Wafaa Adnan Albaik, 32, a case manager at CARE's refugee center in Amman describes her work.

Wafaa Adnan Albaik, 32, a case manager at CARE’s refugee centre. Story available. © 2013 Deborah Underdown/CARE

I have been working at CARE's refugee center for three months. This is the sort of work I have always wanted to do. I've always been interested in humanitarian work, and it's very rewarding to help people in need.

We meet Syrian refugees, assess them, decide on the best way to help them. We might give them emergency cash so they don't get evicted from where they are living or help to pay for medicine and food. We also refer people to other organizations who might be able to help. At the end of the day, I call up cases to book appointments so I can follow up with people and see if we can help provide further assistance.

Working at the center is very satisfying. I listen to people and try my best to help them but, at times, my work is difficult and upsetting. In Mafraq, I met a family who is very poor – the mother had to sew clothes into a blanket to cover up her children at night. They had no food or water. Their home suffers from humidity and on rainy days, the water would flood the house. When leaving their house, the lady cried out, "Please don't forget us, please don't forget us!"

Refugees also tell me about life inside Syria. They talk of being surrounded all the time, no food, no water, hearing the constant bombing, the children living in constant fear; many of them have been attacked at their homes. People had to bury bodies at night, if they did so in daytime, they were at risk of being killed.

The hardest part of my job is managing expectations. How do I tell someone who comes to us that we can't help or that they need to go to another organization?  I feel very upset when I can't help someone. By listening and empathizing with refugees, I hope to be able to provide relief and support.

We need more funding so we can assist as many people in need as possible. Yesterday, 120 refugees came to our center – some days we have had as many as 400.

The center will run for as long as we have funding and the situation for refugees here in Jordan remains the same. We anticipate that this will be a prolonged crises with increasing needs but we currently only have enough money to keep the center going until August.

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Two weeks ago, Yawo Douvon, CARE's country director in the Democratic Republic of the Congo (DRC), found himself showing Angelina Jolie and U.K. foreign minister William Hague around the Lac Vert camp for displaced people near Goma, DRC, where they visited to meet with rape survivors. Today, as the G8 foreign ministers gather in London to sign a declaration on preventing sexual violence in conflict, Yawo calls on them to listen to the voices from Goma, support Hague's initiative and provide the means to make the initiative work.

Foreign Secretary William Hague and UNHCR Special Envoy Angelina Jolie visit Nzolo camp, March 2013. Picture Crown Copyright/MOD/LA(Phot) Iggy Roberts

GOMA, DRC (April 10, 2013) – Eastern DRC is known as the "rape capital of the world" and, as VIP visitors have come and gone over the years, it is easy to become cynical and wonder if warzone rape can ever truly be tackled given its prevalence and complex causes.

Some within the media were skeptical when the British Foreign Secretary and the Hollywood actress visited CARE's work in DRC, thinking perhaps it was more of a PR trip than anything. But, guiding them around the camp as part of William Hague's initiative for preventing sexual violence in conflict, I was struck by their sincerity and passion.

We introduced them to women like Marie and Josephine who recounted the horrific experiences they had suffered. We also showed them CARE's work helping survivors of sexual violence with their immediate needs for medical care, shelter, water and food, as well as the longer-term psychological support and financial assistance they need to move on with their lives.

William Hague was particularly interested in hearing about the situation of rape survivors in order to better understand how they can be supported in the aftermath of an attack and protected from future violence. He was moved by meeting unaccompanied children and asked what was being done to reunite them with their parents. Angelina Jolie was shocked by the level of atrocity experienced by the women she met, and wanted to know more about what could be done to help them. She was interested in how important cash transfers were to the women she spoke to and how they represent hope for them to be able to rebuild their lives.

As the G8 Foreign Ministers' meeting takes place in London tomorrow, I hope that William Hague will bring the voices of Marie, Josephine and the others like them who he met on his visit to DRC and Rwanda to the attention of his fellow foreign ministers. The task of tackling warzone rape may be colossal, but I applaud his efforts to seek an end to an atrocity that has brought so much misery and terror not only to so many ordinary Congolese people, but also to countless others the world over.

William Hague has declared a campaign to tackle impunity. By seeking to put in place an international protocol to increase prosecutions, he aims to send the message to perpetrators of warzone rape that their crimes will no longer go unpunished and rape will no longer be seen as an inevitable consequence of conflict. He has invested in a team of experts to gather evidence, investigate and prosecute such crimes. This is important first step on what will be a long and arduous journey.

It's encouraging to see a world leader – and a man – take a stance on this difficult issue and stake his reputation on it. I see in the villages in which CARE works in DRC how much more progress is made when not only women but also men challenge custom and practice, and take a stand against sexual violence.

I know of course that more is required to address the root causes of violence in Eastern DRC, which are complex and deep-seated. They involve competition for control of natural resources by various armed groups and deep grievances over power between different ethnic groups. Impunity for sexual violence crimes is rooted in wider lawlessness, which requires the wholesale reform of the national justice and security sectors.

An international protocol to tackle impunity together with deployments experts can help, but they cannot substitute for – and will not work without – long-term, difficult work to reform such institutions on the ground.

So, the diplomatic initiatives launched at the G8 will need to link to long-term aid programs, to address the unique and complex set of circumstances faced by the DRC and the different – but no doubt just as complex ­– sets of circumstances faced by every other state or region affected by conflict.

And, if they are to benefit from this work, the survivors themselves must see their immediate needs met – for lifesaving medical assistance, as well as longer-term health, counseling and livelihoods support to put their lives back together.

This is what I showed William Hague and Angelina Jolie during their visit to Lac Vert and it is this support that remains chronically underfunded.

What I hope now is that the G8 nations will review their funding to countries affected by conflict, and work with the UN and agencies like CARE to assess how to plug the gaps in frontline services for survivors. It should not be beyond our collective ability to ensure that whoever needs lifesaving assistance receives it. We have just lacked the resources and political will to make this happen, until now.

As I said earlier, I hope that the stories of Marie and Josephine are still vivid in William Hague's mind and that he will share these with his fellow foreign ministers. I ask the other G8 countries, on behalf of the many rape survivors we at CARE have assisted over the years in DRC and other war-torn states, to listen to the voices from Goma and act to end the heinous crime of warzone rape.

By launching his initiative to prevent sexual violence in conflict, William Hague has said "enough is enough." Now it is time for the other powerful governments of the G8 to join his call and provide the means to put it into action.

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Haleemah survived the conflict in Syria. Now she struggles to live in safety in Jordan.

© 2013 CARE

"I came to Jordan last year in August. My village was bombed, and from what I heard, all of the houses are destroyed," she says. As a single woman of 37 years she crossed the border alone one night. An exhausting journey, given that Haleemah is handicapped and can only walk with a crutch.

"When I was 1 year old, one of my legs became paralyzed," she explains and looks to the wall, where the crooked iron crutch waits.

Haleemah, her brother and his family were poor even before they came to Jordan. As refugees they struggle even more to survive. "We have nothing. My brother tried to find employment as a day laborer, but often he works more than 12 hours a day and gets paid very little."

Mohammed had a physical breakdown at the end of last year and is recovering slowly. Adding to the physically strenuous labor and the hidden trauma, the daily pressure of feeding his family was too much for him to bear.

"He saw many neighbors being killed in Dara'a," Haleemah says softly. When Mohammad lost his strength, the family lost its income too. "We were not able to afford the rent last month. Now, the landlord asked us to pay in advance for the coming six months, but we have no money. How shall we pay?" Haleemah asks with desperation in her voice.

Shoeless on the icy floor

The family possesses not a single piece of furniture. No bed, no cupboard, no sofa, nothing but several mattresses lying on the floor, covered by woolen, flower-patterned blankets. They were donated by a local organization. It's cold and damp – realities of the harsh winter in Jordan. The single kerosene heater battles against the fresh breeze creeping through the concrete floor and drafty window frames.

Aryam and Kalid, Haleemah's niece and nephew, squat on the icy floor, shoeless. The children are afraid, shivering every time they hear fireworks cracking outside on the streets. "It reminds them of the daily bombing," says Haleemah.

The Syrian family lacks everything: food, clothes, household items, money. Often they cannot afford to buy water and use what pours out of the tap instead. "The children have become sick and suffer regularly from diarrhea," the 37-year old tells the CARE team visiting Mafraq to assess the situation of the refugees.

