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Women’s Month Profile: Improving Health Care in Afghanistan

Submitted by Sally Cooper,
Communications and Knowledge Exchange Officer at USAID Tech-Serve

Women gather outside a health clinic in the western city of Herat. Dr.Zareena’s work with USAID Tech-Serve supports the Ministry of Public Health in providing quality health care to women across Afghanistan. Photo: Sally Cooper, USAID Tech-Serve

Dr. Zareena sits quietly at her desk in the corner of a large office, her attention focused on the files open on the laptop screen in front of her. “We are very busy here today,” she said, adding with a smile, “actually we are very busy here most days.”

Zareena works at Tech-Serve, a USAID-funded project building capacity at the Ministry of Public Health (MoPH). She works with health professionals at MoPH offices in USAID-supported provinces throughout the country, building their capacity to enable them to deliver quality health services for all Afghans. As part of a team looking after 17 provinces, Zareena’s days are full.

As a child growing up in Kabul through the years of the Russian occupation and the bloody civil war that followed, she recalls her family moving from neighborhood to neighborhood, escaping the fighting and seeking occasional refuge with relatives living in the provinces when the capital became too chaotic.

The fall of the Taliban government in 2001 re-opened a world of opportunities for young women like Zareena. After finishing school, with her family’s permission, she enrolled in the prestigious Kabul Medical University to pursue a career in health care. She was the first girl in her family to study, a choice that brought with it a raft of social pressures. “It was different,” she said, “but it was not wrong.”

After graduation, Zareena said, “I wanted to work in health and learn more.” She worked for a number of health-focused organizations, gaining valuable experience in each before joining Tech-Serve.

One area in which she is particularly interested is Tech-Serve’s leadership and management program which works with public health managers around the country to enable them to lead their teams, face challenges and achieve results. “It encourages me to develop my career in management so I can work for better health of women and all patients,” said Zareena.

Afghanistan has rebuilt its public health system from scratch in the last decade. More women are accessing quality health care than ever before for both themselves and their families. Progress has been slow but, as Zareena notes, “progress has been made. The health of mother and child is better than it was even three years ago.” In 2010, seventy five percent of Afghans seeking health care services were women and children under the age of 5.

But in 2011, Afghanistan’s future remains uncertain. Political tensions and a revived insurgency eat away at many of the gains made in the past decade, particularly for the country’s women. Asked what she thinks Afghanistan will be like in three years, Zareena shrugs. “I wish a brighter situation than today. We see the reality but we shouldn’t lose our courage.” She turns once more to her computer screen, “this is our hope.”

Technical Support to the Central and Provincial Ministry of Public Health (Tech-Serve) is implemented by the Afghanistan Ministry of Public Health and Management Sciences for Health.  Dr. Zareena’s name has been changed to maintain her privacy.

A Dispatch from the Tunisian and Libyan Border

Nancy Lindborg is the Assistant Administrator for the Bureau for Democracy, Conflict and Humanitarian Assistance at USAID on the ground. Photo Credit: USAID

Ras Jdir, Tunisia: I heard boisterous singing as I walked through the transit camp on the border between Tunes and Libya. There, forming a human chain to pass boxes of supplies into a tent, was a group of Tunisian youth, volunteering to assist the tens of thousands of migrants fleeing the conflict in Libya. They provided a welcome counterpoint to the blowing sand and steady flow of Bangladesh, Somalia, Malian and other migrants struggling across the border and into the transit camp.

Only weeks after the Tunisians sparked a regional revolution on January 14th, toppling the corrupt regime of Ben Ali and inspiring the world with their aspirations for freedom and democracy, Tunisians have once again mobilized. The newly installed government of Tunisia quickly provided security and support for transit camps. Citizens across the country have spontaneously provided food, water and blankets, and driven to the border to volunteer. The energetic singers I encountered were part of a group of 40 Boy Scouts who came eager to help. There was a palpable sense of pride in their ability to organize and act in this new era of freedom.

Some 80,000 Tunisians worked inside Libya, alongside the more than a million guest workers from around the world — 200,000 have fled thus far. Already 30,000 Tunisians have returned, often to the poorer communities in the south, which means an influx of unemployed workers and loss of remittances. At the same time, the economy is reeling from loss of tourism in the wake of recent events and loss of important commerce with Libya. And yet, Tunisians, including those in these hardest hit communities, have generously reached out, determined to help.

