Many of the displaced people are now sheltering with host families and often crowded into single-room houses with poor access to clean water and sanitation. To help meet their needs, Oxfam has set up a rapid response office in Bukavu, a city in the province of South Kivu, and is scaling up its work in North Kivu province.
Together with a local organization, Oxfam is now trucking 200,000 liters of clean water each day into major population centers, such as Lubero in North Kivu, where many displaced people have sought refuge. The organizations are also working to rehabilitate the water systems in those communities and Oxfam is distributing essential household items such as soap and buckets.
Though Oxfam is now helping 130,000 additional people, insecurity is making the delivery of this life-saving aid difficult in some areas. Fighters have cut off the roads to places such as Walikale in North Kivu and also to parts of South Kivu. Oxfam is calling on all parties to the conflict to respect their obligations under international humanitarian law and let aid through.
The harsh conditions many displaced people now face follow on the heels of the escalating violence they have endured in the months since the military offensive began. In a recent survey Oxfam conducted, villagers recounted the horrors of rape, torture, forced labor, and reprisal attacks. One woman told Oxfam she had been raped nine times. Other people talked about underground rooms where villagers were beaten and plunged in barrels of salt water. Residents of one community said their entire village emptied out at night, with everyone preferring to sleep in the fields rather than in their own homes. It was safer in the open, they said.
Who is attacking the civilians in Congo? In the survey, which included nearly 600 interviews, villagers reported that both the Congolese army and members of the FDLR were responsible for the atrocities. Earlier this year, members of militia and a rebel group were hastily integrated into the Congolese army, which has led to human rights abuses. Civilians surveyed said that one of the solutions to the trauma they have endured would be to improve the discipline, pay, and training of the Congolese army many of whose members—especially those newly integrated—have not been paid. As a consequence, extortion is widespread.
The UN's peacekeeping force—known as MONUC and the largest of its kind in the world—has a broad mandate in this conflict. While MONUC is reportedly providing rations and logistical support to the Congolese army, Oxfam maintains that the force's main priority should be to protect civilians, and it's concerned that there are not enough safeguards in place for that protection. Oxfam is calling on MONUC to set conditions for its involvement in these operations which, at the moment, are having a devastating impact on civilians.
For example, Oxfam says that MONUC should ensure that the Congolese government is taking clear steps to minimize the impact of this military initiative on civilians by not deploying officers with a documented record of human rights violations and by punishing violations committed by its own forces. The peacekeeping force should withhold its support of the operation if abuses continue, says Oxfam.
The organization also says that the international community needs to recognize that military action alone will not provide the answer for the insecurity that has plagued eastern Congo for so long. In the Oxfam survey, the vast majority of communities affected by the FDLR called for peaceful dialogue, and only two favored forced disarmament. Time and investment need to be put into non-military methods of disarming militia. And there needs to be a widespread recognition that sustainable peace will come to Congo only when the root causes of the conflict have been addressed.
]]>I flew into Mogadishu in a plane full with nine tons of Oxfam aid. We took blankets, mosquito nets, medical supplies, and plastic sheets for families to build temporary shelters. We also took 3,500 buckets: Many of the families who have fled the fighting have lost everything they had, so they can use the buckets to carry clean water and store milk for their children.
At Mogadishu airport, I was met by some of our local Somali partners who quickly unloaded the aid for distribution. We carry out all of our work in the country through partners like them.
People are still fleeing the capital. Every day more buses, vans, and donkey carts carry families out of the city along a road called the Afgooye corridor. In the past few weeks, tens of thousands of people have fled down this road to escape the violence. They are settling in camps nearby, where about 400,000 people have taken refuge in the past two years.
The living conditions in the camps in Afgooye are some of the worst I have ever seen. Families are sheltering in tiny huts, pieced together from plastic bags and sticks. When the rains come, the huts are washed away. Oxfam is about to provide 10,000 new shelters, which will improve the lives of about 70,000 people.
The most urgent need is for shelter, but people also desperately need clean water, food, and medicine. The fighting has had an enormous impact on children's health. One doctor told me that there is so much gunpowder in the air in Mogadishu at the moment that it is making children sick.
When people leave the city and arrive in camps—which are so basic and overcrowded—diseases can quickly spread, and there are few health services. I saw young children lying on the floor of the shelters, too ill to move. Many children are suffering from diarrhea and cholera. Oxfam has helped set up an oral rehydration treatment center where mothers can bring their children for help. Oxfam has also distributed mosquito nets to mothers to help them protect their children from the spread of malaria.
To help address the critical need for water, Oxfam recently expanded its water system—which features large, circular holding tanks—to reach an additional 78,000 people. In total, we now provide water to more than 200,000 people in Afgooye—and we hope to increase the supply in the coming months. Despite these efforts, the need for water remains huge. People line up for hours to get clean water.
But it was the terrible condition of people's shelters that struck me most.
"Our biggest problem is shelter," Halima Abdi, a mother of six children, told me. "If people see this house and the conditions that we live in they will be shocked. It is raining heavily during the nights. Without shelter it is a disaster for us. My children are sick and I'm worried what will happen to them. They don't have enough water or food either.'"
]]>Working closely with Sri Lankan partner organizations, Oxfam is providing primarily clean water, sanitation and public health assistance to families arriving in government-controlled areas, as well as cooked food and other essential relief items. Plans are in place to assist up to 60,000 more.
However, over 50,000 civilians may still remain trapped in a small, heavily crowded rebel-held enclave in northeast Sri Lanka, where humanitarian conditions are now catastrophic. Hundreds have been killed or injured in the past few days. Children are dying of untreated wounds as well as a lack of clean water and unhygienic conditions.
