But when they returned, the full impact of the strongest storm in 16 years was all too clear. Sidr killed at least 2,837 people, destroyed or damaged more than 1.1 million homes, and hurt nearly one and a half million acres of cropland.
"There are so many people without homes or basic sanitation, and who are now likely to be unable to get food, that Bangladesh is facing its most serious humanitarian disaster in many decades," said Heather Blackwell, head of Oxfam International in Bangladesh.
Oxfam is responding with an initial $8.5 million emergency relief effort that will provide up to 153,000 people with clean water and nutritional support. Additionally, the program will offer 15,000 households the means to construct temporary shelters. And as many as 400 latrines will also be built—with a design that will ensure privacy for women.
"People urgently need drinking water, food, and medical support," said Enamul Hoque, a public health advisor working with Oxfam on the response. "Many areas are completely cut off from receiving supplies and markets have been destroyed. There is a need for markets to start functioning properly."
Assessment teams visiting the devastated region have reported that dead animals and debris have contaminated many of the ponds on which most people depend for their drinking, washing, and cooking water. The potential for the spread of waterborne diseases, including cholera, remains high.
Oxfam and its partners are working with communities to clean up the ponds and dispose of the animal carcasses. And though access remains difficult, Oxfam has also started to transport water to some of the more remote areas. We plan to install up to 100 solar desalination stills—as a pilot project—in some of those remote areas to provide drinking water.
Our response plans also call for the distribution of water treatment materials to 15,000 households that will allow them to improve water quality to a satisfactory level. In addition, we will provide up to 200 temporary shallow-tube wells in areas where seawater has contaminated the surface.
Sidr caused massive damage to crops in the coastal region which will have both an immediate and long-term effect on Bangladesh. Severe floods in the north a few months earlier also hit the agriculture sector hard, and with the price of food now spiking, aid workers are concerned that people will not have enough to eat.
Oxfam plans to provide supplemental rations for up to 30,000 households for three months. The distribution, intended to complement food programs undertaken by other groups, will meet about 35 percent of each household's food needs.
In addition, Oxfam will distribute basic goods to 30,000 households. Many families lost everything—clothes, tools, animals—and have no means for replacing them. Our distribution of household goods includes buckets, jugs, mugs, blankets, saris, kitchen utensils, and soap.
]]>"This is not a typical campaign,” said Janet McKinley, chair of Oxfam America’s board of directors and of the Campaign for Oxfam America. “We're not raising money for new buildings or for a perpetual endowment. The highest return a donor can get is to put money to work now.”
“Oxfam is seeking investors who want to expand our programs over a five-year period, building the capacity of poor communities, particularly women, to earn more, save more, invest in their families, and better manage their risks,” McKinley continued. “And given the increasing frequency and severity of natural disasters, those risks are rising.” McKinley and her husband, George Miller, have already committed $5 million to the Campaign for Oxfam America.
“The show of support we have seen for the Campaign is especially significant since Oxfam, in order to preserve its independence and voice, does not accept funding from the US government. The organization depends entirely on gifts and grants from individual donors, foundations, and corporations to carry out its mission of poverty alleviation and social justice,” McKinley concluded.
To date, individuals have contributed 57 percent of the donations for the Campaign for Oxfam America. Foundations and corporations have donated 43 percent. The Campaign has received commitments for 10 seven-figure and 50 six-figure gifts.
Among the leading institutional donors, the New York City-based Ford Foundation has already committed $9 million to the Campaign.
“The foundation shares Oxfam America’s commitment to reducing poverty, creating economic opportunities, investing in women and families,” said Susan V. Berresford, president of the Ford Foundation. “We welcome these efforts to create lasting, equitable solutions to the most pressing global issues.”
Another major donor to Oxfam, The William and Flora Hewlett Foundation in Menlo Park, CA, has contributed $4.5 million in current grants.
“Oxfam makes canny use of its financial support,” said Paul Brest, president of the Hewlett Foundation. “We share its goals of reforming aid and making global trade practices fairer as an effective way to lift the world’s population out of poverty.”
Funds raised through the Campaign for Oxfam America will support longer-term investment in four distinct areas of work:
I like to sleep. But by six o'clock the first rays of the sun are coming through the holes in the wall of my family's shelter, the cocks and donkeys start their shouting, and the camp starts to come to life. The first thing I do when I get up is pray. I ask God to look after my family, and bring peace to Darfur. Then I get on with the household chores... so many chores! I boil the water on the fire to make tea, I wash my brothers' and sisters' clothes, and then I clean the cooking pans. I don't enjoy cleaning and sometimes I'm tempted to do it very quickly, but Oxfam is always telling us to clean the pans thoroughly and I'm scared of getting sick if I don't!