Since the conflict broke out almost two years ago, hundreds of thousands of Syrians have come to Jordan to seek safety. While many find shelter in the refugee camps, the majority head into the poor suburbs of cities like Amman, Irbid or Mafraq.

"It is difficult to collect a comprehensive picture of the urban refugees in terms of numbers. But it is obvious that many of them need assistance," says Ruba Saleh, who works with CARE's Syrian refugee response team. "By listening to the refugees, we find out what they need and can plan our emergency response accordingly."

At the end of last year, CARE opened an assistance center in East Amman where refugees receive mattresses, heaters, blankets and cash to help pay for rent and other needs. More than 20,000 Syrians have received assistance from CARE since 2012. The word about CARE's efforts has spread like wildfire; refugees living outside of Amman arrive daily to ask for help. "With more funding, we hope to open similar centers in cities like Mafraq so people do not need to drive long distances", Ruba says.

While Haleemah and her family need support in all ways, they are relieved to be alive. "Although our lives are miserable, although we have no money, we have survived the violence in Syria. We are safe here," her brother Mohammad says with a sad expression on his face. His wife, Wala'a, is seven months pregnant and with no end to the conflict in Syria in sight, the child will be born in Jordan. A refugee child born in safety, yet with an uncertain future.

By Sandra Bulling, CI Communications Officer, February 2013

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Abu Anas fled Syria last year. Today, he supports other Syrians at CARE's refugee center in Amman

Abu Anas, a refugee and volunteer working at CARE's Syria refugee center. Photo: © 2013 CARE/Sandra Bulling

Abu Anas greets the newcomers with a warm smile. The Syrian family, mother, father and two sons, just arrived here in Amman, Jordan two weeks ago. When the bombing became unbearable, they left their home in Syria. They fled at night, without much time to pack their scarce belongings. And now they are here in CARE's Syria refugee center, asking for help.

Abu Anas leads the parents to a row of seats, where several Syrian families are already waiting. The two sons look curiously around the room, shyly observing the large number of Syrians refugees: those who wait quietly on the black chairs for their turn; others, who crowd around the small counter where Abu Anas and his colleagues register the new arrivals, listen to their stories and explain how CARE can support them. A telephone constantly rings in the background, manned by a CARE volunteer answering inquiries and giving directions to the center. A room full of refugees, who share the experience of violence, bombing and killings in their Syrian home towns, who had to leave everything behind. Who lost family members, friends or neighbors in the bitter conflict.

Since the conflict in Syria broke out almost two years ago, Jordan is receiving an endless stream of Syrian refugees. In January alone, more than 60,000 people arrived in the small desert kingdom. While a large number of refugees seek shelter at the overcrowded refugee camps, the majority head to the poor suburbs of Amman, Mafraq or Irbid. They spend all their savings on rent and basic household items and now struggle to feed and house their families.

A few suitcases, a small saving

Abu Anas cannot but sympathize with the Syrians who come here – as he is a refugee himself."I left Homs, my hometown, one year ago. A bullet flew through the window of my son's room, the glass shattered on the floor. Luckily, my son was not in the room. This was the moment when I realized we need to leave. It had become too dangerous," Abu Anas says. He fled Homs with his wife, Abir, and his five children by bus, crossing into Jordan with a few suitcases full of clothes and the small savings they had."We came to Amman because we had friends here, who let us stay at their house for a few weeks. Then I found an apartment for us in the outskirts of East Amman."

Abu Anas' family had found safety, but the violence followed them in their dreams."My children had terrible nightmares. My daughter Marwa was so scared she did not want me to leave the apartment. She screamed and locked the door, because she feared I would never return. My youngest son would not come close to the window, he was afraid another bullet would hit again," Abu Anas remembers his first months in Jordan."However, the refugees who are arriving now are even worse off than we are. There are no jobs in Syria anymore, so they have had no income for many months, they have lost all their assets and experienced the worst violence one cannot imagine."

Today, one year later, Marwa's nightmares have slowly subsided, yet Abu Anas' concerns for the well-being of his family remain. He pays a rent of 180 Jordanian Dinar (190 Euro) per month, but he does not know how to afford a roof over the head of his family any longer. His savings are gone. He is not allowed to work and earn his living in Jordan. He used to be a French teacher in Syria, with a degree from the University of Homs."Now, I depend on the assistance of others," he says. Assistance that comes from organizations such as CARE, the UN Refugee Agency and others.

Helping other refugees

When friends told Abu Anas of CARE's Syrian refugee center, he immediately visited the large beige building in a poor suburb of Amman, hoping to find help there."Not only did I receive cash assistance, I also applied to help as a volunteer," he says."My son Anas and I both help the CARE staff to register and assist other Syrians. CARE gives each of us a small allowance to help with transport and other costs."

When Abu Anas's family fled Homs, 18-year old Anas was just about to finish high school."His work at CARE keeps him distracted and busy, but I worry about his future," his concerned father says. Like him, young Anas patiently listens to the new arrivals and helps CARE staff to register, distribute cash and relief items such as mattresses, blankets and heaters or refer them to other social services. A young and talented man, he has lost his future in violence-torn Syria.

Since CARE Jordan opened its Syrian refugee center in East Amman at the end of last year, more than 11,000 people have come to seek help. They need cash to pay rent and buy household items and they need health support and psychological assistance to overcome their traumatic experience in Syria. With more funding, CARE hopes to replicate this successful model and open refugee centers in other cities to reach those who are trying to survive on their own.

“On some days, we receive whole busloads of refugee families who venture out here from other Jordanian cities and who have heard of our center from friends and relatives," explains Abu Anas. One day, the center was so overcrowded, he started to organize refugees in two long orderly lines, one for men and one for women. He is a teacher who wants to assist others, provide safety for his family and a future for his children. He is also a man, who is torn between surviving in a foreign country and rebuilding his life, yet hoping to return to Syria, his home."Once the killing has stopped, we will go back. But not before," he says.

By Sandra Bulling, CI Communications Officer, February 2013

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By Adel Sarkozi

Kadidia from Gao region fled to Ségou with her whole family, in total 11 people. "I have no words to express my joy. This is the first time we receieved somthing. May God bless CARE for being by ours side," she said at a CARE food distribution. © 2013 CARE

It is 8 o’clock in the morning in the city of Ségou. The sky is blue and there is mist in the air. In the street that runs all the way to the Niger River, between the courthouse and the town hall, you find one of CARE’s food distribution sites. The place is full of people – women, men and children. But mainly there are women in a sea of bright headscarves. Some cover their faces with their veils, many more wear a bright smile.

Their feet are dusty, but there is joy in the air as they receive their food rations –flower, oil, peas salt and other essential items.

One of the women is Kadidia from Gao region. She fled to Ségou with 11 members of her family. Despite the sack of food pressing heavily on her head, she smiles and says, "I have no words to express my joy. This is the first time we have received something. May God bless CARE for being by our side when we needed it the most."

There are others who have just arrived, hoping they can join the line. Fatoumata, a woman in her 60s, has fled to Ségou with five of her children. She looks tired. Unable to read or write, she is holding out the card indentifying her as a displaced person; she wants to get someone’s attention. "May you help me, and may God help you in return," she says shyly.

Not far from her, in the shade of a tree, sits Mohamed. In front of him is the stick he used in the past for herding his animals; he kept it, though he has no animals left.

"I have been a herder all my life, but armed groups have taken all of my cattle. Now I have nothing left but my life. I fled with my wife and seven children. It took us many days to arrive in Ségou. We walked and walked before we found a driver who took pity on us. Now we are here – safe but without anything."

His voice is trembling, his eyes are red. "I heard a lot about CARE Mali and I came to ask for help," he concludes.

He will soon join the line of people waiting to receive the precious food. Once they receive it, they carry it off back to their families – some by foot, sacks on their heads, others by borrowed donkey carts or motorbikes.

Note: During the past three weeks, CARE distributed in Ségou more than 300 metric tons of food to 17,470 people.

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by Claudine Mensah Awute, CARE Mali country director

About a year ago, the world started to watch with alarm the growing number of people suffering from a severe food crisis engulfing the Sahel region, which, at its peak, affected more than 18 million people.

To make things worse, Mali, once one of the most stable and peaceful countries of the region, saw an escalation of violence as fighting erupted in the north of the country. Thousands of families spilled into neighboring countries, taking refuge in camps hastily patched together on the border of Niger or Mauritania, while many others sought relief and shelter with friends and families in the south of the country.

In recent weeks, Mali has been grabbing headlines troops continue their fight against armed groups in the north of the country.

