Melanie Brooks
Jan. 22, 2012

Dije Ousmana, 45 years old, breastfeeding her two-month-old baby Abdulahadi. Yan Sara village, Dakoro, Niger.

When Dije Ousmana looks down at her two-month-old baby boy, Abdulahadi, she tries not to think of her three other children, all babies like Abdulahadi, who died in earlier food crises. She has seen the signs before, and she is afraid: diarrhoea, difficulty swallowing, crying for more milk when there is none to be had.

In her arms, baby Abdulahadi stirs, opens his eyes, and begins to cry. Dije quietly puts him to her breast, but it isn't long before the cry turns into a wail.

"There is no milk," she said. "I haven't eaten yet today."

Outside, her daughter continues to pound millet for the family's only meal of the day. Dije's six-year-old son runs in and asks when the food will be ready.

Today, Dije and her extended family of 14 will eat just one bowl of millet, mixed with a bit of goat's milk and plenty of water to make it stretch farther. It's been three months that it's been like this, she said.

"The younger children ask all the time why we aren't eating," she said, telling her son to wait. "They don't understand. They think I am just not cooking."

Niger is spiralling down into a severe food crisis. A catastrophic combination of a failed harvest, returning migrant workers from troubled neighbouring countries, and soaring food prices has left more than 5.4 million people in Niger at risk of hunger; at least 1.3 million people, like Dije and her family, are in critical need of help now.

Across Niger, there are communities that have no harvest at all, and have already exhausted their food supplies and are starting to sell their animals and household belongings just to buy food to keep their families alive. In each affected community, the prognosis is the same: this crisis is already worse than the crises of 2005 and 2010.

"It's been years since we've seen a situation this bad," said Dije. "I already sold five of my goats, and we have just one goat left. We've sold everything to buy food."

Here in Yan Sara village, a poor community of 170 people in the barren semi-desert of rural Niger, children are already showing signs of malnutrition: protruding bellies and orange hair revealing the tell-tale signs of nutrient deficiency. Children with chronic malnutrition risk permanent stunting: they will never grow as tall as other children their age, and they may have developmental challenges as well. Severe malnutrition, if not treated, can lead to death.

Nearly 300,000 children will become malnourished across Niger this year, and that figure is expected to rise as the country's food crisis worsens.

But if help is provided now, we can prevent children from becoming severely malnourished, said Amadou Sayo, CARE's Regional Emergency Coordinator for West Africa. CARE has already started a cash-for-work program in partnership with the World Food Programme, which will help families buy food. But more is needed. CARE is raising funds to start an emergency food program for families like Dije's, who are already in dire need. High-energy, nutritious food for children, such as Plumpy'nut, a peanut-butter-like emergency food used to treat mild malnutrition, can help prevent children from becoming severely malnourished.

"Prevention is more effective, and less costly, than allowing children to become malnourished in the first place," said Sayo. "In a food crisis, helping the children is critical, as well as pregnant women and breastfeeding women. The adults can survive a hungry season, but young children are very vulnerable. If they don't have proper food, they start to get sick, they lose weight, and they are at risk of death."

For Dije, the situation is frighteningly clear.

"We need help," she said simply. "I don't want to lose another child."

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Mandefro Mekete, Emergency Operations Coordinator, CARE Ethiopia
Jan. 30, 2012

The case of Ashenafi, 35, illustrates how it is not a single event, such as a drought, that deeply affects people, but rather the cumulative impacts of a number of previous shocks.

I clearly remember July 2011 when the world started to focus its attention on the food crisis in the Horn of Africa. At that time, more than 4.5 million people in Ethiopia were in need of food assistance and water shortages were putting millions at risk of waterborne diseases.

I remember July 2011 because by then it had been almost a year since I released a drought alert for the Horn of Africa to our key partners. In August 2010, la Niña, a meteorological phenomenon that usually provokes dry weather conditions, was forecasted. As an Ethiopian who grew up in the north-eastern part of Ethiopia and who has been affected by drought, I knew the potential consequences of such a forecast.

In response to this, we at CARE immediately started to prepare ourselves to respond to the potential crisis. We launched our first relief interventions in February 2011 with activities to provide water to drought-affected communities in Borena, located in the southern part of Ethiopia. We also provided food assistance in East and West Hararghe in Oromia region and in Afar region in eastern Ethiopia. We later complemented our drought response with nutrition and livelihoods interventions in order to have an effective, comprehensive and integrated approach.

