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Cambodia’s Youth Debate Champion Helps Young People Find Their Voice

Linda Eang won first prize in the International Republican Institute’s televised debate series Next Generation in 2014. / IRI

Linda Eang won first prize in the International Republican Institute’s televised debate series Next Generation in 2014. / IRI

Linda Eang was once known among her family and friends to be shy, so it was quite the surprise when she won a televised debate competition called Next Generation in Cambodia three years ago.

The 24-year-old’s path to victory wasn’t straightforward.

Growing up, Linda was told by her family to stay away from politics. They feared her involvement after seeing so many people killed under the Khmer Rouge regime in Cambodia from 1975-1979. Even now, she says, they can see on the news that people who get involved in politics are sometimes imprisoned or shot.

While Linda is not old enough to remember the darkest days of Pol Pot’s communist dictatorship, her growing awareness of the current challenges facing Cambodia is what inspired her to become involved in student government and debate at her university.

Once she had the opportunity to go to school, Linda learned about the scale of poverty in her country and its under-resourced health care system. “Living in that kind of environment made me want to become part of the solution,” she said.

Linda and her teammates from the Next Generation debate competition. / IRI

Linda and her teammates from the Next Generation debate competition. / IRI

This inspired Linda to get involved with Next Generation, a project of the International Republican Institute (IRI) supported by USAID.

The initiative was Cambodia’s first televised youth debate competition aired on the most popular television network. Each weekly 30-minute episode brought together 24 selected contestants to debate pressing social and political issues such as poverty, and the electoral system, Facebook censorship and gender quotas in politics. Participants built skills in public speaking and engaged on questions of national importance.

Linda, who was 21 at the time, won first place, and the prize was a study trip to the United States.

“Winning the competition was a turning point in my life,” Linda said. “I never imagined myself standing on stage with the confidence and arguments to convince an audience to vote for my team.”

That experience built up her confidence to amplify the issues she cares about and opened possibilities for future careers that she hadn’t contemplated, such as a job in politics or as a debate coach.

It also helped to expose her to the wider world.

In 2015, Linda traveled to the United States a second time as a youth leader to participate in the State Department’s prestigious International Visitor Leadership program. During the trip, she traveled to Texas, Iowa, Seattle, Washington, D.C. and New York City to learn more about the U.S.

Linda is interviewed by Men Kimseng at Voice of America during her 2014 visit to the United States as part of the State Department’s International Visitor Leadership program. / IRI

Linda is interviewed by Men Kimseng at Voice of America during her 2014 visit to the United States as part of the State Department’s International Visitor Leadership program. / IRI

She has also won five additional national debate competitions and a regional public speaking contest in China, and served as president of the Pannasastra University Student Senate from 2015 to 2016.

Linda is passionately committed to empowering young people through her debate coaching.

Linda has become a true political buff. Her inspiration comes from watching others, who previously never cared about a particular issue, start to have discussions based on her debates. “After my friends and family watched the debate about whether provincial governors should be appointed or elected, they started discussing that issue, and people in my community who never cared about that issue before started to talk about it,” she said.

She has also become passionate about empowering young people through her debate coaching and as a trainer at her university’s debate club for the last three years.

“The greatest barriers for young people in Cambodia are the lack of trust and motivation from the environment around us,” she said. “We are taught to be followers — and in some cases, it makes young people lose their creativity and stunts their full potential. But I think that’s starting to change as more young people become educated. If we study hard and work hard, I believe a better future is possible for us.”

After deciding she wanted to start an initiative that everyone could join, Linda also launched a new public debate club in January of this year. She coaches members in “expressing their point of view and, most importantly, building their self-confidence.”

Now that she has become something of a celebrity in her country, Linda is determined to use her position to help young Cambodians recognize that they have the capacity to not only change their own lives, but change their country for the better.

“As I explore different areas of work, I find myself that I want to help other people as much as I can,” she said. “Being able to make an impact on other people through debating and life coaching are my biggest passion. I see a lot of potential in young Cambodians. My life purpose is to empower and mentor them to reach their full potential and help to shape the future of this country.”

