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Archives for Sub-Saharan Africa

It’s All In the Evidence: Water Challenge Demonstrates the Power of Doing Development Differently

Five years ago, USAID and the Swedish International Development Cooperation Agency came together at World Water Week in Stockholm, Sweden, to ask a crucial question: How can we grow more food with less water while supporting small farms?

Sustainable agriculture was, and remains, an important part of the answer. According to our Agency’s own findings, agriculture accounts for 70 percent of the world’s fresh water use. By 2025, two-thirds of the world’s population could be without enough fresh water to meet basic needs – such as hygiene, growing food and having enough to drink.

To combat this urgent problem, our two countries, along with the Foreign Ministry of the Kingdom of the Netherlands and the South African Department of Science and Technology, launched an experimental program to provide inventors and innovators working to improve water use in farming with resources and expertise to refine and test their inventions, reach more farmers and develop financially sustainable businesses.

Securing Water For Food: A Grand Challenge for Development (SWFF) — one of USAID’s 10 Grand Challenges — was that program. Two months ago, we returned to World Water Week – a conference teeming with the experts, academics, development practitioners, innovators and governments that could put lessons into practice – to share findings from this effort I helped lead.

I am always asking how do we transform the development enterprise by doing things faster, smarter and better? One way is sharing lessons learned. And, sharing lessons learned is built into the DNA of SWFF.

A panorama of an auditorium, looking from the rear toward the stage

SWFF Innovator in Panel Presentation at 2018 Stockholm World Water Week. / Benjamin Arthur

SWFF has exceeded the expected outcomes envisioned when the program was created. Innovators have reached a combined 6.25 million smallholder farmers, their families and other customers. For every $1,000 of donor funding spent, innovators impacted 267 customers and end users, produced 267 tons of crops, reduced water consumption by more than 810,000 liters, improved water management on 93 hectares of agricultural land, and generated more than $226 in sales. Through the program, many SWFF innovators have become gender champions, implementing strategies that promote the participation and leadership of women by actively looking for ways to design their projects in a gender inclusive way.

USAID’s team hosted a session covering topics such as how to build momentum among innovators, the timing of funding, promoting women’s participation and the importance of local knowledge and context. Innovators supported by SWFF came from across Africa, Asia, the United States and Europe to speak about their challenges and successes.

Two men smiling and laughing

SWFF Innovators Gabrielle Okello, Green Heat and Bacelar Muneme, FutureWater ThirdEye Mozambique at the Unconference in Stockholm. / Benjamin Arthur

Fauzia Hirome, a farmer from Uganda, talked about using the GreenHeat system to turn organic waste into renewable energy. The system has saved Fauzia time and water while helping her grow more crops – all while making enough money to send her kids to school.

And Nompendulo Mgwali came from South Africa, where the Meat Naturally program has helped cattle ranchers adopt sustainable practices, while also helping local women get jobs as eco-rangers. Not only did Nompendulo start making enough money with Meat Naturally to leave a government assistance program, she became a full-time employee of a for-profit company that Meat Naturally played a role in creating.

A woman speaks at a podium

Fauzia Hirome, a farmer from Uganda, shares details at the SWFF panel session at Stockholm World Water Week about how GreenHeat, a SWFF innovation, has impacted her life and economic livelihood. / Benjamin Arthur

While SWFF has wrought many successes, were always trying to improve and learn.

Outside investment provides our innovators with the capital they need to be sustainable and grow, and not all SWFF innovators have been able to get the investment they need to grow to sustainable scale. Additionally, SWFF is focusing on opportunities to involve the private sector in development work. Many companies, from Pepsi to IKEA to H&M, need water to make their products, prompting them to create their own development goals – some even more ambitious than those created by governments.

A man speaks at a podium

Ku McMahan, SWFF Team Lead, provides innovator data and results at the SWFF panel session at Stockholm World Water Week. / Benjamin Arthur

No matter who we work with, SWFF will always focus on improving lives as farmers are now taking what they’ve learned from us and are using it in their daily lives in different ways.

ABOUT THE AUTHOR

Ku McMahan, is the team lead for Securing Water for Food Grand Challenge for Development, LAB/CDI



Temperature Check: Border Screening of Travelers Key to Stopping Ebola from Spreading

A person wearing a protection suit

A health worker dons personal protective equipment. / Alma Golden, USAID

With confirmation of the Democratic Republic of Congo’s 10th outbreak of the Ebola virus in North Kivu and Ituri provinces, health officials have focused on border screening as a method to identify travelers who could pose a danger to local communities.

Recently, I traveled to the border between the DRC and Uganda with U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Robert Redfield and U.S. Ambassador to Uganda Deborah Malac to see border health screening and surveillance efforts at two key checkpoints.

The border between Uganda and DRC is porous. Several times a week, small-scale traders, mostly women, ferry goods and food across the border by bicycle, cart or on their heads. In addition to traders, local farmers, merchants, business people and refugees move through the area.

At Busunga, a border crossing in western Uganda, the shallow Lamia River acts as a physical barrier between the two countries. People wade across the river by foot, while others do laundry, wash their motorbikes and take baths in the river that flows from the nearby Rwenzori Mountain Range. On market days there, Wednesdays in Uganda, almost 500 people are screened for Ebola.

A woman in a red medical vest greets USAID officials

USAID Senior Deputy Assistant Administrator for Global Health Alma Golden receives information about Ebola at a border crossing between the Democratic Republic of Congo and Uganda. / Courtesy Photo

There are another 16 informal crossing points nearby. At the busiest border crossing point, Mpwonde to the south, more than 12,500 travelers pass through each day. And on Tuesdays and Fridays, which are market days at Mpwonde, there can be a fivefold increase in travelers and shoppers.

