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Giving Birth in Ukraine: So Different From My Parents’ Experience

Getting ready to become a mom. /Olya Myrtsalo, USAID/Christian Kitschenberg

Getting ready to become a mom. /Olya Myrtsalo, USAID/Christian Kitschenberg

In my 13 years working in outreach and communications for the USAID mission in Ukraine, I’ve had a chance to visit many USAID projects and to hear and write many success stories on how what we do has impacted people’s lives. But one project made my heart beat especially fast.

Every time I visited the maternity wards of hospitals cooperating with the USAID Maternal and Infant Health Project, no matter whether in Simferopol or Luhansk, Lviv or Lutsk, I always experienced a warm feeling of happiness for families that had taken advantage of a unique opportunity to experience the birth of their child in an individual family-friendly room, forming a lifelong connection by sharing an important moment.

My parents were not so lucky. Back in Soviet times, my mother delivered me in a very different environment. She shared the birth of her child in a common room with another woman in labor, in a cold, bare, spouse-free environment, on a proletarian Rakhmanov delivery chair while in labor for 24 hours.

When I was finally born, I was immediately whisked away to a separate nursery for newborns. A nurse brought me to my mother on schedule to be fed and then immediately taken away, ostensibly to prevent infections. Visitors were forbidden, including my father.

Standing outside the hospital on a cold winter day, my father tried to get a glimpse of his newborn daughter by looking at a bundle of humanity my mom was holding at the window on a fifth-floor delivery room, some 50 meters away. Hearing my parents recount this story, I felt so sorry for my lonely and scared mother, for my distanced and confused father, and for myself—for being separated from my family at such a critical, early hour of my life.

Thinking about having my own children, I often thought: “I better hurry up and find a maternity hospital before the USAID project ends.”

Father-son bonding. Levko is warmed on his father’s chest for two hours to prevent hypothermia as his mother recovers from a C-section. /Olya Myrtsalo, USAID/Christian Kitschenberg

Father-son bonding. Levko is warmed on his father’s chest for two hours to prevent hypothermia as his mother recovers from a C-section. /Olya Myrtsalo, USAID/Christian Kitschenberg

My son decided to come into this world three years after the project ended. Nevertheless, when it came to choosing a delivery hospital, I turned to maternity staff and wards that had worked with USAID.

The Zhytomyr Oblast Perinatal Center was among the first to join the USAID Maternal and Infant Health Project and was dubbed a project “champion.” It was among the leaders in breaking from Soviet practices and embracing World Health Organization-endorsed, evidence-based prenatal practices.

Headed by the dedicated Dr. Yuriy Vaisberg, the Zhytomyr maternity hospital quickly earned numerous quality awards. More importantly, it became a hospital where women and their families from neighboring cities and oblasts chose to deliver their babies, despite the distance they had to travel.

While I saw the benefit of giving birth at this facility, it took Christian, my partner and father of our child, longer to come around. He couldn’t understand why I decided to travel 100 kilometers outside of Kyiv to check out a maternity hospital.

When we arrived for a visit in April 2015, I found the hospital as I remembered it. The walls still displayed the project posters explaining all the stages of labor, the multiple delivery positions to choose from, the benefits of breastfeeding, and the danger and causes of Sudden Infant Death Syndrome. It also continued to provide courses on breastfeeding and antenatal and postpartum counseling to women and their families.

Our little Levko came into this world on a beautiful sunny day on June 18 at a sturdy 9 pounds, 5 ounces, and 22.4 inches in length. As I had undergone a C-section, Levko was put on his father’s chest for two hours to prevent hypothermia. Whoever came up with this procedure should receive a great prize because it creates an incredible bond between the parent and child. As Christian explained, he felt a strong bond with Levko from the first touch.

After two hours of this, Levko was medically examined and then brought back to me for his first breastfeeding. The three of us spent the next five days together in a hospital room which looked more like a room in any home rather than a hospital ward. I could see and hold my son whenever I wanted and feed him whenever he was hungry or needed comfort. Christian helped change Levko’s diapers, held and calmed him whenever he was cranky, and cared for me as I recovered from the C-section.

Getting ready to go home. /Olya Myrtsalo, USAID/Christian Kitschenberg

Getting ready to go home. /Olya Myrtsalo, USAID/Christian Kitschenberg

As we left the hospital, I couldn’t help but compare how different our delivery experience was from that of my parents. I am grateful to the Center for valuing the importance of these necessary new practices recommended by the USAID project and continuing to offer them. The training and equipment that USAID provided made it possible for these dedicated nurses and doctors to continue to help women give birth safely and comfortably. I hope that, in the not too distant future, all of Ukraine’s maternity hospitals will adopt similar practices.

USAID’s Maternal and Infant Health Project, which ran from 2003 to 2012, provided technical assistance for maternal and child care to 20 regions in Ukraine. More than 50 percent of births in the country today directly benefit from those perinatal technologies.

ABOUT THE AUTHOR

Olya Myrtsalo is a senior development and communication officer in USAID’s regional mission for Ukraine, Belarus and Moldova.

If Fighting Hunger Were an Olympic Event

Emmanuel Ngulube visits programs in the field. /USAID

Emmanuel Ngulube visits programs in the field. /USAID

It’s been a bad two-year stretch in Malawi: The southeast African nation has suffered back-to-back devastating natural disasters. In 2015, record-breaking flooding left tens of thousands stranded in southern Malawi, and this year El Niño brought historic drought and widespread crop failures, pushing 6.5 million people into dangerous levels of food insecurity.

One of USAID’s best weapons for fighting hunger in Malawi is Emmanuel Ngulube, an officer with the Agency’s Office of Food for Peace who has dedicated his entire career to fighting hunger across Africa.

Emmanuel grew up in Zambia and remembers the effects of drought in the 1980s. “We were lucky,” he said, “My father worked for the mines and he could afford to buy food imported by the government, but others relied on emergency food assistance.”

