KOLKATA- STATUS OF ELDERLY POPULATION

Though modern medicine and improved health facilities have contributed to better life expectancy and a huge increase in India’s elderly population in the past 50 years, geriatric medicine and social security measures have failed to keep pace. Consequently, increased longevity, breaking up of the joint family and lack of geriatric care have left the elderly helpless in most cities and towns, this despite the declaration of the National Policy for Older Persons by the Government of India in 1999. Currently, 81 million population is made up of the elderly out of which 30% are absolutely single. Yet, financial and other constraints prevent geriatric wards from being set up in rural and urban centre by the government.

In Kolkata more or less scenario is also similar like other part of India.

On economical/financial point of view these Senior Citizens are categorized in to 3 parts:-

                     ♦From Low Socioeconomic Group/Underpriviledged Group

                     ♦From Middle Class

                     ♦From Higher Class

As per their economic condition these elderly people are suffering from mainly 4 types of Insecurity:-

                     ♦ECONOMICAL INSECURITY

                     ♦HEALTH INSECURITY

                     ♦EMOTIONAL INSECURITY

                     ♦LEGAL INSECURITY

♦ECONOMICAL INSECURITY:-

                     Due to low income or no pension system or more no of family members in
elderly population belonging to Low Socioeconomic Group/Underpriviledged Group
are suffering from economical insecurity.
On the other hand elderly population belonging to Middle Class are also suffering
from economical insecurity due to very low pension or no pension or no source
of income,so they are basically dependent to their children &
due to increase no of nuclear family in majority cases they are neglected.

♦HEALTH INSECURITY:-

                   Health is one of the prime   concern  for elderly population.
Though there is separate discipline- GERIATRIC is specially meant for elderly
people but due to lack of awareness this is not popular till now in
Kolkata. Elderly population belonging to Low Socioeconomic
Group/Underpriviledged Group are much more
sufferer due to their financial constrain & unavailability of any opportunity
in Government Health sector.
Due to huge premium value of Mediclaim/Health insurance, majority of elderly
population belonging to Middle Class are unable to take the facility.
Huge medical cost due to increase cost of medicines & hospital bill
are also key responsible factor for insecurity. Though money is not
prime factor for elderly population belonging
to Higher class but their main insecurity is due to lack
of man power specially during emergency medica
l crisis period. Lack of any Doctor/Medical personnel to attend the elderly
people at home during emergency
is also another factor of insecurity in Kolkata.

♦EMOTIONAL INSECURITY:-

                     Emotional insecurity is mainly seen in elderly population
belonging to Higher Middle Class & Higher class because of nuclear family pattern
& breakdown of family bonding. Major portion of this population remain isolated
from their children. Due to lack of emotional attachment many of them are
suffering from serious mental disorder & depression.

♦LEGAL INSECURITY:-

                   Legal insecurity is another main concern for our elderly people.
Due to lack of knowledge/awareness, many senior citizens are not aware of how LAW empowers them.

          The free legal cell of Calcutta High Court offers help to the elderly.
They can take up abuse-related issues directly with the unit and their cases
will be fought for free.

                               FEW IMPORTANT LAW IN FAVOR OF ELDERLY:-

● Section 125 Code of Criminal Procedure 1973 (Order for maintenance of wives, children and parents)

● An elderly woman facing abuse or turned out of the house by her children can also lodge a complaint under the Protection of Women from Domestic Violence Act, 2005. If there is any evidence of abuse the children can be jailed.

●A male victim can seek justice under Section 323 of the Indian Penal Code.

●The Maintenance and Welfare of Parents and Senior Citizens Act, 2007, has had few takers so far, says Calcutta High Court advocate Jaymalya Bagchi. But this Act compels a child or heir to provide maintenance, including food, clothing, residence and medical attendance, up to Rs 10,000 to parents, including adoptive parents or step-parents.

          SOME SIGNIFICANT INFORMATION REGARDING ELDERLY CARE IN KOLKATA:-

♠ FIRST GERIATRIC CONSULTANT:-

                              DR.KOUSHIK MAJUMDER,MRCP,FRCP-Presently attached with NNC

♠ FIRST GERIATRIC SEPARATE OPD UNIT:-

                               MEDICAL COLLEGE HOSPITAL ON 04.08.2001

 OTHER STATE HOSPITAL WHERE SEPARATE GERIATRIC UNIT IS AVAILABLE:-

IPGME&R (SSKM)

CALCUTTA NATIONAL MEDICAL COLLEGE

♠ FIRST GERIATRIC SEPARATE UNIT IN PRIVATE HOSPITAL:-

                              AMRI(DHAKURIA)

♠ FIRST 24 HOURS HELP LINE & EMERGENCY HEALTHCARE SUPPORT TO HOME:-

                              BANCHBO healing touch(www.banchbo.org.in),HELP DESK-(91)9903388556/9231914390

♠ FIRST HELP DESK OF KOLKATA POLICE FOR ELDERLY:-

                             PRONAM- (033)24190740

♠ FIRST TRAINING INSTITUTE ON GERONTOLOGY:-

                             Calcutta Metropolitan Institute of Gerontology

           KEY PERSON RELATED WITH GERIATRIC CARE IN KOLKATA:-

                     ♦DR.KOUSHIK MAJUMDER,MRCP,FRCP-Geriatric Consultant, Founder of CARES

                     ♦DR.POOVIAH- Geriatric Consultant,AMRI

                     ♦DR.SUBRATA MAITRA-Geriatric Consultant.
                   *DR.TAPAS DAS- Incharge,Geriatric Unit,IPGME&R(SSKM)

                     ♦DR.SUDIPTA KR.SEN-Eminent Medicine Consultant.

                     ♦DR.A.K.ROY CHOWDHURY- Eminent Physician,Chief Medical Adviser,
BANCHBO healing touch.