Chronic food insecurity is, however, commonplace in rural Ethiopia in any year, irrespective of unusual climatic or economic shocks. Many factors contribute to this, including land degradation, limited access to basic social services, population pressure, and near complete dependence on rain-fed, subsistence agriculture.

The vast majority of the Ethiopian population relies on agriculture for their livelihoods. As most agriculture is rain-fed, reliable and sufficient rainfall is critical for the country's economy, livelihoods and food security. Each year, depending on the location, Ethiopia has two rainy seasons and one or two dry seasons. The most difficult period of the year is called the "lean season", when food stocks are low and the new crops have not been harvested yet. This usually happens at the height of the rainy seasons. Food prices tend to rise during that period while livestock prices significantly decline.

People use different mechanisms to cope with the lean season, such as reducing the number of meals per day, buying less preferred food and selling key assets (e.g., livestock). Once key assets are sold, it takes a very long time for people to rebuild their capital. They therefore become increasingly vulnerable over time and are trapped in a cycle of poverty.

So, when the drought hit Ethiopia in 2011, people were not only affected by this event but by the cumulative impacts of previous events (droughts, floods, economic shocks or lean seasons).

Nothing illustrates this better than listening to the people affected by the drought. When asked about the impacts of the 2011 drought, many start recalling the interrelated chain of events over past years that have pushed them over the edge this year. The story of one man in West Hararghe last November is particulalry striking. Ashenafi, a 35 year-old farmer and father of eight children, explained to CARE how he progessively sold his productive assets over the years to cope with the drought or lean seasons. As result, he was backsliding each time a little bit more into the cycle of poverty.

In 2005, Ashenafi was in a position to provide a decent life for his family and send all his children to school. He owned a house with a corrugated roof and had three oxen, one cow, three sheep, three goats and thirty chickens. Then, during the 2006 drought he was forced to sell one of his oxen and three sheep. A year later, he had to sell another ox and his three goats to cope with the lean season. The last ox was sold in 2008, along with all his chickens. And then in 2009, he had to sell his cow that provided milk for his children. Moreover, every time Ashenafi sold his livestock, he did so at the peak of the lean season, which meant that he had to sell at a reduced price.

When the drought hit in 2011, with no other assets on hand, Ashenafi was forced to sell his house. He now lives in a hut with his family and has started to receive food assistance, initially from the Government and later from CARE.

My own family story is very similar to Ashenafi's. We were also farmers, and during the severe drought in 1984, my family lost all their assets. We had to sell our cows, plow oxen, horses and goats in order to survive. During that year and the one that followed, we received support from NGOs. My family participated in cash-for-work projects, where they worked on soil and water conservation activities in exchange for a salary. We also received funds to buy plow oxen that helped us to restart our agricultural activities.

Two years later, my father was able to secure a position as a guard in a government seedling nursery. As a result, we were less vulnerable. We still continued to farm, but a low harvest no longer had the devastating impact it did before.

Progressively, my family was able to rebuild its capital and buy plow oxen, sheep, goats, cows, donkeys and horses. Recovery was a long process, but eventually all my siblings were able to graduate from college and find good jobs. Today, we are in a position to resist shocks, such as drought, and we can also support other family members and friends.

Ashenafi's family can follow a similar path if they also receive timely and appropriate support. Receiving seeds and small ruminants will help his family to restart their agricultural activities in the short term. Water system rehabilitation/development will ensure that his family has reliable and easy access to water, which will positively impact the health of all the members of his household. Since women typically bear the main responsibility for fetching water, this will also free up time for his wife and daughters – time that can be better used for school and productive employment.

Other initiatives, like village savings and loans associations, will help his family to accumulate savings, improve their cash management skills, and enhance their access to credit. Such projects, which focus on gender equality, will also help Ashenafi's wife to be more active in her community and engage in income-generating activities, therefore increasing her family's income.

We know how to support people to improve their resilience against recurrent shocks, thereby avoiding future crises. Ideas abound, but recovery support will be critical. Ashenafi and his family will get back on their feet only if we immediately support them in recovering from the drought and continue to do so in the medium/long term. This way, in a few years Ashenafi's family can also succeed like my family did and become independent and resilient. Let's work together to make this happen.

On March 8, International Women’s Day, women around the world will gather on bridges as part of Women for Women International’s Join me on the Bridge campaign. The campaign began in 2010 when women from Rwanda and Democratic Republic of Congo, in the middle of a violent civil war, joined together on a bridge connecting their countries to call for peace.  In acts of solidarity, women and men all across the globe joined them, and continue to do so each year, demanding an end to the violence, and symbolizing that we can build bridges of peace.  