Celebrating Women and Girls during Women’s History Month

Since 2000, USAID has constructed nearly 3,000 classrooms and renovated 2,700 more allowing many schools to cut class size and eliminate the need for students to learn in shifts. / Bobby Neptune for USAID

Since 2000, USAID has constructed nearly 3,000 classrooms and renovated 2,700 more allowing many schools to cut class size and eliminate the need for students to learn in shifts. / Bobby Neptune for USAID

To eliminate poverty and reduce reliance on development dollars, we need to empower women and girls.  Gender equality isn’t just a women’s issue—it’s everyone’s issue.  By educating girls and ensuring women have economic opportunities, USAID works toward better future outcomes for all people.

Investing in girls’ education

Ensuring that a nation’s girls are educated unlocks human potential, translating into a more productive workforce for that country. A recent study found that every year of secondary school education is correlated with a 10 percent increase in a girl’s future earning power.  If 10 percent more adolescent girls attend school, a country’s GDP increases by an average of 3 percent .

As laid out in the U.S. Global Strategy to Empower Adolescent Girls, USAID, the State Department, the Peace Corps, and the Millennium Challenge Corporation are working together to use adolescence as a point to leverage development and diplomacy efforts. Positive interventions during adolescence can disrupt the cycle of poverty, and instead prepare entire country populations for future GDP growth and thriving economies.

Solita Melus, 33, holds her baby Orelus after he receives immunizations and is weighed by Ketcia Orilius, a community health worker in Haiti. At 3 months old, Orelus weighs 5 kilos, a weight that Ketcia tracks on her tablet. / David Rochkind, USAID

Solita Melus, 33, holds her baby Orelus after he receives immunizations and is weighed by Ketcia Orilius, a community health worker in Haiti. At 3 months old, Orelus weighs 5 kilos, a weight that Ketcia tracks on her tablet. / David Rochkind, USAID

Helping Women Open Businesses

Worldwide, women own or operate up to 33 percent of all private businesses, and women-owned enterprises grow faster than those owned by men and faster than businesses overall. And yet, only half of all women of working age, compared to three-quarters of men, are in the workforce. If the same number of women participated in the global economy as men, the world could grow in GDP by $12 trillion.

In developing economies, women are 20 percent less likely to have a formal bank account than men, and are substantially less likely to use savings and lending instruments. These means it is more difficult for women to start a businesses. USAID saw this challenge as an opportunity, and now e-payments are the default payment method for our programming and development assistance. Since switching from cash to e-payments, providers estimate that Bangladesh alone has saved 40,000 hours in staff time and $60,000 per year, while bringing thousands of previously unbanked women into the financial system.

Caring for Mom and Baby

In developing countries, a mother’s death in childbirth means her newborn is about eight times more likely to die in the first year of life than one whose mother was alive. USAID is working in 25 countries around the world to end preventable child and maternal deaths.  By focusing on cost-effective, high impact interventions, we have helped reduce maternal deaths globally by nearly 50 percent since 1990. And in the past ten years, U.S. Agency for International

Development (USAID) efforts have contributed to saving the lives of more than 4.6 million children and 200,000 women.

These development objectives are interrelated: Researchers estimate that over 50 percent of the decline in child deaths between 1970 and 2009 can be attributed to increased educational attainment by mothers. This research brought together USAID’s education, health, and economic empowerment development strategies: Each piece of development impacts another. By investing in women and girls, and providing them with education and economic opportunities, we are able to ensure that their children and families are safe and healthy – thereby impacting households and communities.

I just returned from New York where I attended the UN Commission on the Status of Women, and we discussed women’s empowerment in many forms. At USAID, our programs provide opportunities for education, economic empowerment, and better health for women to determine their life outcomes, and influence decision-making in households, communities, and societies.