I traveled with Eric Schwartz, Assistant Secretary for Population, Refugee and Migration at the U.S. Department of State to understand better the needs arising from the conflict now engulfing Libya. While there, we announced $17 million of urgent assistance, bringing the total U.S. Government aid to $47 million. Our assistance to-date has gone to UN organizations on the frontlines of managing the camps and transport, to international NGOs able to provide critical help to those still inside Libya, as well as to the Tunisian Red Crescent Society, now an important conduit for volunteers.

Our new funding will target urgent assistance to the Libyans who are still trapped inside a bloody conflict as well as enabling support for those communities in southern Tunisian hardest hit by this crisis. We are inspired by them and as Americans, we are proud to mobilize alongside them in this time of crisis.

I also stopped to talk with two migrants from Bangladesh. They had worked in Libya for a year, but had not received wages for several months. Their employer abruptly shut down the construction project where they had worked. Fearful of the rising violence they headed to the border and along the way were robbed of their remaining money and cellphones. When we met, they had joined the 40 Boy Scouts, inspired as well.

Nancy Lindborg is the Assistant Administrator for the Bureau for Democracy, Conflict and Humanitarian Assistance at USAID.

USAID’s Strong Partnership with Israel Ensured Rapid Response During Disaster

The wildfires that ravaged large areas of Mount Carmel forest, killing 41 people and damaging hundreds of homes in the Northern Israel in early December, were halted with the help of local and international emergency teams. The intensive coordination efforts of USAID West Bank and Gaza with the Government of Israel enabled the rapid mobilization of U.S. Government assistance to combat the forest fires.

Through communications with the Israeli Government, USAID West Bank and Gaza identified the emergency needs and immediately mobilized the USAID Disaster Assistance Response Team (DART) which arrived to Haifa, Israel, on December 5, to work alongside the Israeli firefighters and offer technical expertise. The United States also flew nearly 70 metric tons (MT) of fire suppressant and 3,800 gallons of fire retardant concentrate to Israel.

In addition to assistance from the U.S. and Europe, Israel received help from its Arab neighbors, Jordan and Egypt, as well as the Palestinian Authority who sent three fire engines and firefighters to suppress the fires together with their Israeli counterparts. Responding to this conciliatory gesture, Israeli Prime Minister Benjamin Netanyahu expressed his appreciation and thanks to Palestinian President Mahmoud Abbas.

Helping Israel suppress its largest forest fire ever, USAID also played a role in passing information between different parties and providing emergency advice.

The fires have subsided, but the United States is ready to provide additional assistance to support the Government of Israel if needed.

USAID Administrator Statement on the Passing of Ambassador Richard Holbrooke

The following is a statement from United States Agency for International Development (USAID) Administrator Dr. Rajiv Shah on the passing of Ambassador Richard Holbrooke.

“Last night, we received the sad news that Richard Holbrooke passed away. Richard’s passing will be deeply felt by his family, those he worked with and those he served.

Much has been mentioned about Richard’s tireless commitment to diplomacy, one that stretched across five decades and was marked by incredible accomplishment-supporting the Paris peace talks as a foreign service officer in Vietnam, helping to normalize our relations with China as the youngest ever Assistant Secretary of State for East Asian and Pacific Affairs, and designing the Dayton Accords that ended the war in Bosnia. He was one of this nation’s finest, most dedicated public servants and architects of peace.

But Richard was also deeply committed to development. He worked at USAID in the early years of his career and was a relentless champion of development in this country’s foreign policy pursuits. As Ambassador to the United Nations, Richard elevated the cause of AIDS and the concerns of Africa to the top of the international agenda. And most recently, as Special representative to Afghanistan and Pakistan, he recognized the critical role development played in countering and ending violent conflict.

Islamabad, January 13, 2010 – U.S. Special Representative for Afghanistan and Pakistan Ambassador Richard Holbrooke exchanges signed documents with Mr. Shahid Rafi, Secretary of the Ministry of Water and Power Photo Credit: U.S. Embassy in Pakistan

The late U.S. Special Representative for Afghanistan and Pakistan Ambassador Richard Holbrooke exchanges signed documents with Mr. Shahid Rafi, Secretary of the Ministry of Water and Power Photo Credit: U.S. Emabssy in Pakistan

I know many of you have worked closely alongside Richard and learned much from him.  As a colleague and friend, he pushed us to excel and brought his tremendous intellect and diplomatic tact to our shared mission.  I will be forever grateful for his friendship, mentoring and support and will deeply miss his larger-than-life personality.