                     ♦DR.DHIRES KR.CHOWDHURY- Chief Functionary, BANCHBO healing touch.

                     ♦DR.INDRANI CHAKRABORTY- Director, Calcutta Metropolitan Institute of Gerontology.

                     ♦AMIT ROY-President, Safhi.

                     ♦DR.DIPANKAR DEBNATH-Geriatric Consultant. Institute of Geriatric Care & Research.

             HELP A CALL AWAY (ORGANISATION FOR ELDERLY CARE IN KOLKATA):-

                        ♥ Pronam: (033)24190740

                        ♥ Dignity Foundation: (033)30690999

                        ♥ Helpage India: 1800-345-1253

                        ♥ BANCHBO healing touch: (033)65160058,(91)9903388556
(For medical emergencies only)

                        ♥ Saanjhbaati: (91)9748856000

                        ♥ CARES: (91)9830779291

                        ♥ SOCIETY OF GERIATRIC ANIMATOR: (033)65197474

• Alzheimer and Related diseases Society of India (A.R. D.S.I.)
• Indian Association of Retired Persons
• Bethune Institute of Geriatrics Research and Rehabilitation Centre

                         ♥ Institute of Geriatric Care & Research: (91)9830372605

       ♣ SIGNIFICANT DAY CELEBRATION FOR ELDERLY:-

                       1ST OCTOBER, INTERNATIONAL SENIOR CITIZEN DAY,
ORGANISED BY VISWA PRABIN DIBAS UDJAPPAN COMMITTEE
 If any one like to modify/correct/add any information please inform without any hesitation
 

 Power point presentation on activities of BANCHBO by Kuhu Chowdhury & Sushil Sharma.

 Cultural Programme:-

                      Dance Composition-"Sundarban Garber Dhan"-    based on Sundarban,performed by Children of Sundarban & Kolkata.
                      Dance performance by "Pragyaduti Dance Troup"
                      Tabla Lahara by Biswarup Mistri(S/o Mason)
                      Folk Song by Folk Singer Shymal Gayen.

HONORABLE GUESTS PRESENT IN THE PROGRAMME:-
MR.SHYAMAL MONDAL - Honorable Minister in Charge,Sundarban Affairs(Independent) & Irrigation & Waterway, Govt. of West Bengal.
MR.CLINTON S "TAD" BROWN - Acting Consul General,United States of America.
MR.GOUTAM MOHAN CHAKRABORTY - Director General,Armed Force, West Bengal
Police & Former Commissioner of Kolkata Police.
MD.NURUL HUDA - Counsellor, Deputy High commission of Bangladesh.
DR.PABITRA SARKAR - Former Vice Chancellor, Rabidndra Bharati University.
MR.KALYAN KR. MAITRA - Chairman, Sulekha Works Ltd.
DR.SUDIPTA KR SEN - Chairman, Banchbo, Ex Medical Director, Woodlands.
DR.A.K.ROY CHOWDHURY - Chief Medical Adviser,BANCHBO healing touch.

The whole program me was Conducted by President of BANCHBO - DR.DHIRES KUMAR CHOWDHURY.

 If you like to know more about our NGO please log on- www.banchbo.org.in

 

 

 

In Borena in southern Ethiopia the last two rainy seasons have brought no water. The drought took one third of all livestock, leaving families without income.

Little Salad is sleeping soundly. Gamu Kamad, his mother, is very relieved. Just a few days ago, the 11-months old could do nothing but vomit. He could not crawl, he did not play; he was just too weak. In the past weeks, Gamud feed him only water – she had no money to buy milk. Most of her cattle died. In the Borena zone, in southern Ethiopia, the last two rainy seasons did not bring any water and a worrying drought has gripped the region. In the Moyale district, the land is brown and dusty. Bushes and trees have lost their last leaves, their trunks and branches reach naked into the air. A little green is left on thorny shrubberies and acacia trees, both either too dangerous or too high for cattle to reach.

Gamud and Salad have found help in a health center in the town of Moyale, run by the local government. Salad was weighed and screened. His diagnose: severe acute malnutrition. He was brought to the stabilization center, where he now receives therapeutic supplementary food, provided by CARE Ethiopia, until his condition improves and he reaches a normal weight for a boy of his age. His mother stays with him and receives food as well. “I was very worried about Salad,” she explains. “We came here four days ago, but now Salad’s condition is already much better.” She looks at the tiny bundle lying next to her, still sleeping calmly. “Before I brought him here, he could not open his eyes any more. He threw up the water I gave him. But now he gets stronger every day.”

The health centers in the Moyale district have experienced a rise in malnutrition cases for children under five years. Almost 500 severely malnourished children were admitted from January to June. In 2010, this was the rate for the entire year. In the Borena culture, children are given the most food. They eat first, followed by the father and then the mother. Parents give their children the little food they have, but now they have no groceries left and no money to buy some.

Livestock is life
The prices for cattle are the lowest in the past decade in Moyale. At the same time, prices for food have risen sharply. In a pastoralist society such as in Borena, people depend on their livestock. They are their income and source of nutrition – their life. When livestock die, people lose their assets. In the Borena zone, one third of all livestock have starved. “Even goats and camels find no pasture any longer. This very unique, as they are usually drought resistant animals”, says Mandefro Mekete, CARE Ethiopia’s Emergency Operations Coordinator. But it has never happened before that both the Hagaya autumn rains and the Genna spring rains have failed in Borena. Scientists credit this drought to La Nina, a weather phenomenon that changes weather patterns and causes drier conditions in East Africa.

Gamud has lost 36 of her 51 cattle to the drought. The residual cattle are too emaciated to give milk or to sell on the market. Her husband is trying to save the lives of the remaining ones by taking them to areas where pasture is still available. Some people migrate as far as 400 kilometers in search of water and pasture, putting pressure on the remaining grazing grounds. CARE, in close collaboration with the local government, opened 21 slaughter destocking sites to recover some value from emaciated and unproductive animals that would otherwise die and to prevent conflict that might arise from competition around scarce pasture grounds.