Every day, there has been news of the troops reaching one town after another. But what has been grabbing fewer, or no headlines at all, is the number of people who have been forced to flee their homes amidst the fighting­. They have been forced to flee with little more than the clothes on their backs. And the numbers keep growing. During three weeks in January alone, there have been nearly 18,000 refugees and 12,000 displaced people in Mali.

More than 4.3 million people in Mali are now in need of humanitarian aid.

These numbers can be overwhelming, but behind them, there are people – in flesh and bone, each with a story of their own:

Rokia is a mother of four, who told CARE she fled with her four children. Months before, her husband left their village in the north because of attacks. Rokia is constantly worried about him, and distressed as she doesn’t know how she will fend for her children by herself. Haussa also is a mother of four. She’s now in Bamako after leaving Timbuktu in early January. She told us that she would like to return home though she is well aware there is nothing waiting for her there.

The needs are many. As CARE’s recent assessments have shown, displaced families lack even the most basic necessities. They are in desperate need of food, water, adequate shelter and essential items, such as kitchen utensils, blankets, mats and soap.

For those who are planning to return home, the unknown awaits – how many of their belongings have been stolen? What about the next harvest and will they be able to plant?
And there is a need to come to the aid of those living in trying circumstances in various refugee camps across the border, all of them still suffering from the strain of last year’s food crisis.
If action is taken now, lives can be saved.

For the past three weeks, CARE has been distributing food in two of the five regions most affected, having reached 54,000 people with essential food items. CARE is supporting both internally displaced people and host communities, who are still recovering from last year’s food crisis, with cash-for-work programs and the provision of tools and seeds to help ensure a decent harvest.
In the coming days, food from the World Food Program will arrive in Timbuktu, and CARE and our partners are on the ground, ready to distribute the food more than 130,000 people.

Our emergency response will include providing access to food, water, sanitation and cash programs for 30,000 families, and helping 25,000 children return to school. We’re also responding with long-term development solutions that include disaster risk reduction and food security programs. Many of our activities will focus on women, as they often suffer the most during times of crisis.

Mali is a clear example where aid will save lives. It is the very essence of why most donors support our aid program. It is also why so many individuals give donations. Despite the fact that Mali and its people might be a world away, they are in dire need of our help. And they need it now.

Thank you.

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As told to CARE by Ibrahim, 57 years old

Ibrahim, a 57-year-old IDP in Mopti with his family and the family of his brother. 'I don’t work and the children are not going to school. We manage to eat only thanks to NGOs such as CARE. We need help,' he says. Ibrahim is one of the 21,000 people benefiting from food supplies being distributed by CARE in Mopti. Photo: © 2013 CARE

I had to leave my village of Temara (near Timbuktu) eight months ago because of the crisis in the north of Mali. Since then, I have been living in Sévaré [near Mopti] with my family and that of my brother – about 20 people – in a house we have been renting.

I don't work and the other family members don't either, so we don't have any revenue. The children are not going to school either. God to be praised, we manage to eat once and often twice a day thanks to donations by NGOs such as CARE, or support from our parents.

We are facing enormous difficulties. The main issue is the lack of food as I can't even ensure the three daily meals for my family. Also, my family and I have problems with the accommodation despite the two tents and the one toilet that we were given by the Red Cross.

We need help from aid organizations, especially clean drinking water as at the moment we are using untreated water from the well. I would like especially to receive the emergency supplies that CARE and the World Food Program are currently distributing in Sévaré.

A Mother on Raising Her Family in a Conflict Zone

Rokia, 40-years-old, displaced in Mopti with her 4 children. Her husband had fled before her after he was assaulted by armed groups. © 2013 CARE

MALI: Humanitarian Snapshot (as of 21 January 2013). Click to download.

As told to CARE by Rokia, 40 years old

I am from Niafounke (near Timbuktu).

I have been living in Mopti for nine months. I came here after my husband was assaulted by armed groups and he had to flee. He left me with the four children and we are living now with the village chief of Massaya Daga in Mopti in a small house.

I am very worried about my husband as I don’t often have news from him. But I thank God that my children and I can eat three times a day thanks to food distributions by CARE and the World Food Program. As for water, we use water from the river, mixing it with bleach. Not having an activity to enable me to earn money means that I am faced with a lot of problems trying to raise the children by myself.

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As told to CARE on January 19, 2013:

Camps of internally displaced Malians in Mopti, where CARE provided support. © 2012 Alain Lapierre/CARE

My house is about a dozen meters from the military camp in Diabaly. This Thursday at 5:00 in the morning, we heard gunfire between armed groups and the Malian army, which had rigorously counter-attacked the armed groups in Alatona, at the entrance to the town.

We heard loud gunshots everywhere and, tragically, one civilian was killed in the gunfire. I quickly ran to take cover at a friend's house. I was relieved that my family had already traveled to Markala for the weekend.

It was total panic everywhere in the town of Diabaly and the population had only one choice: hide in their houses and pray to God.

MALI: Humanitarian Snapshot (as of 21 January 2013). Click to download.

I hid for three days in horrible conditions, without any food. The second and third days were particularly nightmarish for me, because as a worker for a water company, one of the armed groups was looking for me to kill me. According to their philosophy, you are not allowed to sell water.

Thanks to a source that I would rather not name, I was quickly informed of the situation. I will never stop thanking the population of Diabaly: not only did they refuse to hand me over to the armed group; they disguised me as a woman and helped me flee the town. On my lips were but one sole refrain that came from the bottom of my heart: May God protect us, God is great.

I walked for 35 kilometers by foot before I came to a place with telephone coverage, and I called a friend in Niono, a town about 60 kilometers away, who came to rescue me by motorbike.

I arrived exhausted and traumatized by the events that occurred in Diabaly. Now, by the grace of God, my morale is better, and I am asking everyone to immediately come to the aid of the people of Diabaly – particularly with food – because they are in desperate need.

*The name of the person in this story has been withheld to protect his identity.

Safe humanitarian access is critical at this point and remains a major challenge for all humanitarian actors in Mali. However, with close to 9,000 people uprooted from their homes since the latest round of violence began on January 10, CARE is eager to better understand the situation and needs of the people. We have a rapid assessment team in the region of Ségou and another team will go to the Mopti region when it's deemed safe.

Please make your donation today to support CARE's lifesaving and life-changing work in Mali and other poor and war-torn countries around the world.

A few days before Christmas, CARE teamed up with partner organizations to distribute relief items in displacement camps around Goma, the provincial capital of North Kivu, where a recent surge in violence has displaced an additional 150,000 people, adding to what’s one of the largest humanitarian disasters in the world.

The relief kits contained blankets, kitchen supplies as well as plastic sheeting which has been financed by the Government of Luxemburg (Photo: CARE)

Countless sporadic settlements have sprung up, with most shelters mainly consisting of sheets and flimsy wooden frames that will be no good during the rainy season. To bring some relief, CARE helped distribute more than 17,500 relief kits containing items such as kitchen sets, blankets and plastic sheeting.

Meet some of the beneficiaries:

My name is Mwamini Bagirisha. I am 20 years old. I’ve lived in Mugunga camp since April 28, 2012, fleeing the conflict between the government forces and the M23 group.

Since I have come from the territory of Masisi to Goma, we have received support two times. First, the Red Cross gave us food and plastic sheeting. Then, the government distributed some food, too. But when M23 took over Goma in November, we lost everything again. The fighting happened here, just right outside of our camp.

I am very happy to receive these relief items because now I can cover my hut again. The cooking utensils and clothes will help us, too. But all I really want is to return to my home village and bring in the harvest. We had to leave our land and the fields when we fled in April.

My name is Jeanne Mujawimana and I am 52 years old. I’ve fled my home in Masisi Bihambwe and now I’ve lived in this camp for three weeks. I haven’t found a place to build a hut yet, so I live in a hangar. I have seven children and am very happy to receive this assistance. This will help me construct a shelter for my family.

I would like to thank all the humanitarians who come and bring us relief like this. It will help us overcome the rainy season. I wish we could also get some food assistance, because we do not have enough to eat. Christmas and New Year’s will be difficult.

My name is Natutarumbo Sofina and I am 72 years old. I fled Masisi five months ago and now I live here with my grandchildren. Their parents died during the war.

In August, we received some support, a plastic sheet and some blankets from the Red Cross. But when Goma was attacked in November, we lost all we had. I am happy to receive these items, the plastic sheeting, the cloths, the blankets and pots will help us tremendously. But we also need food.