I remember reading about the campaign for the first time two years ago.  My eyes stung with tears as I read that the women in Congo and Rwanda would meet on a bridge connecting their countries to call for peace amidst the war.  It was only as these tiny tears turned into huge dollops rolling down my cheeks that I realized something big was happening.  What was it?  And how could I respond especially since I felt so powerless- what could I really do?  

It was weird because I remember feeling no doubt that I would respond, but also feeling full of doubt as to what I could do. In that moment I felt small and helpless yet alive and emboldened.  

All my thoughts going, “you’ve never organized an event like this, you don’t know what it’s like to live with war raging around you, you can’t change anything,” -they got trumped.  On that day, I choose to listen to the knowing in my body, and despite the event being only a week out, I began to plan a small gathering on our beach walkover bridge.  On March 8, 2010, nearly 50 women showed up and I got a taste for what happens when you choose to experience yourself in a new way.  The world changes.  It can be experienced in a new way too.  Maybe that was what touched me so deeply when I read about the Congolese and Rwandan women.  Their act was extraordinary in that despite their outer circumstances, they could choose to see things radically different.  They could imagine peace.  They could imagine what might happen when we connect with one another.  

I like to think it was my future self- the one who stood atop the Acosta Bridge in downtown Jacksonville on March 8, 2011, arm raised in celebration- who pulled me toward her that day I sat in tears at my computer.  The one who saw that the world can be the place that I’ve always sensed it could be.

When we show up, when we listen to the whispers of life, we begin to consciously co-create the future, and like the women in Congo, Rwanda, Afghanistan, Bosnia and everywhere the women are standing on bridges, I can create a unified, peaceful and compassionate future for humanity.  

Voices of beneficiaries: Sapa Rabiou, 55 years old. Sarkin Rima village, Maradi
Jan. 21, 2012

Sapa Rabiou, 55 years old. 11 children, 30 grandchildren. She cares for her elderly husband and three grandchildren in Sarkin Rima village, Maradi, Niger. Sapa participates in CARE's cash-for-work program. © 2011 CARE/Melanie Brooks

Sapa Rabiou, 55 years old. 11 children, 30 grandchildren. She cares for her elderly husband and three grandchildren in Serkin Rima village, Maradi, Niger. Sapa participates in CARE's cash-for-work program. The program, implemented in partnership with WFP, provides participants with 1,000CFA per day (approx. USD2) in exchange for work clearing pasture land of an inedible weed that has taken over the pasture area, and reseeding it with local grasses that will serve as food for local cattle.

"We started to worry last year just before the harvest, when we saw the attack of crickets in our fields. Normally, I would harvest 100 bales of millet from my field. This year, I only got one and a half bales. Some families got nothing.

"I asked one of my sons, who normally harvests120 bales; he only harvested six. We realized we were all in the same situation. And we knew it would be hard. But we had no choice.

"I started selling thatch and firewood to feed my family. I have to walk to Maradi to sell it – it takes four hours each way, and I only earn enough to buy one measure of millet – enough for my family for half a day.

"Our stocks are gone. We have no food. Two weeks ago I started the food-for-work program with CARE. I was paid for the first time yesterday, and I bought food – enough for my family for 10 days.

"If it weren't for the CARE program, I would have had to borrow money. I would have lived day by day, doing what I could to survive, to at least put something in my stomach. I already sold my cow and two goats; I only have one chicken left. There is nothing in my house – just mats on the floor. I've already sold everything.

"My husband is 75, he's too old to work. It's all up to me. How can I be afraid? There's no use to be afraid. This is the situation, whether I'm afraid or not. I have to continue. But everyone in my area is afraid. We were affected by the 2005 crisis and barely recovered. I'm trying to survive this one. I can't say what the future will bring."

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By Melanie Brooks
Jan. 21, 2012

Aminou Chaibou, 29. Serkin Yamma village, Maradi region, Niger. Aminou participates in CARE's cash-for-work program. © 2011 CARE/Melanie Brooks

When Aminou Chaibou left his wife and three small children last year to find work in Nigeria, it was with the hopes of earning enough money to help them survive the worsening food crisis gripping Niger. Like millions of others across the country, his crops had failed; if he didn''t find work, they would starve.

Instead, he ended up losing money – and much of his family''s hope for the future.
"I found work right away, digging ditches for laying electrical cables. I had gone there before for work, when times were bad," Aminou said quietly. "But right when I was going to be paid, there was a bomb attack near where I was working. Things were hard at home, but I decided it was more important to save my life, not the money. So I came home."