Before beginning his career with USAID 10 years ago, Emmanuel was already heavily involved in food security issues as a planner in the Office of the Minister of Agriculture in Zambia, as well as a manager in Zambia’s Food Reserve Agency.

As a program specialist for Food for Peace in the USAID mission in Zambia, Emmanuel spent four years deepening his passion for helping rural communities find long-term solutions to hunger. That fervor traveled with him when he relocated to Malawi to help communities recover from crises and develop lasting food security.

On the banks of Shire River in Nsanje district, Malawi /Emmanuel Ngulube

On the banks of Shire River in Nsanje district, Malawi /Emmanuel Ngulube

Reflecting on his career, Emmanuel said, “The more years I work in food security, the deeper my roots grow and I become more passionate about it.”

Emmanuel’s favorite part of his job is getting out into the rural communities to meet with people, work together and see the fruits of his work flourish. He says he’s always impressed at how many ideas the communities contribute to become more resilient and break the chronic cycle of hunger and poverty.

One woman’s innovative idea in particular stands out to Emmanuel: Ezelyn Kazamira participated in a USAID-funded Village Savings and Loan group and used her dividend to purchase and rent out a motorized pump to farmers in her village to assist with irrigation.

According to Emmanuel, “Not letting development gains be eroded by recurrent floods and drought or climate change is the biggest challenge [to USAID’s efforts to improve food security].”

He’s referring to disasters such as the historic floods in 2015, during which Emmanuel helped USAID and the U.N. World Food Program successfully preposition stocks of food in order to reach the communities hit hardest. Or regional disasters like the Ebola outbreak—Emmanuel’s most memorable and biggest emergency to date. He, alongside others in USAID’s disaster assistance response team, made sure families could still access food, despite closed borders, limited movement and depleted markets.


In the midst of the Ebola crisis, another less visible crisis arose–a food crisis. / USAID

Despite these food security challenges, food insecure families are in good hands with Emmanuel on the ground. For the last 10 years, he has been championing both emergency and development food assistance efforts. And if food assistance were an Olympic event, Emmanuel Ngulube would win a gold medal.

ABOUT THE AUTHOR

Emma Fredieu is an information officer for USAID’s Office of Food For Peace. Follow FFP’s tweets @USAIDFFP.

A Behind-the-Scenes Look at What It Takes to Deploy with the World’s Only International Volcano Response Team

On Christmas Eve 2008, I got a phone call that turned into a professional and personal opportunity of a lifetime. On the other end of the line: the acting director of USAID’s Office of U.S. Foreign Disaster Assistance (OFDA).

The Ol Dionyo Lengai Volcano in Tanzania had been erupting explosively since 2007, and the Government of Tanzania was requesting assistance from the U.S. to determine how much of a threat “the Mountain of God”—in local Maasai language—posed to people living nearby.

Standing in Target, in the midst of last-minute shopping, my first thought was “Can this wait for a few days?” But I knew all too well that the approximately 1,500 potentially active volcanoes around the world never take a vacation.

Ol Dionyo Lengai Volcano means “Mountain of God” in local Maasia language. Photo taken February 4, 2008/ George Seielstad

Ol Dionyo Lengai Volcano means “Mountain of God” in local Maasia language. Photo taken February 4, 2008/ George Seielstad

USAID’s Volcano Disaster Assistance Program (VDAP) has responded either in-country or remotely to hundreds of potential volcanic events, trained scientists and others in 23 countries to respond to potential eruptions, and helped partner organizations save tens of thousands of lives.

It is the only international response team that deploys around the world to help prevent eruptions from becoming disasters. And this year, we’re celebrating 30 years.

The program began in 1986 in response to the tragic eruption of Nevado del Ruiz Volcano in Colombia, which killed more than 23,000 people from volcanic mudflows. Today, at the request of affected governments, VDAP teams help fellow scientists monitor volcanic activity, assess hazards, generate eruption forecasts, and develop early warning capabilities to get people out of harm’s way.

I work for the U.S. Geological Survey (USGS), but for the past 12 years I’ve been on loan to OFDA, where one of my duties is monitoring the latest reports of volcanic activity to evaluate the risks they pose and make recommendations on how we should respond.

Gari Mayberry (right) with a guide in front of Ol Dionyo Lengai Volcano in January 2009. / Thomas Casadevall, USGS

Gari Mayberry (right) with a guide in front of Ol Dionyo Lengai Volcano in January 2009. / Thomas Casadevall, USGS

And shortly after that New Year’s Day in 2009, I got on a plane to Tanzania with two other members of the VDAP team—putting those skills to use on the ground.

VDAP team and scientists from the Geological Survey of Tanzania respond to Ol Dionyo Lengai Volcano in Tanzania. / Gari Mayberry, USAID/USGS

VDAP team and scientists from the Geological Survey of Tanzania respond to Ol Dionyo Lengai Volcano in Tanzania. / Gari Mayberry, USAID/USGS

My first VDAP deployment was an incredible experience. Ol Dionyo Lengai is a one-of-a-kind volcano that spews a unique natrocarbonatite lava that erupts black but turns white when it cools and has a much lower temperature than other types of lava.

Naiyobi village, located about 15 km west of Ol Dionyo Lengai, had been most affected by eruptions with ash falling repeatedly in the village. / Gari Mayberry, USAID/USGS

Naiyobi village, located about 15 km west of Ol Dionyo Lengai, had been most affected by eruptions with ash falling repeatedly in the village. / Gari Mayberry, USAID/USGS

But is the volcano safe? To figure that out, we worked with geologists from the Geological Survey of Tanzania and the University of Dar es Salaam to conduct hazard assessments.

It may sound mundane, but it was hands-on work. Scientists dug into ash deposits to get an idea of how much volcanic material had erupted and could impact populated areas. We hiked for miles around the volcano looking at past deposits to try to piece together the mystery of its previous eruptions, to give us a better idea of what it is capable of doing in the future.

