And it is making a difference. In the areas where Oxfam is working, Ali says, people are reporting that they like our sanitation facilities and can now access water easily.
“In Syria, many people had a good life before. Now, they are desperate.” – Sahar Ali
Lebanon is also receiving refugees in large numbers, but many of the new arrivals are dispersed throughout communities. There, as Ali reports, Oxfam’s discussions focused on our work to help families survive the winter months.
“People liked the materials we distributed to help them stay warm in winter,” she says, referring to the heaters, fuel, mattresses, warm clothes, plastic sheeting, and other materials that an Oxfam partner provided.
But there is a downside to handing out goods: although emergency distributions can help quickly meet the most urgent needs of a community as a whole, they rarely target individual household needs with precision. In one of the focus groups with refugees, a woman explained that she had received a clothing voucher, but she had no children to buy clothes for so she gave it away. Another woman gave away the diapers her family received.
“What’s really needed is cash,” says Ali, “so people can buy what they need most.” One family might need food, another might need medicine, and another might be unable to afford shelter.
So, in both Lebanon and Jordan, Oxfam will soon begin providing cash payments to vulnerable families.
“People here really appreciate that Oxfam talks to them and tries to understand and address their needs,” says Ali.
Ali is no stranger to displacement. She has spent the last eight years helping manage Oxfam’s humanitarian programs in Darfur and, more recently, South Kordofan.
“Displacement is a harsh experience—in Sudan or Syria,” she says. “You can see when you look in people’s eyes how painful it is. They have left behind simply everything.”
And, she says, “they are dreaming of home.”
Learn more about how Oxfam is helping Syrian refugees and donate now to support these efforts.
]]>In April, former rebel fighters, who had been integrated into the Congolese army, mutinied. Dubbing themselves M23, or Mouvement 23, they took control of an area close to the borders of Rwanda and Uganda. When the Congolese army called up troops from across the region to quell the rebellion, that deployment left a security vacuum, prompting other rebel groups and militia to reassert their control.
Now, caught in the crossfire, civilians face appalling abuse at the hands of multiple armed groups. One town—Kashuga in northern Masisi—was attacked 12 times between April and July. In a new report, Commodities of War, Oxfam has documented how these waves of conflict have affected more than 760,000 people so far this year.
“Ruthless militias and government troops are both mercilessly exploiting local communities to help fund their war,” said Elodie Martel, Oxfam’s associate country director. Forced labor and recruitment, illegal taxation, and pillaging are all tactics in this conflict, along with rape, kidnap, and murder.
“These armed men enter our homes and demand money. If you don’t give it, they will kill you,” said one man from Fizi in South Kivu.
“Men no longer walk around this village since they are the ones who are taken, mostly,” added a woman from Kalehe in South Kivu.
As insecurity and uncertainty mount, the pressure on people is growing.
“More than 50,000 people have fled camps and homes since yesterday and are in dire need of shelter, water, and food,” said Tariq Riebl on Monday. Riebl is Oxfam’s humanitarian coordinator in Goma, the threatened capital of North Kivu and one of Congo’s larger cities around which cluster camps for displaced people. “Families have been split up overnight and people are desperately going between sites trying to find loved ones. If fighting intensifies further, there are very few places people can go for safety.”
Oxfam is aiming to reach about 230,000 people affected by this new crisis and since July has been responding to the needs of families in three camps near Goma. As of Tuesday the organization had helped 123,000 with clean water, sanitation services, and protection support. And public health teams have launched education campaigns to reduce the risk that waterborne diseases, such as cholera, could spread. But the largest of the camps, Kanyaruchina, where Oxfam has been building 700 latrines and 120 bathing stalls, is now deserted after people were forced to flee again.
For people of the eastern provinces, the violence is a grim reminder of how weak Congo’s national justice system is. Coupled with a lack of state authority and an ill-trained and poorly paid army, the consequence of that weakness has been decades of sporadic conflict triggered in part by ethnic tensions and disputes over land and resources. The danger and volatility make it very difficult for people to earn a living and have pulled many deeper into poverty.