Both sides must pause in their battle to allow trapped civilians to leave safely and for humanitarian workers to reach the sick and wounded, said Oxfam.
"For each day that passes without at least pause in fighting, civilian families are paying with their lives," said Joan Summers, Oxfam Country Director in Sri Lanka.
Oxfam calls on both parties to the conflict to fulfill their obligations under international humanitarian law by permitting safe civilian evacuations and humanitarian access, respecting the lives and neutrality of all non-combatants.
Oxfam urges the Sri Lankan government to fulfill its obligations under national laws and international humanitarian law by ensuring the humanitarian relief effort is increased rapidly and significantly, allowing both national and international aid workers safe and unhindered access to affected families.
Oxfam also urges the international community to help affected civilians by pressing for a humanitarian pause in the fighting by and supporting efforts to provide the 250-300,000 Sri Lankans displaced by the war with both adequate emergency relief and longer term recovery assistance.
Oxfam has been working closely with local partners to provide safe drinking water, sanitation facilities such as latrines and hygiene kits, emergency shelter, and other essential items to thousands of displaced civilians. Our relief activities have been targeting the most vulnerable civilians such as women and children.
]]>We have been hearing a lot about the mangroves on this trip to the Pacific coast where countless families are struggling against a poverty that forces them to live where no one else will: in low-lying areas prone to flooding and along the sides of dirt roads that become hard to negotiate during heavy rains.
South of here, in a town called Metalío, we have just met with Francisco Calzadilla, a member of the technical team for Caritas, which, together with Oxfam America and three other donor groups, as well as six local non-governmental organizations, has joined a consortium called PRVAS—or Programa Reducción de Vulnerabilidades Ahuachapán-Sonsonate. One of its goals is to help communities carry out mitigation projects to reduce their risk in disasters. And that's where the mangroves come in.
"They serve as a natural barrier—to the waves and the wind off the ocean," says Calzadilla. "They also provide a food source. They serve as an ecosystem for shellfish."
The strip of mangroves Calzadilla is particularly concerned with, stretches for about 20 kilometers around Metalío. He estimates that about 50 percent of that stretch has been deforested as people cut down the trees for both construction material and firewood.
But in August, with support from PRVAS, community members took steps to recover some of those losses, said Calzadilla. They collected, sorted, and planted 20,000 mangrove seeds—they look like long, slender pods—along a two-kilometer deforested strip.
It will be a while—10 years predicted Calzadilla—before the seedlings mature enough to serve as a barrier against the onslaught of Mother Nature. In areas where the mangroves have disappeared and there is nothing to break the force of winds, small houses have blown away, Calzadilla said.
In some neighborhoods around Acajutla, El Salvador's largest port, mangrove forests have been severely reduced—replaced by fill and the simple homes of some of the country's poorest residents.
Further east in the department of Usulután, preservation efforts are underway for some of the mangrove forests in Jiquilisco Bay, where Oxfam America is helping local fishermen organize themselves to improve their production and protect their livelihoods. They depend on the resources that flourish in the dense tangle of roots, mud, and tidal water.
Deep in the pre-dawn gloom of one protected area in the bay, we can just make out a platform where watchmen keep round-the-clock guard over this watery haven supported by funds from the United Nations. Here, mollusks can get a solid start and help to increase the catch that local fishermen need to feed their families.
Later, after the sun is up and the tide has receded, the mangrove forests in Jiquilisco Bay come alive with the chirping and scrambling of wildlife. Herons pick their way over the mud flats. A raccoon darts through the exposed roots. A vulture studies us from his perch on a branch.
Juan Larín Rojas, a 54-year-old fisherman, eyes each one of them with delight. He knows many of their scientific names. This is his turf, and despite the challenges of making a living from these mangroves and the sea around them, he wouldn't give up this life for anything.
"I love fishing. I love the sea. I love feeling free," he says.
]]>The house is gone now, and Canjura, her husband, and their four boys have moved to a new cinder block house—with a tile floor and a composting latrine—built by an aid group a short distance away. But for many poor people settled in this mangrove swamp, all the problems remain of living on marginal land, made more hazardous by the increased flooding climate change seems to be triggering.
And that's why Canjura, with the help of Oxfam America and a consortium of aid groups, is now rallying with other local activists to bring their problems to the attention of the Salvadoran government and push for help.
The consortium, made up of five donor groups and six local non-governmental organizations, started two years ago with a program called PRVAS—or Programa Reducción de Vulnerabilidades Ahuachapán-Sonsonate. The program helps communities in the area organize themselves to better prepare for disasters, carry out small mitigation projects, and win the ear of local governments. The idea behind the PRVAS is to help people help themselves—and find ways to make a new civil protection law, passed in 2005, work for them.
"If we just continue from an emergency response perspective, all we'll do year after year is help rescue people," says Henry Giovani Magaña the coordinator for PRVAS. "We won't help people overcome their vulnerabilities—which is what we want."
We are sitting in a small community center, a low-slung ocean-front structure on loan to residents in this coastal region from a Salvadoran living in the US. Other buildings—some less substantial than this one—line both sides of the street. And further back, amid pools of murky water, stretch what's left of the mangroves in this area. The construction of a railroad down to the coast in the 1930s marked the beginning of their end.
Magaña explains that when the railroad came, landless families, in search of jobs and a place to live, settled here, and slowly the swampland began to get developed. Nearby, the Sensunapan River, now reportedly one of the most polluted in this tiny country, drains into the sea, its water silted and brown. The river serves as both a source of income—shirtless diggers scoop boatloads of sand from its floor—and dread: During heavy rains, the Sensunapan spills from its channel and floods the surrounding homes.
