But now that she has insurance, she can afford to take him to a clinic to get checked out.
According to Devudamma, many mothers here face the same dilemma when their child comes down with fever. Fevers could mean malaria or dengue, both of which are potentially fatal.
"Because they don't know what it is, the tendency is to rush to the hospital," said Devudamma, "But they charge a lot."
"That's where insurance is very handy," she said.
Many fishing families in the Pudimedaka village are deep in debt, borrowing money to rebuild boats, to cover daily costs when the catch is small or injury or illness keep them from working, or, like Devudamma, to pay for medical care.
When fish are plentiful, families have to pay back their loans, usually with a high percentage of their catch.
But health insurance, as part of a broader economic plan, is opening up new possibilities here.
Three years ago, the District Fishermen's Youth Welfare Association (DFYWA) a local NGO, and Oxfam partner, helped families in this village determine that medical expenses were a huge drain on their resources, costing some up to a quarter of their yearly income.
DFYWA also convinced Oriental Insurance, a government of India company, to create policies designed, and priced, for very poor fishing families.
Now, for what they make in a day, families like Devudamma's, can purchase an annual policy, protecting themselves from the costs of sickness, accidents ? even the death of a breadwinner.
With money saved on medical care, families here are buying ice-boxes, fishing nets and fish drying and processing equipment. These investments can help them earn a little more on their catch than they did before.
Health insurance is a great first step, but ultimately, the people of Pudimedaka need a more comprehensive insurance package to keep them out of the pockets of money-lenders, who fulfill a "mafia-like" role, according to J. Saravanan, fisheries expert from the Development Human Action (DHAN) Academy in Madurai.
Beyond medical costs, fishing families would benefit from insurance that covers assets including their boats, houses and even their day's catch.
Initially, Oriental did not know how to insure the traditional Indian catamarans that the poorest fishermen use, since they had no way of knowing whether the boats were seaworthy.
But DFYWA convinced the Department of Fisheries to rate and certify even these homemade boats. As a result, boat insurance should be available soon, according to Oriental representative Srihari Naidu.
Home insurance has also proved tricky for Oriental, since thatched roofs break easily in storms, even though they are also cheap and easy to repair.
And Naidu was confounded by the idea of insuring a fisherman's catch, despite the fact that other insurers have found a way to insure a farmer's crops.
Fish are a common resource, used by many, said Naidu. "We can't possibly know how many fish are in the sea."
Insuring assets, and not just health, would do more to keep vulnerable families out of debt, and allow them to build their savings, add value to their work, earn more money and reduce their vulnerability.
Mahalakshmi Kara, a grandmother in the village, has relied on a health insurance policy for at least a year and has started saving a small percentage of her earnings.
"We never thought that we could save, but we're doing it," she said.
"I don't know how it will be helpful," said Kara, "but if [saving] can lift us even an inch out of poverty, I'll be very happy."
]]>But with more hotels lining the coast, more pollution in the water, more trawlers from South Korea, and correspondingly smaller fish catches every year; poverty is a more immediate threat for these families than natural disasters. Fishermen are using the life-vests to stay afloat in an economy on the verge of leaving them behind.
Economic development and vulnerability to disasters are intricately linked. "Disaster risk increases as a result of the process of human development," explained Professor Hemanthi Ranasinge at the opening of the Sri Lanka Foundation Institute's Oxfam-sponsored disaster risk reduction resource center.
This applies to the rising vulnerability of the poorest people in fast-developing India.
Take these fishing families, for example. When the Visakha Patnam Steel factory moved in 20 years ago, it forced the relocation of a number of families away from the coast. They lost access to the sea, their only income.
Arjilly Dasu was just a child when his family was relocated by the steel plant. Dasu has since founded the District Fishermen's Youth Welfare Association (DFYWA), an Oxfam partner organization that works for the rights of fishing families in the area.
DFYWA has been working in this community for the last 5 years; helping people add value to their catch, diversify their livelihoods, save their money, pay off their debts and buy insurance.
The group also advocates for fishing families in legal battles against the coastal development projects that are supplanting them.
In 2005, DFYWA won a stay but eventually lost the battle of a beach road expansion in Visakha Patnam that displaced eight fishing villages. They have recently lost a similar battle with hotel developers in the area.
Despite the losses, Dasu has made sure that relocated families received relief packages that might lessen the toll development is taking on them.