Our research found that the location of the village, up on a ledge, in full view of the volcano, would provide protection from pyroclastic flows—fast-moving currents of hot gas and rock— and other deadly hazards should an eruption occur.

A VDAP team member consults with scientists from the Geological Survey of Tanzania while children observe. / Thomas Casadevall, USGS

A VDAP team member consults with scientists from the Geological Survey of Tanzania while children observe. / Thomas Casadevall, USGS

I love this volcano. It’s very off the beaten path, usually dwarfed in popularity by neighboring Mt. Kilimanjaro, and immersed in amazing wildlife. Working among the people who live around the volcano and make it part of their lives was magical.

After assessing hazards at Ol Dionyo Lengai Volcano in Tanzania as part of a VDAP team, geologist Gari Mayberry briefed Tanzanian President Kikwete at the President’s Office in 2009. / Embassy staff

After assessing hazards at Ol Dionyo Lengai Volcano in Tanzania as part of a VDAP team, geologist Gari Mayberry briefed Tanzanian President Kikwete at the President’s Office in 2009. / Embassy staff

You might think: Who would want to live near a volcano? But traveling to the villages and seeing the stunning contrast between the dry, bareness of the volcano against the lush, green land of nearby Naiyobi village, you could see why people make their homes there. It’s simply beautiful.

I feel really proud working with this amazing VDAP team. As an African-American scientist, I know that while volcanology is fairly well represented by women, there aren’t that many minorities working in the field. It’s probably why Tanzanians found it interesting that someone who looked like them was coming from America to work with their scientists.

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Working side-by-side with local scientists helps VDAP further its unofficial mission: Make connections and build relationships worldwide, which are integral to the work we do. It’s what we like to call science diplomacy.

It has been nearly eight years since that incredible experience, and I continue to work as the liaison between USGS and USAID, and to focus on reducing the risk from geological hazards, including evaluating the risk from volcanoes.

One thing has changed however. Now I am a mother to two young children. I hope I get the opportunity to take them to Tanzania to see my favorite volcano someday and meet the amazing scientists who deal with its threats.

ABOUT THE AUTHOR

U.S. Army War College Students See International Development in Action to Rebuild Haiti

An international development class at the U.S. Embassy in Port-au-Prince. Photo by Mark White, USAID

An international development class at the U.S. Embassy in Port-au-Prince. (Mark White / USAID)

Benjamin Franklin once said, “Tell me and I forget, teach me and I may remember, involve me and I learn.”

Those were my exact sentiments when I escorted 16 graduate students from the U.S. Army War College to Port-au-Prince, Haiti , earlier this year. These students had signed up for an international development class under the Peacekeeping and Stability Operations Institute (PKSOI) at the War College, a course I lead as USAID’s assigned faculty to the college. This trip allowed these students an opportunity to witness on-the-ground, whole-of-government coordination to rebuild the lives of Haitian families affected by the 2010 earthquake.

Why Haiti? The United States has supported the strengthening of democracy in Haiti for several decades. Even prior to the earthquake, Haiti faced a variety of challenges, including being the poorest country in the Western Hemisphere.

The country is a priority for the U.S. Government and other donor nations following the 2010 earthquake that shattered economic stability in the country. To aid those affected by the quake, the United States committed $4.2 billion in assistance to help Haiti transition from disaster relief to a long-term development plan. Key advancements have been made in such areas as health services, economic growth, and investments in the agriculture sector.

Yet much of Haiti remains fragile and gains in some areas have been difficult to sustain. Obstacles to Haiti’s progress include lack of government capacity and vulnerability to natural disasters as well as challenges related to Haitians’ access to many basic services.

Haiti is one of the most illustrative examples of the possibilities and challenges of development assistance. I took my students to Haiti because I wanted them to see where and how international assistance makes positive impacts. The trip also encouraged dialogue among the students and with the people of Haiti so we could together discuss areas where assistance efforts could be improved.

“The trip brought international development to life. It took the learning from the classroom into a multidimensional opportunity to see defense, diplomacy and development in action,” said Rebecca VanNess, a student in my class.

USAID partners with Department of Defense (DOD) academic institutions, such as PKSOI, to educate DOD staff on USAID’s mission and to encourage open dialogue on how best we can work together to build a more secure and peaceful world. The international development course at PKSOI is part of USAID’s long-term training program that sends USAID staff to DOD academic institutions to foster mutual learning between the two agencies.

“For the first time, I understood why the Army spends its time and money to send its best senior leaders to the War College. Haiti provides a microcosm of all the facets of the [international development course] curriculum,” said Kim Colton of USAID.

I am a firm believer that learning through immersion is one of the greatest tools we can use when educating students about a place with a different culture and language than our own. My goal for organizing the trip was to allow students to get out of their comfort zones, to take what they have learned in an academic setting and see the realities in Haiti, and to come up with plausible solutions that incorporate a development perspective.

During the visit, the students had a chance to meet with representatives of local NGOs and members of the United Nations Stabilization Mission in Haiti (MINUSTAH). The students also participated in discussions at the U.S. Embassy in Port-au-Prince with U.S. Ambassador Peter F. Mulrean, who offered frank discussions on the complexities of working in Haiti.

I was honored to have Professor Grace Stettenbauer, a senior Foreign Service Officer from the Department of State, accompany the class to Haiti. Stettenbauer shared her perspectives on applications of the U.S. national security policy and strategy to the real-world situations students encountered in Haiti.

My students departed Haiti feeling optimistic about its future, agreeing with the commonly repeated expression  that “Haiti is too rich (in resources) to be considered poor.”

ABOUT THE AUTHOR

Mark White was the former deputy mission director of USAID/Haiti and is currently assigned as the USAID representative and professor at the Peacekeeping & Stability Operations Institute at the U.S. Army War College.