And security is a big concern. There have been thefts here, because we cannot lock our doors. And it is hard to find firewood to prepare food because we live next to a national park and it is not allowed to cut wood. Our biggest hope is to find peace and return to our villages.

My name is Florence Hategeka and I am 19 years old. I come from Rutushuru, both my mother and father have passed away. I have come to this camp, Mugunfa, about four weeks ago with my two little brothers. We live in a hut covered with leaves from trees. Every time it rains, we suffer.

Now that we have received this plastic sheeting, I am sure that our situation will improve. We are thankful for this support. Our hope is to return to our home village where we had to leave our land and the food we used to grow because of the war.
My name is Bigirimana Anicet and I am 25 years old. I’ve left my home in Rutshuru about five months ago. First, I settled in a camp called Kanyarutsinya, but after Goma had been seized by the M23 group, I had to flee to Mugunga with my family.

I am a husband and father of three. My wife is sick, so I have come to this distribution with one of my children. Before, we were literally empty handed, because all the assistance that we received in Kanyarutsinya camp was lost when we had to flee. Now I am very happy to receive this support, especially the plastic sheeting for our shelter. This will help improve our difficult lives here.

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On December 15, a CARE team returned from an evaluation mission to South Masisi territory in the North Kivu Province of Democratic Republic of Congo (DRC) — the first one to take place in the region by any humanitarian organization.

Starting in mid-November, the rural areas surrounding Goma, the provincial capital of North Kivu, had been inaccessible due to increased fighting. A CARE team of three visited several villages in south Masisi in a convoy organized by the World Food Programme as soon as the security situation allowed.

In the villages they visited, CARE found large numbers of new arrivals — internally displaced people who've recently fled fighting near their homes. CARE already had programs in the area; organizing food distributions through a cash and voucher system at the local market, providing plastic sheets to cover huts against rain and supporting local health centers with medicine and advice.

When fighting intensified, CARE and other humanitarian organizations had to temporarily withdraw from the region. The CARE Masisi team continued to work around the clock from Goma to ensure an immediate intervention could be launched once the humanitarian corridor to South Masisi was reopened.

CARE's three field staff came back a week after they had left for South Masisi with many observations and analyses of the current needs of the displaced populations, and recommendations for interventions CARE could undertake given the conditions on the ground.

"Most of the displaced persons have been here for five months," reported Emmanuel, one of the CARE staff who visited South Masisi. "They were working in their fields when they heard the fighting in the villages. They fled immediately without having the chance to go back home to take some belongings such as plates or pots."

"They arrived there without anything," he explains. "They sleep on the ground. You know, it's very cold in Masisi and without any household goods it's difficult to prepare to eat. They also don't have easy access to water."

Emmanuel recorded the stories of some of the people he met

Munyarubuga, 62, father of four
"I am a farmer. Thanks to this work, I feed and take care of my family. Due to the insecurity at home, I am blocked here, and I have no way of providing for my family. My family does not even have the most basic items to survive because we fled the hostilities when we were working in the field. We left everything behind. Our little hut here is not big enough for the family and back home our house has been burnt down by armed groups. Upon our return back home, I will have to start from the beginning, buy everything again. That's really terrible."

Uwizeye Therese, 35, mother of five
"When I was working in the field with my husband and my children, we saw smoke above our village; armed groups had put our village on fire. We took our children immediately and left with other people of the village. Where we are now, we suffer. Look at our hut …

It's difficult to find enough to eat, and we have no plates or pots to cook, eat or collect water with. I only have the clothes I am wearing, and to wash my family' clothes in the river takes me a whole day. When it rains, they don't dry and we have to borrow clothes from neighbors."

Madame Nyirabazairwa, 30, mother of two
"Since I've arrived here, I have only received a plastic sheet. Access to resources and services is difficult, and there is not enough space in the camp. I work on a daily basis on other people's land, which is not always assured. Look, my child who sits next to me is starting to get sick because of malnutrition. We really suffer a lot."

Madame Agishanimana, 28, mother of one
"I have been here for around five months. Life here is difficult. Look at my hut, that's all I have. I only have one set of clothes. Finding food is difficult. We hope that when CARE comes here next time, we will receive food. The number of displaced people has increased lately, which limits the chance of getting day work in local fields on which we depend. Everything I use in the hut has been offered by a local family. If I receive a means to prepare to eat, and a blanket to cover my children, that would help a lot. You see, my child who is asleep in the hut suffers from coughing and fever, maybe as a result of the cold and the bad living conditions. There needs to be peace for us to be able to return home and to end this misery we live in."

CARE Distributions

A few days after the assessment, CARE, in partnership with the World Food Programme and the Government of Luxemburg, distributed food and shelter items to more than 8,000 displaced families.

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Interview with Celso Dulce, CARE’s Philippines representative and disaster risk reduction advisor

CARE and partner organizations distribute relief items to people affected by cyclone Bopha (Pable). © 2012 CARE

Cyclone Bopha has affected more than 6 million people. What are their greatest needs at the moment?

The affected people I spoke with said that their foremost needs are food and support for their livelihood recovery. Most of the affected people are engaged in smallholder farming of banana, coconut, oil palm and falcata trees, or as workers in big plantations. In between rows of coconut, smallholder farmers grow vegetables, mainly for household consumption. Cyclone Bopha (also called Pablo in the Philippines) destroyed all these.

At present, people depend to a large extent for their nourishment on food relief. The most common food being consumed by affected populations are steamed rice, instant noodles and canned sardines. People are requesting the inclusion of vegetables in future food distribution.

The main crops being grown by the affected population would take time to recover – banana would take a year to become productive again; coconut or oil palm three years or more. The people recognize the need to immediately restart their livelihood recovery process, but need assistance, in the form of seeds, farm inputs and replacement of farm equipment and machinery lost to Pablo. Considering the local seasonal calendar for agriculture, livelihood recovery support should be provided not later than January 2013. Failing to do so would lengthen the duration of food shortage among affected populations by at least three months.

Are women and girls particularly affected? If so, what are their greatest needs?

The women, consistent with their nurturing role in the family, worry about where to get food for the next meal. They also worry about their children getting sick because of poor shelter conditions, exposing children to the heat and cold and to carriers of diseases such as mosquitos, and because of lack of clean water for drinking and other uses. They worry that their community health center is not functioning anymore, and that they have no access to medicine and health services.

Children, boys and girls alike, are unable to attend school because the school buildings are damaged. Young boys and girls won’t be able to continue attending school due to lost household incomes.

How are CARE and its partner organizations responding?

CARE and our partners are collaborating with five other international organizations (INGO) to fill the gaps in the needs of the most vulnerable households in most affected areas. The INGO consortium is providing comprehensive assistance consisting of food, shelter and essential relief items, water, sanitation and hygiene as well as health support. CARE and partners have targeted upland areas, often populated by indigenous peoples, that are difficult to access and therefore receiving less assistance, if at all.

Targeted beneficiaries, and women in particular, are involved in planning and distribution of assistance. Disaster risk reduction is also incorporated in the response, by providing information on hazards and how individuals, families and communities can prepare for future hazards and reduce risks. Information is provided to households rebuilding their houses on how to incorporate basic risk reduction measures such as selecting proper location and improving construction practices.

Is there a high risk of an outbreak of diseases?

There is already a reported diarrhea outbreak in Cateel municipality in Davao Oriental. Tests conducted revealed that there is high level of contamination of water sources in the area. Mothers report of their children getting sick with fever and common colds, attributed to their exposure to the heat and the rain. In the most affected areas, almost all houses have sustained damage and therefore provide inadequate shelter to family members.

Cyclones are recurring every year in the Philippines. How can people better protect themselves from such a natural force?

The areas affected by Bopha were seldom visited by typhoons in the past. A combination of lack of awareness and preparedness amongst communities and local authorities, unsustainable agriculture practices, and environmental degradation has resulted in this disaster. On the other hand, in locations where CARE has been implementing community-based disaster preparedness that incorporates climate change adaptation and ecosystem management and restoration, communities and local authorities have demonstrated that losses and suffering from disaster can indeed be significantly reduced.

Saint Bernard municipality in Southern Leyte, communities in Agusan del Sur and in Bukidnon and Iligan City have demonstrated that people can better protect themselves by being aware of local risks, and having basic knowledge on what to do prior to, during and after a hazard event. Communities working together with local authorities can develop community contingency plans including early warning systems and evacuation plans, which can be activated in the event of a hazard.