While development puts poor people at risk of disasters, the two are linked in another way. Disasters undo development gains. As Professor Ranasinge said, "disasters put development at risk."
Disasters are expensive. Swiss RE, the Swiss Reinsurance company, estimated total economic losses caused by the tsunami, including damaged property and interrupted tourism, at US$15 trillion.
Disasters impact donor wallets too. In 2005, American individuals, foundations and government donated US$175 billion to people affected by the tsunami, Hurricane Katrina, Central American mudslides and the earthquake in Pakistan, said a report by OECD.
When it comes to disasters, the adage about an ounce of prevention applies. With a little more money spent on effective disaster prevention, huge amounts like these could instead be spent on innovation and investment.
Disaster prevention includes disaster-focused interventions, like flotation devices, early warning systems, or evacuation and rescue plans, as well as longer-term interventions like coastal reforestation, or clean drinking water.
But, because of the link between disasters and development, programs that reduce poverty are also disaster prevention programs. These might include helping people earn more, get out of debt, buy insurance, or claim their political rights.
Most donors, however, are moved to open their wallets only after a disaster happens, when they can see the extent of a tragedy for themselves.
"People don't want to invest in prevention," says Russell Miles, Tsunami Research Program Manager for Oxfam America.
The problem with over-investing or only investing in relief is that most post-disaster funding is bound to short time tables. "That is why we end up doing short-term interventions over and over again," Miles said.
DFYWA has found a way to bridge the gap between disasters and development.
With donor organizations that have tsunami money left to spend, DFYWA frames its projects as "disaster risk reduction" projects.
When working with fishing families, worried about tomorrow's catch, paying money lenders, getting their kids medicine and education, said Dasu, they call it "development."
"Yes, it will be useful in the next disaster," said Mahalakshmi Kara, a local grandmother, of a micro-insurance program in her village, "but it's also useful now, in the day-to-day, and for that we are grateful."
]]>The team are training the hygiene promotion committees today in Mugunga camp today. The training is going well, but the team was called back into town early because of security concerns.
I wonder how many people died in the fighting over the last couple of days. The figure generally quoted of 5.4 million deaths (most due to the resulting lack of access to water and health services) due to the conflict over the last ten years just got bigger. The political history and current situation is very complex, with no simple solution.
We heard that the CNDP rebels have captured the Rumangabo army base and Virunga national park, which is home to the mountain gorillas, and today they attacked Kibumba, which is reported to be almost empty. The population of the town and the camps—around 30,000 people—has moved down to Kibati, 12 miles north of Goma. The Congolese government soldiers are fleeing, leaving MONUC [the United Nations mission in the Congo] to protect Goma. Many of the wounded are unable to get to the hospital.
The Mugunga camps currently have enough fuel to pump water until the weekend, but as there is a possibility that the security situation will deteriorate, so we're taking enough fuel out to them to last another week in case we get cut off from the camps.
Humanitarian agencies will need to get together tomorrow to decide how to act. Thousands of people demonstrated outside the MONUC base today, saying that the peace keepers are failing to protect the people here. We closed the office early. MONUC were told to stay in their base.
The MONUC commander has resigned.
This morning we have a security briefing. The shops and banks closed yesterday and are still closed today. The banks have removed all the money; they would be a prime target if Goma did get attacked. Our staff tell us they feel safer when they have some money in the house to give to the soldiers if their homes are targeted. When I stopped on the way home to buy bananas the women wanted to charge me extra because they thought I worked for MONUC.
I slept through the events of last night. Riots in the prison, where seven people were shot dead, about ten were recaptured and an unknown number escaped. I feel uneasy that escaped convicts could add to the unrest here! A doorman at a nightclub was also shot dead last night when he stopped someone with a firearm from entering. The situation in Goma could be described as tense!
We left work early again today. Only essential staff will be coming in tomorrow. Three international organizations have evacuated to Rwanda. This evening we hear that MONUC has retaken Kibumba and the situation now seems to be under control.
Today started as calmly as any other day. We went to the office as normal; there was less traffic and less staff, but otherwise it was a beautiful sunny day in Goma.
At 2:30pm, a message came over the radio that all NGO staff should remain in their bases. We immediately left the office, passing the gas station, which was full of Congolese army trucks filling up (then heading quickly in the opposite direction of the fighting). False rumors that the CNDP rebels had taken Goma airport created panic across Goma. MONUC have said they are protecting Goma as the Congolese government troops continue to flee. A vehicle, I think a taxi, lay on its side outside the hospital gate. I guess if you are going to have a nasty crash, that's not a bad place to do it.