“This war brings us extreme poverty and leave many killed,” a woman from Rutshuru in North Kivu told Oxfam. “Children no longer go to school and people flee to zones that are somehow safe. Those who return to their village to work their land to provide for their families are killed during clashes, or raped when a woman or girl is alone in the field.”
Oxfam is calling for an immediate halt to the fighting so that humanitarian aid can reach more civilians, especially those who have been displaced.
]]>On the edge of the Taffoga cooperative, in a clearing among the huge mango trees that populate the community, we are welcomed by about 30 women, who describe the horticultural work they are able to carry out with the support of Oxfam, through its local partner ATAD. In the vegetable plot they have planted cabbages, aubergines, gombo (a local vegetable), onions, and garlic. These will enable the women to improve the variety of their diet and they will be able to sell any surplus.
Ramata Zore stops for a few minutes to talk to us while her colleagues water and weed the plot. She is 25 and has 4 children to look after. And at the moment she is on her own, as her husband has gone to the Ivory Coast to look for work.
“The vegetable plot is a help to me, because what I get from it goes somewhere towards feeding my family,” she says. “If I sell some of the vegetables, I can buy millet, which is the staple part of our diet. Also, in these difficult times, we make a recipe based on millet with a few cabbage leaves, which the children love.”
But gardeners here face a daily struggle: Water.
“There isn’t enough water and the wells are drying up,” says Zore. “We’ve had to organize ourselves into two groups: one group does the watering one day and the other does it the following day. In fact…after a few hours of watering, the well is dry and we have to wait a while before we can fill up the buckets again”.
After we have been talking to her for a few minutes, we notice that the coming and going of the women up and down the rows is starting to slow. The four wells on the perimeter of the garden have dried up and the women are congregating around them with their buckets and watering cans, waiting for the water levels to rise again.
“I live in Taffogo and in spite of our having large fields for growing crops, we’ve only harvested four sacks of millet this year, compared with the 20 we can get in a normal year,” says Zore. “But it’s a long time since we had a normal year. Last year, the floods destroyed much of the harvest. We go from one catastrophe to another, either because of too much water or too little.”
“Before, when rain wasn’t in short supply, we had 15 small sheep and cattle,” Zore says. “But we’ve had to sell them all and have now only got one small goat left. As I’ve got nothing else, I’ll have to sell her to buy seeds for next season.”
How to feed her children is always on Zore’s mind.
“Often they tell me they’re hungry and all I can offer them is comfort,” she says. “If there’s something to eat, I give it to them, and if not, I ask the neighbors.”
“My dreams?” Zore asks, surprised at my question about her wishes for the future. “To have enough food to feed my family and a house built of bricks, instead of a shack like the one I live in now. I’d also like to keep up the vegetable plot for five years. Then, if I manage to find something else to do which will enable me to supplement my income, I’ll be able to start a small business. I want to carry on with the vegetable plot and earn money to help my children.”
Oxfam is aiming to help 1.2 million people across seven countries with programs that include cash transfers and cash-for-work initiatives, veterinary care for the livestock on which many families depend, and access to clean water and sanitation. We are also campaigning to change the root causes of this crisis. Find out how you can support our efforts.
]]>“I harvested practically nothing,” Founé Danfakha says of her 2011 yield. She grows groundnuts, maize, and rice in Bembou, a small village about 50 kilometers east of Kedougou, near the border with Mali. The 60-year-old mother of five children and grandmother of four says, “If the rain comes normally, I can get 20 sacks of groundnuts. Last year I got only five.”
Danfakha has about five acres of land. She says her last harvest was dismal: She got three bags of rice, which is about 30 percent of the normal harvest. She planted about an acre of maize, but harvested none at all.
No seed, no harvest
Danfakha is sitting in front of her home, with her four-year-old grandson on her lap. The boy is quiet, and seems to have little energy. Danfakha says she is feeding everyone in the household regularly, despite the fact that the food she grew last year lasted only two months after the harvest in November. Usually she grows enough to last four months. She says she is meeting her family needs with money sent from her daughter, who is digging for gold in a nearby mining area.