Early identification, confirmation and isolation of possible Ebola cases is critical for stopping the outbreak as early as possible. Ugandan Red Cross Society volunteers are screening travelers at all border crossings. Volunteers have been trained on the signs and symptoms of Ebola and are equipped with tools for screening.

Health screening procedures include hand washing with chlorinated water and soap, and a temperature check of travelers using a thermoscan thermometer that can detect a fever in seconds. Those who are screened are given simple, illustrated brochures that provide information about the symptoms of Ebola and how to prevent the spread of the virus.

People with Ebola can have symptoms similar to those with malaria and other endemic infectious diseases, including typhoid and Rift Valley fever. Ebola spreads from an infected sick person to others when there is direct contact with bodily fluids.

Travelers suspected to have Ebola symptoms are referred to Bwera hospital for further assessment; ambulances are available to transport individuals with symptoms to an isolation unit until tests are completed. Health workers have been given protective gloves, gowns, masks and other equipment provided by WHO to reduce the chances of contact with the Ebola virus.

Border screening is just one important element of the complex response to this crisis.

In Uganda’s neighbor, the Democratic Republic of the Congo, the U.S. Government, through USAID, is supporting core interventions to control the spread of Ebola, including: disease surveillance, contact-tracing, triage and isolation, and case management in Ebola treatment units; the prevention and control of infection; diagnostic laboratory support; community engagement; risk communication; interventions in water, sanitation and hygiene; and safe and dignified burial activities.

In DRC, through trusted messengers, community leaders and radio, communities are quickly learning how to protect themselves by learning the basics of the disease, how it is transmitted and what they can do to prevent it, care for and transport the sick, and to safely bury the dead. A targeted vaccination campaign is underway and is initially following a ring vaccination protocol: vaccines are being given to frontline health-care workers and response teams, contacts of confirmed cases, and contacts of those contacts.

The U.S. Government is also providing expertise and supplies. CDC and USAID have deployed over a dozen technical experts to the region in support the response. And USAID supported the World Health Organization (WHO) to send 20,000 personal protection equipment kits (including full body coveralls, heavy duty gloves, and goggles) and 50,000 universal care kits (surgical masks, face shields and gloves, and disinfection materials) to support response efforts in the DRC provinces affected by Ebola.

The Congolese and Ugandans have demonstrated a strong capacity to manage outbreaks. However, never before has Ebola struck in an area quite like this one. The region suffers from chronic insecurity due to local militia groups, and is under a long-term humanitarian crisis, which limits international and national responders from fully deploying disease control measures.

USAID has a long history of engagement in the health sector in the DRC, having worked to improve maternal and child health, immunizations, HIV diagnosis and treatment, and the prevention and management of malaria and tuberculosis.

Map of ebola cases in Democratic Republic of Congo

Map shows the Ebola outbreak in the Democratic Republic of the Congo as of Sept. 5, 2018. Latest figures from the World Health Organization indicate deaths have risen to 92, and confirmed or probable cases are now at 137.

The clinics, health workers, laboratories and health systems supported through USAID funding in both Uganda and the DRC provide the backbone of the response to the current outbreak. The DRC national laboratory, with supports from USAID and other donors, rapidly sequenced the virus, and provided critical laboratory capacity in the field to diagnose the disease at the site of the outbreak. The Ministry of Health is providing essential leadership, coordinating the response in the provinces and nationally.

My visit to the DRC and Uganda was enlightening. I am impressed by the dedication, determination and skill of our partners in the ministries of health and the countless epidemiologists, clinicians, logisticians, social mobilizers, vaccinators and volunteers working to stop the outbreak.

ABOUT THE AUTHOR

Alma Golden is Senior Deputy Assistant Administrator for Global Health at USAID.



The Hidden Costs of Fistula Repair Surgery

Close up portrait of an African woman

Edisa looks forward to her future free of fistula. / Fistula Care Plus

A few months after becoming pregnant with her first child, Edisa’s husband unexpectedly passed away. In need of transportation to reach the closest health facility, and without family nearby, Edisa went into labor at home.

Friends and neighbors contributed money for her transportation to a local hospital, but without enough money for treatment, she labored without medical attention for two days. On Edisa’s third day at the hospital, the staff finally attended her. The child did not survive the prolonged labor.

Edisa returned to her community without a baby, but with a devastating obstetric fistula—an injury caused by prolonged labor and results in a hole between the birth canal and one or more of a woman’s internal organs. The outcome is chronic, uncontrollable leakage of urine and/or feces.

While Edisa was recovering, a neighbor told her that she, too, had the problem of leaking urine after giving birth. She encouraged Edisa to visit Kitovu Hospital, a facility that provides fistula repair surgeries through USAID-supported hospital in Uganda.

Again, Edisa found herself unable to access the care she needed due to financial constraints. Borrowing from friends, Edisa collected enough money for transportation to the hospital located 11 hours away from her home. In Uganda, women can spend up to $25 on one-way transportation costs for two people to a fistula repair facility.

After receiving fistula repair surgery the USAID-supported hospital, Edisa is now completely healed and looking forward to her future. But for the more than 2 million women in sub-Saharan Africa and Asia that are estimated to be living with fistula, the costs of care can be insurmountable, leaving them to go untreated.

Despite increased availability of often free fistula repair in Uganda, women like Edisa can still lack access to this critical treatment.

Because of the factors that can result in an obstetric fistula, including difficulties with transportation to health facilities and lack of quality health services, this injury has a greater impact on women living in poverty. Women living with fistula typically live in impoverished, remote settings with limited access to facilities that provide fistula surgeries.