By 8 a.m. I'm on my way to the community center. It's a short walk from my house and it's run by Oxfam. At the center I take lessons in hygiene and English. I like the hygiene class because I can see how to make changes in our house that keep my brothers and sisters healthy. Now whenever I see a woman not taking proper care of her latrine, or not cleaning her jerry can (for carrying water) I get very upset with her. I like the English class, too, but it's very difficult. Maybe next time we can speak in English, but I don't think so!
I am not married yet. Insha'allah—God willing—I will be soon. But there are few men my age in the camp. Most people here are women, old men, and children. Many younger men are away fighting. Or dead. There was a boy in my village who my friends used to tease me that I would marry, but now I don't know where he is. So for now I live with my mother, two little brothers aged 8 and 9, and two sisters aged 11 and 13. My father is no longer with us. I'm the oldest, which means I get to be in charge, but also that I have to do most of the work while my brothers get to play soccer.
At 10 a.m. it's time to go home and make breakfast. We have two meals a day—breakfast at about 11 a.m., and then dinner in the evening. I like to eat goat meat but here in the camp it is too expensive. My mother taught me long ago to make stew from vegetables, but it would be so much nicer with some chicken in it. I also like assida, which is one of our famous Darfur dishes. It's like a thick porridge made from sorghum. Back in my village, every time there was a celebration—a wedding, a birth, a new visitor—we would have roasted meat to eat and a big party in the village.
After breakfast I head to the Oxfam water point. I do this at least once every day. At the moment there are big queues. Today I had to wait for more than one hour and it was very hot. But the other women have to wait, too, so I get to catch up on all the news while I'm waiting. I usually take one of my little sisters with me to help carry the water home as it can be too heavy for one person.
We use water for everything. I can't even imagine what it would be like to be without it. Every time I eat I need water—to boil the food, to wash the vegetables, to get rid of the dirt and germs. Everything I drink is either normal water or boiled water for tea. I use the water to wash the clothes of the whole family. We don't have any animals but some of my friends' families have donkeys and the water also keeps them alive and healthy.
The afternoon is more of the same. Living in the camp I really notice how life feels very repetitive. I go to school, I cook and do chores, and then I do it all over again. In the afternoon I go back to study at the community center for an hour or so, and then I go home to prepare the evening meal. Even the food is usually the same.
I very rarely leave the camp. Why would I? Here there's a water point, a market, a community center. Outside there's danger—soldiers and guns. My mother goes out of the camp maybe twice a week to collect firewood, which we can use at home and sell what's left over. This is the only money we get. I feel guilty: It's so dangerous for my mother to do this. The women often get attacked or shouted at or shot at. They won't let me go with her. They say only older women should go as young girls are more likely to be attacked. Secretly I'm glad: I don't want her to go alone, but I don't want to go with her because I'm scared of the men.
When I first came here we saw the camp and the aid agencies and felt safe. Unhappy, but safe. Now even the camp is dangerous. At night nobody really goes outside their shelters. When I'm done cooking I stay home and study. I would like to do my English work but I have nobody to practice with. I study until it gets dark after eight o'clock, and then we go to bed and start the day again.
It's difficult for us here. Look at our shelter—it's very basic. This is not home. Soon the rains will come and then some of the shelters will be destroyed. What will happen to those people? I know the aid agencies are doing their best, but there are so many people here and everybody always needs something. I think the only way our lives will really improve is if we go home. But we can't go home because people are still being attacked. I will stay in Kalma until peace comes. I just hope it won't take too long.
]]>The achievements of Oxfam and other aid agencies in Darfur have been truly incredible. Jan Egeland, the former UN Humanitarian Coordinator, described the humanitarian response in Darfur as among the most successful in the world, and he was right. The high levels of mortality and malnutrition that we saw at the start of the crisis have been greatly reduced. Many people now have better access to water, sanitation, and education than they did before the conflict. However, other things have not improved. People in Darfur still live in daily fear of violence. Those living in camps cannot go outside without risking attack. The number of people in need of help keeps rising. There are now four million people in Darfur who rely on aid.
What are the biggest challenges Oxfam faces now in Darfur?
