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Archives for Sub-Saharan Africa

As Featured in FrontLines: Many Paths to Better Health

Kelly Ramundo is Managing Editor for FrontLines Magazine.

April 2010 Frontlines


The U.S. Government, through USAID and other agencies, is working with the developing world to improve health care and health outcomes on myriad fronts. When it comes to improving global health, there is no magic elixir. Instead, progress comes by way of the compounded hard work of dedicated professionals across sectors and regions. Although paths may diverge along with way, the goal is shared: saving and improving lives worldwide.

Mass vaccination campaigns using the new vaccine reached nearly 20 million people in Burkina Faso, Mali, and Niger. Photo Credit: Gabe Bienczycki

From keeping life-saving health care facilities on the electrical grid in Haiti, to contributing to the decade-long quest for an epidemic meningitis vaccine in Africa, to partnering with the government of Swaziland to ensure that a crippling HIV_AIDS epidemic does not become a legacy of future generations, to building up the capacity of Iraq’s civil Service, USAID’s efforts are having an impact in line with our nation’s values and true to our mission of contributing to a more stable and secure world.

Visit the current edition of FrontLines for these and more stories on the various paths USAID is helping to forge to improve global health and shape a better future in Iraq.

Responding to Urgent and Long-Term Needs in Sudan

Earlier this month, I visited Sudan, a nation poised to separate in July into two independent states following a peaceful referendum in January that USAID helped carry out. Since my visit, violence has erupted in Abyei, a disputed area on the north-south border, and threatened the fragile peace in the region.

Resolving the status of Abyei has long presented a difficult challenge. During my visit—together with UK Secretary of State for International Development Andrew Mitchell and Norway Minister of Environment and International Development Erik Solheim—we stressed to the Government of Sudan and Government of Southern Sudan our concern about the destabilizing impact of uncertainty over the Abyei Area’s future.

USAID Administrator Rajiv Shah at a press conference in Juba on May 7th. Photo Credit: Government of Southern Sudan.

In response to the violence, we quickly activated our contingency plans. USAID partners are on the ground in areas where thousands of Sudanese have been displaced by fighting.  And we are working with UN agencies and non-governmental organizations to provide emergency food aid, medicine, water, shelter, hygiene kits, and other assistance.

As we continue to address the emergency needs of people in and around Abyei—as well as in areas across the south affected by violence—we remain focused on helping bring stability and effective development to Sudan over the long term. During my visit, I met with Government of Southern Sudan President Salva Kiir Mayardit and announced that the United States would host an international engagement conference for southern Sudan after its independence.  The conference will enable the new nation to collaborate with other governments and the private sector on development priorities, especially in agriculture.

Nearly 87 percent of southern Sudanese rely on agriculture, livestock, or forestry to make a living.  Ninety percent of southern Sudan’s land is arable, but less than 10 percent is currently cultivated.

I met men and women farmers, who described to me how they struggle to expand their farms, buy quality seeds and fertilizer, and move their products to market.  Because of the challenges they face, the agricultural yield in southern Sudan is only 0.3 metric tons per hectare, despite good conditions and available land.  But the average yield worldwide for sorghum, for example, was 1.46 metric tons per hectare in 2009-10, according to the U.S. Department of Agriculture.  It’s easy to see how much potential is being lost.

I’m proud that this is an area in which the United States and our partners can help.

During my visit, I signed a communiqué with the Kingdom of the Netherlands, the Alliance for a Green Revolution in Africa, and the International Fertilizer Development Center to work with the Government of Southern Sudan to develop the commercial agriculture sector. By increasing productivity, supporting agribusinesses, and improving research and technology, we can begin the process of an agricultural transformation in southern Sudan.

We are working in many other areas to help bring basic services and opportunities to the people of Sudan. In Juba, I especially enjoyed visiting a USAID-supported radio station that not only provides news and information, but also offers lessons in English and mathematics that schools use as part of their regular instruction.  It was a powerful and effective way to extend the reach of education.

As the independence of southern Sudan approaches, we will continue to help build a peaceful, stable region and a better future for all the people of Sudan.

How Free is Your Media? A USAID-Funded Tool Provides Insight

On May 3, the world celebrated World Press Freedom Day. Reflecting on the day’s events, a few important questions arise about what role the media plays in a community and in a democracy.

First, how does freedom of the press compare to freedom of speech? Not only do journalists need freedom to speak and write without fear of censorship, retribution, or violence, but also they need professional training and access to information in order to produce high-quality work. Furthermore, journalists need to work within an organization that is effectively managed, which preserves editorial independence. People need multiple news sources that offer reliable and objective news, and societies need legal and social norms that promote access to public information.