Though fill and levees have altered the landscape in these coastal neighborhoods, the basic topography has not changed—with consequences that have proved dire in the decades since for poor people clinging to this strip of land along the Pacific.
"Nature doesn't make mistakes," says Magaña. "It wants this to be wet. There are floods here all the time."
And now, compounding the trouble, are changing weather patterns that are making life even more challenging for the families struggling here.
"About five years ago we started to notice that the sea is coming in further, and when there are very high tides it's slowly eroding houses along the shore," says Hilton Alcir Aguilar, a volunteer coordinator for the five coastal neighborhoods participating in the PRVAS program in Acajutla. "And the rains are heavier. Before, it would take two hours of rain for water to rise high enough to flood. Now, it happens in one hour."
Canjura has spent all of her 30 years right here in the La Playa neighborhood. And in that time she has begun to see changes that are having serious implications for her family.
"When we have these temporales—the storms that rain for several days—the water rises. But with climate change, we're seeing more flooding and we're also seeing it in areas that didn't flood before," she says. "Here most of the men are fishermen and they used to be able to haul in a lot but because of climate change, the fish seemed to have migrated away from here. It's really affected their ability to support their families. Some are looking for work as bricklayers. Some have opened bike repair shops. And some continue to fish."
Her husband is one of those—a fisherman.
"It has affected us," says Canjura. "He's getting less fish. If we used to eat two tortillas at a meal, now we're eating one." Sometimes, she says, her children go hungry.
"When you talk to people about climate change here, they're much more concerned," said Magaña. "They know storms are going to get worse, and if they're already living in vulnerable positions, it will make them more vulnerable."
What are the answers?
One solution, says Canjura, is the construction of a levee system on the Sensunapan River that would protect the densely populated community along one of its banks. But the price tag is steep, and no one has agreed to fund it, she adds. Nevertheless, other smaller projects proposed by locals and supported by PRVAS members are now moving ahead.
"We're trying to organize community councils so we can put together project proposals and seek support," says Canjura. She points to the recent construction of a seawall in La Playa as proof of what's possible when enough people get behind an idea. Designed to keep high tides from slopping onto the coastal road and into the homes of people along it, the seawall was built with help from Caritas, the mayor's office, and plenty of manual labor provided by the community.
"All of us felt very proud," says Canjura. "We were very happy we were able to achieve that."
Other projects in the works include the paving of a dirt evacuation route in the community of El Milagro. All it takes is two hours of heavy rain before the neighborhood floods with water up to people's knees, says José Vidal Aguillón, chairman of a local community council. A paved evacuation route will allow them to get out fast—without vehicles getting stuck in the mud. A broad drainage ditch, also under construction, will help the floodwaters to drain away more quickly—and prevent possible contaminants in the water from lingering.
But construction projects aren't all that's needed to help poor people in coastal Acajutla weather the increasing challenges they face. They need a voice and they need influence—both of which PRVAS is slowly helping them muster.
"From the training in disaster risk reduction we've gone through with the PRVAS program, we've built our skills to advocate for greater aid from the government—and we're also getting more involved in working with the government," says Aguilar, the community coordinator. "The biggest achievement is the unity in the five communities—that we're united behind the same goal—and the influence we're starting to have in different government institutions."
With that influence, perhaps the communities will be able to lobby successfully for more opportunities for advanced schooling or vocational training in Acajutla—both critical if people are to become competitive in the job market. With fishing drying up, many of the Acajutla's breadwinners are going to have to find other means of making a living.
Canjura seems to be keenly aware of that. She has only a sixth-grade education, and her husband stopped his schooling after the third grade. But all four of their children are steadily moving up through the grades, even as finding the resources to buy the necessary school supplies is a constant worry for Canjura and her husband. Their oldest son will soon be entering eighth grade.
Would she like to see them go on to high school?
Canjura sighs deeply at the question, and is silent for a moment.
"That's my goal," she says finally. "I really want them to get ahead. But the way things are now, it's pretty hard."
]]>In the arid north of the country, where the government has prioritized copper mining, farmers and copper mines struggle to co-exist. Both need water, but the major copper mines, with support from the government and plenty of capital, are buying up the water rights. Farmers, many poor and without powerful friends in the government, are seeing their rivers and streams dry up—or worse, become so polluted they can't use the water.
In 2004, the 2,000 residents of Caimanes, a remote town in Chile's IV Region, faced an additional challenge: a massive tailings dam Pelambres Mining Company built on their doorstep. The dam, which collects waste rock from dissolved copper, would allow the Las Pelambres mine to continue operating for an additional 28 years. And the new tailings dam, when full, will hold 1.7 billion tons of waste.
Despite this huge new source of pollution to their water sources, local people had few outlets to defend their rights. Chile has no provisions in its laws on mining that require any citizen participation in approving or authorizing any expansion of existing mining operations.
But farmers in Caimanes and several other villages continued to voice their concerns that the dam would destroy an entire valley and cut off their supply of water. They said that acid will drain out of the dam, polluting what water that remains, and endangering the one stream that provides their town with water. Tailings dams are also usually a source of dust particles containing heavy metals—these can blow into town and poison people and their animals.
Caimanes is in the poorest region of Chile. Farmers there are concerned about their ability to continue to earn a living, but are also aware that a major earthquake could collapse the dam. This has happened before: In 1965 an earthquake spilled 10 million cubic meters (350 million cubic feet) of mine waste out of a similar holding area and killed 200 people.