Safety and security is by far the biggest concern for both civilians and our staff. Our ability to reach people in need is decreasing due to hijackings and attacks on aid workers. Early in my time here I drove for hours through North Darfur, from El Fasher to our programs in Kebkabiya, through quite stunning scenery. Now this road is far too dangerous for us to use and we rely almost entirely on UN flights. In terms of security, we are operating at the very limit of what we can tolerate as an organization, and if the situation continues to deteriorate then we may be left with no option but to withdraw from Darfur. The humanitarian impact of this could be catastrophic. It's vital that the world leaders do more to ensure an end to the violence so that aid agencies can continue our life-saving work.
The crisis is now in its fifth year. Is there any sign that Darfur will move on from being a humanitarian emergency and into a development and recovery stage?
Oxfam has been working in Darfur for more than 20 years, carrying out development work with local communities. We all hope that we can resume this as soon as possible. But at the moment Darfur is still an enormous humanitarian crisis and we cannot resume large-scale development work until there is a sustainable political solution to the conflict. People continue to be attacked and displaced by the thousands. We are still seeing people arrive in the camps where we work. The situation in Darfur is incredibly complex and we have to be very careful. For example, many of the villages that people have fled from are now inhabited by other communities, and if we were to provide development assistance to them we would risk legitimizing this.
What has been your proudest achievement in your time here?
The relationship between non-governmental organizations and the Sudanese government has been complicated and at times difficult. Back in early 2004 we just could not get our staff members the necessary visas and permits to get to Darfur and respond to the urgent needs there. It was very frustrating. Our staffers have since done a wonderful job in building a working relationship with the authorities—both in Khartoum and at the field level—and as a result these problems have now been eased considerably. Without this success, we would not have been able to have such an impact on the ground and provide water and assistance to half a million people.
And your biggest frustration?
When I took up the post of country program manager, Darfur was one of the world's largest humanitarian crises. Today the security situation for people there is perhaps even worse, and the prospect of peace seems as far away as ever. It has been incredibly frustrating to see the hard work of our staff thwarted by insecurity in so many places. In Gereida in South Darfur, for example, the team did a magnificent job to set up water supply to 130,000 displaced people. But since then we have had to withdraw from the area because of insecurity. Across Sudan there are still many challenges. Marginalization and poverty are still endemic, and there are increasing threats to the nationwide Comprehensive Peace Agreement.
Finally, what personal memories will you take from working in Africa's largest country?
Outside Sudan, very little is known about the country, its people, and culture. What does get attention is mostly war and human suffering. Despite the enormous problems in the country, the Sudanese people are incredibly friendly and welcoming. I can honestly say that in my years of working around the world, my job in Sudan has probably been the most satisfying and enjoyable. The Sudanese are also extremely resilient people. It is incredible to go to the camps in Darfur or to the harsh deserts of the east and see how people cope in the face of adversity. It makes me feel confident for the future that Oxfam can work closely with local communities to help build a better Sudan.
]]>"We get water from this ditch, which is a very dirty and murky channel, where garbage is dumped and even dead animals have been found," says Huarcaya, who lives in the town of Huaya Chica. But now, with the help of Oxfam, many families in Huarcaya's town have clean water to drink—thanks to the distribution of water filters and the training in how to use them. So far, the organization has provided 870 water filters in the districts of Humay and Independencia. The goal is to improve significantly the quality of the local drinking water, which often comes from unsafe sources.
Not only did the quake obstruct canals and collapse water treatment and distribution facilities, it also revealed how poor the water quality was in some areas of the countryside. Before the quake, many families had to buy water from tanker trucks or draw it from wells and irrigation ditches. In all these cases the water was unhealthy. The earthquake worsened this situation by increasing the risk of disease.
With the filters Oxfam has been distributing, people are able to remove impurities and sediments. Water that was initially murky, contaminated, and unfit for human consumption becomes clean and free from harmful micro-organisms.
"We get home tired after doing agricultural work (cotton cultivation) and now we have clean water without having to boil it first," observes Delia Mendoza Suárez, a 50-year-old mother of seven children in the village of Palto. Paltoand six other villages now have clean water for drinking and cooking.
Oxfam has been distributing water from tanker trucks in districts where the population does not have sources from which to draw water. The agency is working in coordination with other institutions, such as United Firemen Without Borders (Spain), Pompiers Sans Frontières (France), and Action Against Hunger (Spain). Oxfam has successfully put into service three water treatment plants and has installed 45 water distribution points, including tanks (of 600 and 1,100 liters) and water storage bladders (of 1,500, 3,500, and 6,000 liters), making available an average of 20 liters of water per person per day in each village within the districts of Humay and Independencia.