When the rains start, Danfakha’s daughter will come back to help her prepare her fields and plant. “I think we will have to cover our needs growing groundnuts,” she says. “I don’t have enough rice seed, but I think I have enough groundnut seed.” When her daughter comes back they will have no income from mining while she works in the fields, so it is a calculated risk.
“The situation is difficult here. There’s a problem of rain,” Danfakha says. “It’s been irregular. If there’s not enough rain, there won’t be a harvest. And if there is no seed, there’ll be no harvest.”
Oxfam is collaborating with local organizations in Kedougou to help farmers there and in other areas of West Africa with crucial agricultural support, so they can plant this spring. Oxfam is also planning work that will help keep drinking water clean and safe, and provide food or short-term employment for cash wages, so farmers can meet their food needs over the summer while they work their fields.
Oxfam is aiming to help 1.2 million people across seven countries with programs that include cash transfers and cash-for-work initiatives, veterinary care for the livestock on which many families depend, and access to clean water and sanitation. We are also campaigning to change the root causes of this crisis. Find out how you can support our efforts.
]]>She planted a maize field and hoped to grow a ton, but only got one 50-kg bag. She says the poor result was due to “lack of rain, lack of good equipment for cultivation, and lack of money to pay for labor.”
Her situation is rather typical in the small village of Bandafassy, about 15 kilometers from the town of Kedougou in eastern Senegal, where erratic rain last year hit farmers hard. The resulting high demand for food grown in other parts of the country is pushing up prices, and forcing farmers who were already struggling to feed their families to find creative ways of coping.
Camara is the one in the family responsible for agriculture, but her husband Nicolas Keita helps prepare fields for planting and the harvest – when he is not away mining for gold to earn cash.
Keita says they planted in early June, but by the end of the month it had stopped raining, and what they were growing dried out in July. They replanted in August, and invested in some fertilizer. The rains were intermittent in September and stopped altogether in the beginning of October. "The rain gap in June and July prevented any decent harvest," he says.
"Things are going to go badly," Camara says she realized after the harvest. "But we will make every effort." She turned to gathering wild fruits in the forest, such as the seed pods of the baobab tree and jujube berries to feed her family.
To earn money, her mother-in-law began making clay pots for storing water; Camara walks 15 kilometers to Kedougou (carrying a 10-pound pot on her head) where she sells the pots for about $5 each. If she can make a sale, she buys food and returns. In a good week, she can sell two or three pots.
Camara reports that after a good harvest she can feed her family for about six months, but this past year the food only lasted about four. She says she is down to her last two bags of rice, one of which she wants to save for seed. “We will always find a way to get by,” she says with a certain resignation. The threat to farmers like Camara is that of another year of diminished harvests: Successive bad years can lead to a downward spiral that even the most resourceful farmer can’t avoid.
Oxfam is designing programs to help farmers like Camara get the resources they need to plant crops this year, so that when the rains come people will have an opportunity to grow what they need for food. Cherif Sow, who works for the Kedougou Association for Action and Development, an Oxfam partner, says the need for support in the area is crucial. “We have to help the communities as quickly as possible to help them survive the lean time, otherwise it will have an impact on their agricultural production.”
Oxfam is aiming to help 1.2 million people across seven countries with programs that include cash transfers and cash-for-work initiatives, veterinary care for the livestock on which many families depend, and access to clean water and sanitation. We are also campaigning to change the root causes of this crisis. Find out how you can support our efforts.
]]>Across West Africa a new food crisis is looming over a population that has already endured three of them since 2005. The last—in 2010—affected 10 million people.
But with early action, the hardship and loss so many have suffered through in the past seven years could be softened and that’s what Oxfam America’s humanitarian workers Isaac Massaga, Julie Savane, and Greg Matthews are taking the first steps to put in place. They are just back from Boulal, a collection of villages in the north, where they were working to identify the greatest needs and the responses that would best fill them—now, and longer-term.