The smell of slaughtered meat hangs in the air. The bones of cattle are thrown into a square, deep pit. Bloods seeps away into the brown ground, leaving dark red streams on the earth. Hasalo Duba has come with two cows to the slaughter destocking site in Dima village. “Before the drought I had ten cattle. Six died already and I brought two here today. I have only two left now; only one of them gives milk,” the 25-years old mother of six children says. She will receive 800 Birr (47 USD) per cattle which allows her to buy staple foods on the market. She will also get some hay and supplementary animal feed to save the life of her remaining two cattle. “Eight vulnerable families will receive the meat of the slaughtered cattle,” Mandefro Mekete explains. “The slaughtering takes place with technical assistance from official meat inspectors, who ensure that the meat is safe for consumption.” However, there is not much meat left on the bones of the barren cattle waiting in front of the slaughtering pit.

No rains expected to come soon
Malicha Galgalo has already received her money. The 40-year old wears a long black dress with red applications; she sits on top of a heap of white bags full of hay, surrounded by children. “I have to find a donkey to carry the bag home. I have lost 25 cows, only five survived,” she says. Malicha believes that Moyale is in a very critical situation. “Before the drought, I could sell the milk and I had a steady income. But now I don’t earn any money and I have ten children to feed.” She depends on food distributions from the government. With the 800 Birr she received for her cow Malicha bought one kilo of grain. “I will save the remaining money. I don’t expect the situation to improve, there will be no rain coming soon.”

The next rainy season is supposed to arrive in September or October. Until then, many pastoralists predict most if not all of their remaining cattle will starve. Some elderly already fear that the Hagaya rains, as the autumn rainy season is called, will fail as well. Kofobicha is 55 years old and has lived through several times of hardship. But the drought has never been as bad. “We don’t expect the next rainy season to come. Even if the Hagaya rains come, no cattle will be left by September,” he forebodes. “But we don’t care about our livestock any more. All that counts now is to save human live. We have accepted that we need to fast, but who saves our children?”

Salad from Moyale town was lucky, he has been saved. Life has returned to him, thanks to CARE’s and the government’s interventions. But many more children and their parents will need assistance in the coming months. They need urgent humanitarian support, but they need also a long-term strategy to become more resilient to the impacts of drought. So Salad’s mother is able to buy him food when the next drought hits.

Dama Godona lives in a place of great contrast: even though the grass in Dire, Borena in southern Ethiopia looks green it is the harbinger of a severe drought. Consecutive failed rains did not provide enough water to yield sufficient pasture growth, which is important to sustain the cattle of the region’s pastoralists. Dama lost seven out of her 17 cattle and used all of her savings to purchase animal feed and water for her livestock. She plans to sell six of her remaining cattle in order to buy more cereals, animal feed, and water.

Over the past weeks Dire woreda (the Ethiopian equivalent of a district) has received some rain. But it is missing the heavy rain needed of bringing new plant or crop growth to the area. The people of Borena are pastoralists and dependent on their cattle, goats, sheep and camels. Due to the drought, many cattle have died leaving people without assets - and prone to food insecurity.

One can tell by the way she carries herself, that she exudes confidence but that she has also experienced hardship in her life. Her husband died in a car accident and since then she has to take care for her four children alone. During the discussion, Dama took the lead in the group, speaking out on behalf of her community and clearly outlining what they need most now in order to adapt to the drought conditions. When asked what the three most important needs are for people within her community Dama stated that she needs food for her family, animal feed and increased access to water, but also support for Village Savings and Loans Associations (VSLAs).

Through CARE’s Regional Reliance Enhancement Against Drought (RREAD) project she was able to contract two loans of 2,000 Birr (about 118 USD) each through a VSLA over the last four years. Upon receiving the loans, she bought emaciated cattle at a low price, fattened them and sold them with profit. With this profit she was able to open a small road side shop. Since opening the shop, she has paid off the loan with interest and is now the head of the very association which helped her increase her income, protect her assets and care for her family. Dama’s position as a pastoralist and a merchant makes her quite unique in this region.

Dama shows that prevention is key to help individuals in times of drought. She demonstrates how increasing an individual’s ability to diversify their livelihoods can spur entrepreneurship, create employment, generate income and ultimately empower an individual. Additionally, it also shows that when Village Savings and Loan Associations are used correctly they can help people provide for their families and can also reduce vulnerabilities associated with drought. Hopefully, Dama’s example will not be so unique in the near future.

Dama Godana knows all too well how difficult the life of a pastoralist woman is. In addition to the usual daily household chores of cooking, cleaning and taking care of the children, she has to walk long distances to fetch water and pasture for the small and weak animals during the dry season.

“Sometimes we have to move to inaccessible areas to look for pasture facing the risk of snakes, injuries and exposure to the harsh rays of the sun,” explains 40-year-old Godana.

When Godana heard what women in other non pastoralists communities around Ethiopia were doing to help themselves, she visited them and with the knowledge she gained she founded the Darara Women’s Savings and Credit Group in 2007. “Most pastoralist women depend on handouts from their husbands. They are not empowered,” says Godana. “I formed this credit group, so that we can work together make some income and improve our lives.”

Dama Godana	Darara Women	Darara Hay pens	Darara Pressing Hay

The group started with a membership of 15 women each paying 60 Birr (about US$ 6) as a registration fee and a monthly contribution of 10 birr (US$ 1) per month. “With this money we invested in two young bulls and during the dry season we bought concentrated animal feed and sold it to the community members,” explains Godana. The group made a profit of 2000 birr (US$ 200).