For many people along the border with Nigeria, travelling to Nigeria to work for several months a year has been a crucial survival mechanism in difficult times. But with the recent unrest in Nigeria – increasing bomb attacks by a militant group, and more recently national protests against the government''s removal of the oil subsidy – many Nigeriens have decided that the work is too risky. Here in Maradi, Niger''s economic heartland, thousands of Nigerien migrant workers have returned home, many with empty pockets.

For Aminou, 29, the situation is even worse; in order to pay for his transport to Nigeria, he had to sell his wife''s only remaining goat. Piece by piece, they are selling the items in their home in order to survive.

"All we have to eat is millet paste mixed with a bit of milk," he said, stirring a spoon through a mostly-empty bowl of thin, soup-like porridge. "We add a lot of water, so it helps us feel full. We eat this twice a day. In a good year, we eat three times a day: millet, spaghetti, oil – many things. This is not a good year. And it is getting worse."
Sitting on the floor of Aminou''s small mud hut in rural Niger, his wife, Assamaou Rabi, 23, says she is afraid if her husband goes back to Nigeria, but they don''t know what to do.

"Our children ask for more food, but we don''t have anything else to give them," she said, as seven-month-old Zainab starts to cry in her arms. Assamaou pulls her to her breast, and the baby suckles quietly.

A complex combination of a failed harvest, returning migrant workers from troubled neighbouring countries, and soaring food prices has left more than 5.4 million people in Niger are at risk of hunger; at least 1.3 million like Aminou and his family are in critical need of help now.

CARE, in partnership with the World Food Programme, has started a cash-for-work program to provide families with cash to buy food on the local market. Here in Serkin Yamma village, Maradi, Aminou and other participants receive 1,000CFA per day (approx. USD2) in exchange for work clearing pasture land of an inedible weed that has taken over the pasture area, and reseeding it with local grasses that will serve as food for local cattle once the rains come in late May.

Aminou said the project arrived at a time when he had almost given up hope. He has been trying to find additional work in Maradi, and is considering going back to Nigeria. He had worked 43 days of a two-month contract; if he goes back and finishes his contract, he''ll receive his pay.

"But with everything we hear on the radio, I think it''s safer to stay here with my family. There was another attack yesterday in Nigeria, just across the border, near where I was working. We need to eat, we need the money, but I don''t want to be killed. Who would look after my family then?"

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Haoua Lankoandé, Advocacy Manager, MMD Project, CARE Niger
Jan. 18, 2012

Niamey, Niger - For those of us in the city, we are seeing the first signs of food crisis spreading across our country. We have seen it before. It has already started, and it is coming fast.

The first phase is when young men and women start leaving the villages, coming to the big towns, looking for work. 'Knock, knock': they come to your door and say 'do you have any work?' You ask them, what can you do? And they reply: 'Anything. I can do anything.'

In the second phase, they come to the door, 'knock, knock': 'Do you have any food? I haven't eaten in three days.'

In the third phase, they don't ask anymore. You wake up and go out side in the morning, and there is a family sleeping on your doorstep. They don't ask for anything, they just look up at you, hoping. If you give them something, they say thank you. If you don't give them anything, they are quiet. They just put their heads down, slowly get up and move to the next house.

It takes just a couple of months to go from phase one to phase three. We are already in phase one. It's amazing how quickly it happens.

We need to act now: provide cash-for work so people can buy food, provide school feeding programs so children stay in school, support resiliance efforts like community gardens and cereal banks. Because once they start showing up in the cities, it means they are already coming to the end of their resources. They have sold their assets. They have no food. This is happening now.

CARE did an assessment in one of the villages, and already we are seeing that there aren't many young men and women left – they are leaving for the cities and towns, hoping to find work. And here in Niamey, people are already starting to show up at our doors. 'Knock, knock'.

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Reshma Khan, Advocacy and Communications Assistant, CARE Kenya
Jan. 19, 2012

I still remember the 1st of May 2011. His Excellency Mwai Kibaki, the President of Kenya, declared the ongoing drought a national disaster and called upon donors and well wishers to support the country in that difficult time. For the many Kenyans living in marginal areas, the failure of two successive rainy seasons had made access to water for their household, livestock and farming needs increasingly difficult. For pastoralists who already live in the harsh arid and semi-arid areas, this made their already difficult lives even harder. The situation then worsened, with the declaration of famine in parts of southern Somalia. More and more families fled the country, leading to an unprecedented influx of refugees to the Dadaab complex in Northern Kenya.