“We’re in a good position now to mitigate the serious consequences of an acute food crisis and to help people not resort to selling assets and cattle to meet their basic needs,” said Matthews, speaking from the Oxfam office in Dakar, Senegal’s capital.
Selling valuables—livestock, farm tools—is one of the strategies poor families without cash employ as a last resort when faced with no other way to get food: They’ll use the money to buy it in the market. But in selling these important assets, they are also limiting their ability to make a living, and that drags them deeper into poverty. Halting that cycle is key to averting a crisis.
During the last growing season, rainfall in Louga was erratic, said Matthews, sometimes coming in great gushes and sometimes not at all. For the crops—millet, cowpeas, and peanuts—the result was dismal. The yields are off dramatically.
One farmer Matthews spoke with said he and his family had just consumed the last of the millet they had harvested in the end of October—300 kilograms worth. That was five times less than he would get in a good year. And the next planting season is still four months away.
How will people manage? Some, like the millet-grower, will pursue petty commerce, such as hunting for wood that they can sell as fuel in the market. But for many herders facing lean times, their strategy is to migrate with their livestock in the hope of finding pasture elsewhere.
In Boulal this year, that migration has started much earlier than usual, said Matthews.
“The hardest months for pastoralists are April, May, and June—right before the rains begin,” he said. “But they’re starting to experience that now, in the beginning of February, so most of their productive animals have already started to migrate.” That means families must take their kids out of school prematurely and abandon other livelihood efforts, like gardens and small shops, that could help support them.
Poor harvests are also adding to the stress herders are feeling. With fewer crops pulled in from the fields that means fewer leftovers of leaves and stalks to feed to the livestock. And as the health of their animals declines, so does the value of sheep, goats and cattle.
Coupled with all of this, said Matthews, are climbing prices in the markets. A 50-kilogram sack of rice that once could be had in a trade of one sheep now costs a herder two or three.
“Because of all this, people are starting to employ early coping strategies,” Mathews said. “They are starting to change the way they eat and manage their finances to prepare for a long, hungry season.”
But even as they take these steps, the future hangs heavily.
“People are really worried about what will happen a month from now,” Mathews said. “Most of the food reserves are already exhausted.”
Among the responses Oxfam is weighing are cash transfers—a tool that would allow hard-hit families to carry on as they would normally. With cash, they could buy the essentials they need during this critical period but not have to sell vital assets to do it, said Matthews. A second approach might be to help herders get access to fodder for their livestock, which provides both food and income for families.
But longer-term, the goal is to help communities become more resilient.
“The bottom line is working with communities to take charge of the issues and find solutions themselves,” said Matthews, pointing to a milking cooperative that had worked successfully in the area for a while. “It’s not about money. It’s about having, at the base community level, the desire to work together and the capacity to manage working collectively.”
Estimable lives in a very small earth-walled home near a drainage channel running along a dirt road. The land around her is almost all mud and the road is under a foot of water in places. Floods plague her village, called Lameau, in the community of Grande-Saline in Haiti’s Artibonite River valley.
This is one of Haiti’s most productive agricultural areas, and over the years, the government and international donors have built a network of canals and channels, to divert water to dry areas, and drain out the wet ones. Small villages line these channels. Just after the harvest, many are drying their rice crop on tarps on the side of the road, near their small homes, some of which are quaint wooden houses that resemble gingerbread cottages. Others are more modest earth-walled dwellings. Children play and swim in the channels, laughing and splashing in the sun.
It looks idyllic but the Artibonite River valley can be a tough place to live, Estimable says. “When there’s too much water in our houses, in our fields, we get upset stomachs. It’s very hard to live here with so much water.” The lack of clean water in 2010 after one particularly rainy period coincided with a cholera outbreak which killed 300 people in this area, according to local officials.