Please join me in extending condolences to his wife Kati and the rest of his family, and let us honor Richard’s enduring contributions both to his country, and to the cause of peace around the world.”

In Honor of International Human Rights Day

Today, in honor of International Human Rights Day and the Universal Declaration of Human Rights, U.S. Embassies and USAID missions around the world are opening their doors to civil society; to the Russian journalists who bravely report on corruption and abuse in the face of grave danger; to the Egyptian human rights activists who fight every day for justice; to the Kenyan political activists who recently helped shepherd a peaceful vote on a Constitutional referendum.

In 1994, USAID became the world’s first donor agency to establish democracy, human rights, and governance as core development objectives.  Since then, USAID has become the leading development agency on these issues.  With over 400 experts worldwide, USAID manages and programs the vast majority of the U.S. Government’s total budget—over three billion dollars this year alone—devoted to these issues.

These investments are critical to our national security and to reflect our national character, making the word safer and more equitable. That’s why the Obama Administration has laid out an ambitious democracy, human rights, and governance agenda for USAID.  We are engaged in a renewed focus to help our partners deliver for their citizens.

In Colombia, USAID created an early warning system to help prevent human rights violations by illegal armed actors, paramilitaries, leftist guerrillas, and drug mafias.

In Indonesia, USAID worked across 9 provinces with nearly 600 local nongovernmental organizations to increase citizen participation in local governance and social service provision.

Across Asia, USAID helped uphold rights to access for at-risk populations, including transgender communities and men who have sex with men, to HIV/AIDS prevention, care, and treatment, as well as building regional and in-country capacities to respond.

In Egypt, USAID is supporting disability advocates to organize and lead the development of policies and programs targeting the inclusion of people with disabilities, impacting over 15,000 Egyptians with disabilities at both the local and national levels.

And in the Democratic Republic of Congo, USAID and its partners helped provide medical services, fight impunity, and promote community awareness of and response to sexual and gender-based violence for more than 100,000 survivors of rape.

At USAID, we cherish the fundamental liberties contained in the Universal Declaration of Human Rights and we promote democratic institutions to fulfill these rights for every global citizen.

Every day, we are dedicated to making USAID the leader on advancing democracy, human rights, and governance globally.  Today on this day, with our friends, with our allies, and especially with human rights activists around the world, we support and honor the global efforts to expand human rights for all.

Palestinian Authority Capacity Enhancement Project Reaches Community Through Cartoons

The Palestinian Authority Capacity Enhancement (PACE) project is working to develop a more professional and competent public administration and civil service within the Palestinian Authority (PA), and to provide more effective, efficient and responsive services and benefits to the Palestinian people.

The project has produced a series of 30 humorous cartoon episodes educating Palestinians about issues concerning democratic behaviors, health and safety issues, etc. The cartoons are broadcast on Palestinian local TV stations. This is an new and innovative approach to pass educational messages to the Palestinian public.

It  has two primary objectives: a short-term focus on the delivery of improved services and a medium-term focus on capacity enhancement of government institutions. The project is currently working with five partner ministries: Ministry of Finance (MOF), Ministry of Transportation (MOT), Ministry of Interior (MOI), Ministry of Telecommunications and Information Technology (MTIT), and the Ministry of Public Works and Housing (MOPWH).

The United States Government’s Response to the Carmel Fire

This originally appeared on the White House Blog.

Today our faith-based office at the U.S. Agency for International Development hosted a conference call with Nancy Lindborg and Daniel Shapiro to detail the U.S. Government’s response to the Carmel Fire in Israel.  Nancy Lindborg is the Assistant Administrator for the Bureau for Democracy, Conflict, and Humanitarian Assistance at USAID and Daniel Shapiro is Senior Director for the Middle East and North Africa on the National Security Staff at the White House.  I was honored to moderate the call and engage with the 180 plus participants we had on the line.

