there are ample sources of underground  water and Dnipro river tributary water provided by aqueducts from the north. The challenge is transporting enough water from aquifers and aqueducts to households in order to satisfy seasonal demand during the periods of increased use. This is particularly true in spring and summer when people use this water to irrigate backyard cash crops, which are critical to supplementing rural residents’ annual income.

The USAID Project “Partnership for Sustainable Water Supply for Agriculture Development in Crimea (SWaSAD)” launched in July 2012 by our Ukrainian partner, Agrarian Markets Development Institute, is successfully demonstrating that with transparent planning, modest investment and strong community support, infrastructure improvements can be made that will bring reliable water service to residents in small communities in Crimea. The Project includes demonstration projects in three districts in Crimea: Saki, Pervimaysky and Razdolnensky.

I joined my colleagues from USAID in late February in visiting the communities selected for partnership on this project. In Saki, we heard from the project’s major stakeholders. A local farmer remarked that this project was “very important” in improving crop yields and local income, and that locals were “enthusiastic” about the prospect of reliable water in their communities.

In many ways, the objectives are simple: most of the project sites involve simply connecting the existing water sources, such as the water in a canal with homes along the streets in the villages, using simple irrigation pipes and pumps, so that people can irrigate their backyard cash crops with non-potable canal water without burdening the community’s drinking water system.

One of the project sites plans a broader-based agricultural application on large, communally-owned plots of land. The site we visited in Pervimaysky would restore the function of Soviet-era water infrastructure to irrigate fields farmed by 30 families. This, in turn, would support 300 beneficiaries in the nearby village, providing much-needed employment opportunities and increased economic activity for local businesses. The difference between an irrigated field and a non-irrigated field was fairly obvious and pretty stark — one field a bright green, the other a dull brown.

As tourism continues to develop in Crimea, water demands will continue to grow.  It is economically critical that the region develops a plan to supply reliable potable water to the tourist centers, while also allowing farmers to irrigate their crops, helping to fulfill Ukraine’s promise as the breadbasket of Europe.

What makes this project particularly unique is that USAID/Ukraine is implementing it with the support of the Development Grants Program, which is designed specifically to increase the capacity of locally-managed and operated organizations, thereby increasing local knowledge to sustain the results of USAID-funded initiatives after grant completion. As part of this initiative, our local implementing partner is improving its internal controls and management processes, and developing its human resources so that it can independently achieve results from similar activities.

In the end, we are not only helping Crimea increase its water security and improve the quality of life of local residents, we are also improving the ability of local NGOs to use their own skills and resources to continue to develop this critical region of Ukraine.

Water and International Cooperation

Christian Holmes serves as USAID’s Global Water Coordinator. Photo credit: USAID

As we celebrate World Water Day, it is important to consider this: only if we cooperate effectively, can we sustain the supplies of quality water necessary for human life.

The United Nations has set 2013 as the International Year of Water Cooperation. USAID addresses the global challenges of water in close cooperation with non-governmental and civil society organizations that undertake the critical frontline responsibility of developing and implementing water programs. Our partners are advocacy groups that bring both knowledge and passion to the challenge, governments that are dedicated to providing a better life for their citizens, and communities that best understand the challenges and solutions. We have reached out to universities that are creating innovative solutions, to the private sector that can build a new global economy while supporting sustainable development, and to international development and financial institutions that provide essential program development, implementation and financial support.

USAID supports water cooperation at the local, national and regional level. Over last 10 years, we have provided some 50 million people with water and sanitation services.

In Somalia, the School Environment and Education Development for Somalia (SEEDS) provides access to water, sanitation and hygiene facilities on school grounds, promotes hygiene education and trains teachers and government officials. The results thus far: 359 latrines constructed and another 189 rehabilitated in 114 schools; 213 hand-washing facilities installed in 90 schools and five water points completed. All told more than 150,000 people in these communities benefited, and student enrollment increased by more than 32,000. It’s important to note that of those students, 12,666 were girls whose parents would only allow them to attend school with the kind of private, girls-only latrines built as part of this project.

In Nepal, where 66 percent of households experience food shortages each year, USAID’s Nepal Economic Agriculture and Trade (NEAT) program is helping cut input costs and boost crop productivity by installing and rehabilitating irrigation systems and training local technicians to maintain them. That, along with parallel efforts that are part of this project, is expected to directly benefit over 300,000 Nepalese and indirectly impact millions in the country by improving the business environment, facilitating trade flows and strengthening fiscal policy.

We support a wide range of development activities to promote Trans boundary water cooperation. USAID and the University of Colorado Boulder are partnering to assess snow and glacier contributions to water resources originating in the high mountains of Asia that straddle ten countries.  This assessment will be crucial in helping to forecast the future availability and vulnerability of water resources in the region, beginning with accurate assessments of the distinct, separate contributions to river discharge from melting glacier ice and seasonal snow.

In the Asia-Pacific region, USAID has supported the efforts of WaterLinks to build the capacity of Asia’s urban water sector. WaterLinks paired water operators from Asia countries to share best practices to meet the demand for water and sanitation and address related issues like wastewater management and climate change resilience. WaterLinks facilitated more than 60 water operator partnerships, resulting in more than one million people gained improved access to safe water supply and sanitation services.

Also in this region, USAID supports the Mekong River Commission and the riparian countries to plan the sustainable development of water resources in the Lower Mekong Basin (LMB), where 60 million people live and 80 percent of them rely directly on the Mekong river system for their food and livelihoods:  USAID supports projects that seek to improve sediment flows and management; enhance scenario planning approaches and promote sustainable fisheries management

In Africa, to help meet these varied water demands across the Mara River Basin; in 2005  USAID provided funding to launch the Trans boundary Water for Biodiversity and Human Health in the Mara River Basin TWB-MRB project. The project has helped local communities develop new water services, refurbish nonfunctioning water systems, and improve sanitation services.

We also support organizations that will build global partnerships. Last year, USAID joined the Sanitation and Water for All Partnership which brings together governments, donors, civil society organizations, and development partners to achieve sustainable sanitation and drinking water.

As a member of The US Water Partnership (USWP), USAID is part of a national effort to unite American expertise, knowledge, and resources, and mobilize those assets to address water challenges around the globe, especially in the developing world. This week, the USWP recognized thirteen new members, including think tanks, universities, government agencies and for-profit groups willing and ready to join a growing number in this country concerned about global water issues.

While there are multiple ways to cooperate, a constant supply of quality water is the fundamental life force that drives us to work together to safeguard this precious resource.

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