Grande-Saline’s mayor, Erole Romeus, drew up a plan to clear out the mud and vegetation choking six kilometers (3.75 miles) of the secondary channels like the one near Estimable’s house. He’s also hired heavy equipment to widen them to handle more water flow. The project is employing two 132-member work teams in a cash-for-work program that provides much needed wages of about five dollars a day for 12 days. The project prioritizes hiring people living near the channels. About 2,000 people in 400 households live in this area and will benefit from better flood control.
Sansion Morisette is one of the workers; she has just spent the morning raking weeds out of the narrow channel running along the road next to Estimable’s house. “It’s about time we started this work,” she says. “I’m out on the street now because water destroyed my house in Rossignol. Take a look around you, we’re lucky if we can get two bags of rice out of our harvest sometimes, the water just eats everything we grow.”
Mayor Romeus says the project in Grande-Saline should take the community a long way towards reducing flooding, especially during the annual hurricane season. “Every time it rains, we can have 200 to 300 small houses destroyed,” he says standing on a flooded road next to the drainage channel, where scores of workers in white t-shirts are clearing away plants and other debris.
“We started talking about rehabilitating these channels as a means to deliver a durable solution to the people here,” Romeus says. “We came to Oxfam America because it is an organization that is interested in helping vulnerable people reduce the risks of disasters.
“Since we cleared all this out, people will probably have an opportunity to harvest. But if we did not, in another week we would have been in danger: the people, crops, and animals.”
Oxfam is devoting $20,000 for this project, which is covering about half the costs and supports the cash-for-work component, wages for heavy equipment operators, and fuel. It’s part of a larger program to reduce vulnerability to disasters in the countryside, and make it easier for people to make a living in farming, an alternative to the overcrowded conditions in Port-au-Prince.
Sancion Morisette is optimistic that the newly rehabilitated channels will help them. “Now I know that when it rains, the water will flow in the channel and go directly to the sea.”
]]>Unfortunately, that’s just what happened in September and October 2010. Abdoulaye N’Dao, a gregarious retired electrician with grey dread locks says the flooding in 2010 “was the most difficult compared to earlier ones… there was a lot more water.” He says his house had water up to his ankles in some of the rooms; he and his extended family of 25 people were bailing water out of the house and its courtyard for days. “Maybe crocodiles and frogs can live like that,” he says months later sitting in his now drier courtyard, “but not people.”
The heavy rains of 2010 triggered the fifth year in a row of serious flooding in Pikine, and capped off one of the rainiest years for Senegal since 1971. Dakar got a total of 20 inches, more than twice the normal amount of annual rainfall. Oxfam already was working with an organization in Pikine called Eau-Vie-Environnement (Water-Life-Environment, or EVE for short), and deployed $295,000 from Oxfam’s “Saving Lives 24/7 Fund” to help EVE respond.
The needs were urgent in Pikine: Oxfam and EVE estimated that 150,000 people in 3,600 families were badly affected, either completely displaced or living in flooded homes. With help from Oxfam, EVE planned an aggressive response, which included:
A fast survey of the worst-affected areas of Pikine, to identify families in the most need: EVE and Oxfam decided to focus its assistance on 2,812 families (roughly 30,000 people) primarily in seven of Pikine’s 16 districts.
Supporting 116 pumps, to remove water from 643 homes, 7 schools, and 18 mosques: EVE supplied fuel for pumps that moved more than a million cubic meters of water, which is something like 264 million gallons, enough to fill more than 400 Olympic swimming pools. This took 15,000 liters (about 4,000 gallons) of fuel. EVE worked with local authorities to help remove water from 228 roads in Pikine.
Removing waste: household garbage and other waste pose a severe health threat, so EVE supported the removal of 3,000 cubic meters (roughly 105,000 cubic feet) of garbage.
Delivering sand: to build up low-lying areas and shore up buildings at risk of being submerged, EVE delivered 10 truckloads of sand to each of seven districts in the city.
Promoting good hygiene: EVE distributed 2,806 hygiene kits with soap, bleach, clean buckets for storing water, mosquito nets, and water purification tablets. In follow-up visits, EVE estimated that 93.8 percent of the households it visited were using adequate methods to treat water, and that these and other measures likely helped reduce diarrhea cases from 3.12 percent of the households to 1.48 percent.