A group of African women

Women at a USAID-supported fistula repair clinic. / Fistula Care Plus

A recently published USAID-supported research study sought to better understand the barriers women face when seeking fistula care. From June to December 2015, a research team conducted interviews and focus groups in Nigeria and Uganda with women affected by fistula, women’s families and spouses, and fistula care health providers

The study found that women face financial barriers when seeking fistula repair surgery, including loss of income and transportation expenses. In addition to direct medical expenses for fistula care, women also face the costs for food and water during their recovery period at the facility as well as costs to hire child care or employees to manage their businesses.

Pooja Sripad, study co-author and associate at Population Council, says that the research team sought to look at the cost and transport involved in fistula repair “more holistically.” She further explained the research team’s surprise at the wide range of barriers reported and how these barriers limit women’s “own agency to seek treatment.”

Due to the complex nature of fistulas and poor quality of care, women often have to receive multiple surgeries and visit different surgical facilities. That also increases transportation and surgical costs.

Mothers waiting in a clinic in Nigeria.

Mothers waiting in a clinic in Nigeria. / USAID

Dr. Mark Shrime, director of the Center for Global Surgery Evaluation at the Massachusetts Eye and Ear Infirmary and Harvard Medical School, says that the results are “yet another example in a growing body of literature showing that the ‘non-medical’ costs of care—things like transportation, food and lodging—are huge sources of catastrophic expense for surgical patients. Most of our health policies, if they look at financial risk at all and most don’t look only at the risk patients face when getting the surgery itself, but this paper demonstrates how ‘free’ surgery is rarely actually free.”

“The implications are pretty evident,” he added, “to deliver truly equitable, quality surgical care, we need to broaden our definition of ‘health’ to include the financial state we leave patients in after we’re done treating them.”

USAID is using this study to improve care for women with fistula. In Nigeria and Uganda, USAID has piloted a groundbreaking intervention that addresses these barriers and will transform how women like Edisa access care.

Women at Kyenjojo Hospital, Uganda.

Women at Kyenjojo Hospital, Uganda. / Amy Fowler, USAID

After enduring six months of leaking and leg pain, Edisa is taking control of her life, empowering other women to seek treatment through interventions like those provided by USAID that address the central barriers to seeking fistula repair surgery.

Before departing for Kitovu Hospital, women in her village who also suffer from fistula were hesitant to seek treatment. For many women with fistula, the emotional costs of returning home without relief is yet another hidden cost of fistula repair.

“They told me that if I got cured, that they would also come. Now, they will come,” says Edisa.

Since 2004, more than 50,000 fistula repair surgeries have been made possible all over the world through Fistula Care Plus Project and other USAID-supported fistula care projects.

ABOUT THE AUTHOR

Bianca Devoto is an intern in USAID’s Office of Population & Reproductive Health supporting USAID’s management team for the Fistula Care Plus project.



Witnessing Hope and Health for Kenyan Orphans and Vulnerable Children

An outdoor playground

Among its many features, COGRI’s sister facility, Nyumbani, includes a playground for children who are at risk, or vulnerable to, HIV.

We were late. Very late. Morning meetings ran over, office tasks required urgent attention and Nairobi’s infamous traffic led to a delayed arrival at the nondescript metal gate outside the clinic in Kawangware, an informal settlement in need of social amenities.

As we hastened our pace to the small administration office, the staff graciously ignored our tardiness and warmly welcomed us to the Lea Toto Clinic operated by the Children of God Relief Institute (COGRI), a non-profit organization dedicated to caring for children and adolescents who have been orphaned from, or are vulnerable to, HIV, and who live in six of Nairobi’s poorest informal settlements. Lea Toto means “to bring up the child” in Kiswahili.

Upon arrival, our hosts handed us a summary on the history of Lea Toto and the Kawangware facility’s impressive pediatric and adolescent accomplishments supported by USAID through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR.

PEPFAR funding helps COGRI staff manage the facility and evaluate the project’s aim—to deliver high quality, high impact pediatric and adolescent HIV care.

Soon an elderly and vivacious Irish nun walked in and quickly introduced herself as Sister Mary Owens, the executive director of COGRI. Sister Mary provided an impassioned explanation of the holistic care COGRI has provided for hundreds of young Kenyans over the past 25-plus years, including: psychosocial support groups, referrals for child victims of gender-based violence, case management, schooling, housing and medical care.

A woman stands outside, next to a carved sign in the middle of a fountain surrounded by rocks.

Sister Mary Owens, COGRI’s Executive Director, has devoted her life to caring for children and adolescents who have been orphaned from, or are vulnerable to, HIV.

Embedded in her introduction was deep hope and advocacy: advocacy for children receiving the medical treatment they need and deserve, and hope that one day soon no Kenyan child will be infected with HIV in utero or during breastfeeding.

There are an estimated 1.6 million people in Kenya living with HIV, of which 120,000 are children ranging from infants up to 14 years old, according to the 2016 estimates from UNAIDS.

Kawangware clinic’s sole physician, Dr. Caroline*, told us that of the 377 children and adolescents who were currently receiving HIV care at the facility, 73 percent have achieved viral suppression, which happens when a patient is correctly taking an adequate treatment regimen. That percentage is notably higher than Kenya’s current average pediatric viral suppression rate of 65 percent and is attributed to USAID’s ongoing commitment to eliminate HIV in Kenya.

Still, there are challenges.

A few children here are not yet virally suppressed due to barriers that far too many children and adolescents face: food insecurity resulting in difficulty tolerating HIV treatment, absence of a consistent caregiver to administer the necessary daily medication and provide support and accountability, and lack of transport fare, making it nearly impossible to return to collect medications.

There are no easy solutions. Nonetheless, the Kawangware staff persist in trying to find ways to better support their patients, to ensure each child and adolescent achieves a healthy, happy life.

One of these young people was only 12 years old when he was brought to Lea Toto by his grandmother. He was in declining health with no improvement in sight, a state common among children and adolescents living with untreated HIV.