In 2004 community members in Caimanes began working with the Environmental Oversight Office (the Fiscalía del Medio Ambiente or FIMA, a Chilean NGO). They gathered signatures on petitions and filed them in legal courts and requested an injunction to halt construction of the tailings dam. In 2005 the Caimanes community group representing farmers in the area alleged that the permit process for the dam had not been followed properly and that there were archeological sites that were being damaged in the construction. In 2007 a local court in the nearby city of Los Vilos ordered that the mine company halt construction of the tailings dam.
The Las Pelambres mine company appealed the 2007 court order, and the decision put responsibility on a government water commission. This commission had already approved a permit for the construction of the tailings dam, with limited participation from local farmers, so it allowed construction to continue. In 2008 the Chile's supreme court ruled that the right to water for the farmers affected by the tailings dam was being violated, and awarded each of the farmers $40,000. In December 2008 the company announced that it had finished the tailings dam.
Oxfam America provided grant funding for FIMA to help the citizens of Caimanes to defend their rights in court, and raise awareness about their situation among people in Chile. FIMA advocated for a hearing at the Latin American Water Tribunal in 2007, which issued a statement calling for the dam construction to be stopped and the citizens compensated. FIMA has also published reports about the situation in Caimanes and prompted considerable coverage of this case in the international media.
Although the citizens of Caimanes did win compensation and a favorable judgment in court, they did not succeed in blocking the dam construction. "Unfortunately for the people, there are no winners," says a report published by FIMA, The Battle for Water in the Pupío Valley. "This compensation will not make up for the destruction of the quality of life in the valley." FIMA says in the report that the people achieved a "legal and economic victory, but a social and environmental defeat."
Nevertheless, the case sets an important precedent and provides an example to the global mining industry of how responsible companies should not operate.
]]>That was 15 years ago. Today, clean water in the small communities of El Recuerdo and Agua Zarca is as precious as ever—and still hard to get. There's no turning on the tap over a kitchen sink and letting the gallons gush. Here, many people trudge to a communal source, fill their jugs, and lug the heavy load home again. But seasonal flooding—sometimes hugely destructive and, with climate change, possibly becoming more severe—contaminates many of the area's hand-dug wells, exposing people to waterborne illnesses.
But now, with the help of Oxfam America and its local partner, PROVIDA, the well that Cruz worked so hard to dig on the school grounds in El Recuerdo is pumping enough clean water to satisfy the drinking needs not only of the students but of about 80 families in the surrounding area. The well is one of five "healthy wells" in southern Zacatecoluca province PROVIDA lined, surrounded with a filter, capped to ensure its cleanliness, and outfitted with a pump that sends water to a large tank for chlorination and storage.
"The families in this area are living in extreme poverty, living as subsistence farmers or low paid day laborers in the nearby sugar cane plantations," says Karina Copen, an Oxfam humanitarian program officer. "They face numerous challenges in having to adapt to the increased frequency and intensity of the flooding in their area. With access to a healthy well, they can at least know that in the next flood, they will have a safe source of water for their families and the good health that comes along with it."
Adaptations, such as these healthy wells, are essential for Salvadoran families living in the department of La Paz in the lower region of the Lempa River where seasonal rains, tropical depressions, and hurricanes, make it one of the country's most flood-prone areas.
Coupled with those natural hazards is the fact that communities in the region have significantly less access to improved water sources and sanitation than other parts of the country. The "healthy wells" along with 27 new composting latrines have been a boon to families in the area.
"Kids are getting sick less; families are healthier," says Santos Efrain Coto, one of the local leaders in El Recuerdo. "When they drank contaminated water they got diarrhea and parasites."
The improved wells are based on a model that's new to El Salvador and designed by an organization called Swiss Labour Assistance. Besides having their tops sealed with cement to prevent polluted flood waters from slopping in, the wells are lined with a type of plastic pipe, known as polyvinyl chloride, or PVC, that extends down into the aquifer. Packed around the outside of the lining is a filter of volcanic rock that prevents contamination from seeping through underground.
At the El Recuerdo school one day recently, teacher Ana Elsa Cubias describes how students used to bring their own water from home to drink during the school day. Now, the refurbished well guarantees them a clean supply right on the spot.
"They're drinking water from a protected source and the kids have water right in the classroom," says Cubias.
A short distance from the classrooms sits a large plastic tank, sky blue and able to hold 1,100 liters of water pumped fresh from the well. Chlorinated, the water from the tank flows to two taps standing just outside the gates to the school. They're accessible to whoever is driving or walking by. And to ensure the stored water stays safe for drinking, the water committee arranges to have the tank cleaned every couple of weeks—a task that falls to a child small enough to wiggle inside and scrub the interior walls with a brush and bleach.
"We make sure he bathes before he gets in the tank," adds Coto, the local leader.
In Agua Zarca, a few communities over, Jose Luis Funes Cruze says that before PROVIDA and Oxfam installed the new well, most of the local residents depended on their own backyard wells for drinking water—and that was a problem.
"The household wells take on a lot of rain water and a lot of filthy water when there's flooding," says Cruz, pointing in the direction of the polluted San Antonio River, which spills its banks during big storms. "The things people throw in—there are pigs up river. And the cheese factory is up river."
In the past, when their drinking supply has been contaminated, families in Agua Zarca have had to rely on the government or aid groups to truck in drinking water for them.
But now, with a new communal well their supply of drinking water is much improved.