All UN and international NGO staff are advised to go to the World Food Programme compound to plan a possible evacuation. I go home to pick up the bag that I packed last night (just in case!) and some food. As the afternoon passes and the sun goes down, the gunshots around the compound become more and more frequent. We are told that the fleeing army is looting town. I have never been this close to so much violence and gunfire. My mother phones, concerned; I hope that she cannot hear the fighting. I feel like we are a bunch of sitting ducks surrounded by armed troops. It is not safe to leave.
About 600 members of UN families, mainly women and children, are here with us. They take refuge in the large warehouse while we try, unsuccessfully, to fall asleep in the car. Before we settle down for the night, we hear that a ceasefire has been announced.
Thousands of the displaced are said to have fled to Kanyabayonga or to the Ugandan border. Oxfam will go and do an assessment to see what intervention is needed there.
Speaking to the public health team, they tell me that last night many people fled the camps where we work to hide in the fields. Nevertheless, there were still reports of rape and looting in the camps by the military. The health centers in the two Mugunga camps were reported to have been looted, though this has not been confirmed. Most people know someone who was killed in the violence last night in the town.
People continue to sleep in public buildings, with host families, and by the side of the road around Goma. We are busy planning how we can help them.
While the office in Goma remains closed, the staff that we have trained from the camps to pump and do water chlorination continue to do their work. The number of displaced people in the four Goma camps has remained stable—except for Mugunga 2, where some new arrivals are housed in large hangars—so our current water and sanitation provision is enough to provide for everyone living there. The water supply is fine and people in the camp continue to clean the toilets to stop the spread of disease.
But the army has set up four tents on the road to Buhimba camp; this is not good news for women there, who are often raped by armed men. I ask the public health team leader to ask the hygiene committee (made up of displaced people we work with in the camps) to broadcast by loud speaker the message that the women who have been raped have 72 hours to get to a health center to take anti-HIV medication.
Rather than spend another night in the car, international staff are temporarily relocated and spend the night in Rwanda.
The EU has pledged to send forces to reinforce the troops here. The Congolese are hopeful that they will arrive soon.
Some of the team attended a meeting in Goma to discuss the current humanitarian situation. Official UN figures are suggesting that 100,000 people have been displaced in the fighting of the past week.
The information that the IMC health center had been looted appears to be untrue, although both the Norwegian Refugee Council and ourselves have had supplies we keep in the camps stolen. Generally the camps seem to be returning to normal, although people are afraid.
Despite the American elections, the situation in the DRC is still the second news story on the television. The report shows the UN aid convoy that went to Rutshuru, an area under CNDP rebel control. There is also talk of the people starving due to the food crisis.
Despite the ceasefire, fighting continues in other parts of North Kivu, and although Goma is calm people are still nervous and afraid. The Prime Minister was in Goma today. We had a busy day planning our work and coordinating with the other agencies responding to the emergency in North Kivu.
For some strange reason there was only one news item all day today... The US has a new president! Joy and relief are visible across the globe.
Today we started our monthly soap distribution in the four camps where we work. We give soap to over 64,000 people as part of our cholera prevention work. We have also been visiting groups of displaced people in Goma and Kibati just a few hundred meters from the front line, home to thousands of people who have fled their homes and camps to escape the fighting in Kibumba. For many of them, this is the second or third time that they have been forced to flee.
Tomorrow we will find displaced people who were already community hygiene educators in their villages so that we can form new hygiene promotion committees here. Thousands of displaced people are staying with host families, in public buildings on porches, and under the stars (and we are in the rainy season!). When I spoke to the displaced people about their health, the illness they all talked about was diarrhea, particularly in young children. It is important that we start our hygiene promotion.
Today I am going south west to Kirotshe to do a public health assessment. Our first stop is a small camp of just over 4,000 people.
This camp looks different from the others. The latrines were full, so the people borrowed tools from the village and have started digging new pits, but there is a LOT of feces that are hard not to step in when you use the toilets. Our first job here will be to form hygiene committees who will teach their peers about why hygiene is important and mobilize this community to keep their latrines clean.
There is no source of water in the camp, but there is a tap in the village nearby, although it does not provide enough water for everyone so people here go to the lake to wash. We will need to train the community to construct private bathing areas and create a new water source.