Second, why is the media important? We care about the media because it is a powerful and critical tool for ensuring that citizens understand the state of their community, country, and world. In this way, citizens are equipped to participate in the democratic process. Media gives a voice to the people and helps to hold governments and institutions accountable for their actions. Media is also the way to spread critical community messages, such as how to prevent HIV infection, where to vote in the next election, and how to address difficult issues with balanced, well-informed analysis so as to promote peace and tolerance.

Lastly, how do we measure how well (or poorly) the media sector is functioning, and how do we gauge progress? With great interest in this subject, USAID has supported comprehensive, multi-year assessments carried out by IREX, which are reported in the Media Sustainability Index (MSI). This tool analyzes challenges in the media sector by country and allows for tracking of progress from year-to-year.  In this way, it helps USAID to better identify media development gaps and possible areas for technical assistance. The 2009 edition of the MSI for Africa is now available, and editions are also available for the Europe & Eurasia and Middle East regions. With multiple years of surveys now completed, the tool spurs discussion and understanding of both the current status of the media in a given country and region as well as the trends over time.

The MSI is both a quantitative and qualitative tool. It draws on a set of panels composed of local media and civil society experts from each country, and the resulting index assesses five objectives important to a successful media system, which include the quality and professionalism of journalism as well as the management and independence of media businesses. The results also capture the rapidly changing new media landscape on the continent.

MSI’s data is used by a variety of advocacy and human rights groups, as well as USAID, other donors, and academics who are interested in tracking the role of the media in larger development processes. Findings from the MSI can inform how we channel our resources; for example, the latest edition of the MSI reveals that weak business management and professional journalism skills are some of the key factors challenging the media sector in African countries today.  In response, USAID programming in countries such as Liberia, Nigeria, and the DRC are better cultivating local skills and building the professional capacity of media.

USAID Helps a Father Find His Voice

When Angelo Domingos’ daughter came to him with news that she would be re-enrolling in school, his heart leapt with joy.  Only a short time had passed since she, like many young Mozambican girls, had dropped out of school after finding herself pregnant at a young age.   Angelo’s other daughter had followed suit, and it seemed likely that they were destined for the downward spiral of pregnancy and lack of education that  affects too many vulnerable young women in Africa.

As a nurse of twenty-four years, Angelo knew from both his professional and now personal experience that young girls are often the most susceptible to predatory adults, sexually transmitted diseases, and the trials that come from having few, if any, role models in the community.  Desperate to help his daughters find a way out of the seemingly intractable problems burdening his family, Angelo began to volunteer with a local program funded by USAID through PEPFAR, and implemented through the Johns Hopkins University Center for Communication Programs.

This initiative, called Avante Raparigas! (Go Girls!), aims to educate communities on how to communicate more effectively with young women about the endless series of dangers, difficulties, and discouragements they are so often forced to endure.   The program excels at bringing parents and children together to discuss difficult topics:  risky sexual behavior, peer pressure, alcohol abuse, and even the prevalence of pornography within the community.  Using a series of visuals, brochures, manuals, and trainings, the Go Girls! Program helps parents navigate the sensitive and often awkward conversations they need to have with their children to support safe and healthy futures.

Young women in Mozambique are disproportionately affected by the HIV epidemic.  With a specific focus on reducing the number of HIV infections in girls aged 10 to 17, Go Girls! has reached out to over 1,000 community leaders in eight different villages and has touched the lives of over 5,000 individuals in those targeted areas.  While Angelo had signed up as a volunteer to help as many young women as possible, the most immediate benefit was the improvement of his  relationships with his daughters.

“My daughters were in the target group that received training in life skills and adult-child communication,” he said at the recent closing ceremony held on May 11th in Maputo, Mozambique’s capital.  In front of an audience of dozens that included U.S. Ambassador to Mozambique Leslie Rowe, Angelo made it clear to all those listening: “My daughters have benefited from the course.”  During his speech, he talked movingly of how they achieved an early victory together when, after learning that many young girls were being lured by older men into video houses showing pornographic films, people in the program convinced the establishments to stop the practice of showing adult films during the day.  They even got the adult video houses to promise not to allow admission to any underage girls, no matter what the hour.