By Elizabeth M. Campa, Advisor for Water, Sanitation and Hygiene, CARE Haiti

A CARE Kenya study on clean latrines in schools indicated that the facilities, along with treated drinking water and soap, decreased disease and improved student health and even boosted school attendance, particularly for girls. © 2012 Brendon Bannon/Melanie Brooks

As 2012 comes to a close, I started to think about my New Year's resolutions for 2013. While I know I will include in this short list to lose 10 pounds (ok, 20), read more books (not related to toilets), learn how to cook Creole cuisine (I live in Haiti after all), I'm also going to include one very big resolution: build 1,000 latrines in Haiti before end of 2013.

I realize most people don't include toilet related resolutions on their lists, but I'm different. Ever since I was a Peace Corps volunteer in the Saharan desert of Morocco, I've appreciated every single encounter I've had with a toilet and running water. I grew up in Chicago, where I never had to worry about where I'd relieve myself or where I'd have to fetch water.

I sure did appreciate this fact when I was in Morocco, living in a small Berber village, where I used a latrine for my first months in my village but switched to relieving myself in a bucket once I moved into my own house before a latrine was constructed for me some months later. I also had to walk up a hill with large buckets to a water source … where village bats lived, also relieving themselves into the water, making the whole village sick (including me). Every single drop of water was precious.

Since my Peace Corps tour ended in September 2002, I've been a bit obsessed with building toilets. Some of my friends even call me the toilet queen and my sister says, "You know, I'm pretty sure mom wanted you to be called a doctor, not a toilet queen."

But in fact, I'm happy and very proud of the successes I've had over the years and even some failures (never order two tons of soap in Baghdad and store it in your home). I used to think there was no way one person could make a difference, but I have – along with the wonderful teams I've worked with in Iraq, Afghanistan, Sudan, the Democratic Republic of the Congo, Laos and now Haiti. Most people take things one step at a time; I like to take things one toilet at a time.

Here in Haiti, the need for improving sanitation is overwhelming. Hundreds of thousands of people living in heavily-populated urban areas of Port-au-Prince use a bag to go to the bathroom and have no access to clean water. In rural areas like Grand Anse, women risk their lives by finding a private place in forested areas, not knowing who or what might be lurking. The CARE WASH team and I are working diligently to change the situation one household at a time, one village at a time, but we need your help. Even though you are also just once person reading this blog, you can make a change. Talk toilets to your friends, co-workers, gym buddy (like I do) or church congregation. You can help us make a change by helping CARE Haiti construct one toilet at a time and improve the lives of women and children throughout this amazing country.

I will keep you updated throughout 2013 on this blog to see how we are doing. We are fortunate to work with some wonderful donors, but we need more help. How about add building toilets in Haiti to your new year's resolution? If enough of us do this, maybe it won't be so crazy.

Happy New Year!

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Families fleeing the on-going violence in Syria are arriving in Jordan and many are heading for the capital, Amman. A recent survey carried out by CARE found that 40 percent of refugees surveyed in Amman are extremely vulnerable and in dire need of help.

Refugee boys in East-Amman, where Syrian refugees are living. © 2012 Thomas Schwarz/CARE

Parents are fearful about being able to pay their rent, buy food and prepare for winter.

Many families had to sell belongings to get out of Syria and are left with little in the way of savings. The rental costs in Amman mean that the risk of falling into spiralling debt is high. Families are afraid they will be evicted and some are even considering a return to their war torn country.

One father CARE staff met, Hai Nazzal, told us that: "Rent is the most important thing for us, if we don't have a roof over our heads we will have to go back to Syria – I can't keep my children here on the streets."

No household we visited is in any way prepared for winter where temperatures plummet to as low as 32 degrees Fahrenheit. Eighty-two percent of those surveyed currently have no access to any heating source.

Parents like Abdul told CARE: "We have no heater, too few blankets and no warm clothes. We're very worried. It's going to get very cold, and it's so damp in these rooms."

CARE's Country Director in Jordan, Kevin Fitzcharles, said: "These families have fled their homes in fear for their lives and now find themselves living in poverty, facing a cold, hard winter. We are providing more than 20,000 refugees with help to pay for food, rent, blankets and heaters so they don't fall further into poverty and hardship."

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About CARE: Founded in 1945, CARE is a leading humanitarian organization fighting global poverty. CARE has more than six decades of experience helping people prepare for disasters, providing lifesaving assistance when a crisis hits, and helping communities recover after the emergency has passed. CARE places special focus on women and children, who are often disproportionately affected by disasters.

CARE has been working in Jordan since 1948. CARE Jordan has extensive experience working with refugees, providing livelihood training and opportunities, emergency cash assistance, information sharing and psychosocial support to Iraqi refugees since 2003.

NOTE: Some names have been changed to protect those quoted. Masisi is located in North Kivu Province of the Democratic Republic of the Congo, where heavy fighting has displaced more than 800,000 people so far.

On December 19, CARE participated in a joint NGO fixing and registration in the Bulengo camp, just outside Goma, that hosts people displaced due to recent escalation of violence in North Kivu, DRC. © 2012 CARE/Sabine Wilke

It is 3:30 a.m. and everyone in Goma is asleep.

Almost everyone.

A group of 50 people from CARE and two of its partner organizations are awake and on their way to their designated meeting point. Seven NGOs and four UN organizations have teamed up to do a census at all of the sites in Goma that have become spontaneous camps for displaced persons. The mission: To count everyone, record their names and determine their needs.

Though we often see reports about the distribution of relief items during emergencies, the public knows little about the many rounds of coordination, data collection and logistical preparations that make the effective distribution of aid possible. So what exactly happens before much-needed help such as food, blankets or hygiene articles are given out to those who have lost everything?

The recent surge of violence in the Democratic Republic of Congo's North Kivu, the easternmost province of the country, has brought with it a sharp rise in the number of people forced to flee their homes. Many of these families have settled in spontaneous sites in Goma, the provincial capital. They shelter under flimsy plastic sheets, in makeshift huts, or in overcrowded classrooms and churches. They need food, water and other relief items. But how exactly do you count the number of people living in such spontaneous sites? How do you ensure that everyone receives support while no one is benefitting twice? How do you identify those in need of special assistance, like breastfeeding women and unaccompanied children?

To get to their census locations on time, many CARE staff have been awake since 2:00 a.m. At 4:30 a.m., everyone puts on their CARE shirts to be easily recognizable once they enter the camps. For this census, CARE will cover one part of Mugunga I camp, where an estimated 12,400 households have settled in recent weeks.

Every census team member receives spray paint and 120 yellow coupons. Their job is to go from hut to hut to find which are inhabited and by whom. People come and go quickly, so some temporary shelters have already been abandoned. The head of the household, if present, is given a coupon to go to a registration desk and submit more information about their situation. CARE staff prefers to give the coupons to a female head of household as they are typically more reliable caretakers of everyone else in their family. The census takers also find out other key information such as if there is a pregnant woman or someone with a chronic disease? How many children live in this household? In the language of emergencies, this is called a "vulnerability analysis."

As soon as the team arrived at Mugunga around 5.30 a.m., things became quite busy. In a spontaneous settlement like this, it is hard to find your way around and make sure you cover the part that you were assigned to. Many families were of course surprised by the unannounced visitors, but it was important to do the census at the same time in all camps and early in the morning before people left to look for work, firewood or go about their daily routines.

"In an emergency situation, this type of census is the most reliable method of getting accurate numbers," explains CARE's emergency response manager Sébastien Kuster. "There will never be a perfect method, but with this exercise we have tried very hard to take all possible circumstances into account."

Once they've handed over a coupon, CARE staff spray paints a mark by the door to make sure no household is counted twice. While the team goes about the job, security officers make sure that the situation stays calm. This is a tense situation for the camp population and this is why all teams have been thoroughly briefed about what to say and how to engage. CARE's values – dignity, humility and respect – were being put to test on this day and the reaction spoke for itself.

"We have largely been welcomed. The people here are very friendly and it was humbling to see how patient these families were about their dire living conditions and how thankful they are for our support," says Joseph, a CARE staffer.

CARE reached out to close to 3,800 households that morning. To ensure that no one was left out, a few CARE staff members and other partners also worked extra hours at a complaint desk. Here people could state their case and they were then accompanied back to their shelter to see whether or not it had been overlooked.

"It was really encouraging to see the whole team getting mobilized for this," says Aude Rigot, CARE's Provincial Director for North Kivu. "From our project officers to the cleaning staff, from finance staff to the emergency team leader, everyone worked hand-in-hand to get the job done."

