But now that she has insurance, she can afford to take him to a clinic to get checked out.
According to Devudamma, many mothers here face the same dilemma when their child comes down with fever. Fevers could mean malaria or dengue, both of which are potentially fatal.
"Because they don't know what it is, the tendency is to rush to the hospital," said Devudamma, "But they charge a lot."
"That's where insurance is very handy," she said.
Many fishing families in the Pudimedaka village are deep in debt, borrowing money to rebuild boats, to cover daily costs when the catch is small or injury or illness keep them from working, or, like Devudamma, to pay for medical care.
When fish are plentiful, families have to pay back their loans, usually with a high percentage of their catch.
But health insurance, as part of a broader economic plan, is opening up new possibilities here.
Three years ago, the District Fishermen's Youth Welfare Association (DFYWA) a local NGO, and Oxfam partner, helped families in this village determine that medical expenses were a huge drain on their resources, costing some up to a quarter of their yearly income.
DFYWA also convinced Oriental Insurance, a government of India company, to create policies designed, and priced, for very poor fishing families.
Now, for what they make in a day, families like Devudamma's, can purchase an annual policy, protecting themselves from the costs of sickness, accidents ? even the death of a breadwinner.
With money saved on medical care, families here are buying ice-boxes, fishing nets and fish drying and processing equipment. These investments can help them earn a little more on their catch than they did before.
Health insurance is a great first step, but ultimately, the people of Pudimedaka need a more comprehensive insurance package to keep them out of the pockets of money-lenders, who fulfill a "mafia-like" role, according to J. Saravanan, fisheries expert from the Development Human Action (DHAN) Academy in Madurai.
Beyond medical costs, fishing families would benefit from insurance that covers assets including their boats, houses and even their day's catch.
Initially, Oriental did not know how to insure the traditional Indian catamarans that the poorest fishermen use, since they had no way of knowing whether the boats were seaworthy.
But DFYWA convinced the Department of Fisheries to rate and certify even these homemade boats. As a result, boat insurance should be available soon, according to Oriental representative Srihari Naidu.
Home insurance has also proved tricky for Oriental, since thatched roofs break easily in storms, even though they are also cheap and easy to repair.
And Naidu was confounded by the idea of insuring a fisherman's catch, despite the fact that other insurers have found a way to insure a farmer's crops.
Fish are a common resource, used by many, said Naidu. "We can't possibly know how many fish are in the sea."
Insuring assets, and not just health, would do more to keep vulnerable families out of debt, and allow them to build their savings, add value to their work, earn more money and reduce their vulnerability.
Mahalakshmi Kara, a grandmother in the village, has relied on a health insurance policy for at least a year and has started saving a small percentage of her earnings.
"We never thought that we could save, but we're doing it," she said.
"I don't know how it will be helpful," said Kara, "but if [saving] can lift us even an inch out of poverty, I'll be very happy."
]]>They were featured speakers on a week-long Oxfam America tour, which passed through five US cities on its way from New Mexico to Missouri. Inspired by Oxfam's Sisters on the Planet initiative—and supported by groups like CARE and the League of Women Voters—the tour focused on the human face of climate change here and abroad, with an emphasis the ways the US can help vulnerable communities survive the crisis.
"Pollution, greenhouse gases, they don't respect boundaries," said Voré Gana Seck, the speaker from Senegal. "This is a global problem that needs global solutions."
Sharon Hanshaw, executive director of Coastal Women for Change and one of Oxfam's Sisters on the Planet, spoke about her personal losses from Hurricane Katrina, as well as the storm's lasting effects on her home town of Biloxi, Mississippi.
Speaking at the Kansas City, Missouri, public library, Hanshaw explained that it's not just past hurricanes that concern her community, but the ones ahead, which are predicted to intensify. "This year we've had four hurricanes in the last six months," she said. "Gustav was called a dud, but it still flooded our houses."
In Biloxi, she said, hurricanes not only wreak physical damage, but also add to the burdens of people already among America's poorest.
"Times were hard pre-Katrina, and now it's even worse; prices have gone up," said Hanshaw. "We still have people living in trailers, no healthcare, no childcare, no public library. We don't need a handout from the government. We need infrastructure to help our community live again."
Seck, Executive Director of Green Senegal and president of the international NGO coalition CONGAD, highlighted the common ground between Senegal and the Gulf Coast. In both places, she said, the poorest families are the ones to bear the burden.
At an event at the Omaha, Nebraska, public library, Seck compared the effects of climate change to those of a war: "You can't produce enough food, you can't harvest. You don't have enough money. You can't send your kids to school."