Jose Baessa, a 47 year old school headmaster, is another who has witnessed first-hand the results of this program.  Jose asked Go Girls! to work with his students, and quickly noticed the difference in the way the young girls carried themselves, and communicated with other. Most tangibly -they were no longer becoming pregnant.  In fact, just one year into the program, teen pregnancies in the Mogovolas District of Nampula Province—where Jose was headmaster—dropped all the way to zero.  A shocking—albeit thrilling—turn of events for a community too often beset by bad news. Jose even noted a closer relationship between teachers and students after Go Girls! began their work.  In one memorable case, school teachers were able to successfully intervene with four girls who were involved in prostitution—a practice all too common in rural Mozambican communities.  “Now the girls are enrolled in a training course for teachers,” Jose said, beaming with pride.

Not all the benefits have been anecdotal.  Results from the Go Girls! evaluation suggest that the lessons learned in meetings remain with the program’s beneficiaries – over 90% of adults who participated in Go Girls! recall the content of the adult-child communication sessions they attended, such as topics on how to talk to children about safe sex and HIV/AIDS.  Girls whose parents participated in the adult-child communication program reported improved relationships with their mothers and fathers, and girls whose teachers were in the program reported feeling safer in school relative to girls not in the program.  Of course, imitation is the most successful form of flattery and to that end many principals and teachers are hoping to replicate the program with children outside the current target ages of 10 to 17 years old.

The need for action is strong.  With HIV infection rates at extremely high levels amongst Mozambican youth, a program like Go Girls! that targets HIV reduction can make a life or death difference to vulnerable young women.  As U.S. Ambassador Rowe noted in her speech at the ceremony, “Survey results indicate that Mozambican girls aged 15 to 24 are currently afflicted with an HIV prevalence of 11.1% whereas their male counterparts only have a corresponding prevalence of 3.7%. This is unacceptable, period. It is up to all of us to work together to make sure that our programs – across all sectors – address the vulnerabilities of women and girls, especially to HIV and AIDS.”

While the bigger picture is very important to someone with a strong social conscience like Angelo Domingos, it was clearly his personal benefit from the program that brought him the greatest joy.  Despite all the adversity his daughters would continue to face, he could relax knowing that they were back on track to receive an education and hopefully, a brighter future.

USAID Brings Electricity to Key Towns in Western and Eastern Equatoria

USAID brought electricity to two key towns in southern Sudan in February— Maridi in Western Equatoria and Kapoeta in Eastern Equatoria—as part of USAID’s effort to provide basic infrastructure to the underdeveloped and war-affected region.

Electric power in the two towns will improve community security and the ability of local merchants to conduct business; will benefit government institutions, health care facilities, and students studying after dark; and will reduce reliance on polluting energy sources such as diesel for generators and kerosene.

More than 80 percent of southern Sudan’s rural population does not have access to electricity. “We know this project will have an immense impact on promoting economic activity, enhancing security through street lighting, improving reliability of electricity to schools and clinics, and providing convenience to households,” said U.S. Consul General in Juba Ambassador R. Barrie Walkley, at the inauguration of the Kapoeta power plant with Government of Southern Sudan officials on February 4. The Maridi plant was inaugurated February 23.

Each of the two new plants can serve approximately 900 customers, and were built so that future expansion could be added. In 2008, USAID brought electricity to Yei in Central Equatoria, and helped establish southern Sudan’s first electrical cooperative.

Read more about our projects in southern Sudan.

USAID Joins Netherlands, Agriculture Organizations to Boost Southern Sudan Agriculture

USAID Administrator Rajiv Shah today in Juba, Sudan, signed a communiqué on behalf of the U.S. Government to help boost private sector engagement in agriculture in southern Sudan, where the vast majority of people rely on agriculture for their livelihood.  In spite of enormous potential of the agriculture sector, most southern Sudanese farmers grow only enough to feed their families, but not to earn an income.

Listen to part of his speech at the event:

USAID, the Netherlands, the Alliance for a Green Revolution in Africa, and the International Fertilizer Development Center signed the communiqué, agreeing that they will help develop southern Sudan’s commercial agriculture sector by increasing agricultural productivity, supporting agribusinesses, and improving agricultural research and technology through:

  • Expanded use of quality seed and integrated soil fertility management
  • Development and expansion of an agro-dealer network
  • Revitalization of local agricultural training and research centers
  • Development of policies and regulations that support business development, sound regulatory practices, and innovation
  • Development of institutions that promote and support market infrastructure and information systems
  • Increasing farmers’ and entrepreneurs’ access to finance.

“Any effort to transform agriculture has to be comprehensive,” Shah said.  “The days of doing a small demonstration project in one part of a county and calling that agricultural development must be over.” Noting that he met with smallholder farmers from surrounding villages before the event, he added, “It is the smallholder farmers, most of whom are women, who will determine whether or not this effort succeeds.”