As Women’s History Month comes to a close, we hope you continue to honor the women who have overcome barriers, pioneered the paths that all of us walk—women and girls, men and boys—and continue to contribute to a better future. We will continue to work for increased opportunity and prosperity for women and girls—leading to a more stable and secure world for everyone, everywhere.

ABOUT THE AUTHOR

Marita Eibl is the Acting Senior Coordinator for Gender Equality and Women’s Empowerment at USAID.

Partnering to Improve Women’s Lives in Bangladesh

On International Women’s Day, USAID recognizes a joint mission with the U.S. Pacific Command to repair devastating childbirth injuries and improve the lives of women in the Asia-Pacific.

Sukuri waits for fistula surgery at Kumundi Hopital in March, 2014. Locked in a cycle of her husband leaving her to remarry and then returning to her, she hopes for the repair of her fistula and a united family. / Amy Fowler, USAID

Sukuri waits for fistula surgery at Kumundi Hopital in March, 2014. Locked in a cycle of her husband leaving her to remarry and then returning to her, she hopes for the repair of her fistula and a united family. / Amy Fowler, USAID

The prospect of motherhood often brings anticipation and joy. But for women living in extreme poverty, motherhood can bring fears of obstetric complications or death, or a prospect of rejection or broken families if they suffer permanent disabling injuries.

Particularly in sub-Saharan Africa and South Asia, many women who give birth find themselves with a devastating maternal injury. Called obstetric fistula, the condition is a hole in the birth canal that results in chronic, uncontrollable leakage of urine and/or feces. Fistulas are commonly caused by obstructed labor without access to timely and skilled medical care, such as cesarean section.

All too often, women with fistula are abandoned or neglected by husbands, unable to work, ostracized from their communities, and left to deal with heartache after a stillbirth.

For Hosnera, a housewife in Bangladesh, the future looks brighter thanks to USAID’s Fistula Care Plus project. Fistula Care Plus trains doctors and nurses to perform fistula surgery and provide expert pre- and post-operative care and work in communities to prevent fistulas through access to quality, timely care during labor.

Hosnera has lived with a fistula for 10 years and Bangladeshi doctors have been unable to repair it. After receiving training from USAID, doctors at Kumundini Hospital successfully performed the surgery and Hosnera is now fistula free.  

Hosnera at Kumundi Hospital in March 2014. With training from Fistula Care Plus, doctors at Kumundini Hospital were able to successfully perform the surgery. Photo by Amy Fowler, USAID

Hosnera at Kumundi Hospital in March 2014. With training from Fistula Care Plus, doctors at Kumundini Hospital were able to successfully perform the surgery. Photo by Amy Fowler, USAID

Other Bangladeshi women are not so fortunate. Throughout the country, an estimated 71,000 women have fistulas that require surgery, and each year an estimated 2,000 more Bangladeshi women develop them. The 13 centers and hospitals in Bangladesh that conduct fistula repair can only perform about 1,000 operations per year, leaving about half of the women with untreated maternal injuries. To address this gap, USAID and the Department of Defense (DOD) are working together to help boost the number of local fistula surgeons, as well as surgical repairs.

USAID and DOD collaborated on a joint medical mission in November 2016 to train local Bangladeshi medical personnel on improved techniques for fistula repair and prevention. The training was possible through a one-year interagency agreement between USAID and the U.S. Army Pacific Command (PACOM). The first phase involved a two-week intensive training on fistula repair and prevention among a team of Bangladeshi medical students, nurses and surgeons from PACOM’s Regional Health Command-Pacific, surgeons from Tripler Army Medical Center and USAID health officers.

“This effort helps advance U.S. Pacific Command and Regional Health Command-Pacific’s mission to prevent disease and improve the health of systems and individuals across the Asia-Pacific,” said Brigadier General Betram Providence, commanding general of Regional Health Command-Pacific. “Together we can help Bangladeshis have access to basic or specialized medical care.”