For local farming families, she said, a decrease in rainfall means that staple crops like rice, millet, and vegetables often fail to reach maturity, leaving families with less food to eat and fewer extra crops to sell. To earn a better living, some of these farmers migrate to already-crowded cities like Dakar, where floods and poor sanitation are leading to an increase in water-borne diseases like cholera.
Others join the ranks of the "climate refugees": teens and young adults who leave their villages for Spain or the Canary Islands, looking to earn money to send to their families back home. Hundreds of these young people have died while attempting ocean crossings in small, fragile boats.
"In Algeciras, Spain, there is a burial ground called the "Cemetery of the Unknown People," said Seck. "These are our environmental refugees. They are the unknown."
Despite these hardships, both speakers' organizations are leading efforts to help their communities survive the crisis.
"The first thing we have to do is be resilient," said Hanshaw, whose group distributes hurricane preparedness kits—containing fresh water, food, insurance papers, and flashlights—to Biloxi seniors and families. They're also offering affordable child care options to help women in the community return to work.
Hanshaw's organization also trains local women to go to Washington, DC, and "tell the stories that are not being told." Their message to legislators: "We're still here. We're going to be here. And climate change affects all of us."
Seck's group teaches Senegalese farmers new techniques that help crops grow in a drier climate, like drip irrigation systems and faster-maturing seeds. Seck showed photos of the successful projects in action: first a riot of green seedlings, then tall plants in orderly rows, flourishing beneath a wide blue sky.
So far, she said, these innovative methods are only in place in a few villages. But with the support of wealthier countries like the US, projects like these could help farmers throughout the region.
Many audience members at these events signed up for Oxfam's online climate change action team, which provides ways to directly influence US legislators on the issue.
For some, the speakers' words brought a change in perspective. "I came here expecting to hear about Africa, but I didn't expect to hear Sharon's story, right in our backyard," said Lillian Pardo, a retired physician who attended the Kansas City speaking event. "You don't see this on the news."
Andrew Jameton, a professor at the University of Nebraska Medical Center, was the last to speak in a question and answer session in Omaha. "I want to fight this, and a lot of people feel the same way, but it will be a tough century," he said, adding that, because of the speakers' words, "I'm not optimistic—but I'm hopeful."
]]>I eventually made it to Mirogane, the main city in the department, which had also been severely affected by both Gustav and Hanna. Here things got interesting. As I made my way along Route Nationale #2, I began noticing trucks full of produce lined up on the side of the road. They were carrying avocados, bananas, and other fresh produce from the South and Grand Anse to be sold in the markets of Port-au-Prince. However, they would not make it to those markets because the bridge on the highway was 1.5 meters?or nearly five feet?under water. The women who had purchased the merchandise in order to resell it, were clearly distraught as the fruits and vegetables had already begun to rot.
As I neared the bridge, or where the bridge should have been, Haitian police officers were posted to prevent vehicles from attempting to cross. A few days earlier, the Haitian government formally closed the highway.
Already in the days following the closing of the road, a group of entrepreneurs had organized alternative transportation for foot passengers and small loads. A shuttle-ferry system had been established. For 15 Haitian gourdes—roughly 38 cents—a man carries you on his back or shoulders and puts you in a "chario," a small wooden boat. Once full, two or three men push the boat across the 229-foot stretch of water to the other side, where for another 15 gourdes, another man takes you on his shoulders to dry land. Here I was able to get on public transport into Port-au-Prince.
Despite this alternative transportation, the road closure combined with the extensive damage caused by the storms will have a great impact on the area. The inability of aid groups to use the road means that help will be slow to reach the isolated areas most affected by the storms. There are great public health risks and food security issues that will need to be addressed in the coming days, weeks, and months and access to the area is critical.
]]>Its danger—splashed across satellite images in spirals of angry red and yellow—could not be discounted. But still. They had all just returned from one grueling evacuation. Could they turn around and leave home again?
That's the question that haunts so many of the preparedness meetings Whitney attends in her role as a community organizer and executive assistant for one of Oxfam America's local partners, Bayou Interfaith Shared Community Organizing, Inc., or BISCO. And it's the question for which there is no real answer.
"A lot of people took the money they use to pay bills and used it for evacuation costs," said Whitney. "Now they're back home and their bills are due and they don't know what to do and they hear they have to leave again? Not in this life time."
It's hard to say which worry is worse for Louisiana residents: the possibility of a second storm or the evacuation that may precede it. Evacuations are costly, exhausting, and disruptive on many levels.