After all the data is consolidated, CARE and its partners can begin the distribution of necessary relief items. CARE will provide plastic tarps and team up with other agencies to hand out several goods at the same time.

The next morning, everyone is back at their desks in the CARE office and goes about their usual activities to keep CARE's programs running. These early birds might still have tired eyes and swollen feet, but their spirits are high and the job has been done. For today, that is all that counts.

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About CARE
Founded in 1945, CARE is a leading humanitarian organization fighting global poverty and providing lifesaving assistance in emergencies. CARE places special focus on working alongside poor girls and women because, equipped with the proper resources, they have the power to help lift whole families and entire communities out of poverty.
Last year, CARE worked in 84 countries around the world to assist more than 122 million people improve basic health and education, fight hunger, increase access to clean water and sanitation, expand economic opportunity, confront climate change, and recover from disasters. To learn more, visit www.care-international.org.

NOTE: Some names have been changed to protect those quoted. Masisi is located in North Kivu Province of the Democratic Republic of the Congo, where heavy fighting has displaced more than 800,000 people so far.

On Dec. 12, CARE participated in a joint NGO fixing and registration in all camps and spontaneous sites that are hosting people displaced due to recent escalation of violence in North Kivu, DRC. CARE’s teams were responsible for parts of Mugunga I camp and went from door to door to hand out coupons for registration. © 2012 CARE/Sabine Wilke

Claudine* has lost everything. Only 22 years old, she has lost her family, her health, her dignity and has no way to earn a living.

Claudine is one of an estimated 130,000 people who have fled conflict in eastern Democratic Republic of Congo's North Kivu province during recent weeks and is one of countless women there subjected to brutal sexual attacks. When she describes what happened to her, she speaks softly, with her head tilted down, never looking up into the listener's eyes.

Claudine was forced to leave her home in Bweremana, a village in the territory of Masisi. There and in surrounding areas of North Kivu, violence flared up again in May between armed groups and the army. Claudine's family fled their home so quickly, they lost track of each other. Claudine found shelter in a camp outside Goma, but had no idea where her parents and siblings had gone.

When she went to look for wood in the nearby national park to construct a hut, she was approached by two guards with sticks.

"They said I was not allowed to cut wood and they asked me to hand over my machete," says Claudine. One of the men then walked away. The other one took Claudine by force, tore off her clothes and raped her.

This pattern is frustratingly common in eastern Congo. Women and girls are forced to venture out of their camps or villages to collect sticks or firewood. When walking long distances all by themselves, they are easy targets for attack and rape.

"When I went back to the camp, I didn't talk about it. I was ashamed." Claudine recalls. "Two months later though, I was still not feeling well, so I decided to look for help. I was hospitalized and found out that I am pregnant."

In November, a new wave of fighting in and around Goma forced Claudine to temporarily leave the camp. When she came back a few days ago, she found her hut destroyed and her few belongings stolen. She spends nights with friends and neighbors who can sometimes accommodate her. During the day she carries goods across the camp as a way to make a little bit of money to buy food. The heavy loads make her back hurt and endanger the unborn child.

In eastern Congo, rape is systematically used as a weapon of war. It destroys not only countless women's lives, but breaks apart families and communities. Despite epidemic levels of rape, survivors are still severely stigmatized. Husbands, families and communities often marginalize and discriminate against survivors because of the shame they are believed to bring. As a result of the fear of isolation and stigma, survivors seldom dare to speak about their experience and hardly ever reach out for help.

Furthermore, sexual and gender-based violence is also deeply engrained in the norms and structures of society there. More than half of the men responsible for sexual violence in North Kivu over the first six months of 2012 were civilians, according to the United Nation's Population Fund. The region is dominated by patriarchal norms and rape-supportive attitudes among men that subordinate women and normalize rape, as shown in a recent study by Promundo and Sonke Gender Justice Network.

To provide survivors such as Claudine with timely and adequate medical and psychosocial assistance, CARE works in camps and villages to train educators to identify sexual and gender-based violence. Community workers organize activities and spread messages to break the taboo of sexual violence and encourage survivors to reach out for help. CARE trains these community workers in three camps around Goma—one of them where Claudine is sheltered. CARE also provides psychosocial assistance and medical support to health centers, such as post-exposure prophylaxis kits and antibiotics to help prevent the transmission of HIV and other sexually transmitted infections and diseases.

Medical and psychosocial support are paramount to support survivors. But they also want to get back on their feet economically and regain a respectable position in their communities. Therefore, CARE supports survivors and other vulnerable people to form groups and helps them start small activities to earn money. Claudine will be part of this program. CARE also provides socioeconomic support through village savings and loans groups, which allow poor communities to collectively save money and start small businesses.

After connecting with CARE staff, Claudine now plans to visit the health center for regular pregnancy checkups and to get treated for the abdominal pain she's had since her attack. Through one of the camp groups she is now part of, she hopes to save enough money to pay for a trip back to her home village. Someone told her they saw her mother there recently, she says, her face lightening up for the first time. The thought of being reunited with her mother is a beacon of hope for Claudine in this desperate time.

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December 11, 2012
Sarah Zingg
sarah.zingg@co.care.org

*name has been changed

About CARE
Founded in 1945, CARE is a leading humanitarian organization fighting global poverty and providing lifesaving assistance in emergencies. CARE places special focus on working alongside poor girls and women because, equipped with the proper resources, they have the power to help lift whole families and entire communities out of poverty.

Last year, CARE worked in 84 countries around the world to assist more than 122 million people improve basic health and education, fight hunger, increase access to clean water and sanitation, expand economic opportunity, confront climate change, and recover from disasters. To learn more, visit www.care-international.org.

By Sarah Zingg

Women who have been raped in recent fighting between rebels and government soldiers pose for a photograph at a hospital in Goma, DRC on November 25, 2012. Sexual violence has been used by all sides of the conflict, and thousands of women have been subject to it. © 2012 Kate Holt

"My husband won't come back. He heard that I've been raped. He will never come back,"Marie, a mother of seven and pregnant with her eighth, speaks as she sits upright, eyes fixed on the listener. "My husband left for Bunia [up north] where he went to look for work and food for the children. I tried, and still try, to keep what happened to me as a secret, but someone told him."

Rape in the conflict-ridden eastern part of the Democratic Republic of the Congo (DRC) is epidemic, and continues to be a taboo. Husbands, families and communities often marginalize and discriminate against survivors because of the shame they are believed to bring.

Marie and her family are among almost 130,000 people who have been displaced as a result of the renewed violence between government forces and rebels in North Kivu, a province in eastern DRC. It is not the first time Marie had to flee. She left her home village Ngungu in Masisi territory in August when armed groups fought each other and attacked surrounding villages. She found refuge in a camp in Goma, North Kivu's provincial capital. But her feeling of safety did not last long.

"I went to look for wood to construct a hut. Two men came up to me and asked me for my machete. They took my machete, and then they took me by force."Marie was raped by both men, she explains with a clear voice, her hands calm on her lap.

This pattern is frustratingly common in DRC: Women and girls are forced to venture out of their camps or villages to collect wooden sticks or firewood. When walking long distances by themselves, they are easy targets for attacks and rape.

For a long time, Marie was too ashamed to speak of what had happened to her. She still suffers from abdominal pain. Marie only went to see a doctor four months after it had happened. By then, it was too late to receive post-exposure prophylaxis (PEP) that helps prevent the transmission of HIV and other sexually-transmitted infections and diseases. The PEP kit has to be taken within 72 hours to be effective.

When November came and with it another escalation of violence, Marie left the camp and sought refuge with relatives in Minova, a town about 50 kilometers south of Goma. A few days ago, Marie came back to Goma, but only with her youngest son; she didn't have the money to pay for the transport costs for her other six children.

When she returned to the camp, she found her hut had been destroyed. "I am scared to go out again to look for wood to build another hut,"she says. She found temporary shelter in a school. Classrooms are crowded, hosting anywhere from 165 to 300 people.

Despite these desperate conditions, Mary has a plan, "I am waiting for the food distribution. I will sell the food and with the money, I will send for my children."

Marie goes about small activities, such as working in the fields of the local community, to make a little bit of money to buy to eat.

CARE, in collaboration with International Rescue Committee (IRC), is working in three camps around Goma to train community workers to help prevent and treat cases of sexual violence. These community workers will organize activities and spread messages to help break the taboo of sexual violence and encourage survivors to reach out for support. CARE and IRC also are providing psychological and social assistance to survivors to help them overcome the traumatic experience.