Dadaab refugee camps were created in 1991 to respond to the influx of Somali refugees fleeing the fall of their Government. Located some 80 kilometers from the border with Somalia, the three camps at Dadaab were originally built to house around 90,000 people. Today, they are home to over five times that number, mostly Somalis. Despite the severe overcrowding, CARE has continued to work in the camps over the past twenty years, providing much needed relief food, water, sanitation and hygiene to the refugees. When the influx peaked at over 1,000 new arrivals per day, CARE stepped up its programs to provide food, water and other relief items. Additionally, we continued with our gender and community development agenda, providing counseling to numerous gender-based violence survivors in the camps as well as operating schools with over 15,000 learners.

We also scaled up our work in North-Eastern Kenya. Cash-for-work projects provided families with a financial safety net that could assist in the purchase of food and other basic necessities. Our emergency livestock projects assisted with the prevention and treatment of diseases of livestock that survived as other livestock in other areas were dying. CARE teams also rehabilitated emergency water and sanitation facilities to assist local communities.

It was really encouraging to receive the full support of CARE International members, who readily sent us emergency staff from their head offices. These colleagues covered all sectors including water and sanitation, gender advisors, media and communications specialists and numerous other field experts. This support is much appreciated in such a crisis and mirrors the core of CARE's vision: joining forces to help those in need.

"Building resilience, not dependency"
Over the past six months, as the crisis has put the region's most vulnerable populations in an even more precarious situation, CARE Kenya has been able to assist over 1 million of the most vulnerable pastoralists as well as refugees in Dadaab directly. While we are proud of this achievement, many challenges still remain. The security situation in North-Eastern Kenya and Dadaab has deteriorated in the past couple of months as the Kenyan Government and allies have sent troops to Somalia to engage the Al-Shabaab insurgents there. This has meant that our work in Dadaab has had to be limited to only life-saving activities, while our security measures in North-Eastern Kenya projects. But we don't intend to stop what we are doing; aiming to defend dignity, fight poverty and provide basic life-saving assistance to those who need it most.

The approach we have taken is to 'build resilience, don't build dependency'. CARE recognizes that with climate change, population growth as well as rising food and oil prices, poor communities in the arid and semi-arid lands of Kenya's North-East and the Somali refugees need assistance that builds on their own capacity, skills and experience. The communities we work with are far from passive, helpless and dependent! We see this every day: In Dadaab, CARE is being supported by more than 2,200 refugee workers in managing food distributions, teaching children and creating community committees. In North Eastern Kenya, we are building local communities' skills in managing water and other natural resources, in increasing financial service provision and financial literacy, and improving livestock market chains. We know that these crises are going to hit again, and we want to build peoples' capacity to cope with the problems without asking for external assistance. This is how we can help defeat poverty and defend the dignity of those we work with.

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Haiti – 2 year anniversary of earthquake

Like so many places in Haiti, idyllic natural beauty and the harsh reality of deep poverty collide in Tiawa.

Perched atop a mountain in Léogâne, Tiawa affords an extraordinary view of the surrounding area. Unfortunately, much of that vista is scarred by destruction. Haiti's devastating January 12, 2010 earthquake destroyed 80 to 90 percent of the buildings in Léogâne, according to official estimates. It was the area hardest hit by the quake.

In Tiawa, the quake gave rise to an impromptu camp of 1,500 people; people who had lost many members of their families, and nearly all of their possessions. CARE began supporting the families with emergency relief supplies immediately after the earthquake. Now CARE is helping them make the transition from recovery to rebuilding.

Today the camp's population is steadily dwindling. Many residents have rebuilt their homes. Others have moved to improved shelters built with assistance from CARE or other aid groups.

Jean Elie Maitre, VSLA Technical Advisor, is holding a training session for a group of women in a camp in Leogane where CARE has just started implementi­ng the Village Loans and Savings Associations.

Integral to CARE's five-year, $100 million program to help Haitians rebuild their country are initiatives to help them develop their own economic opportunities after they've moved out the camps. In the fall, CARE launched the first Village Savings and Loan Association in Tiawa. VSLAs are self-managed savings groups. CARE teaches participants, the majority of whom are women, who save and loan money in small groups.

Members borrow money from the savings fund to pay household expenses and to start small businesses. The loans are repaid with interest which is then shared among the group members. Participants earn a greater rate of return on their savings than they would in a bank, while building bonds with their neighbors. VSLA loan repayment rates are near 100 percent.