With Gustav, Whitney was lucky. She and her teen-aged son, who has Down syndrome, got an early start—to avoid getting stuck on the highway—and found a welcome refuge in the home of Whitney's sister in Tallahassee, Florida. They stayed about a week, avoiding the hotel bills that many other families have to swallow.
On average, what does it cost a family of four to evacuate?
"$250 a day, easy," said Whitney. "They're going to burn at least one tank of gas to get there and one to get back—so about $120 for fuel. And $125 to $130 a day for a hotel. Plus three meals a day. That's about $100 dollars. And those are the bare necessities."
Add it all up, and you've taken a big bite out of any family's budget. Factor in the disruptions—the missed days of school, the lost income from work—and the dread of multiple evacuations becomes clear.
"People don't have the wherewithal—financial, emotional—to get out," said Whitney. "Back-to-back storms, people say ugh. They're not going to leave. It's too hard."
Convincing some people to join even the first evacuation of the season can be a challenge, said Whitney. And that's particularly true for old-timers who have weathered other storms, even severe ones such as Hurricane Betsy in 1965. That storm, with gusts reported up to 160 miles per hour, left 75 people in the US dead.
But Whitney pointed out that some of the natural defenses that once helped to keep people safe—the coastal islands and marshlands that absorbed some of the energy from earlier storms—have eroded. And waterways built by oil companies in recent decades now funnel dangerous amounts of water inland during violent storms.
"The elderly don't realize those things," said Whitney, adding that it took the graphic details from a study on storm surge to convince her own mother about the wisdom of evacuating in advance of Gustav. Public awareness programs that BISCO is promoting feature work done by the Louisiana State University Agriculture Center and the LA Sea Grant Program. It shows what could have happened to Thibodaux if Hurricane Rita, which struck three years ago, had hit just a little west of where Gustav did. Despite being the highest part of Lafourche parish, a large portion of the city would have been under water, some of it five or six feet deep, Whitney said. Lafourche Parish would have had extensive flooding and most of neighboring Terrebonne Parish would also have been flooded. BISCO has been working hard to educate the public about the danger of storm surges—and to pay attention to more than just the wind speed of top-category storms.
What's the solution to all of this?
Improving the safety of communities would help, said Whitney, and that way perhaps fewer evacuations would be necessary. Healthy marshes along the coastline are one of keys to that safety, she added.
"Man has destroyed that protection and now we're forced to get out to survive," Whitney said. "Before, people could prepare. They could board up, stock up on supplies. They knew how to protect themselves from the furor of nature because nature itself provided protection."
Restoring the marshland would restore some of that security, said Whitney.
"The technology is there, but the political will is not," she said. And that's where BISCO comes in. Grounded by generations of families who have made southern Louisiana their home, the organization is determined to change the political landscape.
"Our goal is to work with communities and networks across the country to help build the will to save the coastline," said Whitney.
]]>Almost one week after Tropical Storm Hanna descended on Haiti, getting food and supplies to Gonaïves has been virtually impossible. The main road from Port-au-Prince was cut when a bridge collapsed just outside of St. Marc, and the road is cut off from the north, as the bridge in the neighboring town of Ennery was washed away. The alternative route through the Central Plateau proved difficult for large trucks carrying supplies, and rough waters have delayed planned shipments of humanitarian aid via boat.
According to UN estimates, 60,000 people are said to be in temporary shelters. "The conditions of those in shelters are horrific," says Rowley. "There is no food, water, cooking materials, basic toiletries or medical supplies, sleeping mats, or latrines. People are in desperate need of anything and everything. Many people have injuries to their feet, he adds, because they are having to wade through the water without shoes.
People are fleeing the town by the hundreds—on foot, in cars, whatever way they can. Some are moving up to the small plateau to the north of Gonaïves, others are going south.
Ogè Léandre, a 45-year-old father of six, explains how he and his family barely managed to get to the shelters in time. "The waters from Tropical Storm Jeanne [2004] did not reach us, so we did not think that we needed to evacuate this time. We packed up everything off the ground and stacked it on top of tables and beds. But then the water started to rise, and it did not stop. So we decided to go to the shelter. But the water was already so high and strong that I could not hold onto one of my children, and the water swept her away. Luckily someone was there to grab her. We got to the roof of the shelter, and about an hour later watched as our entire house was washed away."
In the meantime, Hurricane Ike grazed the northern coast of Haiti early Sunday morning, bringing more rain to Gonaïves and other towns in the Valley. The rain washed out the bridge in Mirebalais, and massive flooding and deaths are being reported in the town of Cabaret, just north of Port-au-Prince.