During the training, the DOD team demonstrated improved techniques that help prevent fistula, as well as improved surgical methods with the use of certain tools. DOD also assisted Bangladeshi surgeons during fistula surgeries, some of whom had been trained through the USAID project. A second phase of the mission is scheduled in April 2017.

“I appreciate the PACOM team giving me the opportunity to share knowledge and skills,” said Prof. Begum Nasrin, one of the trainee fistula surgeons. “I think my knowledge from this training will be help me alleviate the patient’s sufferings. I hope for more of this kind of program in the future.”

By the end of the joint mission, the team successfully completed 36 fistula-related surgeries helping women live happy lives with their family. One of the women was brought to Kumundi Hospital last fall for repair surgery during the visit with PACOM surgeons. Since the birth of her last baby nearly four years ago, she had suffered from recto vaginal fistula, a condition characterized by continuous leaking of the stool through the vagina. Today, she is finally free of fistula.

“The terrible days with leaking stool are over,” she said. “I am now enjoying a different and better life. Thanks to the friendly doctors for making it happen.”

Since 2005, USAID has tested new approaches to identify women with fistulas in Bangladesh before taking expensive trips to hospitals for curative treatment. USAID has improved the surgical and nursing skills of health care personnel to prevent and surgically repair obstetric fistula, uncovered the unintentional creation of fistula in caesarean section and hysterectomy, and has supported the repair of obstetric fistula for more than 2,000 women.

“Our collaboration with PACOM helps build enduring, strategic relationships with partner nations,” added Natalie Freeman, USAID Senior Development Advisor to PACOM. “Working together helps us achieve common ground.”

USAID and DOD have partnered since 1961 to make best use of our combined skills and resources and help improve lives around the globe.

ABOUT THE AUTHOR

Kristen Byrne is the Strategic Communications and Outreach Specialist for USAID’s Office of Civilian-Military Cooperation.

When Violence Is Not the Exception

 Anju, before heading off to a job interview. /Amy Fowler, USAID

Anju, before heading off to a job interview. /Amy Fowler, USAID

It had been only six months into the marriage before Anju’s* dream of a “happily ever after” was shattered to pieces. Hailing from Haryana, a state known across India for its shockingly high rates of female feticide, Anju dared to believe that her husband would love and keep her well.

“In the beginning, he was very nice to me,” she says. “But it all changed when my father died.”

When her husband’s family realized that Anju may have received an inheritance, they began to demand more dowry. But Anju’s mother, try as she might, was never able to fulfill their requests. With a young son to take care of and already living in an unhappy household, Anju found her daily life worsening when her brother-in-law tried to force himself on her.

Anju turned to her husband for support and was shocked when, instead, he told her to accept the advances of his brother. It was then Anju learned her husband’s family traditionally shared women. When she refused to take part, they took away her phone, beat her, raped her, and threatened to force her into prostitution.

Worried for what her son would learn and how he would grow up, she tried to run away but was caught. As punishment, she was locked in a room, separated from her son, and starved. Her sister contacted the police, who helped rescue Anju and her son from her husband’s family.

Sadly, this sort of violence against women is not the exception. In India, rape is the fastest growing crime. According to the country’s National Crime Records Bureau, every 29 minutes, a woman is raped; and every nine minutes, a case of cruelty at the hands of a husband or relative occurs. Gender-based violence (GBV) is widespread. It threatens the health, freedom and security of victims and yet remains largely hidden by a culture of silence.

USAID, however, is working to change these statistics. Take Anju, who, through an aunt, heard of a USAID-supported crisis management center where she received psychosocial and legal counseling. With a newfound confidence, she is pursuing legal action and has a court case against her husband. In her words: “The day I first came here, I was so afraid. Now I know what I have to do. I am with my child. I am independent.”

This crisis management center, which to date has dealt with 1,905 cases, is supported under USAID’s Wajood project. Wajood works to increase access to GBV services such as counseling, trainings and linkages, and to transform negative gender norms within communities.