"We're very grateful—the whole community is—to have that water," says Blanca Lidia Jiménez, who lives close to the well makes about six trips a day to fetch enough water for the seven people in her house. "We don't get sick so much when we drink the water from this well. The little kids would get swollen bellies, but with the new well that problem has been solved."
Still, the situation in Agua Zarca points to the challenges of providing clean water in this area. The community's new well was built on the only land available: next to a cow pasture—an arrangement that could be problematic during the wet season when rain sloshes manure about and allows it to seep into the groundwater.
The deep plastic lining on the well and its volcanic-rock filter help, though, says Guillermo Morán, a professor and researcher at the University of El Salvador's Earth Sciences Institute. He worked with Oxfam America and another of its partners, the Harvard Humanitarian Initiative (HHI), to evaluate the effectiveness of the wells while studying the health practices of families who use them.
The study is an important component of Oxfam's public health work: It promotes accountability and offers a different model for aid groups by linking their work with that of universities.
"We have the field experience and they have the technical expertise," says Miriam Aschkenasy, Oxfam America's public health specialist. "Together we're able to evaluate programs at a higher standard and at one that increases accountability."
In its draft report, HHI said that individuals who live in communities with "healthy wells" were less likely to have diarrhea and reported fewer cases of the illness during the time of the study. But the draft report also revealed that in two of those communities, some people were still using hand-dug wells for their drinking water while other people from places without "healthy wells" were making the trek to a community that had one to fetch their water.
"The study gives us insight in a way we couldn't have anticipated," says Aschkenasy. "It gives us an idea of where to focus in the future. We now know we need to find a way to encourage people who are still relying on the hand-dug wells to use the healthy ones instead. And it gives us great incentive to build more of them."
]]>Tacked to the outside wall of a government office building in Zimbabwe, the warning served notice to all who could read English that Mudzi district is in the throes of a major public health crisis.
Like wildfire, hot spots of cholera—a waterborne diarrheal disease that can kill quickly if not treated properly-- continued to erupt in late January in this rural northeast region on the border with Mozambique. I heard about the spikes—and the challenge of stopping their spread—at the morning meetings at Kotwa hospital, where aid groups and government health officials gather to coordinate each day’s attack on the disease. Oxfam and its local partner, Single Parents Widow(er)s Support Network, or SPWSnet, are among those responding to the crisis.
Fanning out from the hospital grounds, a small team of nurses, water engineers, and public health promoters hit the road each day, traveling up to two hours to reach the more remote areas where people need everything from clean water to basic information about cholera prevention. And they return each night—sometimes long after dark—to prepare their reports for the next morning.
The news they deliver, along with their statistics, is often unsettling: Reports of people drinking from a stream in which others are washing dirty clothes and dishes; shortages of oral rehydration salts and disinfectant; an ox cart toting a patient who died before reaching a clinic. All of it paints a picture of a country crippled by hyperinflation and failing water and sanitation systems. In Mudzi, less than a third of the households have access to proper latrines, according to one estimate.
Already cholera has sickened close to 85,000 people across Zimbabwe, killing more than 3,900 of them as of Feb. 6. The World Health Organization has called it one of the largest outbreaks ever recorded. And Mudzi, poor and far from central areas of commerce and government activity, has been one of the hardest-hit districts.
Here, in Mudzi, fear of the disease is palpable. Fist bumps have replaced handshakes as people worry that palm-to-palm contact could transmit cholera. Some people are even afraid to eat, though of course they must, one man tells me.
“We are not settled,” says the man, Wonderful Nyatsuto, as he helps a SPWSnet engineer repair a deep well, known as a bore hole, about a mile and a half from his home. About 15 people in his village have contracted the disease, he says, and a third of those have died. Cases of cholera started to erupt when people began fetching their water from a nearby river after the bore hole stopped functioning. Across Mudzi, many of the region’s 600-plus boreholes no longer work and communities are too poor to repair them. But without a supply of clean water, residents face a growing danger from the disease.
“We are trying to maintain the rules they tell us,” Nyatsuto adds. “Boil water. Clean hands before you eat. Clean the toilet.”
Still, in a region where many locals supplement their meager incomes by panning for gold in a network of streams and drink the contaminated water as they labor, people are continuing to get sick.
But getting to a clinic is no easy matter. Functioning ones are few and far between. Some have no medicines. Others have no medical equipment. And so sick people trudge great distances to get the care they need. Roads are rough, sometimes barely more than tracks through the bush, cars are scarce, and fuel is both dear and hard to find—even for aid workers who have access to outside resources to buy what they need. Sometimes, aid groups have to send vehicles all the way back to Harare, the capital, a two-and-a-half hour drive from the Kotwa hospital, to scrounge for a small supply of fuel that they can port back to keep their trucks in Mudzi running.
One day in late January, 49 patients packed a clinic in Makaha, a ward in Mudzi where cases of cholera were suddenly spiking. A series of tents and one dimly lit concrete room served as wards for people stretched out, limp and mostly silent, on cholera cots—beds with large holes cut in the middle beneath which buckets are placed.
Snaking between the tents and the out buildings was a narrow path of mud bricks powdered, here and there, with flecks of white—the remnants of the dried lime-chloride used to disinfect contaminated surfaces. Mixed with water, a jug of it sat at the exit of the clinic, a reminder to all visitors to give their hands a thorough dousing.
As she finished hosing down an empty cot with the chloride solution, a nurse, her face flat with exhaustion, described some of the misery she had witnessed in the last few days. A mother, six months pregnant and very sick with cholera had managed to get herself to the clinic only to lose her baby. The next day, her husband arrived with their five-year-old son whom he had carried more than 16 kilometers from their home in search of help. Weak with cholera, the boy had died en route. And now the husband was gravely ill, too. The nurse was uncertain whether he would survive.