"We cannot wait for the roads and bridges to be repaired," says Oxfam's Humanitarian Coordinator Kone Amara. "We must get supplies into Gonaïves now. We are in contact with the United Nations' peacekeeping mission here to see how we can begin delivering aid with helicopters. The World Food Program is also preparing shipments by boat once the seas have calmed."
While Oxfam continues to evaluate the damage caused by Hurricane Gustav and Tropical Storm Hanna in other parts of the country, the agency is scaling up its first-response efforts to Gonaïves, where it has a shipment of drinking water and relief materials ready for distribution.
]]>Oxfam is simultaneously assessing the needs and distributing essential supplies in the department of Nippes, and we are coordinating with local authorities to provide support for six emergency shelters in the Port-au-Prince metropolitan area. In the hard-hit city of Gonaïves, where lack of access initially thwarted relief efforts, the agency is now supplying families with basic household items and five-gallon containers of clean water.
]]>"At least a third of the houses we've seen have sustained wind damage," says Oxfam's Kenny Rae, who has visited many of the towns south of Thibodaux, Louisiana.
If Hurricane Gustav visited our home towns, most of us would consider it a major disaster, but in coastal Louisiana, Katrina set the bar of dread so high that this level of destruction is a huge relief.
Yet, when it comes to questions of poverty and vulnerability, Gustav picked up where Katrina left off. An Oxfam assessment team touring the most troubled areas is finding that solid homes held up relatively well in this storm, and that the worst destruction was visited on trailers and more vulnerable houses.
The Native American community of Isle de Jean Charles, which is located in what may be the most exposed location in the hard-hit parish of Terrebonne, has experienced "terrible damage," according to Oxfam's Kenny Rae. "Houses have been ripped off their foundations. We saw one leaning on a levee."
Since the hurricanes of 2005, Oxfam America has been working with a network of local partners on the Gulf Coast, focusing on poor communities whose needs have fallen through the gaps in the government response. Hurricane Gustav is a new chapter in the same story.
"Oxfam will work with our partners in the area to ensure that these communities receive the federal funds they need to rebuild their homes and their communities," said Minor Sinclair, who directs Oxfam America's development programs in the United States.
"We'll work on ensuring that temporary housing assistance gets to those who need it most—and quickly. And that rebuilding dollars prioritize low-income communities."
But first, the short-term needs. Damaged roofs, for example, need to be covered quickly with tarps before rain destroys home interiors. And community aid providers have their own problems: many have to repair their offices immediately or find new ones. As partner organizations begin to gear up their work, Oxfam is standing by to support them for projects that can't wait.
"Thousands of Louisiana families are returning home today to find their homes damaged by Gustav," says Sinclair. "I hope that this country's generous spirit—whether through FEMA or through private donations—continues to stand with these families in their time of need."
]]>Case lives in the town of Houma, in the parish now thought to be hardest hit by Hurricane Gustav. She works there, too, as director of the Terrebonne Readiness and Assistance Coalition (TRAC), an Oxfam partner. She usually sits out the storms that blow through her town, but this time she evacuated, and now she sounds worried.
"We're trying to get information from the ground, but it's coming in very slowly. We're hearing about a lot of wind damage. When Rita made landfall it was 180 miles away; this made landfall in Houma, so we got the full brunt."
She describes the vulnerability of the bayou communities. "Picture fingers going out into the Gulf. There are no barrier islands to block the storm surge. We know there's water in there. How high, we don't know."
But worry hasn't interrupted her planning. She's thinking about everything from how to help people get access to their FEMA benefits to how to get tarps onto damaged roofs as quickly—and safely—as possible. ("If I put volunteers out and put them on a roof, I want someone there who knows what they're doing.")
TRAC will carry out its own disaster response program, but Peg Case always seems to be thinking about the big picture, so she and her group have taken a leading role in coordinating the 30-40 local aid organizations in the area. At times of disaster, TRAC helps them stay abreast of each other's plans and whereabouts.
"Coordination is important because no one can do it alone," she says. "And it's very economical, because it means we're not stumbling on each other."
She keeps her eye on the future, as well, trying to work out long-term solutions to the problems of living in vulnerable coastal areas. It was in 2005 that TRAC, Oxfam America, and students from the Massachusetts Institute of Technology began to collaborate on an idea for a house built on pilings that could withstand hurricane-force wind, rains, and battering—and that bayou dwellers would find appealing and livable. Three of the so-called "lift houses" have since been built, and in the aftermath of the hurricane, she can't wait to visit one.