Family Planning for the World’s Youth Promotes Peace, Health and Prosperity

A mother with her child at the Nhamatanda Health Center in Mozambique. / Arturo Sanabria, Photoshare

With close to 600 million girls growing up in developing countries, achieving global prosperity starts with educating and empowering these young women so they can be healthy, productive members of their communities and become agents of change.

This year’s World Population Day encourages us to “Invest in Teenage Girls.” Voluntary family planning is one tool that can both educate and empower young women worldwide.

Access to voluntary family planning and reproductive health services for everyone, including youth, is vital to the future of our planet. About half of pregnancies among adolescent women in the developing world are unintended, with about 23 million young women wishing to avoid pregnancy, but not using modern contraception. This puts them at high risk of unintended pregnancy.

As we observe World Population Day on July 11, we acknowledge that young people hold the key to determining the future of our planet and to ensuring we meet the Sustainable Development Goals (SDGs)17 goals focused on ending all forms of poverty, achieving social justice for all, and tackling climate change by 2030.

Voluntary family planning is an important intervention that cuts across the five themes of the SDGS: people, planet, prosperity, peace and partnership.

A nurse shows a client an implant rod, and explains how it works during a family planning outreach at a Nairobi informal settlement. / Tobin Jones, Jhpiego

Voluntary family planning affects people. It supports adolescents’ rights to information, and the rights of girls to remain unmarried and childless until they they are ready and desire to bear children.

Family planning saves lives. Today, pregnancy and childbirth are the leading causes of death for adolescent women. By helping young women time and space their pregnancies, family planning helps reduce the number of high-risk pregnancies, and allows women to properly feed, clothe and educate the children they decide to have. Studies show that by 2020, family planning could help avert approximately 7 million under-5 deaths and prevent 450,000 maternal deaths in USAID’s priority countries.

A poster in a Sare Bilaly health hut in the region of Kolda, Senegal. / Amy Fowler, USAID

Family planning impacts the planet. Access to family planning can slow global climate change and improve the health and environment of households and communities worldwide, and research shows that it already has. A 2013 report warns: “poor reproductive health outcomes and population growth exist hand-in-hand with poverty and unsustainable natural resource use.”

Family planning helps reduce poverty and contributes to economic growth and prosperity. Nearly 21 percent of the world’s population—some 1.5 billion people—still live on less than $1.25 per day. By slowing rapid population growth, family planning can help to decrease the sheer number of poor people.

Reducing adolescent fertility can contribute to a “demographic dividend” of rapid economic growth. Having fewer children per family leads to more household savings and increased investments in each child. In Korea and Thailand, governments aligned population policy and family planning services with human capital development policies, particularly girls’ education, to accelerate economic growth.

Voluntary family planning can contribute to peace. Studies show that a large “youth bulge” (defined as a high number of 15- to 29-year-olds) is associated with a high risk of civil conflict. The political impact of fertility decline is measureable: Research shows as a country’s population ages, the probability of attaining and maintaining a liberal democracy is increased.

Worldwide, more than 30 million adolescent women are not in school. Early and unintended pregnancy can be both a cause and a consequence of dropping out of school, so family planning can help women and girls stay in school, become literate, and achieve their educational and employment aspirations. All of these outcomes lead to more peaceful communities and societies.

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Health workers in Mali. / Jane Silcock, USAID

Family planning partnerships at the global and country level will be critical to achieving success as we work toward reaching a grand convergence between the developed and developing world in the next 15 years. As the largest bilateral donor for family planning assistance, USAID has played a crucial role in increasing access to modern contraception. And through our youth policy, USAID strives to integrate youth reproductive and sexual health needs into all of our programs and partnerships.

Young people today will decide our future. We need them to participate in the social, economic, political and cultural life of their communities to eliminate poverty and achieve our collective goals. We also need to recognize the diversity of need and experience of this age group when developing reproductive and sexual health programs and services. As we help youth to succeed, voluntary family planning will be an essential element of our long-term development strategies.

ABOUT THE AUTHOR

Ellen H. Starbird is the director of the Office of Population and Reproductive Health at USAID. Get updates about USAID’s Family Planning work via @USAIDGH.


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Resilient Health Systems Can Prevent and Contain Pandemics

Capt. John Whiteside of the U.S. Public Health Service dons Personal Protective Equipment as he prepares for a new potential Ebola case at the Monrovia Medical Unit in Liberia. USAID led and coordinated the U.S. Government's relief efforts in West Africa for the Ebola response. / Neil Brandvold, USAID

Capt. John Whiteside of the U.S. Public Health Service dons Personal Protective Equipment as he prepares for a new potential Ebola case at the Monrovia Medical Unit in Liberia. USAID led and coordinated the U.S. Government’s relief efforts in West Africa for the Ebola response. / Neil Brandvold, USAID

Resilience is one of those buzzwords that every so often captures the hearts and minds of development practitioners. The importance of this particular term, though, becomes all too clear as the world faces an increasing number of humanitarian crises, including outbreaks that can turn into pandemics.

Did you know, for instance, that every year, up to 500,000 people die from the flu? And in years when pandemic flu occurs, millions of people can lose their lives. The 1918 pandemic flu is a good case in point, as it infected up to 40 percent of the populations of some countries and killed up to 100 million people.

As a result of global warming, more pathogens with pandemic potential continue to emerge, many of which originate in animals (zoonotic). They include Ebola, H5N1 avian flu, H7N9 avian flu, HIV/AIDS, and two kinds of coronavirus: severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

In this scenario, resilience is about detecting potential pandemic threats, and then mitigating and containing them. This concept came to the forefront during the 2014 Ebola outbreak when already stretched and under-resourced health systems in West Africa were confronted with a surge of patients, a contagious virus, overall lack of preparedness and minimal resources.

A technician swabs the throat of a duck at Bangkok’s Klongtoey Market during an avian influenza survey. / Richard Nyberg, USAID

A technician swabs the throat of a duck at Bangkok’s Klongtoey Market during an avian influenza survey. / Richard Nyberg, USAID

And to be fair, Ebola caught us by surprise also in North America where health personnel initially felt inadequately trained and hospitals struggled to put in place a rapid plan of action.