USAID’s Wajood project works to increase access to gender-based violence services such as counseling, trainings and linkages, and to transform negative gender norms within communities. /Amy Fowler, USAID

USAID’s Wajood project works to increase access to gender-based violence services such as counseling, trainings and linkages, and to transform negative gender norms within communities. /Amy Fowler, USAID

These efforts reflect USAID’s global commitment to prevent and respond to gender-based violence and promote women’s empowerment and gender equality. We know that sustainable and inclusive development cannot be achieved without ending gender violence.

Today, Anju has joined the many survivors who have been helped by this center and others like it. As she raises her son to respect women, she is now confident that she can “take action and live without a man.”

Her strength astounds me. When I first met Anju, she spoke hardly a word and would not look me in the eyes. Weeks later, and knowing that her story could help other women, she confidently told me and others her experience before proudly heading off to a job interview.

Her story is just one of many in the struggle against GBV, but it embodies the extraordinary courage and resilience of survivors. During these 16 Days of Activism Against Gender-Based Violence from Nov. 25 through Dec. 10, let us think of Anju and recognize the importance of ending GBV, not just so women like her can lead better lives, but also so the rights of everyone, everywhere, are forever protected and ensured.

*Name changed to protect identity.


ABOUT THE AUTHOR

Katherine Kemp recently worked as a summer hire in USAID’s Health Office in India.

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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.

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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Responding to Madagascar’s ‘Silent’ Emergency

With support from Catholic Relief Services, Sisters of Charity provide hot meals to the elderly and children in Tshiombe./Christopher LaFargue, USAID

With support from Catholic Relief Services, Sisters of Charity provide hot meals to the elderly and children in Tshiombe. / Christopher LaFargue, USAID

Because of its slow onset, Southern Africa’s drought may not be headline news. But its impacts are being felt by millions. At least 12.8 million people in Southern Africa will face crisis levels of food insecurity by the end of this year.

Madagascar has been especially hard hit. About 80 percent of the population in the country’s seven southern districts—665,000 people—are in need of emergency food assistance.

I recently traveled to Madagascar with U.S. Ambassador to the United Nations Agencies for Food and Agriculture David Lane. There we met with communities struggling to find enough to eat after three years of consecutive drought made worse by El Niño.

20160519 Tshiombe CRS Community Canteen 1

Soeur Josiane from Sisters of Charity speaks to Dina Esposito about the soup kitchen in Tshiombe. / Christopher LaFargue, USAID

During our trip, we saw visibly malnourished children and adults, including many elderly. In Tshiombe, we spoke with Soeur Immaculata, a nun from Sisters of Charity, who opened up an emergency soup kitchen to provide regular hot meals to children and the elderly. She told us she had not seen so much suffering since the severe droughts of 1992 and 2006.

We also visited Ankilimafaitsy Primary School in Ambovombe, where the U.N. World Food Program is providing children with lunch as part of a school lunch program that feeds almost 300,000 Malagasy children daily. For most of these children, this school lunch is the only food assistance they receive; it has become a vital lifeline in these communities as parents struggle to put food on the table.

Here are three steps we—and other donors—must take to help the people of Madagascar during this “silent,” but devastating emergency:

20160518 Ambovombe WFP School Canteen 3 (1)

Children receive hot meals from the Sisters of Charity soup kitchen supported by Catholic Relief Services in Tshiombe. / Christopher LaFargue, USAID

1. Coordinate support

During my trip, we announced an additional $8 million in food assistance to the Malagasy people, bringing the United States’ total El Niño response in Madagascar to $17 million. But we must work with the government and the donor community to coordinate our assistance. We encourage Madagascar’s national and local officials to assess immediate needs, more proactively mobilize their own response, and more effectively draw global attention to the crisis, mobilize contributions, and facilitate donor planning.