During the dry season, the group sold scarce cereals like maize, beans and sugar to the community members and to date their membership has increased to 23 with a total budget of 8459 Birr (US$ 845) plus 4 bulls. Haymaking

CARE International in Ethiopia, under the Resilience Enhancement against Drought (RREAD) project, realized the difficulty these women faced in seeking pasture for their animals and trained them on haymaking. “Training the women’s group in haymaking was not only meant to lessen their burden but also to make pasture available for the small and weak animals during the dry and drought season, thus increasing their chances of survival,” says Temesgen Tesfaye, CARE project officer in Ethiopia. For the Darara women’s group haymaking has become second nature. Immediately after the rains stop they cut hay and collect it as it begins to yellow. This sequence retains the hay’s nutritional value. The hay is then laid out to dry on especially made beds to prevent its decay. Afterwards, it is piled in stacks and stored for use in the dry season.

“We are thankful to CARE for this initiative because during the drought seasons we don’t have to suffer anymore,” says Ashure Jaldessa, a member of the Darara women’s group.

The RREAD project also provides the group with a one-off payment of 25,000 Birr (US$ 2500) to strengthen their trading business and livestock marketing. “This money will increase our household income and improve our resiliency to drought,” beamed a happy Godana. RREAD also trained the women to handle different roles and responsibilities within the group. These include basic auditing, financial management and record keeping skills.

For Godana, the journey has been long. Married as a child at a tender age of 8 years, Godana lost her husband three years later. With no education but full of determination and ambition, she started selling local brew until she got enough capital to sell roofing materials, a business she still runs to date.

“I have no education and that’s something I regret but life experiences have taught me a lot and one lesson I learnt is that one must always strive to make life better and this is what I tell my fellow women,” says Godana. “This does not mean that education is not important. It definitely is and we must ensure that our girls to go to school and stay there.”

Godana’s efforts to improve the lives of women in her community caught the attention of Ethiopia’s Prime Minister Meles Zenawi who in 2001 awarded her with a medal that reads, “Although illiterate, this woman’s struggle to uplift the women in her community has made her a symbol of development and we are proud of her.”

I arrived in Borena Zone, Oromia Region, in the southern part of Ethiopia two days ago. I am here with my CARE colleagues to conduct a deeper assessment on the impact of the current drought on women, men, boys and girls. We have talked to different groups, and even though we just had four basic questions, there was so much to listen to and to learn from. Basically, I could have asked 10,000 questions! Today we visited Moyale woreda (a woreda is the equivalent of a district), that is bordering Kenya. It has not rained there in the past six months, only the last ten days saw some rain. However, these rains were very sparse and did not bring enough water. So some areas look greener now, while others are still very dry.

But a green pasture does not mean there is no drought. The people of Borena are pastoralists and dependent on their cattle, goats, sheep and camels. But so many cattle have died already. Even though pastoralists move them to one place in order to avoid diseases, I could see carcasses lying around, there are just too many of them. Some people told me that this is not the first drought, of course, Ethiopians are used to the cycles of aridity and rain. However, what is really unique now is that it is not only cattle dying, but also sheep and goats. This is really concerning because goats usually resist quite well to drought since they can eat almost anything if needed (shrubs, bushes, branches, etc.).

A whole day to fetch water

There is not enough pasture, there is not enough water. This has a huge impact on women. Women are usually responsible for fetching water and they have to walk much longer distances now than before. One group of women told me that before the drought, it took them 30 minutes to the water point for one way. Now they have to walk three hours – one way. The second group mentioned that they not only need two hours now instead of 15 minutes to fetch water but they also need to queue at the water point for four to six hours. Because there is very little food, they don’t take anything to eat with them. They come back home hungry and exhausted. And they have to go through this ordeal every day.

In addition of spending almost the entire day to get water, women also need to collect pasture for their cattle. They therefore have very little time for their daily household chores. They can’t properly take care of their children and provide them with food. In some cases, I saw elderly people watching small children. But very often parents see no choice but taking their children out of school. School drop outs are already being visible here in Ethiopia, and it is mostly girls who need to stop their education because they have to assist their mothers with household chores and take care of their siblings. One young man of 17 years told me about the drop outs in his school. His 4th grade consisted of 82 students before the drought. Now, just 25 students are attending school – and most of them are boys.

One meal per day

I saw many cattle that are really, really weak. People told me many of them were too weak to stand up without help and how they constantly needed to support them to do it. A minimum of three strong people are needed to do this. I have not had the opportunity to see that myself but one of my colleagues sent the picture he took during one of its field visits. Impressive.

Since there is no pasture, men need to climb trees to cut leaves and use them as fodder for their livestock. People also reduce their food intake. While most families usually had three meals every day, they now can only eat once per day. Children eat first, then the father and the mother is the last one to receive what is left. So it is no surprise that most women told me: “We need food.” Even though there is food to buy at the market, the prices have steeply increased for the last months. In April 2011, the food index increased by 35.5 percent in Oromia Region compared to April 2010. People just cannot afford to buy products any longer.

An important element of a pastoralist diet is milk. Since their cattle are dying and starved, there is a shortage of milk, so people have replaced nutritious milk with tea. Without any nutrients and proteins, people are at high risk of becoming weak and malnourished. In some areas, I heard of conflict that arose due to the scanty resources. When pasture and water is limited and when people see their animals dying, tensions can get high.

These are all very concerning accounts. However, most people expect that the biggest impacts have not even begun. The worse is yet to come. The rains of the past days belong to a short rainy season and after it another dry cycle that will last until September starts. People have huge fears about their future and their ability to cope with the drought. The Ethiopian government is already responding to the drought with different interventions of which food distributions. I saw one of those today, but it is clearly not enough to reach every one who is in need right now.

By Audrée Montpetit, CARE Senior Humanitarian Program Quality Advisor

We traveled ten hours by car from Addis Ababa to reach the CARE Ethiopia Borena Field office based in Yabello. This small town is located some 200 kilometers from the Kenyan border. CARE is scaling up its emergency relief operations rapidly to address the worsening drought situation for this primarily pastoralist population. The Borena pastoralists are known for their hardiness and endurance, as well as for their cultural tradition of ensuring that the children are fed and asleep before the men eat, and finally the women. When malnourishment of children amongst this population becomes a source of concern, it is clear that there is a crisis on hand.