Behind her, on a shelf, stood a plastic barrel—a mini storage tank for the mixture of oral rehydration salts that were helping to keep the clinic’s patients alive. But the barrel had barely two inches of liquid left in it—nowhere near enough to sustain all those who desperately needed the sugar-and-salt mixture. And there was no more solution anywhere else in the clinic. Fortunately, we had a small supply of rehydration packets in our Oxfam truck and immediately gave them to the nurse. But that’s not all she needed. The clinic had just two doses left of ciprofloxacin, an antibiotic used to treat a variety of bacterial infections including severe cases of diarrhea.
Beyond the tents, was the observation area—a patch of dirt in the shade of a large tree. Here, patients waiting to be admitted slumped on the ground and those who had improved continued to rest before making the journey home. Outside the gate to the clinic, family members huddled around small cooking fires, the smoke curling around them. They were preparing food for the patients inside—a kindness that was also a cause of concern to nurses who feared cholera could soon sweep through the family support network.
Compounding the challenge of treating cholera is the widespread hunger many people in Zimbabwe are now confronting in the months leading up to the next harvest. Hunger has left people weak and more vulnerable to the disease.
The World Food Program plans to feed more than five million people in February, the greatest number in a single month since 2002. But because more people need food, the program is reducing ration size so that it can stretch its stocks far enough to accommodate everyone.
For some families, even coming up with the basics to fight cholera—such as sugar for a rehydration solution—can be daunting. Dutchman Matika tells of having to borrow sugar from a neighbor to make his wife the solution when she came down with cholera. As he speaks, two of his young sons listen intently, their hair tinged with orange—a sign of malnutrition. With 11 children and three wives in his household, Matika says mealie meal—a local staple—is in short supply.
“When you walk around, you see it,” says an aid worker about the malnutrition that has followed on the heels of several poor harvests and that’s affecting people most acutely in the interior of the country. “Poppy tummies. That’s one of the very clear indications. It’s mainly in kids. And you get wasting away in adults.”
But this year, in Mudzi, there are signs the next harvest may be better. While there is never enough fertilizer to guarantee robust crops, the rains during the current wet season have been unusually plentiful. Where corn and sorghum, millet and ground nuts have been planted, green shoots abound—slivers of hope for the future.
]]>The Yanacocha gold mine is currently operating on 26,000 hectares (about 63,700 acres), high above the city of Cajamarca in the Andes mountains of Peru. But that is just a small area: The government conceded a total of 282,000 hectares (690,000 acres, slightly , larger than the state of Rhode Island) to Minera Yanacocha, a company comprised of majority owners Newmont Mining of the United States and Minera Buenaventura of Peru. Yanacocha continues to be a significant part of Newmont Mining's global production, contributing about a quarter of the 5.3 million ounces of gold Newmont sold in 2007.
Minera Yanacocha is working aggressively to expand the mine. In 2004, the mine began exploring for gold on Cerro Quilish, a small mountain that comprises the top of the watershed supplying the city of Cajamarca and the rest of the valley. Dairy and potato farmers in the area and many others opposed to mining Quilish blocked the road to the mountain in 2004. There were weeks of violent confrontation between police and protesters. In the end, Minera Yanacocha stated publicly that it had underestimated the concerns of local people and asked the Ministry of Energy and Mines to revoke its permit to explore for minerals on Cerro Quilish.
The mountain remains in the mine's concession area. Many of the Quechua-speaking indigenous people in the area consider Quilish their apu, a mountain spirit, and a sacred place. "When the clouds gather above Quilish, we know it will rain," says Nelida Chilon, a 24-year old from Bajo Porcón, midway between the city and the mountain. "We want to protect Quilish, our source of water. The [mining] engineers tell us there is water, and no pollution, but we know the land does not produce as it used to, and there is less water than ever."
Local governments representing communities opposed to mining on Quilish also adopted laws to designate it a protected natural area. Other communities where the mine intends to expand have taken similar measures. Oxfam America's partner GRUFIDES is supporting efforts by local communities to protect their land, and provides training and other support to local people eager to learn about and defend their human rights and protect their water sources. With help from Oxfam America, GRUFIDES is also working with the regional government's environmental management agency to create a land use plan that would clearly designate areas for agriculture, human settlement, mining, and other activities.
Minera Yanacocha is disputing 12 local ordinances that prohibit mining, and plans to expand mining exploitation to these and other areas, including La Zanja, where one person was killed by police during a demonstration in 2004. The environmentally fragile high altitude wetlands of El Solitario, where there are 240 ponds and lakes, is another area of proposed expansion.
Minera Yanacocha is claiming jurisdiction in Lima where the company is officially located and where judges are not familiar with these local areas. Communities are hard pressed to be properly represented in the proceedings due to costs and distance (375 miles). "With that kind of trial you know who is going to win," says Marco Arana, one of the founders of GRUFIDES, Oxfam America's partner in Cajamarca. He added that when legal and institutional roads are closed to citizens, it leads to confrontation, and "adds to the social exclusion and asymmetry of power in Peru."
Oxfam America is supporting the work of GRUFIDES to help local communities defend their rights and create an appropriate land use plan for the region. Oxfam is calling on Minera Yanacocha to:
The pool above the Gonnoruwa anicut is peaceful, cool, and long-awaited. Here, at a bend in the Malarara River, water that pauses above the dam nudges up against the sluice gate of a hand-dug channel.