Crucially, VSLAs elevate the status of women in their communities by demonstrating how the economic empowerment of women helps not just women, but everyone around them, including men and boys.

At one of the first VSLA meetings in Tiawa, the group sang a song composed by VSLA field manager Yves François Constant. "Where VSLA people stand, there's no space for misery," they sang. "Where VSLA people stand, women have autonomy."

CARE VSLA staff holding an information meeting for a group of civil society and women's organizations and two representatives of the city hall  in Carrefour where CARE has just started implementing the Village Loans and Savings Associations.

The Tiawa VSLA groups grew out of a gender-based violence counseling and support group CARE launched after the earthquake. After helping women survivors cope with the aftermath of gender-based violence, CARE is helping them take the next step by offering a VSLA program as a way to help the women weave their own economic safety nets. CARE's objective is to help women, and therefore their families, gain autonomy.

Although all of the money in a VSLA comes from the participants, CARE is facilitating VSLA growth in Tiawa and elsewhere in Haiti by fostering connections with responsible local businesses. Through CARE, VSLAs will soon team with Haiti-based Earthspark International to market green and clean energy products in Haitian communities. Conservation and better environmental stewardship are essential to Haiti's long-term recovery.

And to make sure their growing savings are stored safely, CARE will partner with a local mobile phone provider to develop a mobile wallet designed specifically for VSLAs. It will allow VSLA members to securely store and transfer money electronically, eliminating the need for group members to guard large stores of cash.

Though the VSLA model is new to the earthquake zone, it is not new to Haiti. Prior to the earthquake, CARE helped groups of women start VSLAs in Grand Anse, in the southwestern corner of the country. When survivors from other parts of Haiti poured into Grand Anse after the earthquake, the families with women who participated in VSLAs were better able to cope.

"Parents had to accommodate and feed their [returning] children and grandchildren," said Léonne Rochas, a regional VSLA chairwoman in Grand Anse. "The financial autonomy they gained from VSLAs helped them a lot."

CARE and the original Haitian VSLA groups in Grand Anse are now rapidly expanding.

"We don't advertise this product. It does its own marketing," Rochas says. "The women around us have seen how savings have gained us more respect in our families and communities. We are role models now."

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"I see her growing up and developing physically and I worry," she says. "When you become a mother at a young age, without any other asset available, you live the rest of your life in misery. No mother would like to see her child living in a similar situation."

Maude is attending a meeting at CARE's reproductive health center in the community of Santo, Léogâne. Officials estimate Haiti's devastating January 12, 2010 destroyed 80 to 90 percent of the buildings in Léogâne. This included not only homes but also the infrastructure of the normal life people rely on: markets, schools, government offices, and health clinics.

The earthquake turned Santo into a tent city of almost 10,000 people. CARE quickly moved in to help, distributing delivery kits and supplies for pregnant mothers and newborn babies, and offering counseling sessions to lower the risk of gender-based violence in this traumatized community.

More recently, CARE built the Santo health center, one of two it has constructed so far and one of 10 planned in all. CARE staff and nurses from a nearby hospital offer education on overall sexual health, contraceptive pills and injections, condoms and group informational sessions for men and women on the prevention of gender-based violence.

Maude often brings her daughter to the center because she's determined her daughter will avoid the hard life she has had. At 36, Maude is the mother of eight children.

"I have four children with a man I didn't love," Maude says. "He didn't want to use contraception and I didn't know how to protect myself." Maude eventually got married and had four more children with her husband. She and her husband attend CARE-sponsored sessions at the center because they've agreed they do not want to have more children.

Nurse Marie Kencia Dulorme is preparing a vaccine at one of the women's centre setting up by CARE in Leogane to provide reproductive health and referral services.

"My husband participated in numerous session organized by CARE's staff," Maude says. "He is now aware of the risk I run by multiplying pregnancies and has decided to protect me by using condoms."

Maude's daughter attends sessions on teaching her about birth control, prevention of HIV and other sexually transmitted diseases, as well as classes on preventing gender-based violence. Maude says the classes have relaxed tensions between her and her daughter. Her daughter now understands her worries, she says. And she now has the right words for explaining to her daughter how and why to be cautious.

Maude expresses gratitude for the center, and she is not alone.

"Even when CARE staff is not here, women from Santo who were trained by CARE are inside sharing their knowledge with their peers," says Willio Sainvilus Latagnac, president of the Santo community association. "The community made this space their own and women have their own area where they can discuss their problems, find solutions together, and regain strength."

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