Upon arrival to Lea Toto, the young man was immediately initiated on ART. His treatment, coupled with strong psychosocial support including peer mentoring, enabled him to regain health and confidence. Through COGRI’s unwavering dedication to this patient’s health and education, the now 23-year-old young man proudly holds a certificate in graphic and web design and has successfully started his own shoe business.

Kawangware also operates Nyumbani, a sister facility that is home to COGRI’s state-of-the-art laboratory and is one of a select number of sites in Kenya performing HIV drug-resistance testing. The lab also provides fee-based laboratory services to external facilities for both HIV- and non-HIV-related conditions to fund its operations.

Exterior of a blue buuilding

COGRI’s sister facility, Nyumbani, is dedicated to caring for children and adolescents who have been orphaned from, or are vulnerable to, HIV.

It was easy to forget the dire situations many COGRI beneficiaries face as we wandered through the immaculate grounds and observed the contagious joy coming from several young children as they were laughing, playing and learning.

It was during our Nyumbani visit that Sister Mary shared stories from the early 1990s, a time when the only HIV medications available were inconsistent drug donations from overseas, necessitating numerous medication regimen changes for each child.

While the piecemeal approach was far from today’s standard of care, the children were receiving treatment that many people living with HIV in Africa did not have access to at that time. The devotion of Sister Mary and the Kawangware and Nyumbani clinic staff, coupled with the tremendous progress made thus far through USAID and PEPFAR support, brings Kenya closer to halting the HIV pediatric epidemic, granting a brighter future for all Kenyan children.

*Full name withheld to protect privacy.

A Man Among Men

Themba stands outdoors speaking to a group of people who are sitting on the ground

Themba talks to beneficiaries

Here’s how we’re transforming gender norms to improve food security in rural Zimbabwe

In 2014, I was on a site visit to one of our food security activities and shared with beneficiaries my experiences supporting my wife to care for and feed our daughter, Simpie. A group of about 20 gathered under a tree, sitting in the dirt and listening attentively.

I told them I could comfortably change Simpie’s diapers, and that I trained her to use a potty and dressed her up nicely, taking care to match the colors of her clothes. I also did her hair, and you would never know it was not her mother who did it! I am proud of all that.

The women seemed to enjoy my story, especially when I shared that I cook, and had introduced Simpie to maize flour porridge fortified with either peanut butter or eggs. Like most 2 year olds, she was a fussy eater and feeding her required patience, encouragement and even goal setting— all of this based on trust and a strong relationship.

Two men stand outdoors, both looking at a printed chart

I got a different reaction from the men. None of them made eye contact with me as I spoke. To the contrary, they looked at the ground and started using sticks or their index fingers to draw in the soil.

It was clear I was causing discomfort. I could practically hear their thoughts: “That is women stuff.” I would not be surprised if some thought “wadliswa” or “akadyiswa,” meaning that my wife had used a love potion on me. Most traditional men couldn’t imagine a man in his right mind caring for his child in this way.

In a profound way, men directly and indirectly influence mothers’ ability to feed and care for their children. In a typical day in rural Zimbabwe, a mother must collect water, search for firewood, make a fire, cook and wash dishes, repeating this cycle for every meal. She must also spend a large proportion of the day tending to the family’s crops.

Mothers simply do not have the time in the day to focus on all their responsibilities, including the childcare and nutrition necessary for the healthy growth and future productivity of their children.

In 2014 when I gave that talk, USAID had just launched two Food for Peace activities, implemented by consortia led by World Vision and Cultivating New Frontiers in Agriculture, to reduce stunting in rural parts of Zimbabwe, where approximately one-third of children were malnourished. These activities addressed the root causes of malnutrition, including gender norms that prohibit healthy infant and young child feeding practices.

It was evident that to improve child nutrition, USAID and our partners had to work with men.

So our partners devised strategies to increase male involvement, including the concept of Male Champions as community role models. Their campaign motto: “Indoda Emadodeni,” or Man among Men. Male Champions recruit their peers and organize monthly meetings to discuss men’s roles and responsibilities.

Monthly group trainings are interactive and challenge men to debate and resolve problems. Our partners also engaged traditional leaders in gender dialogues to reflect on and challenge social norms that are a barrier to optimal nutritional practices and gender equity.

Headman and Male Champion Munyaradzi Gwenhamo said, “From when we were children, cooking has been a woman’s duty in our society. If a man is seen cooking, he will be a laughing stock ofA man stands ourdoors, holding a badge that reads "USAID Male Advocate" the village. Bad things would be said about his wife, especially being accused of using love potions. However, after male advocates training, I realized that manhood would not be lost by cooking. Actually, I am realizing I am a better cook! I can prepare porridge for my child and feed her. She loves me. My wife also feels relieved when I do so; she is happy too.”

The impact of Male Champions is not merely anecdotal. In areas where the campaign was piloted, a survey found statistically significant improvement in supportive behaviors such as fetching water and firewood, caring for the children, accompanying their wives to a health facility and cooking.

According to annual partner reporting, there was an increase in joint decision-making between spouses from 30 percent in 2016 to 82 percent in 2017. The proportion of men accompanying their spouses for antenatal care visits increased from 55 percent in 2016 to 67 percent in 2017.

In just four years, I am seeing major progress. Already, when I share my experiences caring for my daughter, men no longer hide their faces with embarrassment but rather look at me with appreciation—or at least amusement—and say “uyindoda emadodeni” (you are a man among men), high praise that does not come that easily.

It is important to me that I can advocate for these changes because I practice them myself in my own family. It is even more rewarding to see other Zimbabwean men who are now doing the same.

RELATED LINKS:

Themba Nduna is a nutrition advisor in USAID/Zimbabwe’s office of Humanitarian Assistance and Resilience.