People tell us that some women have been raped when they go to collect firewood for cooking. Where ever we go we see armed men: in the villages, on the road by the camps. While we walk around the camp we hear shooting and shelling from the hills behind. People seem nervous but they live with this every day. A visit to the health center shows that four cases of cholera have been diagnosed here in the past week.
On the way back to the office we stop at the health center in Sake. They have run out of the intravenous dehydration fluids needed to save the lives of people with severe diarrhea, so they have to send patients miles away to Kirotshe. I will follow this up tomorrow.
My day began with gruesome photos on the television of the bodies of people reportedly killed by CNDP rebels in Kiwanja. One woman gave the rebels the money they demanded but they still shot and killed her husband.
The public health team go out to Kibati to continue our work there, but they are forced to return to Goma by gunfire, which created huge panic amongst the displaced population there. Many were seen heading for the safety of Goma.
We are told by the UN to restrict movement and stay where we are.
]]>We had five staff there when the fighting broke out at 11:30 AM. They were beginning meetings with community members and were starting the digging of latrines. Then it happened. The shelling.
"It was between the volcano and the hill near the camp," said Herman, an Oxfam public health promoter, "about two kilometers away from the camp."
People were lining up to get their food distributions from the World Food Program and they suddenly scattered.
"They wanted to get to their shelters to grab their belongings," said Herman. "They knew they had to flee again."
The team reported that they saw one man in his forties crying. "I fled Kibumba camp and now they are chasing us again," he said. Another was more resigned, "We are used to this," he lamented. And sadly people are. Many people in the camp have fled for the third, fourth, fifth time.
Thousands ran toward Goma town. After a night of hiding with host families and in schools and churches, most have returned to the camp but remain scared and vulnerable. Even before this latest incident, the people in the camp were nervous. I can't even imagine the fear they feel now. The rebels have been pushed back northward, but there are just 700 meters between the positions of the rebels and the Congolese government forces. Oxfam is back there with teams today. These people need our help, but it is far from easy in the current insecure environment.
Last weekend, the UK Foreign Minister David Miliband and his French counterpart Bernard Kouchner visited Goma. They came with much diplomatic fanfare and media attention, and they said good things. They called for urgent reinforcement of the UN peacekeeping troops, but they have failed to follow through and effectively protect civilians. Today, the European Union will meet to talk about the situation in the eastern Congo.
The people of Congo are still living on the edge with little protection. They urgently need the European Union to take action. Even before the fighting around Kibati, people were telling us about being attacked by armed groups when collecting firewood or food from the nearby fields.
While European Ministers are closeted in debating chambers today, hundreds of thousands of eastern Congolese will be eking out an existence in the region's squalid camps. They need real action, not another mountain of words. The EU must agree to send additional troops to support the UN in eastern Congo and must push for a ceasefire, so we can get aid to the people that desperately need it.
]]>Fidel had an 18-year-old brother who deserted the Mai-Mai, one of the eastern Congo's multitude of armed factions. Men from the group came looking for his brother at family home, but he wasn't there. Fidel was. They decided to take him instead.
"My mother begged and cried," he says. "The rebels said they'd spare me, if my mum paid them $100. But we were poor and didn't have the money."
As he was snatched away, his mother screamed. The soldiers said that they would kill her if she didn't shut up.
He still finds it difficult to play, he says. Even though he is now in safe place, he still has the memories.
"I used to carry ammunition for the soldiers as they fought on the front line. One day I saw 60 bodies dead in the battlefield. I knew then I needed to escape or I'd end up dead myself."
After six months of enduring beatings with sticks, Fidel managed to escape one night when the soldiers were sleeping. He ran two miles in darkness of the night until he reached the base of MONUC, the UN peacekeeping mission for Congo.
From there, he was taken to CAJED, a Congolese NGO that rehabilitates child soldiers and other vulnerable children, and helps them reintegrate back into the community. I am at the transitional center run by CAJED and UNICEF that aims to help the children come to terms with their trauma.
After they leave the center, CAJED keeps in contact with the boys and helps them adapt to civilian life. This is a difficult stage. In a country with grinding poverty and few job prospects, many child soldiers get re-recruited. CAJED's community work aims to prevent that, and Oxfam supports CAJED at this stage.