In a presentation at the CARE office, the CARE field staff and government officials jointly painted a very grim picture of the current situation and repeatedly referred to a disaster in the making with the loss of over 200,000 livestock dead in Borana (out of 750,000) as a result of lack of pasture and water. Without cattle, there will be neither income to buy food or milk to feed the children. As the cattle weaken and become emaciated, they no longer produce milk and often reach a stage that by the time they are slaughtered, there is hardly any meat left on the bone to consume.

In one of CARE’s innovative programs in close collaboration with government authorities and community leaders, we aim to recover some value from emaciated and unproductive animals that would otherwise die from the effects of drought. Slaughter destocking decreases the grazing pressure at times of high pasture scarcity. We saw carcass after carcass being thrown into a pit after the animal was killed, and those animals that still yielded some meat were butchered and shared amongst families identified by government authorities as vulnerable. CARE Ethiopia’s program of de-stocking provides an opportunity to pastoralists to sell their cows at a fair price and to receive in addition to nearly USD 50 for each cow, grain to feed two remaining cattle. This project is an excellent effort to help families not only gain some savings from their cattle before they die from weakness, but also to try to save those that they still have.

But their remaining cattle are very few. Of original herd sizes of 15, 30 or 40 in nearly every case, women and men would tell us that they had only two or three cows left. They have lost the majority of their cattle in the past few months with mounds of partially decomposed skeletons scattered throughout the landscape attesting to this fact.

The respected elderly clansmen of Borena have predicted that the next rains will fail as well. Scientists credit the current drought to the La Nina phenomenon which changes weather patterns and causes drier conditions in Eastern Africa. The rains are not even due for another two months yet they are expecting the worse as their situation now is very grim. A dignified elder told us that there was no hope for them: ”We shall pass, but we must help the children.” He told us that they are not able to care for their cattle and that this is not their first priority anymore. The major issue is now the health of their children who are already starting to suffer. His words highlighted the scenes and conversations of the day visiting a local health center where too-thin babies were being treated for malnutrition, to the destocking site, and water provision activities, and later to the amazing clan gathering of around 15,000 Borena who meet every eight years to elect new leaders.

At this gathering, we were told that there were very few cattle and camels. One of the elders gestured to the encampment area and said: ”Look, it is empty. In the past years there were too many cattle and we had no space. This year we have hardly any cattle.” They told us that their fate is not in their own hands, and that they have to pray to God for rain. However, their cultural wisdom of ages past leads them to believe that the rains in September will fail again.

There is a window of opportunity for the Borena: If assistance is able to reach them at this time. They have lost their assets, their source of family insurance has gone, and they now face three months, at the very least, of continued drought. They are sure that without help, they and their families are at extreme risk of losing their lives. The CARE Ethiopia team has worked diligently over the past years to develop an excellent strategy and complementary set of interventions to help mitigate this situation in Borena. But, the complex set of factors created by a catastrophic region wide drought caused by the La Nina phenomenon, the loss of a cattle market in the Middle East, chronic poverty and the dramatic increase in food prices has resulted in a situation where the Borena are on the edge of disaster.

CARE is acting now to scale up and expand our efforts in our current programming areas of CARE Ethiopia -- to save lives that will be at extreme risk in the coming months. But we need more help. We need to prevent people from leaving their homelands in search of refuge, to prevent a further long term catastrophe including complete loss of livelihoods as well as loss of lives.

Story of Shangara Hassan, a Somali woman who traveled to Dadaab refugee camp with her four children.

“I think I am twenty years old. I have four children – two of them are very sick and two of them are OK. The oldest is six years and the youngest is six months.

"I have come to Dadaab from a village in southern Somalia. I came with my children, alone, to save our lives. There was a very bad drought there – it hasn’t rained for four years, and everything was very dry. Nearly all of our animals had died because there was no food for them to eat. We used to keep small animals – goats and sheep. What few we have left my husband has stayed to look after. Once they are dead he will come here too. We used to have nearly sixty but now there are less than ten.

"On our plot in our village we used to grow sorghum and that is what we used to eat. But because there has been no rain, the sorghum hasn’t grown. The ground has become very dry and the seeds don’t even come up anymore.

"Nobody has seen a drought like this for many years. Everyone in our community in Salag is leaving. All of my neighbors left at about the same time as me and they are living around me here in Dadaab. The only people who are remaining are the ones who still have a few animals alive to look after but I think they will all come here soon.

"There was hardly any water left to drink either. We used to get our water from a nearby stream but this had dried up. There was no water point in our village. So when the stream dried up we started to walk to a river that was a long way from our village to collect water to drink, wash and cook. It would take me about two hours to walk there and three to walk back when my container was full. It was very hard work because it was so hot. I can’t remember when it has been that hot in Somalia before.

"My husband decided that we had to leave when we hadn’t eaten for over a week. He said if we didn’t leave we would die.

"We arrived here about two weeks ago now. We walked from our village to the border and then we got a bus along with other people from our village. When we arrived in Dadaab we went to a reception point and were given some maize, sleeping mats and some other things. We had nothing with us. I couldn’t carry anything when we left because I had the four children.

"But now all of that food is gone. We are meant to go and be registered now so that we can get food regularly. But I have been there twice now and each time I have been told that I have to come back another day because there are too many people waiting to be registered.

"My second born child, Habiba, is very sick and my third born is starting to get sick. Because I haven’t registered I don’t think I can go and find them medical help. I don’t know where to go to find them a doctor as this camp is very big.