Making Education Safe for All

Classmates in the Democratic Republic of Congo celebrate their success after a performance at an event organized to celebrate the International Day of the Girl Child. Photo Credit: Julie Polumbo​

Would you want to participate in class if there was a chance your teacher might hit you if you made a mistake? Could you concentrate on the lesson if your classmates were making fun of your appearance?

For millions of children around the world, violence in schools is a daily reality.

While parents and communities expect schools to be safe and protective environments, research shows that students face high levels of violence, including corporal punishment, bullying, sexual harassment and assault, which is called “school-related gender-based violence.”

This abuse has negative impacts on girls’ and boys’ physical and mental well-being, and also hinders their ability to learn, stay in school and achieve their full potential.

Recent research [PDF, 1.6MB] commissioned by USAID reveals that students who experience bullying have lower test scores in reading, math and science. Additionally, we know that corporal punishment is linked with poor academic performance, low class participation and poor health and  well-being [PDF, 545K].

Adolescent girls are also especially at risk for sexual violence in schools, which can lead to dropping out, pregnancy, HIV/AIDS and early marriage—all factors we know to perpetuate the cycle of poverty.

Evidence also suggests that the cost of education, including school fees, uniforms and books, may stop some poor families from sending their girls to school. Too many schoolgirls, who are keen to continue their education, fall prey to sexual exploitation by older men, exchanging sex for money, food, mobile phones and school fees.

Ending violence in schools is not only the right thing to do, it’s the smart thing to do. We know that educated, employed and civically engaged youth drive economic growth, democracy and prosperity. We know that students who feel supported and safe in their schools learn best. Failing to protect our children can further perpetuate cycles of violence, instability and unrest

This is why USAID couples its investments in teaching children to read with strategies that will keep them safe—including in crisis and conflict environments. A lasting end to school violence requires collaboration with host-country governments and local communities spearheaded by  mothers, fathers, community leaders, teachers and school principals.

African-led institutions, such as the Association for the Development of Education in Africa, help foster policy dialogue between development agencies and local policymakers to share ideas, lessons learned and knowledge on educational reform. The association empowers African ministries of education to directly take on barriers to education, such as school violence.

USAID also partners with African governments to end school-related gender-based violence throughout the continent.

Ugandan children perform at a two-day conference on gender-based violence hosted with the Ugandan Ministry of Education and Sports. Photo Credit: RTI International/LARA

In Uganda, the Literacy Achievement and Retention Activity works with the Ministry of Education to train teachers, children and communities to recognize, prevent and respond to violence within schools. By creating positive and supportive school climates, Ugandan girls and boys are more likely to participate in class and stay in school, clearing their path to educational achievement and economic success.

With support from the U.S. President’s Emergency Plan for AIDS Relief, USAID works in schools to help adolescent girls become Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) young women. The DREAMS Initiative supports violence prevention programs in schools across 10 sub-Saharan countries where girls are at the highest risk of contracting HIV/AIDS.

Across the continent, we see promising new approaches that help us understand what works to prevent and respond to violence within schools. We all must support more rigorous research and evaluations to build our global evidence base on violence prevention programming and policy.

Read more about this year’s 16 Days of Activism against Gender-based Violence campaign.

RELATED LINKS:

Cheryl L. Anderson is the senior deputy assistant administrator in USAID’s Bureau for Africa. She previously served as mission director for USAID’s Southern Africa, Ghana and East Africa Regional missions.

Oley Dibba-Wadda is the director of Human Capital, Youth and Skills Development at the African Development Bank. Dibba-Wadda has also served as the executive secretary for the Association for the Development of Education in Africa and executive director of Forum for African Women Educationalists.

Ghanaian Chef Works to End Hunger by Reducing Food Waste

In 2011, Elijah Amoo Addo was taking out the trash at a restaurant in Accra, Ghana where he worked as the head chef when he came across a homeless man scrounging through the dumpster for food. The man said he was collecting the leftovers to feed his friends on the street.

Founder of Food for All Africa, Chef Elijah donates bags of recovered rice to beneficiaries.

Founder of Food for All Africa, Chef Elijah donates bags of recovered rice to beneficiaries. / Paul Osafo Buabeng

Elijah was touched by the encounter and from then on, he vowed that no more food from the restaurant would go to waste. He started recovering surplus food from the kitchen to feed the vulnerable and mentally challenged in his community, but he envisioned something bigger.

Initially, it was difficult for Elijah to communicate his vision, as he had little knowledge of the problem of food waste and hunger in Ghana. He started an advocacy group to research these issues and create a social intervention program.  

Elijah came to learn that building a sustainable food system is a priority for the Ghanaian government and stakeholders within the food supply chain. About 95 percent of vulnerable communities across Ghana are not getting enough nutrition. One in five babies born in Ghana are stunted, which has been calculated to cost the economy $2.6 billion a year, about 6.4 percent of the country’s GDP.

Around this time, Elijah learned about the Young African Leaders Initiative (YALI), launched by the U.S. Government to invest in the next generation of African leaders. He applied to the West Africa Regional Leadership Center in Accra, but his restaurant supervisor was not supportive of taking time off to attend the training. In the end, Elijah decided to quit his job so he could fully immerse himself in the program.

The leadership and business skills he learned in the 2014 training helped him launch Food for All Africa.

 Food recovery and redistribution van of Food for All Africa. / Paul Osafo Buabeng

Food recovery and redistribution van of Food for All Africa. / Paul Osafo Buabeng


Elijah and his team operate the first community food bank in Ghana. The center creates efficient and sustainable nutrition streams for low income and vulnerable communities by redistributing surplus food from restaurants, working with rural smallholder farmers to connect their produce to urban hospitality companies.

The organizations also hold a forum for stakeholders to address the inefficiencies within our food supply chain and collaborate in building a more efficient and sustainable food supply chain across Africa.