The point is that resilience in the health sector is not static but rather an ongoing and evolving state of affairs. Much of the work that USAID does in the global health space is focused on strengthening health systems, so they perform well and are resilient.

Well-performing health systems provide sustained, equitable access to essential services for all without financial hardship. They are better able to bounce back when adversity strikes; are prepared to detect and respond to emerging disease threats; are able to adapt to adverse conditions; address a wide range of health challenges; and offer innovative solutions by leveraging diverse skills and views.

USAID invests in health system strengthening by partnering with countries to better manage financial resources, to ensure the right health workers and medicines are available where and when needed, and to inform and strengthen governance for effective service delivery.

And, yes, we all know that pathogens do not wait patiently in line to get their passport stamped. Contagious diseases will continue to threaten humanity because of the globalized nature of the world we live in and the impact of climate change.

Our work on emerging pandemic threats is meant to prevent, or at the very least, to contain a humanitarian crisis and minimize the impact of disease outbreaks on human health and the economic and social stability of countries. We do this by building the capacity of countries to prevent the emergence of new zoonotic diseases, to detect them early and to control them in a timely and effective manner.

Health innovations can strengthen health systems and save lives during a disease outbreak by quickly leveraging collective expertise and delivering practical and cost-effective solutions. Last year, USAID in partnership with the White House Office of Science and Technology Policy, the U.S. Centers for Disease Control and Prevention, and the Department of Defense launched Fighting Ebola: A Grand Challenge for Development.

The initiative was to help frontline workers provide better care and stop the spread of Ebola in West Africa. Global innovators generated close to 1,500 ideas. Half of the funded innovations are either in use or available for purchase today.

This past April, the Agency launched the Combating Zika and Future Threats Grand Challenge. Through this effort, the Agency will invest up to $30 million in groundbreaking innovations and interventions that enhance our ability to prevent, detect and respond to the Zika virus and other future infectious disease outbreaks—in both the short and long-term.

This latest Grand Challenge specifically calls for solutions that improve and enhance vector control (methods that eliminate the transmission of pathogens from animals to humans), personal and household protection, surveillance, diagnostics and community engagement.

We are also enhancing preparedness and response by creating university networks across the U.S., Africa and Southeast Asia to train graduates in a variety of sectors and disciplines.

As the world becomes increasingly connected, we must ensure that health professionals are able to address the complex, multi-sectoral disease detection, response, prevention, and control challenges in their countries and regions.

In this context, resilience is about helping other countries be more well-rounded and prepared to create a safer, healthier world for all.

ABOUT THE AUTHOR

Irene Koek is the Acting Deputy Assistant Administrator for USAID’s Bureau for Global Health.

Even Amid a Humanitarian Crisis, Education Cannot Wait

Nepalese children attend school in a temporary learning center following the April 2015 earthquake / Derek Brown for USAID/Nepal

Nepalese children attend school in a temporary learning center following the April 2015 earthquake / Derek Brown for USAID/Nepal

Education is a core component of a humanitarian response. However, too often education remains severely underfunded given competing priorities. But without it, children — and girls in particular — are at increased risk of abuse, exploitation, disempowerment or worse.

While working in international education for more than 30 years, I’ve seen how natural disasters, famines and wars can sideline education.

And yet we know from research — and our own life experiences — that going to school and learning is critical; it provides children with a sense of normalcy and helps prepare them for the future. An extra year of secondary school for girls can increase their future earnings by 10 to 20 percent. Research even shows that investing in women and girls can boost an entire country’s GDP.

Children attend a morning assembly at a temporary learning center in Nepal / Kashish Das Shrestha for USAID/Nepal

Children attend a morning assembly at a temporary learning center in Nepal / Kashish Das Shrestha for USAID/Nepal

However, over the past decade, we have seen greater consideration of the long-term need of children affected by crisis and conflict. Education in these contexts is prioritized by the U.S. Government — we know it’s critical to the global effort to end extreme poverty and build peaceful democratic societies.

Providing access to quality education for children and youth in crisis and conflict is one of USAID’s priorities for education. Between 2011 and 2015, we provided millions of out-of-school children and youth in 20 countries with access to education.

That’s good progress, but it’s not enough. As a result of the conflict in Syria, the world is experiencing the worst humanitarian crisis since World War II. Syria is among 35 crisis-affected countries where 476 million children are in desperate need of educational support.

Aminata, 16, teaches her younger siblings while schools in Liberia were closed during the height of the Ebola epidemic / Neil Brandvold for USAID

Aminata, 16, teaches her younger siblings while schools in Liberia were closed during the height of the Ebola epidemic / Neil Brandvold for USAID

A shift in USAID education response

For decades, humanitarian and development assistance were often partitioned, and this sometimes led to not focusing on returning many displaced children and youth to school until after a crisis or conflict had ended. Education has always been a key focus in the international refugee response; but this at times has not been true in the case of natural disasters or even in the case of internally displaced children.

As crises have become longer — families are displaced for 20 years on average — children may spend their entire childhood exiled from their homes. Without education, a new generation grows up without the basic skills needed to contribute to their community and society.

The U.S. Government is now committed to ensuring that whenever a crisis or conflict hits, education is not disrupted. Prioritizing the continuity of education reaps long term rewards, and contributes to a smooth transition from humanitarian assistance to sustainable development.

Victoria Cole, 12, hasn’t let the Ebola crisis interrupt her education. Here she participates in in an outdoor classroom while schools in Liberia were closed during the height of the Ebola epidemic / Neil Brandvold for USAID

Victoria Cole, 12, hasn’t let the Ebola crisis interrupt her education. Here she participates in in an outdoor classroom while schools in Liberia were closed during the height of the Ebola epidemic / Neil Brandvold for USAID

In the past year, the United States has responded to the education needs of children living in a range of crises, including violent conflict in South Sudan, gang violence in El Salvador and Guatemala, the Syrian refugee crisis, earthquakes in Nepal, and the Ebola outbreak in Liberia.