The event was held at Rajaf Farm, a commercial farm near Juba, which is financed by three British and seven Sudanese partners on land that was previously not being farmed or otherwise utilized.  They agreed with the population of adjoining Rajaf Village to help establish a community farm that the villagers will plant and manage, with assistance from the commercial farmers.  The collaboration has brought employment and agricultural training to the village residents, who previously did not earn a daily wage.  Now they earn 3 Sudanese pounds (approximately $1) per hour ($8 per day) to work at Rajaf Farm and are learning technical skills.

Working Together for Healthy Communities in Senegal

Lois Quam is the Executive Director of the Global Health Initiative.

In the Senegalese village of Nianing, I joined a group of elderly ladies in a circle of plastic chairs as they sang a simple song, a drum keeping time with their claps.  Despite their years, each stood up one by one to dance a few steps.  But this “grandmothers’ group” does more than dance – they counsel young wives of the village to limit childbearing from 18 and 35 years of age and space births two years apart.

Executive Director of the Global Health Initiative Lois Quam Visits Senegal. Photo Credit: GHI

I met lots of other people in the village who cared about the good health of their community too:  political and religious leaders, volunteer health workers, and the counterpart to the grandmothers, a newlyweds association.  Their focal point is a “health hut,” which USAID supports through equipment and training of volunteer community mobilizers and health practitioners.

The health hut belongs to the village and you can see the difference it makes.  It’s been four months since they’ve had a positive malaria test, and in March nearly 40 women have come in to receive family planning services.  At the district health post down the road, we learned that they hadn’t lost a mother since the renovation of its maternity ward, thanks to safe, delivery services provided by qualified personnel – including a young, dynamic midwife named Felicity, who had been recruited by the district health post health committee.

As they opened their records for me, I could see their pride in the statistics they shared, which testified to the fact that practically everyone is engaged in the good health of the community. It moved me to see the way village leaders and extended families work together on a daily basis to develop and operate the health care services that they really need.

During my trip, I also met with religious, civil society, and implementation partners in a lovely reception at the Ambassador’s residence.  A highlight of this evening was meeting the Senegalese military leaders engaged in combating HIV/AIDS.

You can see that they have been built up over time with the long term support of the American people.   The health hut – and their good health – belongs to them.  I am really proud of the work that the United States government, through USAID, the Peace Corps, the Department of Defense, PEPFAR and Centers for Disease Control have done to help make that possible. And I am so proud of how effectively our team works together.  To learn more about health huts in Senegal, click here.

Hopes and Challenges for the World’s Newest Country

Juba, Sudan:   She sat in the shade of a transit tent at this port city on the White Nile, surrounded by her worldly possessions and eight children.  A symbol of the hope and the challenges facing south Sudan as it moves towards independence on July 9, the woman arrived a week earlier by barge from Khartoum, where she had lived for decades with her now-deceased husband.  With family roots in the south, she responded to the January referendum that overwhelmingly approved independence for the region by loading her children and furniture on a barge and heading south.  When she arrived in Juba, she kissed the ground and sang songs of praise all night.

But now, she worries about the future.  When I met her, she felt that her prospects were few: her money had run out; she had no land or job possibilities, no experience in farming, and no relatives or friends in the south; her children were unlikely to attend school, which required fees and purchase of uniforms.  She still believed she made the right move, but the lines creasing her forehead betrayed new doubts.

After decades of civil war that caused up to two million deaths, the separation of north and south Sudan will occur in July.  There are still tough negotiations underway to resolve remaining separation issues – including the exact location of the border, citizenship for southerners still in the north and northerners still in the south, distribution of revenues from oil production mostly in the south, and the status of the border area of Abyei – but most experts expect the separation to occur without significant new north-south violence.

The new country of south Sudan will have much going for it, including leaders publicly committed to democracy, transparency, human rights and socio-economic empowerment.  It also stands to benefit from revenues from oil production and, perhaps most importantly, the strong commitment and friendship of the international community.

At the same time, the challenges for south Sudan are daunting.  The new country will rank among the world’s worst on the socio-economic scale, with high rates of infant and maternal mortality, widespread illiteracy—up to 97 percent for women—and a lack of potable water and sanitation.  Despite significant oil revenues, the south lacks the most basic infrastructure such as roads, schools, hospitals, and houses.  The government lacks trained personnel, armed militias need to be demobilized and reintegrated, and civil society organizations need to be revitalized.   There are also continuing disputes over land, as well as the risk of spill-over from conflict in northern Uganda and Darfur.