Ready-to-use supplementary food provide children with much needed protein, vitamins and minerals to fight malnutrition./Christopher LaFargue, USAID

Ready-to-use supplementary food provide children with much needed protein, vitamins and minerals to fight malnutrition. / Christopher LaFargue, USAID

2. Plan early for a scaled up emergency and recovery response 

As in the ongoing Ethiopia drought response, early warning is the key to early response. Forecasts indicate that Madagascar’s lean season could begin as early as August rather than October. Children under 5 in this area have unusually high rates of malnutrition. It is urgent that we complement expanded food assistance for families in these southern districts with specialized foods to prevent and treat malnutrition.  

I was particularly impressed by Madagascar’s National Office of Nutrition and its efforts to screen and treat cases of moderate acute malnutrition. We met with well-trained volunteers who were educating young mothers about nutrition. With USAID support, children are being provided with ready-to-use supplementary food. Sustained assistance will be critical in the months ahead to prevent children from sliding into the more serious condition of severe acute malnutrition.

Equally important will be ensuring that families can grow their own food in the next cropping season. A seed distribution plan must get seeds in the hands of farmers by September.

Women farmers in Amboasary tend to a cleared communal vegetable field through a World Food Programme food for assets activity. / Christopher LaFargue, USAID

Women farmers in Amboasary tend to a cleared communal vegetable field through a World Food Programme food for assets activity. / Christopher LaFargue, USAID

3. Continue to invest in resilience

Although the current drought is outpacing the ability of many Malagasy farmers to cope, some farmers have remained self-reliant with our investments. Some of our disaster mitigation efforts include working with farmers to grow more drought-resistant crops like sweet potato and cassava. We are also helping farmers to build assets, access more land near water sources, and improve nearby water points for humans and cattle. Voucher programs help fishermen buy tools and other resources during this drought.

Under a creative arrangement, local farmers are growing corn on large-scale plantations, between rows of sisal (a plant used to make rope and rugs), in exchange for keeping the fields cleared and tended. The farmers keep one-third of what they grow to sell or eat, they reserve a third for seeds for the next season, and another third is sold to the World Food Program for its school lunch program.

The program has especially benefitted women farmers, one of whom told me, “We used to have to take our children out of school when they turned 15. Now they can stay on into high school. Our girls no longer have to ask men for money to buy soap [a local euphemism for prostitution].”

These efforts are making a clear difference as communities cope with drought. We must continue to scale up these investments—and help expand opportunities for populations to make a living during both good and bad times.

The people of Madagascar will inevitably face future climate shocks in addition to the current drought. We can help them to mobilize, plan and build resilience to those shocks to promote security and avert emergencies.

ABOUT THE AUTHOR

Dina Esposito is USAID’s Acting Deputy Assistant Administrator for Democracy, Conflict, and Humanitarian Assistance. @DEsposito_FFP


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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.

Empowering Women Through a Simple Purse

Imagine giving birth without the help of sterile tools, a doctor, nurse or midwife. This is the experience of nearly half of women giving birth in low-income countries — and many are at high risk of infection. With limited access to antibiotics, these infections often prove fatal.

One woman is trying to change that.  

Zubaida Bai, founder and CEO of ayzh, speaking at USAID's Partnering to End Extreme Poverty and Achieve the Global Goals event. / USAID

Zubaida Bai, founder and CEO of ayzh, speaking at USAID’s Partnering to End Extreme Poverty and Achieve the Global Goals event. / USAID

Zubaida Bai is the co-founder of ayzh, an organization providing women’s health resources to underserved women globally.  The venture’s first product is a clean birthing kit that includes all the items recommended by the World Health Organization to prevent infection at birth.

Infections at birth affect more than 6 million women annually. Even worse, poor hygiene and sanitation during birth is directly linked to the preventable deaths of more than 1 million women and newborns each year.

In celebrating International Women’s Day earlier this month, we recognize women like Zubaida who are revolutionizing their field and making history with their achievements. With the support of USAID and other organizations, Zubaida’s work establishing ayzh has saved the lives of women and newborns on a global scale.

Zubaida posing with the clean birthing kit. / Ayzh

Zubaida posing with the clean birthing kit. / Ayzh

This is her story: After earning her engineering degree, Zubaida Bai decided to go back to India to serve the women she had seen suffer her whole life from health and financial hardship.