"Children and adults get stomach illnesses because the water is not clean. After the earthquake, the situation had worsened since there was no water. Now we have it again but it continues to be dirty," said Amalia Valdiviezo Meza, whose family now drinks filtered water.
To help address the ongoing problems, Oxfam is also coordinating a public health campaign through the local press. It's helping to spread information on the proper use of water, latrines, and hygiene to avoid the spread of disease.
"A month after the earthquake, the health risks keep increasing and we must not lower our guard. On the contrary, we will double our efforts to promote hygiene and good health," says Mónica Ramos, Oxfam's public health promoter in Pisco.
As part of that effort, Oxfam has distributed 1,650 hygiene kits, which include soap, shampoo, brushes, and towels, among other items. To achieve a more complete response, latrines and accompanying sinks for washing are also being installed.
Helping Oxfam to achieve its goals have been members of "Jovos," or Young Volunteers for Disaster Prevention, who came from Moquegua, in southern Peru. Assistance has also come from members of the "Grufides" group who have been helping with the installation of tents and temporary shelters as well as with the promotion of public health through talks on hygiene and the proper use and maintenance of water filters.
Maribel Sanchez is the communications officer for Oxfam International in Pisco, Peru.
]]>When Colombo University's Community Extension Center in Sri Lanka uncovered mistreatment of tsunami survivors, the researchers went straight to the country's Human Rights Commission to right the wrongs.
Anawim Trust researchers studying good practices among Indian non-governmental organizations (NGOs) in empowering women didn't settle for documenting what they saw: soon the NGOs were implementing new, more women-friendly policies in their organizations that reflected what they'd learned from the Trust.
And long before the Institute for Policy Studies had published its study on Sri Lanka's disaster management systems, researchers had already helped reshape the key national disaster agency.
This is research at its liveliest, where the findings get results before the ink is dry.
"The studies we're supporting aren't destined for a dusty shelf somewhere, and they're not carried out by academics from faraway places," says Russell Miles, an Oxfam humanitarian specialist. "We're partnering with local researchers who are dedicated to solving problems in their own countries."
The Oxfam program involves a process known as participatory action research. The "action" part of the name has to do with its purpose: getting immediate results, rather than studying issues simply for the sake of learning. And it's participatory in that focus groups and other interactive activities in the communities take precedence over Internet searches and leafing through books at the library.
"Reducing disaster risks is a complex process that requires continuous learning," says Miles. "We've found a way to ensure that community members are at the center of that learning process."
]]>The companies – Novartis, Merck and Pfizer – are resisting moves by India, Thailand and the Philippines respectively to use safeguards that are written into World Trade Organization (WTO) intellectual property rules in order to protect public health. Each company is trying to impose its patent monopoly on a big-selling medicine to stop the countries from exercising their rights to trade in cheaper generic equivalents.
"The industry is fighting hard because developing country markets, especially in Asia, are vital for its future growth and these medicines under dispute are so valuable," said Celine Charveriat, head of Oxfam's Make Trade Fair campaign. "These disputes put monopolies and profits over public health, which is exactly what world leaders promised would never be allowed to happen under WTO intellectual property rules."
Pharmaceutical sales across the world's four biggest emerging markets, including India, grew by 22.3% in 2005 compared to single digit growth in the US, Europe and Japan. Of the medicines in dispute, Novartis' anti-blood-cancer drug Glivec is worth $2.1 billion in annual sales and its patent begins to expire in 2013. Pfizer's hypertension drug Norvasc is worth $4.7 billion in annual sales and it wants to extend its patent that has already begun to expire in some countries.
In a statement prepared for Oxfam, Constant Gardner author John le Carre said yesterday:
"Here is what I wrote five years ago in the Afterword to The Constant Gardener: 'As my journey through the pharmaceutical jungle progressed, I came to realize that, by comparison with the reality, my story was as tame as a holiday postcard.' The reality today is worse. By imposing one-to-one deals on individual governments, Big Pharma is dishonoring hard-won international agreements designed to allow lifesaving generic drugs to be produced and marketed in countries where there is urgent and demonstrable need. The present posture of Novartis in India is a classic example of Big Pharma's unbeautiful priorities. With unlimited legal resources Novartis is challenging India's sovereign right under international law to supply cheap, non-patented drugs in situations where the public health is at risk. If the case succeeds, Novartis will have protected the health of its account books at the expense of those who will die because they can't afford the drugs that could save them. "
"Since India is the main supplier of inexpensive medicines to the developing world, a victory for Novartis will also curtail access to affordable medicines in Africa and Asia," Charveriat said. "These three disputes show that the intellectual property system cannot work to protect public health if companies can continue to undermine developing countries from using legitimate health safeguards. In two cases, we have a legal battleground where poor people are losing out to vested interests."