"In my grandparents' time, my parents' time, and even my time, we had this idea to take water from the river for our crops," says D. A. Ekanayaka, who lives in the village. "All of these people for generations knew they could take water, but they didn't know how."
This is the dry region of Sri Lanka, where irrigation is the lifeblood of agriculture. Although the Malarara River is only a few kilometers from the village of Gonnoruwa, Ekanayaka's parents and grandparents had no way to transport enough water for crops from A to B. The result: crop failures, sometimes four seasons out of five. The villagers were nearly destitute, forced to depend on moneylenders to make up the endless shortfalls.
Then came the tsunami, which took the lives of 60 people in Gonnoruwa and a neighboring community. If the wave had struck on another day of the week, the village would have been spared: Gonnoruwa is 25 kilometers (about 15 miles) inland. But Dec. 26 was market day in the coastal town of Hambantota, and many of those who went to buy and sell never returned.
But when, in the immediate aftermath of the disaster, the villagers were offered food handouts by aid agencies, they took the long view: what they needed wasn't food; it was the means to grow it. If you really want to assist us, villagers told aid agencies, help us get water to our crops. Oxfam took them up on it.
A small group of village women took charge of the anicut project. It was they who negotiated with Oxfam, government irrigation authorities, masons, and vendors. And they organized the community to provide labor for jobs like transporting materials and mixing concrete.
But as women stepping into a leadership role normally occupied by men, they were put to the test from day one.
"At the start, the men tried to do some things just to see whether the women would give up. To see whether we had the courage to continue the work," says Mallika Abayakoon.
At home, there were complaints from husbands that the cooking, cleaning, and child care were being neglected; at the construction site, there were refusals to carry out the tasks assigned. But the women were a force to be reckoned with. When men balked at the labor asked of them or the wages offered, the women simply stepped in and did the work themselves—even when it involved heavy jobs like mixing cement.
But they always had the support of a handful of village men, Ekanayaka among them. "They didn't care about food, time, or anything," says Abayakoon. "They were like our fathers, our brothers, our very good friends. They treated us really well."
The anicut was completed in March of 2007, and the village that once struggled to produce a single crop can now grow two a year. What does this mean to the women of Gonnoruwa and their community? They are eating three meals a day; they have pulled themselves out of debt; they can grow rice and home gardens, too; they are building better houses for themselves; they are sending their children for extra classes and helping them continue with higher education.
But the gains don't stop there. The women's husbands—now proud of their wives' huge contribution to the community—support them in new ways.
"Most of the men changed their behavior because of the anicut project," says one of the women. "Now half of the household work is done by my husband, even if I'm at home."
And instead of a handful of men supporting women's leadership in Gonnoruwa, there are now scores.
K. Somawathi is a member of the women's group. She is shy and has a serious look about her, but when asked how it feels to be a respected community leader, she smiled and says, after a pause, "It's unbearable happiness."
]]>There, on the shore behind what's left of a half-constructed mansion, the chug-chug-chug of a diesel pump holds the promise of clean water for 11,042 people at Buhimba camp. They are just some of more than one million villagers forced to flee their homes as conflict has swept across the eastern provinces of that vast country. A short distance away, a second pump, submerged deep in the lake, provides water for an additional 18,016 people in two other camps known as Mugunga I and II.
Without clean water, without decent sanitation, and without the public health outreach that helps people understand the link between the two, waterborne diseases could ripple through theses camps with devastating consequences. That's what Oxfam, together with its local partner, Action Santé Femme, or ASAF, was determined to prevent when it helped establish the water systems for these three camps—and a fourth, Bulengo—outside Goma, the capital of North Kivu province. Through a network of rigid plastic pipes, storage tanks, and outdoor faucets, water from Lake Kivu now gushes into the jerry cans of thousands of families with the turn of a tap.
At the top of a short but steep hill at Buhimba, where two massive water storage tanks frame the sprawling camp below, Helene Kanyere Ndakas stands ready with a notebook in hand. She is the manager of this storage station—and knows better than almost anybody the importance of making sure the system runs smoothly.
What gives her that special knowledge?
Ndakas herself relies on the water that flows from it. She and her family are among the thousands of people who are now making their homes temporarily at Buhimba.
Flipping her notebook open, Ndakas points to the careful records she keeps each time she opens the valves to refill the tanks with lake water. And she notes the amount of chlorine that goes in to guarantee its cleanliness. Hired by Oxfam, Ndakas is on water duty from 6am to 4pm each day—a job she takes very seriously.
"People are depending on her," says Charles Mampasu, an Oxfam program manager in Goma. "And they're happy with her job."
In a place where there was little or no infrastructure to support a water system, supplying tens of thousands of people with clean water on an emergency basis has been no small feat. And making sure they continue to have access to it when Oxfam moves on to its next project is one of the organization's central concerns. That's why Oxfam is working hand-in-hand with ASAF to help it build its ability to handle the water system on its own, particularly in Mugunga camps.
A tour through Mugunga I shows how important a steady supply of clean water can be—especially when people are struggling with such harsh living conditions. Built on fields of sharp volcanic rocks, the shelters many people now call home are not even tall enough in which to stand. Made from grasses and dried banana leaves flung over a frame of saplings and topped with a plastic sheet, the huts offer only minimal protection from the elements. To keep warm—and to drive the bugs out—many people cook on small wood fires inside their huts, the smoke curling into their lungs and out through the cracks in the shelter walls.
At the health clinic, the nurse on duty reports that respiratory infections are among the most common medical problems he sees. About 150 people a day flock to the clinic with a host of ailments that also include malaria, tuberculosis, and diarrhea. The latter is what the clean water—and scores of latrines that Oxfam has also installed—help to fight.