She worked in India for four years developing technology appropriate for low-resource settings, before she decided to spin off on her own. Both Zubaida and her husband Habib were passionate about helping women, so they started looking for opportunities to design for this underserved population.

On a field visit to a rural village, Zubaida discovered that some midwives used a sickle — normally used for cutting grass — to cut the umbilical cord. This was an “aha” moment for her.

Reflecting on the infection she contracted when her first child was born in one of the best facilities in India, she thought, “If I had everything and had to suffer an infection, what would women in these villages be facing?” This is the moment that launched Zubaida into a whole new world of maternal health.

“It made me very determined to make my childhood dream come true – to improve the lives of women,” she said in a blog for TED.

In 2007, Zubaida and her husband participated in MIT’s International Development Design Summit, a program that brings together people from across the globe to collaborate and build projects that address issues faced by the world’s poorest communities.  The program exposes participants to practical design for development.

Zubaida and other IDDS participants in morning circle, the way that summits start their days with team building exercises, announcements, and appreciations. / IDIN

Zubaida and other IDDS participants in morning circle, the way that summits start their days with team building exercises, announcements, and appreciations. / IDIN

After studying how to best succeed in markets in developing countries, Zubaida founded ayzh in 2009 and a year later launched the clean birth kit. She called it “janma,” which means “birth” in Sanskrit. The $3 purse comes with six items to ensure a safe and sterile delivery at half the cost of comparable birth kits.

Ayzh hires local Indian women to assemble the packages, allowing them to develop a stable income. Since 2010, about 250,000 kits have been sold in India, Afghanistan, Gambia, Laos, Ghana, Malawi, Nigeria, Zambia, and Haiti — reaching 500,000 mothers and babies.

Ayzh plans to reach 6 million women over the next five years, improving maternal health and breaking the cycle of poverty one woman at a time.

With support from USAID’s Higher Education Solutions Network (HESN) through MIT’s International Development Innovation Network, ayzh is developing a similar kit for newborns. It will provide the tools necessary to make transitions for new mothers and their babies as smooth and healthy as possible.  

Through HESN, USAID is empowering entrepreneurs and researchers at universities so that people like Zubaida can get the funding and mentoring they need to jump start their ventures.

Zubaida Bai and ayzh intern Kelly Brennan iterating on potential impact metrics they can use when communicating with their stakeholders during a workshop in Chennai, India. / Kyle Munn, SEAD

Zubaida Bai and ayzh intern Kelly Brennan iterating on potential impact metrics they can use when communicating with their stakeholders during a workshop in Chennai, India. / Kyle Munn, SEAD

Last year, ayzh was selected to be a part of a cohort of innovators at the Social Entrepreneurship Accelerator at Duke  — another HESN partner — to receive mentorship and capacity building to expand their global reach and impact. The Evidence Lab at Duke is providing support to ayzh to find the best ways to measure and communicate its impact.

With the support of USAID and other organizations, we hope this venture and others like it will continue to improve the health of women around the world.

ABOUT THE AUTHOR

Danielle Somers is a communications analyst for the U.S. Global Development Lab’s Higher Education Solutions Network (HESN). Emily Jablonski is a virtual intern for HESN and student at the University of Michigan.

Innovative HIV-Prevention Product for Women Could Be New Tool in the Fight for an AIDS-Free Gen

Ending the HIV/AIDS epidemic can only be achieved with multiple prevention options that meet women’s needs and fit within the context of their lives./Kate Holt/Africa Practice

Ending the HIV/AIDS epidemic can only be achieved with multiple prevention options that meet women’s needs and fit within the context of their lives./Kate Holt/Africa Practice

HIV/AIDS is the leading cause of death worldwide for women of reproductive age.

Even with marked improvements in HIV treatment, women — especially those ages 15-24 — continue to be at a disproportionately high risk of HIV infection throughout Africa. In fact, in some parts of Africa, young women are more than four times more likely than men to become infected with HIV.