Some companies, including Merck and Novartis, say they can discount prices or donate medicines to poor patients instead. Oxfam says that this is not the long-term solution to sustainable access to affordable medicines and does not cover all patients who need them.
"Donations can help poor people in specific situations, such as disease eradication programs,' said Charveriat. "However, discount programs keep all decisions about who can get medicines and for how long in the hands of the companies. A sustainable and proven way to get affordable medicines to people is by generic competition."
"The Philippines, Thailand and India have taken important steps to use public health safeguards to reduce the price of medicines and respond to serious public health problems. They should not be bullied when rightfully applying these rules," Charveriat said. "We applaud their efforts. They should remain strong against this corporate pressure and the companies should drop their lawsuits and their objections."
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The declaration states that developing countries must be able to use public health safeguards written into the World Trade Organization's (WTO) intellectual property rules (called TRIPS) in order to access cheaper generic versions of patented medicines. Generic competition is the most sustainable way to keep the price of medicines down, according to Oxfam.
"Rich countries have broken the spirit of the Doha Declaration," said Celine Charveriat, head of Oxfam's Make Trade Fair campaign. "The declaration said the right things but needed political action to work. That hasn't happened. We've gone backwards. People are still suffering or dying needlessly."
Since 2001 things have become worse for sick people in developing countries:
According to the World Health Organization, 74 percent of AIDS medicines are still under monopoly, 77 percent of Africans still have no access to AIDS treatment, and 30 percent of the world's population still does not have regular access to essential medicines.
At the same time, rich countries, especially the US, are bullying developing countries to impose stricter intellectual property rules in order to preserve pharmaceutical monopolies. This is restricting generic competition and keeping prices high.
"Global health statistics are grim but the US continues to negotiate trade deals with stricter rules that limit how a country can use public health safeguards," said Charveriat. If implemented, these deals will result in Colombia having to pay an additional $940 million per year by 2020 to cover the increased cost of medicines, affecting nearly 6 million patients. Similarly in Peru, the price of medicines could increase by 100 percent in 10 years and 162 percent in 18 years.
Other rich countries, particularly those among the European Union, have quietly consented to US actions. Pharmaceutical companies have gone even further by directly challenging countries such as India and in Philippines that have sought to use the safeguards.
In 2005, cancer patient groups in India used Indian intellectual property law to stop a patent application by the Swiss company Novartis for its anti-cancer drug, Glivec. This allowed Indian companies to continue making generic versions at $2,700 per patient a year, as opposed to Novartis having a monopoly priced version for sale at $27,000 per patient a year.
However Novartis recently appealed the court's decision in a direct challenge to India's right to interpret the TRIPS Agreement to protect public health. If Novartis is successful, it could jeopardize India's generic export industry. India is the world's leading exporter of generic medicines, with 67 percent of its exports going to developing countries.
"Novartis has told Oxfam that there is no commercial market for Glivec in India and that it is challenging India in order to align Indian intellectual property law with TRIPS," Charveriat says. "However, India is only trying to use the flexibilities rightfully available to it under TRIPS and Novartis is seeking to block that right."
Meanwhile in the Philippines, the government has conducted tests and issued regulatory approval for a cheaper patented version of Norvasc, a heart disease drug now under patent to the US company Pfizer. The government is doing this to ensure that a cheaper patented version of Norvasc that costs almost 90% less will be available immediately from when the patent expires in June 2007.
Oxfam believes that the government's action is consistent with the TRIPS Agreement and with the Philippines intellectual property law. However, Pfizer is now suing the government. If Pfizer is successful, it will severely limit the government's ability to access cheaper medicines and assert its right to enforce TRIPS safeguards.
"Developing countries have a responsibility to use the public health safeguards but when they try to do so they are put under huge pressure," Charveriat said.
In order to make the Doha Declaration work, Oxfam is calling for:
"Rich countries must live up to their commitments and stop undermining the Doha Declaration with their selfish actions," Charveriat said. "Now more than ever we need a global trading system that puts health before profit and makes medicines affordable for all."