Alongside Fidel in the transitional center, I meet Michel. Michel wears a T-shirt with a rhino on it, and has flecks of vibrant green paint on his arms and forehead. He's been painting. But despite the familiar childhood activity he was in the midst of, his mood seems much darker than Fidel's. He spent four years with a rebel group and was forced to fight.
His story starts simply. He was abducted when he left his house to get some milk. He never returned. But then the horror escalates. Michel was taught to fight. He shot people and remembers jumping over bodies in the battlefield. His friend was taken prisoner by another armed group. They discovered him hanging from a tree with blood pouring from his ears and his nose. It is horrible to learn that a 12-year-old child has seen such scenes.
The stories of children like Fidel and Michel painfully underscore why we need to find an end to horrific violence that has plagued the eastern Congo for too long. Child protection agencies have reported that Mai Mai militia in the town of Rutshuru recruited 37 children into military service the week before last. An estimated 150 children have been forcibly recruited since heavy fighting resumed in August.
Congo's armed men need to put their weapons down and find a peaceful solution to this conflict. Five millionfour hundred thousand people have died in Congo's decade-long war. The people of eastern Congo have suffered too much. We need to push our politicians to keep up the diplomatic pressure and find a political solution to this harrowing war. Only then will we be able to confine the stories of Fidel and Michel to the history books.
Names have been changed to protect identities.
]]>Thousands more abandoned their villages and the temporary camps in which some were sheltering when fighting intensified in late October around Goma, the capital city of North Kivu Province directly across the border from Rwanda. The violence culminated in an armed stand-off outside the city on Oct. 29, and CNDP's call for a ceasefire. By November 7, that ceasefire was no longer holding.
The crisis has left the longer-term peace process—and a January ceasefire between the government and 22 armed groups—in shambles. The CNDP has claimed that the January peace agreement, which had been violated numerous times, favored the Congolese government and its forces.
The latest fighting follows more than a decade of conflict in the eastern provinces and stems back to the 1994 Rwandan genocide. But many other factors contribute to the ongoing violence as well: weak state authority, the illegal exploitation of Congo's vast natural resources, and the free flow of arms across porous borders.
The result is disaster for the Congolese caught in the crossfire and suffering from the deprivation constant conflict brings. Humanitarian needs are escalating: The fighting forced some aid groups to suspend their operations, preventing life-saving help from reaching those who needed it. Since 1998, an estimated 5.4 million people have lost their lives to the conflict and the hunger and disease it unleashes.
In early November, Oxfam was already helping about 85,000 people, including 65,000 camped in four temporary settlements around Goma. The organization planned to help an additional 100,000 people in areas to the north and west of the city. Assistance has included the provision of clean water and sanitation services—essential in preventing the spread of waterborne diseases-- to those in the four camps. Oxfam has also been trucking water to 20,000 people in Kanyabayonga north of Goma.
Oxfam is calling for:
My neighborhood was one of the worst affected by the fighting, which went on all last night. About two kilometers from my house, the gunmen went into a compound and killed seven innocent civilians. Our neighbors were attacked by gunmen who came into their compound and robbed them, taking mobile phones and money. We were okay, but I found some bullets in my compound.
I was in the Oxfam office when the panic started yesterday. People saw the national army troops leaving Goma with their tanks and vehicles, and at the same time they saw the UN troops shifting civilians to a safer compound. No one informed the population about what was happening, and they thought the rebels were going to take control of Goma. People panicked.
Many people took advantage of the panic yesterday to make trouble. They looted shops and robbed families. It was a mixture of people fighting, criminals, and undisciplined soldiers, using small arms like AK-47s. But in other areas there was a deployment of national army units who were disciplined and protected the people. I haven't seen UN soldiers anywhere myself.
Today, it's calm and very quiet. Usually the traffic here starts at six in the morning, but I looked out at 10AM and all I saw was one motorbike. The shops are all shut. Life hasn't started up yet.
A lot of people are displaced and are living in the suburbs of Goma in very harsh conditions, and the fighting is making those conditions even worse because there's no access for humanitarian workers.
In particular, one group of displaced people has now been forced to move for the third time in a couple of months. They are living in schools and hospitals, or with host families in and around Goma. They desperately need water, food, and shelter. There's no health care or medicines. People are living in the open air, and if they do get a little food it's not enough to feed the whole family.
This current crisis has made it harder for Oxfam to respond. We are watching the situation and I'm going out this afternoon to check out our work in the camps.
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