Elijah said leaving his restaurant job enabled him to fulfill his passion for entrepreneurship and risk taking.

Elijah feels confident he made the right decision. Today, Food for All Africa recovers up to $5,700 worth of food each month from businesses within the food supply chain — including manufacturers, importers, farmers and hotels.

The organization aims to reach 1 million low-income people by 2020. To do so, Food for All Africa works with orphanages, schools and vulnerable communities.

 Food recovery and redistribution van of Food for All Africa. / Paul Osafo Buabeng

Food recovery and redistribution van of Food for All Africa. / Paul Osafo Buabeng


The most defining moment of Elijah’s career was in October 2015. “I envisioned feeding 5,000 beneficiaries on UN World Food Day and drawing global attention by attempting a Guinness World Record for the longest table on the day,” he said. “It was difficult work but we pulled it off even though we couldn’t break the record. To crown it up, it dawned on me when in July 2017 I did receive a Queen’s Young Leader award from Queen Elizabeth II in Buckingham Palace.”

Elijah hopes to scale his services to other parts of Africa in the next five years while building stronger partnerships with businesses.

“Every generation needs to sacrifice and build a better place for its children and future generations,” he said. “And Africa today falls on our shoulders to work in raising the aspirations of children and changing the African story. Africa needs you and me.”

RELATED LINKS:

Fridah Wanjiku is a Digital Communications Specialist based in Nairobi, Kenya. She serves as a Virtual Student Foreign Service intern with USAID on the Young African Leaders Initiative team.

What Does ‘Back to School’ Mean for Children in Crisis and Conflict?

Aisha Mohammed, who fled with her family when Boko Haram attacked her village in Northeast Nigeria was able to continue her education through a non-formal learning center funded by USAID. Erick Gibson/Creative Associates International for USAID

Aisha Mohammed, who fled with her family when Boko Haram attacked her village in Northeast Nigeria was able to continue her education through a non-formal learning center funded by USAID. Erick Gibson/Creative Associates International for USAID

As summer winds down here in the United States, “Back to School” displays with colorful arrays of supplies remind us that students and teachers are preparing for the coming year.

But for many children around the world, going back to school in the traditional sense is elusive.

Each year, conflicts and crises halt or delay the education of 80 million children worldwide. Schools, books and materials are destroyed. Children are forced to leave their homes and communities, often with only the clothes they’re wearing.

In many long-standing conflicts, children spend a significant amount of time out of school. Because the average duration of displacement is 20 years, many children will spend their entire childhood outside of the traditional classroom. The longer they’re out, the less likely they are to ever go back.

However, we know that school is necessary not only for their continued education, but also their emotional and physical protection—and this is critical when their worlds are in chaos.

What ‘Back To School’ Means for Children in South Sudan and Northeast Nigeria

When people are forced from their homes, schools and communities by conflict, USAID partners with development and local organizations to act quickly to help redefine what “school” looks like—ideally so that children are back learning as soon as possible. The conflict or crisis may be ever changing, but USAID seeks to keep learning a constant factor in children’s lives.

Aisha Mohammed (third from left), age 17, and her friends take a break after classes at a USAID-funded non-formal learning center in the capital of Borno State, in Nigeria. Erick Gibson/Creative Associates International for USAID

Aisha Mohammed (third from left), age 17, and her friends take a break after classes at a USAID-funded non-formal learning center in the capital of Borno State, in Nigeria. Erick Gibson/Creative Associates International for USAID

In South Sudan, Nyaradio Gatkuoth and her family fled to a safe haven at the United Nations compound in the capital city of Juba after civil war erupted in 2013—when she was 15 years old. Nearly four years later, conflict continues to disrupt millions of lives in South Sudan.

South Sudan has the world’s highest proportion of out-of-school children, with nearly 70 percent of primary school-aged children missing out on education. Since a political crisis erupted into civil war in 2013, more than 800 schools have closed, and an estimated 900,000 children have abandoned their studies. Today, the formal educational system is still in crisis.

Nyaradio said living in the UN Protection of Civilians site in South Sudan was “like a prison” because she was never able to leave the site. However, she says, attending the Hope Primary School at a site run by UNICEF, and supported by USAID, is a bright spot in her day.

As part of USAID’s Back to Learning initiative, we have supported UNICEF in enrolling more than 430,000 South Sudanese children and adolescents in school, including recently demobilized child soldiers. We have also helped establish more than 950 temporary learning spaces since the civil war began.


Seventeen-year-old Aisha Mohammed grew up in the town of Gwoza, in Northeast Nigeria, and was forced to flee with her family when Boko Haram attacked her village.  Eventually, they settled in the urban center of Maiduguri, which houses hundreds of thousands of Nigerians seeking refuge from the horrors of the ongoing insurgency. As a result, Aisha missed out on formal schooling for nearly two years.

The Boko Haram insurgency has had devastating effects on the education sector in Northeastern Nigeria. UNICEF estimates that nearly 1 million school-aged children have been forced to leave their homes and communities as a result of the ongoing violence.  At the same time, an estimated 3 million children have no access to education across the Northeastern states of Borno, Adamawa and Yobe—those most acutely affected by the insurgency.

Through the Education Crisis Response program, USAID is providing non-formal education in the places where formal schools don’t exist, or where they are too overcrowded to accommodate the influx of children fleeing the insurgency. The curriculum includes basic math and literacy, but is also helping children deal with the emotional effects of what they have experienced. USAID has established more than 1,400 learning centers in Northeast Nigeria, helping 88,000 children like Aisha go back to school.