Direct financial support: With funds from Oxfam, EVE allocated 40, 000 CFA francs (about US$80) to more than 1,500 of the most severely affected households, so they could buy food, medicine, and clothing.
Abdou Diouf, the executive secretary of EVE, says Oxfam did not just provide some assistance during the crisis and then withdraw along with the flood water. “This is the first time since Pikine has experienced these floods, that an [international] organization has intervened during the flooding and has decided to continue intervening after the flooding,” he says during an interview in his office in Pikine in April. Diouf says EVE was able to use a small amount of money left over from a grant from Oxfam to deal with floods in 2009 to prepare for the 2010 rainy season. When the heavy rains hit in 2010, volunteer assessment teams were already in place and trained to take action.
Oxfam also is supporting EVE’s work in 2010 to help local governments to lobby for funding they can use to improve drainage systems, and keep the pumps running in chronically flooded areas of the city.
Diouf also says the cash transfers represented “… a revolution in our intervention this year. People really appreciated this; I had people coming to the office here to specifically thank EVE and Oxfam for the money.”
Each recipient got about 40,000 CFA francs, which is about US$85. It’s unusual for an aid organization to provide money instead of food, clothing, water, and other assistance. But it allows those affected by the flood to spend the money on what they need the most, rather than what an aid organization decides is best for them.
When Assiatou Niang got her cash, she immediately thought about food. “We had no food, so I bought a bag of rice,” she says. With 30 people living in the household, including most of her nine children as well as those of her injured sister, food was a priority. “I also needed cement to repair the house, and I needed money for daily expenses around the household.” Niang is 58, and recently widowed. The cash helped her feed her family and cover other expenses for about a month over the winter.
Distributing cash is also economically efficient, according to Isaac Massaga, Oxfam’s program officer based in Dakar. “If you distribute rice in a community, you are preventing the local dealers from selling their own stock,” he says. “By helping people access food in the local market, we also help suppliers, and at the same time it helps maintain the market.”
EVE and Oxfam found a credit union that supervised the distribution of the funds to only those with vouchers provided by EVE according to the results of its household surveys. EVE transferred more than US$130,000 to families in Pikine.
]]>Their mission? To build some of the 700 latrines Oxfam is helping to fund in the Petite Riviere area of the Artibonite province, where the deadly waterborne disease first broke out in October. It has now reached every province in the country, aided in its rapid spread by Haiti’s poor infrastructure: 50 percent of Haitians don’t have access to clean water, and more than 80 percent don’t have latrines.
For some of the families in this rice-growing region, that’s about to change. The latrines are part of a multi-pronged effort, including a public health education campaign, Oxfam has launched to help 125,000 people in this area stop a disease that hadn’t surfaced in Haiti since 1960. By the end of November, cholera had already sent more than 34,000 people to the hospital and killed more than 1,750 across the country.
Oxfam is also tackling the outbreak in Cap Haitien, Haiti’s second largest city, and in Port-au-Prince, the capital. There, intensive efforts to provide clean water, sanitation services, and public health education to people displaced by the January 12 earthquake has prevented any known cases of the disease from cropping up in the camps where Oxfam works.
Along with the household latrines in Petite Riviere and the construction of 50 school latrines, Oxfam is planning to drill 50 boreholes to be fitted with hand pumps and repair three water networks to provide people with greater access to clean water. But as important as those initiatives are, stopping cholera requires education—how to prevent it and how to treat it and to know to seek medical help when diarrhea and vomiting starts.
In coordination with the ministry of health, Oxfam has taken to the airwaves in Petite Riviere, broadcasting information on how to prevent cholera. It has trained government community health workers as well as peer educators on key messages and they are fanning out to spread the word. Equipped with battery-powered bullhorns, Oxfam health promoters are trekking through fields and across canals, sharing vital information with farmers as they work.
“Members of the community are very keen about what is being said,” said Mario Guerrero, the cholera program manager in Petite Riviere. “They have the feeling when they go into the trainings that there’s no way out if you get it.”