"I am dying to see how it weathered the storm," she says. "I'm sure it did fine," she adds. "And if it did do fine, it means let's look at building communities this way." It's not just disaster readiness that she has in mind. Case sees durable houses like these as a means of preserving a culture that makes it living off the land.
But for now, the problem in front of her is getting home to Houma and figuring out what's going on.
"We're about to see what's missing, what the weaknesses are, how we can build on that, and how we can function as a unified body. It's reassuring that we're partners in this together."
]]>Although the force of the storms was an act of nature, what the American people have since witnessed—an uneven and often incompetent recovery effort—is the result of deliberate human acts. If we refuse to address this as a nation, it will go down in history not only as a failure of leadership, but also as a failure to hold our government accountable.
Two fundamental indicators, housing and jobs, provide stark proof of the stalled recovery. Full recovery is possible only when affordable homes are coupled with secure, decent jobs. Without quality jobs and affordable housing, low- and moderate income families are unable to return to their former lives. Decent wages allow people to return home and recreate vibrant communities by providing the necessary workforce to rebuild the region.
The situation grows increasingly critical, but despite challenges, there is a way forward. We face a historic election; the next president of the US must guarantee a just, equitable, and complete recovery. America must take immediate action to ensure that people struggling to rebuild their communities get the support that their hard work and innovation demand.
]]>On a recent Wednesday morning in the West Arsi Zone, a large crowd of people gather outside the government offices in the Shalla district, where, according to government figures, 55,598 people have been identified as needy, but only 10,000—people with the most severe wants—are getting help. In this crisis, distinctions based on need have begun to blur.
"For us, it is becoming even more difficult to tell who is the poorest of the poor," says one man.
The faces of the people in the crowd are gaunt, their clothes are tattered. Suddenly, a low roar swells from their midst. They surge from the compound and out onto the road, surrounding a pair of aid workers in a dense, crushing circle. They are desperate to tell their stories, desperate for help.
A middle-aged man shouts out that local officials promised two weeks ago to support the people with wheat, oil, and corn, but so far he has received nothing. Instead, the crowd's vigil, now in its fourth day, is met only with this admonition: wait.
An elderly man adds that one of those in the crowd on the road couldn't wait anymore and died there the day before.
Others say they have been filling their stomachs with a leafy weed that has sprung up since the rains came. But the greens—boiled in water and salted—have made some of their children sick with diarrhea.
Weak from lack of real food and their stomachs filled with forage, the children of one mother sometimes faint on their way to school.
"Can you help me?" she asks, staring at the aid workers.
A short distance away, mothers rest on a long line of benches under the shade of a giant tree at the Shalla health center. Small children, unnaturally still, sit on their laps, their cries occasionally piercing the din. This is a feeding center where some of the weakest children come for a week's supply of Plumpy Nut—a nutrient-packed food supplement for malnourished children.
Not all hungry children qualify for the supplement. Some are deemed still well enough not to require it. One of them is the 11-month-old son of a single mother. He is her only child, and desperate to have him get more food, she offers to give him away to an aid worker—a gesture of hopelessness other mothers make, too.
A five-year-old girl holds the hand of her father as she limps slowly toward the packets of Plumpy Nut a worker is counting out for her. She has recently spent 15 days in a hospital in Shashemene because of severe malnutrition, and is now strong enough to rejoin her family. But her mother is sick following the delivery of a new baby, and the two-and-a-half acres of seeds her father just planted for the next harvest have all been washed away by a sudden heavy rain.
"We are facing so many disasters at the same time," says the leader of a local community, where he notes that one man died the day before and many of the women are sinking into exhaustion. "Drought, flood, disease."
]]>The first of the schools is scheduled to open this month in the city of Pengzhou. The building is constructed out of strong, lightweight materials, and it's designed to last for ten years or until it can be replaced by a permanent structure. Its outer walls are made of Styrofoam encased in thin steel sheets, and inside are classrooms, offices, and a cafeteria. It is a primary school that will serve 932 students, and it's supplied with desks, blackboards, and other supplies—all purchased as close as possible to the earthquake-affected areas in order to boost the economy of the stricken region.
A central feature of the Pengzhou school is that, like the others to come, it is earthquake resistant.
"It will be able to withstand a quake of up to 7.0 on the Richter scale," says Howard Liu, Director of Oxfam Hong Kong's China Unit.
After a disaster, it's crucial for aid providers to do whatever possible to ensure that the affected communities won't have to relive the terrible episode one or two or ten years down the road.
"We can't prevent earthquakes," says Oxfam risk reduction specialist Jacobo Ocharan, "but we can try to prevent future earthquakes from causing so much suffering."
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