  • Nepal: On April 25, 2015, Nepal was shaken by a magnitude 7.8 earthquake that claimed lives, destroyed homes, and reduced thousands of schools and classrooms to rubble. USAID and partners sprang into action by building more than 1,000 temporary learning centers to ensure children could continue their education while the rest of the communities were rebuilt around them.
  • Liberia: In August 2014, at the height of the worst Ebola outbreak in history, all schools were closed, leaving 1.5 million children at home and unable to learn. Crises like Ebola don’t only affect the health of communities, but also their ability to continue working and learning. In response, USAID worked with the Liberian Government to integrate basic Ebola prevention and treatment information into the curriculum, supply classrooms with prevention supplies, and prepare for future suspected cases. These measures allowed schools to reopen six months later.
  • Syrian refugee crisis: Since the start of the conflict in Syria, the Department of State has worked with international and nongovernmental organizations to open and refurbish schools, provide educational materials, pay school fees, and offer accelerated learning programs for refugees and host communities in neighboring countries where 2.4 million Syrian refugee children now reside. These same partners provide protective family care and reunification, protect distressed children from violence and abuse, provide counseling and psychological support, and meet other critical needs of children both inside Syria and in neighboring countries.
  • Nigeria: Since 2009, a violent insurgency has gripped much of northeastern Nigeria and displaced more than 1 million children and youth, greatly diminishing their education and job prospects. Since 2014, USAID has worked with local partners and officials to ensure their education can continue by establishing about 600 nonformal learning centers in communities where displaced children and youth have relocated – temporary shelters, markets, churches, mosques and under the shade of trees. The international community is far from reaching all of those children in need, however. We must do more.

Bridging the humanitarian and development divide

No one donor can do this alone — we must work together with countries affected by these crises and a range of education experts. That is why the U.S. Government is enthusiastically supporting Education Cannot Wait: A Fund for Education in Emergencies.

The fund is championed by the UN Secretary-General’s Special Envoy for Education Gordon Brown, Chair of the Global Partnership for Education’s Board of Directors Julia Gillard, UNICEF’s Executive Director Anthony Lake, the U.S. Government and other donors.

Education Cannot Wait, managed by UNICEF, will help transform the global education sector and bridge the humanitarian and development divide by collaborating with non-traditional actors for a more agile and rapid response to education in emergencies. Ultimately, the fund will increase safe and quality education so that all children have the opportunity to learn, amid emergency and protracted situations.

With 75 million girls and boys most directly affected by crises globally, we know that solving this problem requires collective action. This is why we call on the private sector, host country governments, civil society, and traditional and non-traditional donors to all come together.

Education Cannot Wait must engage new actors — non-traditional donors, the private sector, foundations and philanthropists — to contribute to financing the platform. They can make education as much a priority as food security, shelter and health. New actors can unlock new funds, and their participation can help the international community create transformative and long-lasting change in the lives of the world’s most vulnerable young people.

It’s a challenge that must be addressed through strong political will and financial support.

As a veteran development worker and education specialist, I’ve seen firsthand what happens when children and youth are given an education–how going to school and continuously learning allows them to heal and grow.

These children and youth, when provided with an education are given a new hope for a better future and a chance to succeed — they become self-sufficient, are better able to earn a decent living, and contribute to their societies in a productive way. We all benefit.

ABOUT THE AUTHOR

Evelyn Rodriguez-Perez is the Director of USAID’s Office of Education in Washington, D.C. Ms. Rodriguez-Perez is a veteran educator of 30 years and a Foreign Service Officer previously stationed in Peru, Egypt and Honduras.

Q&A: How We Are Working To Rid Mozambique of A Blinding Disease

A community drug distributor provides a young mother with the appropriate dose of the trachoma-fighting drug Zithromax as part of a mass drug administration in Mozambique. / RTI International

A community drug distributor provides a young mother with the appropriate dose of the trachoma-fighting drug Zithromax as part of a mass drug administration in Mozambique. / RTI International

In Mozambique, almost 7 million people are at risk of losing their sight from trachoma, an eye infection that is the world’s leading cause of blindness.

A devastating disease that often strikes poor communities, trachoma is fueled by crowded living conditions and limited access to clean water and proper sanitation.

USAID has supported Mozambique’s government to fight trachoma since 2012. Thanks to the efforts over the past year of the ENVISION project, a collaboration between Mozambique’s Ministry of Health, USAID and other international partners, 1 million people in Mozambique are no longer at risk of contracting the eye infection.

The goal of the project is to eliminate the blinding disease within Mozambique’s borders by 2020.

With such an ambitious timeline, the manager of the project Sharone Backers discusses progress, challenges, partnerships, and what work is left.

What are the consequences of trachoma?

If left untreated, trachoma causes eyelids to turn inward and painfully scrape the cornea. Children can’t function in school, and adults become unable to care for their families and work their crops as the constant itching and unbearable pain worsens.

Eventually, blindness takes over, and lives and futures are changed irreversibly.

Is treatment reaching those who need it?

This year, more than 3.5 million people in five provinces of Mozambique are expected to be treated through mass drug administration. This will be a huge accomplishment largely due to partnership between our country office and the International Trachoma Initiative, which is delivering the trachoma-fighting antibiotic Zithromax.

A child in Mozambique receives an oral solution of Zithromax as part of a national campaign to eliminate trachoma by 2020. USAID supports the campaign through its Neglected Tropical Diseases program. / RTI International

A child in Mozambique receives an oral solution of Zithromax as part of a national campaign to eliminate trachoma by 2020. USAID supports the campaign through its Neglected Tropical Diseases program. / RTI International

Last year, at least 80 percent of those who were eligible received treatment in almost all of the targeted districts, and about half were women.