"Also if I go with one child, I don’t have anyone to leave the other children with. I am also breastfeeding my youngest and if I carry her, I can’t manage to carry Habiba too. Her condition is getting worse every day and I don’t know what to do. I am worried that all of my children may get sick soon because we are only eating once a day as we only have very little maize left.

"But even though it is hard here, it is better than what we left behind.“

Story of Osman Sheikh Hussein, who fled drought and conflict in Somalia to arrive at the Dadaab Refugee Camp in northeastern Kenya.

“My family and I have come from Somalia – from Baidera in the Upper Juba Valley. I took the decision to leave with my family because of drought and violence. The situation had become very bad. There had been no rain and everybody was starving.

"We walked by foot all of the way. It took us 32 days and every night we stayed under the sky. When we reached the border with Kenya some of the women and children were very tired and sick. So I managed to get some money and paid for them to come here in the back of a truck. It was a difficult journey.

"We have been here 29 nights now but still haven’t been able to register to get food aid. When we first arrived, we went to a place with other new arrivals and we got some food and other basic things. Because we had to leave out town quickly we left nearly everything behind. Along with way we lost some things too – the children were so tired that we had to carry them.

"I have been wanting to leave Somalia for a long time – the situation never gets better. There was nothing left in Somalia – it wasn’t like it used to be. There were no schools or health facilities – and I want my children to have an education.

"The security situation was getting worse and the drought has meant that there is now a lot of violence because people are hungry. I don’t know when the conflict is going to end and in our community it hadn’t rained for nearly five years.

"Everybody’s animals have died. We used to have a big herd of goats and sheep and also some camels. All of them have died because of lack of food. It is so dry there now and I don’t think the rains are going to come again.

"Here we only have this shelter that we have made from plastic sheeting and wood. But at least we can get food and water. There is a health center too and for the first time in many years I feel safe and don’t go to sleep worrying my children may die."

We’ve just returned from a visit to Dadaab Refugee camp in northern Kenya, where I was accompanied by the CARE Canada President and CEO Kevin McCort, CARE Australia Head of Fundraising Andrew Buchannan and CARE USA Head of Foundations Liz McLaughlin.

In my more than 20 years of field experience with CARE, I have not seen such widespread levels of the effects of lack of food on so many people.

Every single man, woman and child that we saw and met with of the more than 1,500 people arriving daily do not have a spare ounce of flesh on their bodies. The adults are literally down to the bone; the children are incredibly listless, showing obvious signs of malnutrition and distress.

Single mothers carry one or two children on their backs with others holding tightly onto their ragged wrap. We met groups of over 40 people who had traveled together, leaving behind the elderly whom they knew would not be able to make the walk of 20 or more days to reach Dadaab. They do not know if they will ever see each other again.

Every single person with whom we talked -- from those who had just arrived after a grueling journey to those who have been waiting in small hastily and sparsely constructed shelters, to those working as volunteers with CARE to provide food and some basic essentials -- asked us to help them to tell the world of their plight.

“Please share our message from Dadaab that we need help, that we cannot wait, that we have come this far and we still do not have the food and shelter that we need.”

There are more than 15,000 refugees who have arrived who are still not on the U.N. registration system and are not entitled to receive basic health services or a monthly ration of food. We met many of these people on the outskirts of one camp where CARE is now providing additional water and sanitation services. When I asked to see their vouchers that were provided to them upon arrival to confirm when a date had been set by which they would be officially registered, I was surrounded by many people who dug into their carefully wrapped worn bags and pockets to show me vouchers with dates for as far away as mid September.

One young woman asked, “I am hungry now and I have no shelter, how will I be able to wait this long for food for myself and my children? We thought we would be able to get help here but there is no help.”

Yet, these vouchers are like gold, and each one is carefully wrapped up and tucked back away for safe keeping. Without a voucher, a family does not get into the system, and therefore it is as if they had not walked and risked their lives to reach Dadaab. They do not exist in the system.

Our CARE staff is working many long hours each and every day to help speed up food distribution, to get water and sanitation services out to those who are escaping from the drought plaguing the region, and to increase educational services for the influx of many more young children.

The commitment and dedication of our staff is incredibly impressive, and they are doing this in the face of many challenges and difficult working and living conditions. There is no complaint voiced ever, yet their faces are lined and, at the end of the day, they're almost too tired to talk. We must get them additional help and support and we need to get it to them now.

I am extremely heartened by the great willingness and generosity of the CARE members to offer expertise and personnel as well as hopefully, in the short term future, significant additional funding. Many of the people who we met thanked us -- for the support they are receiving now and for what they truly hope will come.

Engda Asha, Emergency Project Manager for CARE Ethiopia in West Hararghe, gives an update on the devastating effects of the drought on one of the worst-hit parts of Eastern Ethiopia.

The situation in West Hararghe is critical. As verified through nutritional survey conducted by some aid agencies, there is an increased percentage of children under five showing signs of acute malnutrition in most districts of the zone. The number of households needing general food assistance is increasing at an alarming rate every day. As a result, the number of beneficiaries to be addressed by CARE alone has skyrocketed from 28,000 at the beginning of the crisis to 135,240 just as of 12 July 2011. People are mostly in need of food assistance.

Owing to the seriousness of the condition, the regional Disaster prevention and preparedness commission (DPPC) officials are on stand by, closely monitoring the situation on weekly basis. A command post is in place at kebele level (lowest administration unit) and they report to the Federal level. CARE is one of the members of the command post and is involved in situational assessments every week.

Currently, it has started to rain in this part of Ethiopia and hence some water is available both for people and livestock. Following the improvement in the availability of pasture and water, I can say that livestock condition is improving. But the human condition remains critical, because there is not enough food.

We meet Asli at the registration centre in IFO sitting under a leafless tree with her four children, one of whom kept crying. When we ask her what the problem is, Asli says that the child is two years old and mentally challenged, and he has had a fever for the past few days. When asked whether she had taken him to hospital, she told us that the registration process was more important at the moment.