The success of the new state is of vital importance to the international community.  South Sudan will border seven states – Chad, Central African Republic, Congo, Uganda, Kenya, Ethiopia and northern Sudan – and instability in south Sudan could destabilize this already fragile region.  South Sudan has been plagued by droughts and famines, and the need for humanitarian assistance will likely remain high.  South Sudan also sits astride the White Nile, and Egypt and north Sudan in particular want the life-blood of their countries to be secure.

Equally important, as a prime mover of the 2005 agreement that secured north-south peace, the United States is bound to its legacy.   USAID, the State Department and other US agencies are working with major development partners to support south Sudan’s transition by strengthening government institutions, empowering citizens and civil society, supporting the delivery of health care and education services, promoting productive sectors such as agriculture, and addressing grievances that fuel conflict.  These steps are critical to providing a visible “peace dividend” to a war-weary population with high expectations for the fruits of independence.  At the same time, we are helping build the basis for long-term economic and stability: a strong and independent central bank, a credible monetary policy and exchange rate regime, and a transparent public financial system to manage oil, tax and assistance revenue.

Working with the UN and other organizations, our government is also assisting returnees to reintegrate in their areas of origin in the south, including some 300,000 since last December alone.  We support the registration and processing of returnees at Juba’s port and elsewhere; provide relief supply to vulnerable families, such as blankets, mosquito nets, and plastic sheeting; and support communities that are absorbing high numbers of returnees with health, water, sanitation, and job opportunities.

The story of the migrant woman in Juba took a positive twist after our encounter.  Like other returnees, she is receiving a three-month food ration from the UN World Food Program.   Given her vulnerability, the UN High Commissioner for Refugees will help her build a basic home, provide training and support to help her set up a small business, and visit her regularly to monitor her situation until she is fully settled.

With the combined efforts of the international community, the future has begun to look brighter for her.  Similar support and attention can also brighten the future for the rest of southern Sudan as it prepares to become the world’s newest nation.

Donald Steinberg serves as Deputy Administrator of the U.S. Agency for International Development.  He previously served as U.S. Ambassador to Angola and as a member of the UN Civil Society Advisory Group for Women, Peace and Security.

Ox Plow and Other Training Help Southern Sudan Farmers Increase Agricultural Yields

Residents of southern Sudan have long relied on subsistence farming utilizing traditional methods. These practices, such as hand tilling and broad casting of seed, result in crop loss, disease, and infestation, and severely limit farmer’s yields.

USAID is working to overcome these challenges by introducing new technology and farming methods to residents of Northern Bahr el Ghazal, Warrap, and Unity states.

Maliah Gai Luoi, a USAID beneficiary from Lingere Boma in Mayom County, Unity state, is learning firsthand the benefits of ox plow technology, proper spacing and planting techniques, and improved seed varieties.

Maliah returned to Lingere in 2000 after years of living as an internally displaced person at a camp on the outskirts of Khartoum. At 30 years old, he is responsible for 18 dependents, whom he had been supporting with a small retail shop and cattle trading business. Maliah first saw ox plow farming during his time in Khartoum, but never considered that he would one day practice it himself. When USAID offered ox plow training in Mayom County during June 2010, Maliah was quick to sign up.

After 30 days of training on the proper commands and instructions for his bulls, BRIDGE provided Maliah and another farmer with an ox plow to share. When he began farming his fields, Maliah saw that ox plowing was an easy, quick, and effective method of cultivation. He was amazed that he was able to plow a plot of land in two days.

In addition to the ox plow training, Maliah participated in other USAID trainings on planting techniques, crop spacing, pest control, and weeding, and received a grant of improved maize seed. When harvest season arrived, Maliah experienced a record yield from his maize crop, something he attributes directly to the training and USAID assistance. “I’m so happy, imagine I have harvested 10 bags, nearly 1,000 kilograms, in just one season. This year, food will not be a problem for my family,” he said.

News of his and others’ success with ox plow technology traveled rapidly through the surrounding villages. One farmer said, “Why are we dying of hunger if we could produce so many bags of maize using our bulls?”

Our Sympathy to the World Food Programme

On behalf of the U.S. Agency for International Development, I would like to extend our heartfelt sympathy for the loss of Santino Pigga Alex Wani of the World Food Programme (WFP). Our deepest condolences go to his colleagues at the World Food Programme as well as to Santino Pigga’s friends and family. We are deeply saddened by his loss of life and the tragic circumstances that led to his passing in Southern Sudan.

In Southern Sudan and throughout the world, WFP’s dedicated staff face dangerous and challenging conditions as they provide emergency food aid to people in desperate need. We applaud the staff at WFP for their bravery, dedication, and commitment to the world’s hungry.

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