Women play a powerful role in gathering their families together; they are usually the ones taking children for vaccinations, but they are often the last ones receiving health care themselves. It’s heartening to see women receiving this treatment, so they can in turn benefit and nurture their families.

How do you assess where treatment is most needed?

Mozambique’s Ministry of Health tracked cases of trachoma across the country, mapping where disease rates were high enough to require mass treatment. ENVISION and others provided support — a lot of dialogue was needed, as much was at stake in getting it right.

It’s an enormous task to provide treatment to everyone – but having a clear and accurate picture of trachoma rates is a crucial first step.

ENVISION supported mass drug administrations for trachoma in 10 districts of Niassa province in 2013. These have grown each year since then, and are now conducted in all provinces where trachoma affects at least 10 percent of the population.

What lessons have we learned from our success in fighting trachoma in Mozambique?

Strong engagement with communities, at all levels, is crucial. Conversations with community leaders, before mass treatments begin, ensure they understand these campaigns and will encourage people to participate. High levels of illiteracy mean that posters are sometimes not the best option; however, community radio messages are more far-reaching.

After every mass treatment, ENVISION and the Ministry of Health began reflecting on what needs to be improved.

Distributing antibiotics only gets us so far. Other solutions to fight trachoma include ensuring facial cleanliness, making environmental improvements — such as access to clean toilets, and sometimes providing medical interventions like surgery.

We’ve learned that we must leverage our resources and partnerships to support a full strategy that include those components.

For instance, with support from the Queen Elizabeth Diamond Jubilee Trust, we are working with partners to increase trichiasis surgeries in four provinces.

We are also engaging with NGOs working in the water, sanitation and hygiene sector and the Ministry of Health to incorporate facial cleanliness messages and environmental improvements into programs and policies. We’re particularly proud of a recent partnership with WaterAid to improve access to safe water sources and sanitation.

So what’s next?

It’s amazing to think about how far we’ve come in such a short amount of time: Already, mass treatment is no longer needed in Niassa, Mozambique’s largest and most remote province, since rates of trachoma there have dipped to less than 5 percent.

Current trends tell us that active trachoma levels could fall significantly across the entire country by 2018. This means mass treatment will stop, and we will monitor districts for the next three years to evaluate whether further treatment is needed. We are very excited that this phase may be around the corner.

The trachoma-fighting community in Mozambique has faced its fair share of challenges, but commitment from all involved – from the government to the communities themselves – has kept progress moving.

With support from our partners, I am sure we can eliminate this blinding disease and classify Mozambique as a trachoma-free country.

ABOUT THE AUTHOR

Record Population Displacement Shows Needs are Rising

One in three Syrian children, born after the conflict began, have never known a life without war, insecurity or displacement. A new report reveals Syria has the second-largest number of internally displaced people in the world, due to conflict and violence. / Louai Beshara, AFP

One in three Syrian children, born after the conflict began, have never known a life without war, insecurity or displacement. A new report reveals Syria has the second-largest number of internally displaced people in the world, due to conflict and violence. / Louai Beshara, AFP

While the Syria crisis has been going on for more than five years, it wasn’t until the lifeless body of a 3-year-old toddler washed up on the shores of a Turkish beach last September that the plight of the Syrian people made headlines again and struck a nerve with the general public.

His story — and that of the 12 other refugees who drowned with him — is part of a greater humanitarian tragedy unfolding worldwide.

Syria’s crisis has become the most pressing humanitarian emergency of our time. Since the conflict began, hundreds of thousands of Syrian refugees have crossed international borders, risking their lives to reach the safety of Europe.

But this doesn’t represent even half of the people fleeing the violence. Inside the war-torn country, 6.5 million people are internally displaced, meaning they were forced to flee their homes but stayed within their country’s borders.

Worldwide the picture is clear: Conflicts like the Syria crisis have changed the pattern of humanitarian needs, which are growing at an astronomical rate.

According to a new report released by the Internal Displacement Monitoring Centre, 40 million people globally were internally displaced due to conflict and violence by the end of 2015 — the highest figure ever recorded. More than 21 percent, or 8.6 million people, were newly displaced in the last year alone.

In 2015, 8.6 million people were newly displaced due to conflict and violence, and 19.2 million more people were displaced due to disasters. / Internal Displacement Monitoring Centre

In 2015, 8.6 million people were newly displaced due to conflict and violence, and 19.2 million more people were displaced due to disasters. / Internal Displacement Monitoring Centre

Most of these displacements occurred in the Middle East and North Africa, where fighting in Yemen, Syria and Iraq contributed to more people being displaced in this region than in all other regions in the world combined.

In addition to conflict, natural disasters contributed to record-breaking global population displacement, with storms, flooding and last year’s Nepal earthquake accounting for millions more people being uprooted from their homes and communities.

USAID’s Office of U.S. Foreign Disaster Assistance responds to an average of 65 disasters in 50 countries every year, working to ensure that humanitarian aid reaches internally displaced people (IDPs) around the world.

Globally, there are twice as many IDPs as there are refugees. But since IDPs remain in their country and don’t cross international borders, they do not receive the same protection provided to refugees by international law.

To make matters worse, in some of the world’s most dangerous and insecure regions, humanitarian organizations are not given access to deliver critical aid to the people most in need.

Despite these obstacles, USAID disaster experts are working with dedicated humanitarian partners to deliver much needed food, safe drinking water, emergency health care and shelter to IDPs.

We also support activities that protect the most vulnerable — like women, children and elderly people — as well as programs that help address the physical and emotional trauma endured before, during or after a crisis.

In 2015, 8.6 million people were newly displaced due to conflict and violence, and 19.2 million more people were displaced due to disasters. / Internal Displacement Monitoring Centre

In 2015, 8.6 million people were newly displaced due to conflict and violence, and 19.2 million more people were displaced due to disasters. / Internal Displacement Monitoring Centre

But the reality is that the humanitarian system is straining under the weight of today’s multiple and complex global challenges — from conflicts that won’t end to the widespread displacement they fuel.