What ‘Back To School’ Means for USAID During a Conflict or Crisis

USAID is working around the world to expand equitable access to education for children and youth in crisis and conflict-affected environments. For us, “Back to School” during a conflict or crisis means:

  • Providing safe learning opportunities for students and teachers, especially the most vulnerable (such as girls and children with disabilities);
  • Rebuilding education systems, including support to teachers; and
  • Using conflict-sensitive education programs, community engagement and disaster-risk reduction activities to prevent and mitigate future conflict.

Today’s humanitarian crises are more complex and protracted—like the ones in Northeast Nigeria and South Sudan—and require programs that are responsive, flexible and tailored to the context. These programs help young people thrive despite their circumstances, and contribute to peacebuilding and economic growth in their communities.

Although conflict forced her and her family from their home, Nyaradio has completed grade 8 and is waiting to join secondary school this year. “I want to study up to university. I want to be a journalist one day,” she says.

She also says school makes her happy: “We study, sing, dance and forget about our problems.”

Tanzania’s Young Leaders Bring Innovation to Development Challenges

Abella Paul Bateyunga. /Young Business Leaders of Tanzania

Abella Paul Bateyunga. /Young Business Leaders of Tanzania

In Kiswahili, “bora” means better. Two years ago, Abella Bateyunga, 29, founded the Tanzania Bora Initiative to give y oung Tanzanians a voice, a sense of belonging, and a connection to other youth who want to change their country for the better.

The initiative empowers young Tanzanians through data-driven projects, youth-led television shows on political participation, and training for young girls in computer coding.

The Tanzania Bora Initiative leadership team. / Tanzania Bora Initiative

The Tanzania Bora Initiative leadership team. / Tanzania Bora Initiative

Abella founded the initiative after she returned from two months in the United States on a fellowship with the Young African Leadership Initiative (YALI). Funded by the U.S. State Department and USAID, the fellowship is a huge honor; only 1,000 youth across Africa are chosen each year. YALI fellows get to meet other young rising African leaders in their cohort and are offered opportunities for leadership training at U.S. universities.

Abella Bateyunga with the Tanzania Bora Initiative team. / Michael McCabe, USAID

Abella Bateyunga with the Tanzania Bora Initiative team. / Michael McCabe, USAID

As the 2015 national elections in Tanzania approached, Abella thought about new ways to engage Tanzanian youth to both vote and mobilize peacefully. She also thought of ways to empower youth to use data-based evidence and advocacy to engage local and national leaders on social issues.

Abella’s background as a lawyer and former radio reporter for the BBC in Tanzania positioned her to develop a strategy to engage youth in the election and in data-driven development efforts for employment and youth voice.

Girls in the “She Codes for Change” course. / Tanzania Bora Initiative

Girls in the “She Codes for Change” course. / Tanzania Bora Initiative

Creating Youth Dialogue in Tanzania

Many countries in sub-Saharan Africa  are facing a “ youth bulge ” due to high fertility rates; in Tanzania, over 73 percent of the population is under 30.

“She Codes for Change” provides a safe space for girls to learn coding. /Theirworld, Mticka Almas

“She Codes for Change” provides a safe space for girls to learn coding. /Theirworld, Mticka Almas

In Tanzania and other countries, the government and key civil society partners have developed national plans of action to reduce violence against children and youth that stems from domestic violence and other community violence. In other countries, governments are restricting the ability of civil society organizations to speak out on the rights of minority or excluded groups, including youth who are underrepresented in decision-making.

With support from USAID’s Consortium for Elections and Political Process Strengthening and implementing partner the International Republican Institute, Abella started the Tanzania Bora Initiative with a small budget and a core team of five savvy young social media leaders.

Participants of the Kijana Wajibika (Youth Be Responsible) consortium, which demands youth accountability and participation in civic issues. /Kijana Wajikia and Restless Development Tanzania

Participants of the Kijana Wajibika (Youth Be Responsible) consortium, which demands youth accountability and participation in civic issues. /Kijana Wajikia and Restless Development Tanzania

In just two years, Abella and her team have brought innovation to Tanzanian media and civil society with initiatives like Data Zetu, funded by the U.S. President’s Emergency Plan for AIDs Relief (PEPFAR) in partnership with the Millennium Challenge Corporation to promote data-driven advocacy by youth.

Working with artists and young journalists, Abella helps create dialogue in communities based on evidence and data about what is happening and what works through community solutions. Data Zetu empowers youth to gather data from the local government on services and analyzes it to determine areas in need of improvement.

Participants of the Kijana Wajibika (Youth Be Responsible) consortium, which demands youth accountability and participation in civic issues. /Kijana Wajikia and Restless Development Tanzania

Participants of the Kijana Wajibika (Youth Be Responsible) consortium, which demands youth accountability and participation in civic issues. /Kijana Wajikia and Restless Development Tanzania

Other activities have included engaging pop music groups in Temeke District — one of the largest and poorest areas in southern Dar es Salaam — through its Arts for Change project. Abella and her team work with these musicians to write songs that champion their issues.

Given the rise in violence in Tanzania, Abella partnered with USAID-supported partner Search for Common Ground and others to counter violence in the home and community, as well as violent extremist messaging, through television shows, youth peace festivals and media campaigns.

Kijana Wajibika recognizes youth as an asset who can contribute and lead change. /Kijana Wajikia and Restless Development Tanzania

Kijana Wajibika recognizes youth as an asset who can contribute and lead change. /Kijana Wajikia and Restless Development Tanzania

Abella and the Tanzania Bora Initiative also supported the Kijana Wajibika (Youth Be Responsible) consortium funded along with the Restless Development movement   – for youth to demand accountability and participate in civic issues and learn to use data for decisions. Abella’s TV program creates data ambassadors and trains journalists, particularly young women, to collect data and empower youth on topics related to the national youth agenda: employment, sexual health and education.