“When we get registered, we will be settled enough and we can then seek medical care,” she said.

With nearly 1,500 people arriving in the Dadaab refugee camps in North-eastern Kenya every day, registration is taking nearly three weeks to register new families, and arrange for them to settle into the camps. It used to take just days.

To help people cope with the delay, CARE, in partnership with the World Food Programme, has increased our emergency food distribution to new arrivals. CARE staff provide new arrivals with three weeks of food, instead of a two-week supply. Once families are registered in the camps, they are entitled to receive regular food rations, and critical support such as access to safe drinking water and medical care.

The life Asli led with her family in Somalia took a turn after all the cattle and goats they owned died because of drought and her crops failed due to lack of rain.

“The situation got worse every day. We spent all the little resources we had, until we had nothing more to spend,” said Asli, whose children are aged between four years and three months old.

“The sight of seeing our children crying, and me having no breast milk for my baby, made my husband Abdi Osman Abdi decide to take the little money of our savings and come to Dadaab Refugee Camp which we had been hearing about while we were back at home. Even some of our neighbours had fled to Kenya because they said in Dadaab there are different agencies that give food, medical care and education for free and that’s all we need.”

Their journey from Somalia was long; it took the family five days to reach the Ifo refugee camp in Dadaab. They went to the reception centre after their arrival and they were given wrist bands to prepare for registration and access to safety and support from the many aid groups working in Dadaab.

But in the confusion of arrival, Asli and her family didn’t know to go to the food tent to receive their food rations. According to CARE staff, so many people are arriving, exhausted, traumatized and hungry, they sometimes misunderstand how to access help and get the supplies they are entitled to when they first arrive. That’s how CARE staff found Asli and her family when we were giving information to new arrivals about how to get assistance, and how to report and seek counseling if they had been attacked or sexually assaulted as they fled Somalia. Asli and her family were sheltering at their makeshift structure outside the camp, along with all the other new arrivals – but it had been 13 days since Asli’s family arrived, without food.

“My children are sick and hungry,” she said. “We have been here from six o’clock in the morning. It is now one o’clock, and the sun is hot. We do not have any money with us. We have been seeing women selling tea and mandazi (local donut-like pastry), but we cannot afford it. We will wait to get registered then we can go look for food from any good Samaritan.”

As soon as CARE staff found Asli and her family, we quickly arranged a representative from UNHCR to ensure they received their three-week ration of food, and soon they will be registered and settle into their camp in Dadaab.

But Asli’s relief at arriving in Dadaab – a hot, barren camp in the middle of nowhere – shows how difficult her life was at home in drought-stricken Somalia. It shows how important it is to find long-term solutions to food shortages and drought, to help people stay at home, instead of seeking shelter in overcrowded refugee camps.

Photo: © CARE 2011

I woke up early in the morning and accompanied American and German journalists to a reception center before it had opened for the day. We found people sitting outside in neat rows. Women with their small children made up three lines of about 20 adults each, then two lines were made up of families, fathers and mothers together with their children, and lastly, another three lines of single men, young and old alike. This is the prioritization for access to the reception center – women and children first.

What struck me today were the children and the mothers. I have had the privilege of traveling to many places in this big world of ours. I have found that in places where I spend time with people with whom I don’t share a common language, smiling and nodding hello is a great way to initiate communication. Often, the children I have met along the way find ways to laugh, to play, to joke with me…or the youngest of the children stare and sometimes cry if I get too close.

Here, at the reception center, the children were not laughing, not playing…. The mothers did not really give me a smile back, barely any nodded back at me – rather they just stared at me. The children were sitting, very quietly and others curled on their mothers laps. Not exactly what you think of when you think of a two year-old in line somewhere. Many of these people have just arrived from their long journeys here. And at 7:30 am, they were really only focused on the last few hours before they were to receive their first ration of WFP food.

Later in the afternoon, we arrived at the area where refugees who have been here for about three months had set up their homes. We arrived around 4:30 in the afternoon. Areas with water taps were bustling with activity. Women and men were talking along the side of the dirt road, as women with wood on their heads and a man on bicycle passed by. Goats grazed on mostly barren bushes. And there were children – wow, were there children…they were hard to miss: running, smiling, laughing, playing, and wrestling. I was struck by the contrast of this morning’s scene. Water. Food. Shelter. Latrines. Education - all the services these refugees were now accessing; it gave me hope.

The worst drought in 60 years is spreading across East Africa, creating the most severe food crisis in the world and threatening the lives of 10 million people. Life-saving support is urgently needed. Make a donation |Learn more

La pire sécheresse des 60 dernières années se répand à travers l'Afrique orientale, provoquant la crise alimentaire la plus grave au monde qui menace la vie de 10 millions de personnes. Des secours sont urgemment requis. Faire un don | En savoir plus

Emergency Media Officer Alexandra Lopoukhine describes the situation in Dadaab refugee camp, northern Kenya, where nearly 1,500 people are arriving each day.

When a family arrives:
Outside of the reception centres, crowds of people are waiting. UNHCR has set up a structure that is open on all sides, but has a roof to help shade the burning noon day sun. It is still not big enough for all the people. The people are quiet; they are exhausted and in what seem like shock. They are called into the reception centre in small groups to keep the flow inside moving.

Once they are called up to enter the reception centre (a fenced in compound with various tents, benches, tanks and taps of water CARE provides) , they go to one of the three reception centres being run by UNHCR staff. They first go through an electronic finger printing screening which registers them and their family. They get coloured bracelets based on which camp they are being received in (Blue bracelet in Ifo, Yellow in Dagahaley and Red in Hagadera). They then move to receive non-food items – being distributed by CARE staff (plastic mats to sleep or sit on, blankets, jerry cans). At that point they move to food tent, and receive two weeks’ worth of food. CARE staff gives the food out. There is a medical tent for malnutrition screening and the CARE tent for counselling. The final step is they are given a registration date and time to get to the one UNHCR Registration centre which they then get their WFP ration card, and tents and allocation of land.