That’s why the U.S. is seizing the unique opportunity that the World Humanitarian Summit presents to re-affirm our commitment to international humanitarian law, strengthen the international humanitarian system, and improve coherence between humanitarian and development assistance.

It’s an opportunity for us to work collectively with our partners and other countries, bringing all of our expertise to bear, to ensure that we can meet 21st century challenges. This is a significant and long-term task, but one which many agree is long overdue.

Today’s unparalleled challenges require new and innovative solutions. The United States is prepared to roll up its sleeves to figure out ways to better support our partners while continuing to serve the growing number of people who are in need of humanitarian assistance worldwide.

This month’s World Humanitarian Summit presents an opportunity for the international community to come together to form innovative solutions to help those most in need. / Michael Gebremedhin, USAID

This month’s World Humanitarian Summit presents an opportunity for the international community to come together to form innovative solutions to help those most in need. / Michael Gebremedhin, USAID

ABOUT THE AUTHOR

Delivering Life-Saving HIV/AIDS Drugs Around the World

Laboratory systems and commodities are a critical component of USAID’s global health supply chain and integral to achieving an AIDS-­free generation. / SCMS

Laboratory systems and commodities are a critical component of USAID’s global health supply chain and integral to achieving an AIDS-­free generation. / SCMS

As the warm Haitian sun comes up, Chantal leaves her four children behind to get her HIV treatment, traveling for three hours in the back of a crowded jeep.

She bumps over unpaved roads to her monthly visit for antiretrovirals, one that she has been doing routinely for several years to keep her disease at bay.

Her children don’t know that she is HIV positive, and she doesn’t want to tell them. She makes this long trip over rough and ragged terrain to preserve her privacy and escape the possibility of stigma, still prevalent in Haitian society.

Hours later, she finally arrives at the Hôpital Immaculée Conception and waits her turn at the pharmacy to see the dispenser for her medicine. This local hospital’s pharmacy is consistently stocked with life-saving antiretroviral drugs as a result of the USAID-led Supply Chain Management System project under the President’s Emergency Plan for AIDS Relief (PEPFAR).

“I’m confident that my medicine will be here,” says Chantal, “When I come, I always find it.”

Since 2005, the supply chain project has been procuring and delivering drugs, laboratory supplies and reagents to hospitals and clinics like Hôpital Immaculée Conception all over the world.

The global health supply chain works to get life-saving HIV/AIDS commodities to even the most rural places around the world. / Jean Jacques Augustin, SCMS

The global health supply chain works to get life-saving HIV/AIDS commodities to even the most rural places around the world. / Jean Jacques Augustin, SCMS

With support from PEPFAR, USAID established the supply chain project to provide a reliable, cost-effective and secure supply of products for HIV/AIDS programs in PEPFAR-supported countries. The supply chain project is to-date the largest ever public health supply chain in the world, and leverages the collective power of many different partnerships, both private and public, to deliver critical products to fight the HIV/AIDS epidemic.

Through this project, USAID focused on saving lives by aggressively scaling up treatment access, promoting country ownership, and investing in sustainable country health systems to make real and lasting progress toward achieving universal access to lifesaving HIV and AIDS products.

For 10 years, the supply chain project has been driving improvements in public health systems. These efforts — in coordination with the efforts of many donors, partners and individuals around the world — are driving toward the ultimate goal: an AIDS-free generation.

As a result, the Supply Chain Management System project

  • Delivered $2.4 billion of life-saving commodities, including antiretrovirals, essential medicines and laboratory commodities
  • Directly procured a majority of the lifesaving antiretroviral drugs used to treat 5.7 million people in developing countries
  • Negotiated a dramatic drop in the cost of drugs to treat a single HIV/AIDS patient to $110 per year
  • Saved hundreds of millions of dollars through the procurement of generic antiretrovirals
  • Delivered 239 million HIV tests to high-prevalence countries, so that millions of people around the world could know their status
  • Saved more than $176 million in shipping costs over the last 10 years
  • Supported local partners in 25 countries to build capacity and country ownership of supply chain management
Chantal, an HIV-­positive woman, waits for her monthly supply of antiretroviral medication at the Hôpital Immaculée Conception in Haiti. / Jean Jacques Augustin, SCMS

Chantal, an HIV-­positive woman, waits for her monthly supply of antiretroviral medication at the Hôpital Immaculée Conception in Haiti. / Jean Jacques Augustin, SCMS

There is no doubt the supply chain project has made an incredible impact on the lives of millions of people around the world, like Chantal. For the last decade, on behalf of the U.S Government, this project has successfully operated the largest public health supply chain in the world.

As a result, patients know their status and are getting the treatment they need. Mothers can care for children born without the virus. HIV-positive parents can go to work and provide for their families.

As the supply chain project draws to a close, a new phase of the U.S. Government’s Global Health Supply Chain Strategy begins under the Procurement and Supply Management project.

Looking forward, the challenge of the Procurement and Supply Management project is to build upon the successes of the supply chain project. In an effort to control the HIV/AIDS epidemic, the new project will rapidly scale up prevention, treatment and care, while harnessing innovations and efficiencies to shape best practices in supply chain management in Africa and elsewhere.

Doing so will require ongoing investments in preventing and treating HIV/AIDS, as well as continued support for national supply chains.

USAID’s vision to take advantage of supply chain innovation to make an impact on eliminating the burden of HIV and AIDS worldwide will serve as a critical foundation to achieving the goal of an AIDS-free generation.

USAID’s global health supply chains promote country ownership of public health programs and create sustainable country health systems. / Ulf Newmark, SCMS

USAID’s global health supply chains promote country ownership of public health programs and create sustainable country health systems. / Ulf Newmark, SCMS

ABOUT THE AUTHOR

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