]]>Dr. Almendares is a renowned defender of human rights and the environment. He has a long trajectory of work in the poorest communities of his country, providing people with free health care, organizing them, and passing on his knowledge. In his academic career, he has directed research at prestigious universities and institutions, including the University of Pennsylvania, Harvard University, and the Cardiovascular Research Institute in San Francisco. In his own country, he has dedicated himself to the sciences, first as a professor at the Medical School, later as its dean, and eventually as rector of the Autonomous National University of Honduras.
After the award ceremony we spoke with Dr. Almendares:
What does it mean to you to be nominated and then elected for this prize from InterAction?
I accepted this recognition as a noble and generous act by the organizations in the United States, and also as an act of solidarity with the people we are working with to build a better world that is more respectful of human rights and environmental justice. This honor has been a great act of moral support for me in the face of the all the risks we take in order to defend the life and dignity of human beings and to provide for a great love of humanity and our planet earth.
What inspired you to study medicine?
My greatest inspiration was my mother. I call it the theology of dreams. When my mother was pregnant she dreamed she was in paradise and that I worked with plants, the environment, and serving humanity. I come from a poor family. We lived in a poor neighborhood plagued with alcoholism, prostitution, and violence. Thanks to my mother's advice, I didn't get involved in all that. She never physically or psychologically abused me and she taught me a culture of non-violence. But it was a struggle to make it out of that environment. When I was in college sometimes I went hungry. I was malnourished and anemic. When I it was my turn to spend six months in bed, I learned what it meant to be a patient, and that as a doctor, one must be humble. When I graduated from the university with a degree in medicine, I had three callings: to work on behalf of the poor, to educate, and to dedicate myself to science.
These callings led you to establish various projects aimed at improving people's lives...
For many years we have run a clinic for poor people where we provide free medical attention. Mostly we work with the urban poor residents of Tegucigalpa and with indigenous people in some of the most remote communities in the country, where doctors rarely venture. In addition to providing medical attention, we do organizing work. For example, we work with 26 communities in the Tegucigalpa urban areas. We organized the women in these communities into a committee called the Honduran Committee for Peace. Now they have family gardens. Also, with the support of a Canadian organization, we have constructed more than 200 tanks to store the water that they get only once a month. We held natural medicine workshops to teach women how to treat common illnesses themselves. For example, chamomile, mint, and linden flower teas, and massage techniques, can relieve stress and tension. We have taught them how to treat a cough or diarrhea. We are also concerned about the environment and founded the Madre Tierra [Mother Earth] movement. Now we are working on a reforestation project. We asked the kids in the program how many trees they would like to plant. The told us one million trees. So, with the dream of planting a million trees, we are working with them in the poorest neighborhoods. We have already planted more than 15,000 trees and within this movement we have created a school of sorts, where kids are learning how to care for the environment and their health.
How is your work related to Oxfam America's work?
Through our work with Madre Tierra, we have been involved with Oxfam on the issue of mining. Madre Tierra has been studying the health impacts of heavy metals. We have been conducting research for five years in the Siria Valley region of Honduras, where there is a large mine. With the help of a Harvard student, we were able to get baseline data on the health conditions in the community prior to the mine, in order to make a before and after comparison. We go to the communities to conduct research and clinical exams and what we have noticed, interestingly, is that it is mostly the women who are ill, not the men who work in the mines. The women use the water often, to cook, clean, and wash clothes. We have seen many health problems in their skin, eyes, and nervous and respiratory systems. Oxfam America has helped a lot by providing us with information on technical and ethical issues. It has worked on a broad scale in many different areas.
In all these years that you have spent working with the poorest of the poor, have you seen any changes in the people, their situation or policies?
Yes, we have seen changes. The people have a better perception of their situation; they are more aware. This allows them to dissent and make demands of the authorities if they disagree with decisions they make. We also work in human rights. We have a center for torture victims and violence prevention, inspired by the teachings of Gandhi, Martin Luther King, and Francisco Morazán [Morazán, a Honduran politician and defender of democracy, was the last president of the Federal Republic of Central America in the mid-1800s]. We have been able to promote a message of non-violence with government institutions, which we see as directly related to the issue of health. We advocated for the government to incorporate mental health issues in its human rights agenda and women's rights into the health agenda. The government also approved and ratified The United Nations Convention Against Torture.
Your work presents you with some of the toughest situations in your country. What motivates you to keep going?
Despite it all, I always maintain great optimism and a love for the earth. I appreciate the cooperation from the international community. I have found great human beings in all the continents: Africa, Europe, Asia, and America. I am very grateful for this. We must always have love and compassion among us and with all that we do.