There are structural drivers that directly and indirectly increase women’s HIV risk, including poverty, gender inequality, sexual violence and a lack of education. Many women face unequal access to reproductive health services, including HIV/AIDS education, diagnostic services and treatment programs, putting them at an increased risk of contracting HIV.

Gender norms can also discourage women from asserting control over the timing and circumstances of sex, including negotiating protection against HIV using common prevention methods, such as condoms.

Women need HIV-prevention options that are discreet, do not need their partner’s agreement to use, and that are easy to access and convenient to use.

The Ring Study findings may give new hope to women who need diverse options to protect themselves from HIV and AIDS./ Matthew Willman/Oxfam, Courtesy of Photoshare

The Ring Study findings may give new hope to women who need diverse options to protect themselves from HIV and AIDS./ Matthew Willman/Oxfam, Courtesy of Photoshare

Results released today at the Conference on Retroviruses and Opportunistic Infections in Boston show we are one step closer to having a new prevention tool exclusively for women that fits within the context of their lives.

Through the United States President’s Emergency Plan for AIDS Relief, USAID has invested $25 million in an innovative research trial known as the Ring Study, which was led by the International Partnership for Microbicides.

The Ring Study looked at women’s use of a simple vaginal ring, which is prescribed by a doctor and self-inserted to provide 30 days of continuous, sustained release of the antiretroviral dapivirine. The study found the dapivirine ring helped protect against HIV during vaginal sex among women ages 18 and older.

The monthly dapivirine ring is a longer-acting HIV prevention method specifically designed for women, who bear the greatest burden of the global HIV/AIDS epidemic./ Molly Snell, Courtesy of Photoshare

The monthly dapivirine ring is a longer-acting HIV prevention method specifically designed for women, who bear the greatest burden of the global HIV/AIDS epidemic./ Molly Snell, Courtesy of Photoshare

The Ring Study showed that the monthly dapivirine ring safely reduced HIV infection overall by 31 percent compared to a placebo. Similar results were seen in a sister study, known as ASPIRE. ASPIRE found that the ring safely reduced infection by 27 percent overall. This is the first time that two large clinical trials have yielded statistically significant results in finding that a microbicide can protect against HIV infection.

However, we must recognize that these results are only the starting point for further research. Despite both the Ring and ASPIRE studies showing a statistically significant protective effect against HIV, the dapivirine ring did not reduce infection quite as much as researchers had hoped. While disappointing, we should see this as an opportunity to gain more information in order to create a more effective HIV-prevention product.

To do this, researchers need to look closely at the information collected during the study to figure out why there wasn’t a bigger effect: Was the dapivirine ring itself not as effective in the women in the study? Were women not able to use the product consistently? So far, we know that women who used the ring more had a lower chance of becoming infected with HIV, but we need more information to say for certain.

It is particularly important to understand the influence of consistent use of the dapivirine ring on the study results for younger women. If we look at the Ring Study results broken down by age, women 18-21 years had only a 15 percent reduction in infection, while women older than 21 had a 37 percent reduction.

If younger women, who are at the highest risk of infection, are not able to use the dapivirine ring consistently, we need to understand why and look at whether different marketing, education or additional interventions could improve use and, as a result, decrease their risk of infection.

While the Ring Study’s results have raised many new and important questions, ultimately, the dapivirine ring is the first longer-acting and discreet female-controlled HIV prevention method that has been shown to safely offer protection.

Innovative prevention methods like the dapivirine ring could offer an important additional prevention tool for women unable or unwilling to use other strategies.

If we hope to achieve an AIDS-free generation by 2030, we must continue to invest in products that empower women across the world to protect themselves from HIV.

ABOUT THE AUTHOR

Elizabeth Russell PhD, MSc, is a Senior Advisor for Biomedical Prevention Technologies in the Research Division of the Office of HIV/AIDS. She provides technical assistance for pre-clinical and clinical research projects supported by USAID for new microbicide products.
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