But after people have learned something about the disease and its transmission?
“They have the idea you can do something,” said Guerrero.
Doing something is what Erntz Jean and the team of volunteers were all about: With materials provided by Oxfam—wood for walls and a roof, and a slab to cover the pit—they were helping their neighbors build the first latrines many of them have ever had.
“That’s how we do things here,” said Jean, standing near the just-built wooden structure covering the latrine of Lozina Cena. “We help each other.”
The team picked up their tools and wove between the hedges and small houses to their next location: a narrow pit, six feet deep, just beyond the canopy of a giant mango. They got to work sawing two-by-fours, hammering, and preparing the frame for the housing of the latrine.
“Everybody here is very happy about this. Not only me—everyone in the area,” said Jean, who was among those who received materials to build a latrine. A carpenter by trade, he said he never had the money to build one before this.
“As a carpenter, if there was work, I’d be working and I’d have the money to do this. But there’s no activity here—no jobs,” said Jean.
Down the road, Eugene Joseph, a father of five children, had almost completed his new latrine. He spent a part of five days digging the hole—after starting in a different spot in his yard and hitting rock.
“Before, we didn’t use any latrines. We went in the bush or the street,” he said, noting the street—a rough dirt road—was about 40 meters from a canal leading to the Artibonite River from which his family pulls its drinking water.
“We were never sick,” said Joseph.
But the cholera outbreak scared him.
“We thought it would spread around our house,” said Joseph. And so with Oxfam’s help he decided to build the latrine.
“We’re proud of this,” he added.
A few houses away, Charite Estimable, echoed Joseph’s fear. But she wasn’t really worried about herself: She had been treating her water in a sand filter for most of the past year and had received some chlorine tablets from Oxfam to purify it further. It was her children—she has 11—whose health she was fretting over.
“I was afraid for my children in Port-au-Prince,” she said, noting that six of them were now living in the crowded capital.
Estimable’s neighbor, Altagrace Nicolas, also voiced confidence in her ability to keep cholera at bay.
“I’ve always been careful with myself and my children,” she said. “I’ve never been negligent. The reason it spread in some places is because people were not careful.”
To help everyone become more vigilant, Oxfam has been sending out teams for random monitoring of the water families collect and treat with the chlorine tablets the organization has been distributing.
Toting a bucket loaded with a couple of pitchers and a chlorine testing kit, George Van Vulpen and Elie Saint-Cyr, public heath engineers for Oxfam, hit the dirt roads of Akacite and Trankilite, two communities near the Artibonite River. Stopping at one house here, another there, they took a scoop of drinking water, tested it for residual levels of chlorine, and discussed the results with the householders—all with an eye toward encouraging proper use of the tablets. Had they been adding the tablets to the water? When? Were they dropping in the right number of them?
“For sure they’re using them,” said Van Vulpen, packing up the gear after the last sample of the day. “Most of them (the samples) have residual chlorine.”
That was a good sign—and so was the news he picked up along the way.
“In Akacite, they didn’t know of anyone who was sick anymore,” said Van Vulpen.
“We have a feeling that we are doing better than other parts of the country,” said Guerrero, the program manager for Petite Riviere. “Reported cases are going downward—slightly. But downward.”
]]>Dénéus works for Oxfam in the commune of Petit Rivière in the department of Artibonite in Haiti -- an area recently plagued by cholera. She sets out in the morning in a four-by-four truck, seeking out farmers in the fields who may not have heard the radio programs Oxfam has recently broadcast about proper hygiene and sanitation measures to stop the cholera, avoid infection, or the basic steps to help stricken people survive.
Spotting a crew of five men preparing a field to plant potatoes, she asks the driver to stop the truck, and she bounds out the back, moving across the road, down a well-worn path, jumping across an irrigation ditch, to the edge of the field.