]]>One of the remarkable things about Darfur is the number of people who are still volunteering with health committees after three years of living in Abu Shouk and Al Salaam camps outside of North Darfur's capital of El Fasher.
About 60 percent of the original committee volunteers at Abu Shouk have continued with their work. At nearby Al Salaam camp, the number is 80 percent. Their help is pivotal to the success of Oxfam's public health work in the camps. Every week they spend several hours visiting households in their allocated blocks and inspecting the surrounding areas.
They go shelter to shelter talking with families and sharing information on good hygiene. They check latrines for cleanliness and wear. And they instruct families on how to keep their water clean by making sure the jerry cans in which they store it are scrubbed with powdered soap and chlorine.
"We wanted to serve our people and to raise the awareness of the population so that everyone's at the same level," says Kaltoum Ali Asad, a volunteer at Abu Shouk.
"If we don't volunteer to do something the people would suffer and there'd be outbreaks of diseases and illnesses," adds Namma Saed Haroun at Al Salaam camp. "If we didn't volunteer it would be us who would eventually suffer, so we will continue to volunteer."
Their efforts win high praise from the agency.
"The volunteers work really hard," says Hussaam Eddin Mirghani, Oxfam's team leader at Abu Shouk. "They volunteer because they're afraid of diseases, especially diarrheal diseases, spreading throughout the camp. The volunteers really feel the necessity to support their communities and their people, who are really suffering in this dreadful situation."
Camp life is bleak. Ahmed Eysa, who has lived at Abu Shouk for three years with is family, makes that clear.
"Life here is horrible," he says. "It's full of difficulties, and we don't have any solutions in our hands. There are no choices for the people living here in the camp."
But Eysa has made one choice—an important one that will make a difference to others in the camp. He chose to volunteer, and he has continued giving his time for three years.
"We have to adapt to our situation and we really need to respond," he says. "There's no way we could give up."
Soon, the rains will come and fall heavily. Living conditions in the camps will deteriorate, and the threat of diseases like cholera, malaria, and diarrhea will rise. Then, the job of the health committee workers will be even more vital.
]]>According to an Associated Press story, President Correa publicly pledged government support for the case, which began nearly 10 years ago in the United States and was thrown out on appeal in 2003. Since then the court in Ecuador has been conducting judicial inspections of polluted areas, gathering evidence a judge will use to make a decision, possibly in the next year.
During the same week, indigenous leaders representing the people affected by the pollution in the Orellana and Succumbios region of Ecuador attended the annual meeting for shareholders of ChevronTexaco in California. Humberto Piaguaje, a leader of the Secoya indigenous people, called for the company to resolve the case and help clean up the environment. "We want you to give us back our lives," Piaguaje said. "We want you to let us live in peace and harmony with nature. We want you to repair the damage so that our children do not have to continue suffering."
Oxfam America has supported the Amazon Defense Front's legal case for nine years, and assisted in the creation of the Assembly of Delegates of Communities Affected by Texaco, a community-based organization that has ensured those most directly affected by the pollution have a voice in the legal strategy.
"We think it is positive that President Correa has declared his support of those affected by pollution in the Lago Agrio region," said Javier Aroca, who coordinates programs related to indigenous rights for Oxfam America in South America. "We consider this is a signal that the government is interested in investigating and sanctioning those who are responsible."
"It is important to remember that the people affected are demanding compensation for almost 10 years now," Aroca said. "The pollution has affected the health of indigenous peoples and peasants... there have been cases of skin diseases and cancer. Furthermore, the lands are not as productive as they used to be, which has affected the agricultural economy. From our point of view, the government of Ecuador should support the affected population to complete the legal procedures, which are very expensive."
A win for the Amazon Defense Front in this precedent-setting case could change the landscape of the oil industry, and further establish the rights of communities to be compensated for negative social and environmental effects of oil operations.
]]>But once they know this they take serious action, learning how to prevent the disease by sleeping under nets treated with insecticide, and filling in puddles and other places where mosquitoes can breed. They take special care to help pregnant women get access to government-sponsored prenatal care, which includes a free mosquito net.
A recent survey of villages where Saving for Change groups have been formed is showing that 75 percent of members understand that mosquitoes transmit malaria, while only half of non-members in the communities know this. Seventy percent of members knew that mosquito nets are an effective way to prevent malaria, compared to only 40 percent of non-members. More than half of members said they slept under a bed net the previous evening, compared to just 30 percent of others in the community. And more than 40 percent of Saving for Change members said they had purchased a bed net since joining a group, evidence that the availability of information about the value of bed nets contributed to changes in behavior.