Highlights of the U.S. Government’s response:

  • A USAID Disaster Assistance Response Team (DART) of 10 people arrived in Haifa, Israel on December 5 and remains in place as the response continues.
  • The DART, which includes a National Incident Management Organization (NIMO) team with fire management experts from the U.S. Forest Service, is currently working alongside their Israeli counterparts at the command center at Haifa University.
  • The Israeli government expressed greatest need for fire suppressant and retardant.  In response, the U.S. Government has delivered 111 metric tons (MT) of fire suppressant and 3,800 gallons of fire retardant concentration.   This assistance was delivered via five US C-130 aircrafts.
  • Of the 111 MT’s, this included USAID who airlifted approximately 27 MT of Fire-Trol retardant and 22 MT of Fire-Trol fire foam with the addition of 20 MT of fire foam donated by Italy.

The Government of Israel has been leading an extraordinary effort to contain and suppress the wildfires, and – as a result of the success of that effort – several operations that were in motion to provide additional aircraft and support were not needed but remain in a “stand by” status should the situation change.

Echoing the President’s remarks from last Thursday’s Hanukkah Celebration at the White House, our deepest condolences are with everybody in Israel who is affected by this tragedy and the family and loved ones of those in harm’s way.  USAID is committed to continuing to work with our partners as the Carmel region transitions from disaster response to recovery.  Our faith-based office at USAID is taking the lead for the U.S. Government and is coordinating the flow of information with the NGO community as together we look towards long-term recovery and reforestation.

If you would like to make suggestions about how we can add value to conversations taking place amongst NGOs or if you’d like to receive updated information about the U.S. Government response, please send us an email at FBCI (at) usaid.gov.

Ari Alexander serves as Deputy Director at the Center for Faith-based & Community Initiatives and the Coordinator of Global Engagement at the United States Agency for International Development.

From the Field

In Nicaragua, we will co-sponsor The Food and Agriculture Organization (FAO) of the United Nations’ two-day fair from November 11-12th in Managua to continue the celebration of World Food Day. The purpose of this activity is to bring attention to the serious problem of world food security.  As the second poorest country in the hemisphere, the issue of food security is critical for Nicaragua.

In Iraq, we will hold training as part of the Iraq Legislative Strengthening Project (ILSP).  The training will focus on 1) Legislative Drafting Training, 2) Analyzing Law 56 of 1977 “collecting Governmental Debts”, 3) Basic Report Writing and 4) Motivation and Team Building.

In Kyrgyzstan, we will open a Food for Peace food distribution site.  This event will support transparency of food distribution and also support reconciliation and trust among ethnic group beneficiaries.

Picture of the Week: In the Spirit of Election Day

Iraq elections

Iraqis count votes at the Independent High Electoral Commission (IHEC) headquarters in Baghdad on March 12, 2010, following the country’s second general elections since the U.S.-led invasion in 2003. With assistance from the USAID Elections Support Program, the IHEC successfully administered five major electoral events between 2004 and the March elections in Iraq. Photo is from Ahmad Al-Rubaye / AFP.

Midwives from Afghanistan Gather for Capacity Building Training in Alexandria, Egypt

On October 21, USAID/Egypt Director James Bever and Dr. Hassan Sallam, Director of the Suzanne Mubarak Regional Center for Women’s Health and Development (SMC) participated in the graduation ceremony of a mix of 31 Afghan Midwives of various ages and from various provinces. The Midwives attended the training program at the SMC in Alexandria and it was funded through the Health Services Support Project, implemented by USAID/Afghanistan.

Afghan midwives with their Egyptian trainer at the end of the USAID/Afghanistan funded capacity building training held in Egypt. Photo Credit: USAID/Egypt

Afghan midwives with their Egyptian trainer at the end of the USAID/Afghanistan funded capacity building training held in Egypt. Photo Credit: USAID/Egypt

The SMC was selected as a training provider for its excellent results in the areas of women’s health and development in Egypt and in neighboring countries. The SMC is the lead partner organization for the USAID/Egypt funded Global Initiative for Breast Cancer Awareness. The training focused on the development of knowledge, skills, and attitudes necessary to provide care to Afghani women with the ultimate goal of ensuring safe motherhood.

In his remarks during the event, the USAID/Egypt Director lauded Egypt as it has achieved its Millennium Development Goal Number 4 of reducing the under-five mortality rate by two thirds between 1990 and 2015 and it is approaching the achievement of MDG 5 in reducing the maternal mortality ratio by three quarters between 1990 and 2015.  “Egypt is now leveraging those achievements by hosting training programs like these where our Egyptian counterparts can share valuable lessons learned and effective practices with efficient health practitioners from Afghanistan to improve health not only in Egypt, but around the world.”

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