It’s best for those accompanying Dénéus to stand behind her when she gets into action: she routinely uses a battery-powered megaphone to greet the farmers, and her words are loud and carry a long way. She asks them if they have already been trained on how to avoid and treat cholera and proper hygiene and sanitation practices. If they seem unsure or say no, she launches into the routine: she explains that cholera is a bacterial disease, can be passed by drinking contaminated water, and can be controlled by washing your hands before putting anything in your mouth. She encourages them to chlorinate water before drinking it, and to take early action to treat people showing symptoms of diarrhea and vomiting with an oral rehydration solution.
Some of the farmers stop, lean on their hoes, and listen, while others keep piling the moist earth into long mounds, in preparation for planting. But even the ones who keep working shout questions as they go: Where can we get soap? What about helping people who are sick? Where do we get the chemicals to treat our drinking water? Dénéus responds to all the questions: She refers people to centers where oral rehydration solution is available in their village, so they can ensure sick relatives can survive. And where to get one of the 35,000 cholera kits Oxfam is distributing, which have all the things they need to keep clean and treat their drinking water.
One topic dominates discussion in each of the 10 or so fields she sees this morning: she urges the farmers, “avoid going to the toilet right on the ground!” This is a major, longstanding problem in rural Haiti since well before the January 12th earthquake hit Port-au-Prince nearly a year ago: with no sewage system, running water, or proper latrines, many rural households must answer nature’s call in the open. Not all households have a latrine, so the farmers ask for advice: it’s simple, Dénéus says, dig a hole and bury the excrement. But Oxfam is also deploying a team of engineers to help farmers with simple materials to build their own latrines as an important step to reducing vulnerabilities to water-borne diseases like cholera. They plan to help install 700 latrines in Petite Rivière.
Dénéus is relentless, she repeats her messages with the same enthusiasm for each group she encounters toiling in the hot December sun, sweat running down the side of her face. “If you don’t think cholera can kill you, go to the hospital, go to the morgue, and see for yourself,” she tells any skeptical farmers.
Passing by a group she spoke with earlier in the morning now taking a lunch break, she stops and poses a question: “Did you wash your hands before eating?” Of course the answer is yes, but when she asks if they used soap, a few look down, but most of them make no excuses: soap is expensive and they are not accustomed to bringing it to the fields with them. Another form of behavior for Dénéus to change: With Oxfam distributing free soap, expense is not an issue in the short term, and eventually she hopes that farmers will improve their hygiene practices in the fields as well as at home.
After a productive morning tour of the fields, Dénéus stops by a few oral rehydration centers in the community of Marqès. These are simple tables stocked with clean water, mixing bowls and cups, and small packets of oral rehydration salts. These tables are staffed by trained volunteers who can teach people how to mix the life-saving solution, and ensure that anyone with a sick family member has access to this essential therapy. Cholera can kill in just a few hours by completely dehydrating a victim, so oral rehydration is essential. Dénéus checks the supplies, and coaches the volunteers on preparing solutions, how to answer frequently asked questions, and asks if there has been any activity at the centers as part of the monitoring Oxfam is doing in the community.
Dénéus has a law degree and is working for Oxfam because she says the right to life is one of the most basic. “I came here to save lives; that’s what Oxfam is doing here,” she says as she leaves the fields after a busy morning.”I’ve only been working here a month, but I’ve seen Oxfam doing good work, and it is saving lives. The rate of mortality is reduced, and the rate of people getting sick is also lower thanks to Oxfam.”
The work of Dénéus and other public health promoters is reaching out to 125,000 people in the region, using the radio and in-person visits to push key messages about good hygiene and sanitation habits. Mario Guerrerro, Oxfam’s program manager in Petite Rivière, says this effort is proving essential. “The training for people to change their habits is making the difference,” he says in his office, looking over the declining mortality figures in a report from the health ministry. “Once people understand, they do their best to treat their water.”
Toward the end of Dénéus’s rounds this one morning, she encounters nearly 40 farmers in a relatively small area she can hit in one stop. She moves through her presentation, answers a few questions, and concludes her visit with a phrase, a promise, and a wish: “Zero cholera!” she shouts, her final words to the farmers.
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