Overall, malaria killed 22,000 people in Mali in 2005, and ranked third among all causes of death after respiratory infections and diarrheal diseases, according to the World Health Organization's latest figures. The death toll for children is particularly severe. Mali ranks 175 out of 177 countries in the rate of death from all causes of children under five, at 218 per 1,000, and malaria causes about 17 percent of those deaths.
"Malaria is a crucial problem in Mali," says Macky Doucouré, president of the non-governmental group CAEB, one of Oxfam's Saving for Change partners in Mali. "The majority of deaths of pregnant women are due to malaria. More women in Mali die from malaria than they do from AIDS...as many as die in childbirth."
The death toll is heavy, but so is the price to stay alive, as many families struggle to find money to transport sick people to clinics, and buy medication. "Some families have to spend as much as 60 percent of their income on health care," Doucouré said. This is why malaria is an important topic when it comes to community finance programs: nothing will destroy a family's assets like chronic illness.
Once women are organized into Saving for Change groups it is easier for them to work together to educate people in their village about malaria and take steps to prevent it. "It is a really big change for people to understand that there are things they can do in their own villages to prevent malaria," Doucrouré said.
He described one village where women in a Saving for Change group took some extraordinarily active steps. "They decided to create their own committee to help women prevent malaria, and encourage the use of insecticide impregnated mosquito nets at night while people are sleeping. Each night members of the committee would visit homes to make sure women and their children were sleeping under their mosquito nets, and they would even fine women not using the nets 50 CFA or maybe 100 CFA [10 or 20 cents]."
"Creating a committee to prevent and help people treat malaria is a significant innovation for these families and their village, and it was made possible by the Saving for Change group financed by Oxfam—it is something the women created themselves to deal with the problem, it did not come from outside the village."
]]>The Kenyan government, international donors, and aid agencies must all immediately take action to address the crisis, Oxfam said.
Dadaab is one of the world's largest concentrations of refugees. Its population now stands at more than 250,000—almost three times its intended size. Up to 100,000 more people are likely to arrive by the end of this year as Somalis continue to flee violence and seek refuge in Kenya.
A new Oxfam assessment of the humanitarian situation in the camp has uncovered a serious public health crisis caused by a lack of basic services, severe overcrowding and a chronic lack of funding. More than 20 cases of cholera have been confirmed. Kenya recently closed its border with Somalia, yet refugees continue to arrive daily and the border closure is actually exacerbating the crisis, the report found.
"Conditions in Dadaab are dire and need immediate attention. People are not getting the aid they are entitled to," said Crosland-Taylor. "Half of the people in the camp do not have access to enough water. Women and children—who make up over half Dadaab's population—very rarely have access to adequate latrines."
Oxfam's report recommended that the Kenyan government re-open the Kenya-Somalia border, and provide additional land near to Dadaab for a new site to ease the overcrowding. The report also recommended that international donor governments urgently respond to UNHCR's appeals for more funding to deal with the crisis, that UN and aid agencies ensure that recent increased efforts to address the crisis are sustained, and that local Kenyan communities near Dadaab are not neglected.
The Kenyan government's decision to close the border has not stopped refugees coming, but it has made conditions much worse for them and their Kenyan neighbors, and has added to health risks in the camp. Reception centers on the border run by the UN High Commission for Refugees (UNHCR) used to give health checks to new refugees. However, as a result of the border closure, these centers were closed down, meaning new arrivals no longer receive the health checks before reaching the camp. In such overcrowded conditions, even a single case of cholera can spread rapidly.
"Until there is a lasting peace in Somalia, many more people will continue to flee. The Kenyan government must address this humanitarian crisis, rather than ignoring it. An open but managed border will allow Kenya to meet its legitimate security concerns, but also allow refugees to receive the assistance to which they are entitled under international law," Crosland-Taylor said.
The situation in Dadaab has led to increased tensions between Somali refugees and the local Kenyan community, particularly over rights to land and resources such as water and trees.
"Dadaab is in a very poor region and the needs of the local communities must not be forgotten," explained Crosland-Taylor. "More funds are needed for aid agencies to help local people as well as refugees. Scarce natural resources have to be shared by everyone, and projects are needed to explore alternative technologies and ways of ensuring that those resources are managed in an equitable and sustainable way."
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