In a recent survey undertaken in one of the camps, many women expressed a strong wish to start economic activities. That is why CARE now organizes small groups of survivors and other vulnerable people in the three camps to and helps them start a small business to get back on their feet so they can provide for themselves and their families. Marie will be a part of this program.

"Yes, I will participate, and I will also tell women about the importance of getting medical assistance as soon as possible after an attack,"she affirms as she tights up her son with a colorful cloth around her back and returns to her chores.

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by Anders Nordstoga
NOTE: We recently found a few stories that got lost in our inbox. While they are from November 9, 2012, we thought you still may like to read them. Here's one:

Syrian refugees lacking legal status are at risk of exploitation.

Having come to Amman as an illegal refugee in May 2012, Ayatollah was offered a job at a supermarket.

"I worked there a month, from 10 in the morning until midnight, sometimes until 2:00 in the morning. Then, they refused to pay me. I only got five dinars (US $7.00). Then, I worked two weeks as a painter receiving only 11 dinars. We feel humiliated," he says.

Ayatollah entered Jordan with his wife and three boys, ages 8, 7 and 2, having fled in a hurry from their home in Homs. They were taken to a provisional transit camp near the border and stayed there for a few days, before finding a Jordanian to pay a token sum and sign as the family's guarantor. They went to Amman, where they have some relatives. They were able to find a house. It was in a very bad shape, but they thought they could just about afford it.

"Now we owe two month's rent, but the landlord is patient with us. He says he will cut electricity next week, but he doesn't threaten to throw us out. We've borrowed a gas cylinder from a neighbor, who will soon need it back, because of the winter."

While we're talking, another neighbor comes by with his two sons. Mohammad is also a refugee from the area around Homs. His father and sister were killed in an explosion. He spent some time in jail and tells of grueling experiences. He needs an operation on his arm and his leg, he explains, but cannot afford to be unavailable for paid work, if something should come up.

Since the family left Homs, Ayatollah has developed anemia. He was directed to a public health center, but hesitated because of the anticipated expenses.

"We have received 150 dinars from CARE in emergency assistance, as well as some money from family and friends and food packages from a local organization. We used it to pay rent, buy food and diapers, but no medications."

All the children go to school. While they are playful and seem happy, they all have bad coughs. The mother tells us they get sick from drinking the water. She sometimes boils it, but gas is expensive.

by Anders Nordstoga
NOTE: We recently found a few stories that got lost in our inbox. While they are from November 9, 2012, we thought you still may like to read them. Here's one:

Eleven-year-old Rafa and her family fled from Homs when bullets were coming through the walls of their home. Now they get cash assistance from CARE to help pay for rent and food in the Jordanian capital of Amman.

"We were very afraid when we left our home," Rafa begins. "We had to leave in a hurry and we couldn't take anything with us. No clothes, no toys, not the doll that I had always had with me. A lot of bullets were hitting our house and some entered into the rooms. I was very afraid that one would hit me."

"Some day"

In spite of these memories Rafa wants to go back home as soon as she can. "It's okay here in Amman. We can go to school, and this is something that makes us happy. The teachers are good to us, even though we have difficulty with some of the subjects, like Jordanian geography. But I like my country better. When we were leaving Homs, I kept asking my mother when we could go back. ‘Some day,' she said."

Rafa's mother Rana, 27, still gets the question. "My youngest son asks me all the time: ‘When are we going back? I want my [toy] motorcycle.' But the children are happy that we escaped the bombing. We used to huddle together in corners and they cried. And they are very happy that they're able to go to school. That's something they talked about a lot in Syria: they didn't like missing out on school."

In the end, the family had no choice but to leave their home in a hurry.

"They said that if we didn't leave, they would shoot us," explains the mother. "Soon after we had left, our house was bombed. We stayed in Damascus for two months, and then we went south and tried to cross the border to Jordan. Even though we had passports, the Syrian police wouldn't let us pass, so we went to Daraa."

From there, they were escorted across the border at night. "We had to pay them with our clothes. It was very hilly and we walked for hours. The children were terrified. They were told not to make a sound and not to stop walking. They will never forget what they went through, but at least now they feel safe."

Sold her gold ring

Having crossed the border, the family stayed two weeks at the Zaa'tri refugee camp before they managed to leave for Amman. Getting by in the city would be a challenge.

"I had a gold ring, which I sold, so we could pay for rent the first month. I got 150 dinars (US$ 210) from CARE which took a heavy load off our shoulders. Even with this help, we have gotten into debt. Without it, we would probably have had to ask other local organizations for food and sell what we could. My husband works at a factory that makes food packages for the Zaa'tri refugee camp, but the salary isn't enough for us all to live on."

December 6, 2012 – CARE is responding to the humanitarian needs in Rakhine State, Myanmar, where more than 100,000 people have been left homeless following two outbreaks of violence between Rohingya and Rakhine groups.

CARE staff distributing family kits to Thae Chaung Village Beneficiaries.. © 2012 CARE

Violence first broke out on May 28, prompting authorities to declare a state of emergency. The disturbance left 87 people dead, 120 injured and 5,000 houses damaged and uninhabitable.
On October 24, renewed violence occurred in eight townships, leaving 89 people dead, 136 injured and more than 5,300 houses and eight religious buildings destroyed, and more than 32,000 people homeless.

CARE is working with the Myanmar government and local organisations to provide shelter for families whose homes were destroyed. CARE’s Strengthening Partnerships and Resilience of Communities (SPARC) program operates in 29 villages in the Maungdaw Township. In two of the villages where SPARC operates, all the houses were completely destroyed and the villagers relocated to temporary camps. With support from the Australian government, CARE will reconstruct more than 125 houses in these two villages.

CARE has already provided blankets, clothes, mosquito nets, cooking equipment and personal items, such as soap, to 2,000 families living in temporary shelters in Sittwe. We also provided 850 baskets of rice seed and 1,200 bags of fertilizer in Maungdaw, Buthidaung, Sittwe and Rathedaung to help families plant crops.

CARE family kits at distribution point. © 2012 CARE

CARE has worked in northern Rakhine State and other states of Myanmar since 1995. CARE aims to improve the living standards of rural communities through health education, emphasizing HIV prevention and nutritional support for children and pregnant mothers. CARE also runs microcredit, water and sanitation, and food programs to help people lead healthy and productive lives.

Hurricane Sandy was the largest Atlantic storm ever recorded. Americans understandably view is it as an American emergency as the storm left 131 Americans dead and did tens of billions of dollars in damages to some of the most populated parts of the country.

Flooding in Léogâne © 2012 CARE

Before hitting the U.S., however, Sandy inflicted severe damage in the Caribbean. Worst-hit was Haiti, where the storm affected 1.8 million people, or nearly 1/5 of the country's total population. CARE's staff in Haiti reports the storm flooded 18,000 homes and forced more than 21,000 people into evacuation shelters.

Although the storm is long-gone, the worst of Sandy's impact in Haiti may be yet to come. Torrential rainfall during the storm and in the weeks since have devastated Haiti's agriculture sector. According to the UN's Office for the Coordination of Humanitarian Affairs, 42 percent of Haiti's corn crop, 30 percent of its rice crop and 20 percent of its bean crop have been destroyed. 1.2 million Haitians are vulnerable to immediate food insecurity and an even larger potential crisis looms because the crops destroyed in the ground last month made up a substantial proportion of Haiti's 2013 projected harvest.

Sandy was a powerful reminder of Haiti's vulnerability to environmental change. According to the Climate Change Vulnerability Index, Haiti ranks highest among 200 countries for risk of vulnerability to climate change in terms of potential floods and mudslides. As Haiti will continue to face natural disasters that destroy people's lives and livelihoods, CARE recognizes the urgent need to advocate for long-term development in Haiti while striving to integrate Disaster Risk Reduction activities into all of its programming.

In addition to our long-term work in Haiti, CARE is responding to the storm with water, sanitation and shelter initiatives that have reached 2,300 families, or approximately 12,000 people. In Grande Anse, CARE has distributed 252 hygiene and shelter kits. CARE has also received initial approval from USAID for an eight-month extension of its food voucher program in Grand Anse which provides nutritional foods to 12,000 families in 9 communities.

In Léogâne CARE has distributed 400 boxes of water purification tablets, 1,600 oral rehydration solution packets used to treat dehydration from severe diarrhea and 451 leaflets and posters on the prevention of diarrhea and related illnesses. The team distributing them also provided training on strengthening existing shelters, safety and cholera prevention. As part of on-going water and sanitation program in Carrefour, CARE is building latrines and outdoor shower facilities, some of which were damaged by Sandy.