Living in the camp:
Because the camps are full, people are setting-up their places to live where they can find land. This has lead to sprawling overflow, haphazardly set up. Deforestation (de-shrubbing) has taken place. This is a real source of tension with the host community- this is the land that typically Kenyan-Somali use as nomadic feeding and living grounds. So, when the wind blows, the wind blows red dusty dirt all around. At time the dust is so thick, you cannot see one foot in front – cars stop, people cover their faces; lack of visibility can last up to a minute. The houses are round stick buildings with any type of covering around. The wind can blow these houses down. The children are generally covered in the dust. Feet are perpetually dirty it seems. The sandy-ground is hot, and many refugees have no shoes. Flip flops from China seem to be the most popular type of footwear.

One woman’s story:
Hawa Aden Hassan, 30 years old with 3 children, her husband stayed in Somalia, she has been here 5 months. She and a friend went out to collect branches to make their houses and they were attacked. They were able to get away and suffered only minor injuries. They are now afraid to go out and collect what is needed; she said they are sleeping in the open air. They generally don’t feel afraid, but they really want schools for the kids.

“The violence (in Somalia) is not good. This place is good as long as there is no fighting and there are schools to go to.” 14-year-old boy

Newly arrived refugees from Somalia wait to be registered at Dagehaley camp, one of three camps that make up the Dadaab refugee camp in Dadaab, Noertheastern Kenya on the 9th July, 2011.

July 10, 2011

This morning, CARE staff were discussing, at length, ideas and plans on how to increase water supply in the areas where the newly arrived refuges have settled. A CARE International Water Expert has been with the team here in Dadaab for a few days now, assessing current needs and formulating a plan forward: more 10,000 gallon tanks; more drilling; more boreholes.

This afternoon, I headed out to the outskirts of Dagahaley and talked with some people who have been here for less than three months. A crowd quickly formed. One woman told me about the lack of water. Above us all, stood a very tall man (I am quite short, but he really was tall) and he explained to me that way too many people have to share one latrine. He told me they need more water – what they have now really isn’t enough. The crowd all agreed.

It was then that I explained that a water expert has come to help CARE determine what we can do about the water supply situation. I told him we know it is not enough. I told him the world is paying attention; money is coming-in to help get them more food, more water and more support. I apologized that things are this way right now, but that with all the new people coming recently, it has genuinely been hard to keep up. I asked them for patience.

What happened then will stay with me for a very long time. As my translator finished explaining that we were working hard to figure this out, he smiled. He smiled and stared me in the eyes and said thank you. The crowd nodded their heads and smiled as well. I say this now, this “thank you”, was the most sincere exchange I have ever been part of.

Newly arrived refugees from Somalia collect water at a water point that is having water delivered to it by a CARE water truck at Dagehaley camp, one of three camps that make up the Dadaab refugee camp in Dadaab, Noertheastern Kenya.

By Alexandra Lopoukhine, Emergency Media Officer
July 7, 2011

On the far outskirts of the Ifo camp (one of three that make up the Dadaab Refugee Camps), round houses – sticks intertwined and covered with tattered cloth and pieces of torn plastic, are home to the newly arrived refugees. Today, I walked around and met a few people who had just arrived – last week in fact.

There was excitement to have me around, the children were pretty interested in me and there was a lot of laughter and smiles. It is a wonderful thing about being human: the smile transcends languages.

But through an interpreter, I was able to understand the language of pain. The stories I heard today did bring me to tears, I will admit. So too did seeing malnourished children. Mothers patiently waiting at the Médecins Sans Frontières clinic which was well placed in the middle of the newly arrived area of homes – their children receiving the immediate care they needed. CARE delivers water to this clinic; it was great to see a partnership of this sort, with the same goal of supporting the refugees, in action.

Some families have walked two weeks. Two weeks. Sleeping where they could, pushing-on to get to this camp. The children are much smaller than they should be. One story I heard was devastating: a mother walking, arrives at the clinic, takes her baby off her back and finds it has died without her knowing. I can't even imagine the pain this causes her. One man spoke to us in perfect English – he told us he has been a refugee since 1991, and now, here among the newly arrived, is his grandfather.

I feel privilege to have this time here, to talk and to hear the stories of people. I was asked today to tell the world, to share the stories and the reality of the situation. Thank you for reading.

Women and children collect water from a temporary  water tap near the Ifo camp. (Photo: 2011 Alexandra Lopoukhine/CARE)

By Alexandra Lopoukhine, Emergency Media Officer
July 6, 2011

The heat is strong and the wind is blowing. The shade provides relief. People are lined-up, orderly and patient. There is an overwhelming sense of calm. This is not exactly what I would have expected in the Dagahaley Registration Center, as today, 1,055 people wait for food and to be brought into the United Nations High Commissioner on Refugees (UNHCR) system.

Then, we spoke to a few of the women and they explained their long and challenging journey that brought them here, to Dadaab, the world's largest refugee camp. They told us of their days of walking, of the challenges they faced in the last few days, and last few hours before they reach here. The hunger they faced at home. The insecurity. One women explained she had heard on the radio in Somalia that here, in Dadaab, they were giving away free food. This was the information she needed to get her kids in order and start the move. People were calm, I realized, because they had arrived.

They arrived to be greeted by staff from UNHCR, World Food Programme, CARE, and so many other organizations here, ready and able to support them. Relief was offered in the tangible supplies water, food and order.Orderly lines, orderly registration points, orderly information given to people reeling from their recently history of chaos. This is today's relief.

Newly-arrived refugees from Somalia wait to be registered at Dagehaley camp, one of three camps that make up the Dadaab Refugee Camps in northeastern Kenya. Photo: 2011 Kate Holt/CARE