Snaking across the rocks, over roots, and through the mud, a network of wide black plastic pipes carries the water from Lake Kivu. It's replacing a temporary supply that another agency had been trucking in daily and storing in two plump water bladders—they look like giant egg yokes when full—at a cost of $3,500 a week. Nearby, the water blasts from faucets when kids turn on the taps to fill plastic jugs before lugging them home.
The water jug of choice for many kids has a familiar look: it's the container that once carried their family's allotment of cooking oil, doled out during the regular food distributions that displaced people have no choice but to depend on. Here at Mugunga, nothing goes to waste—not the jugs, and not the precious water they carry.
]]>Byakupita Wabinwa, president of the management committee that oversees the Kabimba health clinic, is standing below the sign. He is a small and serious man with a serious problem—one that plagues not only his community but that crops up frequently in this region of Democratic Republic of Congo: cholera.
Here, in the eastern provinces where years of conflict have taken a toll on social services, outbreaks of the waterborne disease are just one of the consequences of underinvestment in everything from roads, to health clinics, to clean water.
Sometimes, if maintenance of the simple delivery system has been lax, the water at this clinic doesn't run at all. That's why an enormous black cylinder is lying on its side in the clinic's front yard. It's a storage tank, waiting for installation as part of Oxfam's program to help ensure the clinic has a reliable reserve of water as well as decent sanitation facilities. In the back of the yard, a pair of pit latrines and two bathing stalls are under construction. And nearby, deep in the ground, lies the newly dug "placenta pit"—the local solution for disposing of hazardous medical wastes including afterbirth from the maternity ward.
Though it has no doctor and just five nurses, this is a busy place—serving an area with nearly 14,000 people. About 75 make their way here each week—some walking two hours down from the mountains—to receive treatment for malaria, to get tested for tuberculosis, to fight the cholera that erupts from time to time, especially during the rainy season.
Tacked to the door of one of the buildings is a sign, warning with explicit detail in Swahili, about the symptoms of cholera. It urges those who've got them to head for the nearest health clinic as soon as possible.
On this day, there are no cholera sufferers at the Kabimba clinic. But sometimes, during outbreaks, as many as 20 people a week come for treatment, though there is hardly the space for them. People lug their own bedding with them and spread it on the floor. A small building—about 30 feet long by 15 feet wide—serves as a quarantine area.
"But how can you put 20 people in that building and keep them healthy?" asks Wabinwa.
Inside, the walls are grimy with stains and the ceiling is collapsing. Of the original 10 cholera beds—mattresses with holes in the center beneath which buckets can be placed—only three remain. The plastic covering on one of the mattresses has pulled away, exposing the foam around the hole and leaving it like a sponge to sop up germs. A rickety wooden rack serves as a post for the intravenous drip.
As primitive and ill-supplied as the Kabimba clinic is by western standards, Trish Morrow, Oxfam's public health team leader for rural villages around Uvira, assures visitors that it's better than many that serve some of Congo's 62 million people, vast numbers of whom live in poverty. Few have the resources to pay for much medical care at all, but many live at risk of contracting serious diseases—like cholera—to which that poverty, with cruel irony, exposes them.
Nowhere is that more clear, perhaps, than along the stretch of land between the Mulongwe and Kavimvira rivers just outside of Uvira, South Kivu province.
It's there, between those two central sources of water, that the greatest number of cholera cases in the area erupt, says Jill Markvorsen, Oxfam's program manager for Uvira. During the first week of January, an outbreak almost reached epidemic proportions. At the cholera clinic in Uvira, workers charted 64 cases of the disease&mdasdh;one shy of the number that would have triggered the implementation of Uvira health zone's cholera contingency plan. Instead, officials, staffers from Oxfam and other aid groups, and volunteers from the Red Cross managed the flare-up by chlorinating water sources, making public health announcements on the radio, and providing information to people about measures they could take to improve hygiene and sanitation.
A few months later, in mid-March, both banks of the Mulongwe River are teeming with activity. Not far from one edge, a bare-bottomed boy dashes behind a bush and squats to relieve himself. Pigs root in a heap of rubbish that inches, black and slippery with mud, almost into the water. It rushes by filled with silt. Men wash their clothes. Others drive trucks and cars into the shallows to rinse off the dust and dirt. Up stream, a market crowded with people hugs the bank.
For those who have no other source, the Mulongwe River also serves as their supply for drinking water. It's no wonder then that cholera, caused by ingesting water or food contaminated by the bacterium vibrio cholerae, is one of the ugly facts of life for people living in this war-torn region.
At the Uvira cholera clinic, Oxfam helped to install a large tank that stores a backup supply of water—collected from the roof during rainstorms and precious for its relative purity. Two large rooms—one for men and the other for women—serve as sick wards. Simple beds—wood frames with sheets of rugged plastic stretched taut across and cut in the center with a hole—are scattered about the rooms. Others are piled outside.
The wards are empty on this mid-March day—a good sign.
Morrow, the public health team leader, says that the medical staff in Uvira has been trained well to provide patients with good care. Though there is not so much it can do to prevent people from contracting a disease that's so closely linked to the lack of public services—like potable water—the staff has been successful, says Morrow, in stemming the tide of cholera deaths.
And in a place where basic precautions take on ominous importance, blue buckets filled with a mixture of water and a heavy dose of chlorine dot the perimeter of the clinic's yard. All visitors are advised to scrub their hands with that solution before they leave. Most do—and duck out smelling like a swimming pool in the western world, but grateful for it.
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