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With early warning, small problems in Ethiopia won't grow

By Coco McCabe

To families who depend on their camels for the basics—milk, meat, and a good price at the market when they need cash—the creep of this disease across Ethiopia and into Moyale is troubling. It's not a crisis yet, but the red flags have gone up.

And they're exactly what Oxfam America and its local partner, the Gayo Pastoralist Development Initiative, hoped to spot when, together with the Harvard Humanitarian Initiative, they piloted an innovative early warning system for the region. Now just beyond its first six-month trial period, the system is designed to track changes in local conditions that could signal the advent of hardship for people—and get them help before the problems spiral out of control. The program is targeting 21,346 people scattered in the villages of Tuka, Arganne, Danbii, and Mudhi Ambo.

Oxfam and its partners started this initiative following a devastating drought in 2006 that left more than 60 percent of the livestock dead in some pastoral areas. The drought was accompanied by conflict that forced the displacement of many people.

How it works

How does a disease with no name in a remote and dusty part of Ethiopia find its way onto the radar screen of an international aid group a third of the way around the world? Through a lot of hard work.

It starts with data collectors—four of them, hired by Gayo—with strong legs and the commitment to make a monthly trek to five far flung households in each of the four villages. Sometimes, the data gatherers, who are all women, will walk a full day to reach the households that are participating in the program. Selected by Gayo, the households represent a range of prosperity, with some better off than others.

And it's the women in those households that the data collectors have come to see—because they are the ones with the hard facts about the well-being of their families. The women are available most of the time while the men are away, traveling with livestock in search of pasture and water. Out and about in their villages, the women have been keeping mental tabs on what's been happening with others, too.

How much water seems to be in the ponds and streams this season compared to last? Are there more cases of diarrhea in the village this month—or less? How many meals a day are children getting? And how about the adults?

"Women know it all," said Miriam Aschkenasy, Oxfam's public health specialist who helped to develop the program, including those questions. They are designed to reveal critical information that can paint a comprehensive picture of a community's health. And they give the women a way to voice the knowledge they have of their community and local environment.

"The women make sure they're informed about what is happening in their villages. They talk to other women in anticipation of the data collectors' arrival," said Aschkenasy.

"The community saw this program as having a lot of value," added Emily Farr, Oxfam America's deployable humanitarian officer who, with Aschkenasy, recently made a field visit to Ethiopia. "Never before has someone come to their houses to collect information on them. It makes them understand people are concerned about what's affecting them. It makes them feel valued."

The data collectors spend 20 to 30 minutes at each of the five houses on their list, and plot the answers to 24 questions on a visual analog scale—a tool that gauges attitudes and perceptions that cannot be easily measured. And in this case, it's particularly useful in gathering data from people who may not be able to read. It's also easily convertible for charting on a graph—from which the trends then become visible.

"We are using scientific methodology to convert feelings into comparable data," said Aschkenasy. "That's what makes this cutting edge."

Good evidence

Once the collectors return home with their data—about malaria and milk production, plantings and harvests, livestock deaths and births—Gayo compiles it, along with anecdotal comments gleaned from the villagers as well as statistics gathered from district markets and health posts, and from the Oxfam office in Addis Ababa the material gets emailed to Boston.

"One of the things important to me is that this early warning system is based on evidence," said Aschkenasy. "That increases your ability to do monitoring. It also lets you know that the programs that follow are based on real information, rather than conjecture, and can be sharply focused."

For instance, said Farr, if there is a problem with food availability, this kind of tracking system will help aid groups, local partners, and the communities themselves develop solutions that address that problem very specifically.

In meetings with community elders about the early warning system, they told Oxfam staffers that changes in local conditions occur seasonally—or every three months. They agreed that it would be useful to analyze those changes on a quarterly basis. Regular analysis would allow them to pool their resources and develop timely solutions to their problems.

Community elders also said that they could use the data to address ongoing issues, too, such as with the quantity and quality of water available for villages.

"One solution is to reduce the distance to water by digging more ponds and building cisterns," said one of the elders. "We can contribute the manpower and may ask for small inputs like cement."

Next steps

But for now, what about those camels?

Nazareth Fikru, Oxfam America's regional humanitarian coordinator based in Addis Ababa, said that data gathered from the communities around Moyale show that about 189 of these highly prized animals have died in the last six months.

"The disease was initially reported in May, 2005 in Afar—eastern Ethiopia—some two years ago and gradually expanded to other pastoral areas like the Somali region and the Borena area of Oromia," said Fikru. "Some research is going on by the ministry of agriculture and rural development together with the Food and Agriculture Organization, but so far, no information about the causes or controls has been shared."

Oxfam is not planning to address the camel illness itself, but the fact that it has showed up in the data-gathering will help the organization and Gayo stay alert to the problem and the effect it could have on the overall health of the communities they are working with.

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