Recognizing that youth often don’t know their rights, Abella created the “Know the Constitution” campaign — an online portal which is complemented by a television show called “One Voice” (Sauti Moja) serving as a college competition on rights and the constitution.

Amplifying citizens’ voices through data. /Data Zetu

Amplifying citizens’ voices through data. /Data Zetu

Tanzania Bora Initiative-led activities under Data Zetu. TBI/Data Zetu

Tanzania Bora Initiative-led activities under Data Zetu. TBI/Data Zetu

Abella also recognizes the importance of skills-based opportunities for youth who want to make a difference. That was the impetus behind starting She Codes for Change in partnership with Apps and Girls . The program trains girls from each region on digital literacy and computer  coding.

“Creating mobile apps on issues that concern girls has a transformative effect on their opportunities,” said Abella. “The girls have developed apps on female genital mutilation prevention, bus fares, fashion and rights.”

Abella Paul Bateyunga was chosen by USAID partner IREX as a Young African Leadership Initiative fellow in 2014. / Courtesy of Abella Bateyunga

Abella Paul Bateyunga was chosen by USAID partner IREX as a Young African Leadership Initiative fellow in 2014. / Courtesy of Abella Bateyunga

Abella describes her vision for how international development organizations such as USAID can best approach engaging youth as partners in development:

“Youth bring three key tools to the development field: Innovative ideas, a wicked broad knowledge of how to mobilize networks via media (especially new media) and record numbers of youth in Tanzania and around the world. We aren’t the hope of tomorrow, we are changing things today.”

Raising Goats (and Confidence) in Uganda

Women share highly nutritious goat milk from their own livestock with their children to improve and diversify their diets. / ACDI/VOCA

Women share highly nutritious goat milk from their own livestock with their children to improve and diversify their diets. / ACDI/VOCA

One key to women’s empowerment is self-confidence. When a woman truly realizes her worth and can publicly act on that confidence, the world changes for her.

One woman living in the Karamoja region of Uganda—where tradition dictates much in the lives of men and women—had little confidence in her own abilities, that is until she was offered an opportunity to generate income for herself through USAID’s Resiliency through Wealth, Agriculture, and Nutrition in Karamoja Project.

When Joyce Owalinga first married, her husband Sagal managed the family’s money, choosing when and how to spend it. “My husband controlled all the money, and when he went away for long periods of time for work, my children and I had very little food. We would sometimes go to bed hungry.”

Despite economic disempowerment, Joyce, like many women in her village, is responsible for feeding her family. To come up with the money, she collected and sold firewood and charcoal and did odd jobs for others, yet she still failed to scrape together enough for her family’s basic needs. “I couldn’t even afford salt and flour, and I had nothing to call my own.”

To empower women as income earners in their communities—and strengthen food security in Karamoja while diversifying livelihoods for rural families—USAID partnered with ACDI/VOCA and Welthungerhilfe to introduce a hardy breed of goat—Galla, or “milk queens” into the region.

Livestock owner and her family show off their “Milk Queen” goat. / ACDI/VOCA

Livestock owner and her family show off their “Milk Queen” goat. / ACDI/VOCA

The project’s unique approach organized 211 women’s livestock groups, comprised of about 10 women each and initially consulted  with village elders to determine how to best counter expectations of traditional roles and to secure support, as men typically care for livestock and keep the money from sales.

After attending a training to learn how to care for the goats, Joyce received five of her own.  She and other group members attended additional trainings on health management and how to build shelters for the animals. The  goats began to thrive under their care.  

As the women demonstrated their herding skills, gender norms in communities began to change little by little. When Joyce went into the village to sell her goats’ milk, she was able to keep the proceeds and reinvest in the business. After the group took part in animal care training sessions, Joyce confidently spoke to others about how to trim a goat’s hooves. As she spoke, Sagal listened carefully to learn more about the intricacies of animal care.

A recent assessment of this project revealed that 65 percent of community members now recognize livestock group members as new leaders in their communities. And, perhaps not surprisingly, 61 percent of members reported improved marriage dynamics as a result of owning the goats. This holds true for Joyce and Sagal. He quietly mentioned that he now holds more respect for Joyce and intends to give her the first calf born this season.

Lokibeyia Livestock Group Chairwoman Rachel Akol herds one of her many goats.

Lokibeyia Livestock Group Chairwoman Rachel Akol herds one of her many goats.

Now chairwoman of her livestock group, Joyce has successfully increased her stock of goats from 5 to 15. She recently made the decision to sell one of her goats and used the profits to start her own business.

“Now, I have something that I can call my own,” she proudly noted. “As chairperson of my group, I can also now speak with confidence. The other women and community members respect and listen to me, and my husband now respects me.”

As Joyce and other group members grow more confident, they are leading by example and teaching their children how to spot health problems in goats. By involving a new generation in this activity, children now understand that both men and women can own and take care of livestock, fostering gender equality within the children’s minds.

This project represents lasting, sustainable change in Karamoja—a catalyst tool for empowerment that is ushering in a new way of looking at the world.

Food security, economic empowerment and gender equality must all be seen as crucial elements to community resilience, and the project is making strides to ensure that communities in Karamoja value all of these.

Gender equality and women’s empowerment are a core pillar of sustainable development, and USAID currently supports gender programming in more than 80 countries. For societies to thrive, women and girls must have access to education, economic resources, healthcare, and technology.

To achieve USAID’s mission of ending extreme poverty and promoting the development of resilient, democratic societies, programs seek to ensure inclusivity, strengthen the voices of the marginalized and vulnerable, and help women and girls reach their full potential.

ABOUT THE AUTHOR

Mark Mitchell is the deputy chief of party for the USAID Resiliency through Wealth, Agriculture, and Nutrition in Karamoja project. Paul Guenette is ACDI/VOCA’s chief communications officer.
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