On Saturday morning, a team of CARE staff left Goma for Rubaya, a town approximately 50 kilometers northwest of Goma. Due to the recent escalation of violence, CARE was not able to access our program sites in the territory of Masisi since mid-November.

Photo (from left to right): Samuel, Eric (driver), Nino (security), Emmanuel and Joseph get ready to drive to Rubaya.

Samuel says, "Our goal is to find out the needs of the communities. We will talk to local farmers and see if they have been able to work in their fields. We will visit markets to find out which products are available. We will assess water, sanitation, hygiene and shelter needs of displaced people and host populations.

"We will collect as much information as possible to see how CARE can best respond to the most urgent needs. Security remains a big concern but we hope to be able to scale up our work in Rubaya and the whole region of Masisi soon."

Before the recent escalation of violence, CARE has implemented a food voucher project in the Masisi region that enabled poor families to buy much-needed supplies in local markets.

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(November 28, 2012) – Mamatsuri Mathinyane is a 33-year-old widow, and she is trying to find a way to feed her five children until the next harvest. She has tried everything to budget the money she has – and to find a way to bring in more income – but she knows it may not be enough.

Mamatsuri Mathinyane with three of her five children. Photo to accompany human interest story. North-Eastern Lesotho (Mokhotlong District). © 2012 Teshome Assefa/CARE

Because she has no plough animals, Mamatsuri hasn't been able to sow her plots during the current planting season. Instead she has been able to rent half the land to a tenant who will pay her R400 (about $45 US) when the harvest season comes. But the harvest is not until May, and Mamatsuri does not know how she will buy food for her family during the coming months.

Lesotho experienced a poor agricultural season last year as well, and Mamatsuri did not collect a harvest then either. Currently, she has no food in storage, and her family's only income is the settlement money she receives from a neighbor who was found guilty after killing her only horse. This income provides just enough to feed her children, but the settlement payments will end next month, leaving Mamatsuri with no income – and four months until the harvest.

She does not have many assets left that she could sell. Once, she and her husband had five cows as well as the one horse. After her husband died of tuberculosis four years ago, Mamatsuri was forced to sell two of the cows to cover the cost of the funeral. Over the next few years she found herself having to sell two more cows to buy food and cover other household expenses during difficult times. Now she has just one cow, and she has sent it to a family member's farm so that it will not be stolen. She has tried to earn money by starting a small business brewing local beer, but found that she just couldn't make a significant profit.

Unfortunately, Mamatsuri's story is a typical example of how critical food shortages impact thousands of female-headed families, especially in contexts where a wide range of underlying factors make the crisis worse: poverty and already-exhausted savings (including livestock), insecurity, a high risk of HIV and AIDS, and years of poor harvests and unpredictable rains that may be linked to a changing climate.

Lesotho is a very small country, and media and humanitarian attention has been slow to arrive, perhaps in part due to the focus on high-profile crises in the Horn of Africa and across the Sahel. While these large crises require a great deal of attention, there is a risk that countries like Lesotho and families like Mamatsuri's may be overlooked.

CARE has been one of the first agencies to begin responding to this crisis, beginning with the distribution of seeds to vulnerable families so that they are able to plant in the current agricultural season. This is vital as unless farmers have the support they need to plant next year's harvest, the emergency is likely to deepen and affect an even larger population. In addition to seed distributions, over the coming months CARE plans to deliver a combination of cash vouchers and cash-for-work programmes to enable people to buy food in the market.

In addition to an immediate response though, long-term assistance for recovery and future resilience is also vital. Even when the next harvest season arrives, Mamatsuri will only earn R400 from her tenant, which is only enough to feed her family two meals of maize a day for about three months. With barely enough money to feed her family, Mamatsuri will have to wait to rebuild investments and safety nets, such as her cattle and horse. For this reason, CARE works to connect our emergency response existing long-term CARE programming in Lesotho, which includes efforts to improve agricultural production, irrigation projects, community gardens and vegetable cultivation, and other programs such as village savings and loan associations.

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by Elizabeth M. Campa, Water Sanitation and Hygiene Coordinator, CARE Haiti

Flood waters surround a water pump in Léogâne, Haiti. © 2012 CARE

"Haiti is the country with the highest risk of vulnerability to climate change in terms of potential floods and mudslides," according to the Climate Change Vulnerability Index. The index ranks nearly 200 nations and their vulnerability to climate change. The arrival of hurricane Sandy proved this tragic statistic true – once again.

Contrary to the effects causes by tropical storm Isaac, which hit Haiti in August and brought strong winds, this time communities were mostly affected by the massive quantities of rain. Assessments conducted on October 26 and 27 in the areas where CARE works (Léogane, Carrefour and Grande-Anse) showed the extent of the damages. In Léogane, located along the coastline, several villages were washed by massive flooding, leaving more than 300 families homeless and forced to seek refuge in schools and churches or with more fortunate neighbors.

The situation in Carrefour was even more devastating. Here, a region of over 450,000 inhabitants, most people are living in transitional shelters constructed after the devastating earthquake in 2010 (more than 1,100 of these shelters were built by CARE). Hurricane Sandy damaged more than 300 shelters and destroyed 200 latrines currently under construction.

Carrefour is also a region with very scarce access to potable water. People trying to reach water spring catchments can only do so by crossing a river that now is swollen. And to make a bad situation worse, many of the water kiosks (places where people are able to clean water for a small fee) have been closed, due to power shortages and the absence of operators, leaving the population no other choice than to use river water for drinking that has been contaminated by fecal matter due to lack of latrines in the area.

Grande-Anse, and its 12 communes, was most affected by Hurricane Sandy. Massive rainfalls washed away bridges and homes. An estimated 3,000 homes were destroyed or badly damaged, and more than 1,600 people displaced. Many areas are still completely cut off. The destruction has had a high impact on food security: 40-50 percent of crops are lost. The production was already expected to be low due to droughts and tropical storm Isaac, therefore placing this farming community at higher risk in terms of increasing levels of malnutrition.

Cholera is another pressing issue. Grande Anse has the highest cholera prevalence in the country. CARE’s immediate response consists of supporting cholera treatment centers through programs already in place in the area, repairing existing cholera treatment facilities, through our partner Médecins du Monde-France, as well as improving water sources. We’ll also focus on the distribution of aquatabs to purify water, tarpaulins and tents, hygiene and kitchen kits, and water containers as well as the promotion of hygiene in the area. In conjunction with the local water authority, DINEPA, CARE erected a water bladder containing 1,500 gallons of chlorinated water, and will continue to do so as needed, particularly in areas where cholera is likely to spread.
The lack of clean water and proper sanitation in Haiti is often simply overwhelming.

In my 12 years of experience working overseas in development and emergency programs, I find it unbelievable that Haiti experiences such low levels of access to water and sanitation, considering its close proximity to the U.S.A. Hurricane Sandy will not be the last storm that passes through Haiti. We will continue to see natural disasters destroying people’s lives and livelihoods and they will need our assistance. It is imperative that we invest in improving water and sanitation and disaster risk reduction, so people can protect themselves and be prepared for future disasters.

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By Yemisi Songo-Williams and Christina Ihle
CARE International in Sierra Leone
Koli Soko Village, Makeni, Bombali District

Receiving a cholera prevention kit. Photo: © 2012 CARE/Tim Freccia

Marie, 75 years old, does not feel well. For the first time in her long life she is affected by cholera, but she knows the signs of the disease very well. Last week she was taking care of her 8-year-old grandson Zechariah, helping him to survive the infection, fighting with him for his young life. Thanks to ORS (oral rehydration solution) treatment, he is feeling better now and plays quietly in front of the house, as if nothing out of the ordinary has just happened to him. Although happy to see their child fully recovered, the family remains fearful for Maria's life. Her body is not as strong as Zechariah's, and she does not seem to have the strength to resist the water-borne disease.

42 people are already infected in the small village of Koli Soko, which is the home of about 2,000 people. Two people have already died; cholera can kill within hours when someone is not strong enough.

Koli Soko has a small health center which provides medical treatment and is managed by the government. But still, the lack of proper drainage and waste disposal systems coupled with heavy rains in the last few days has caused flooding and put the entire community at risk. Maria's son shows us their one and only water source: a small, still pond near the village; it is dirty and teeming with mosquitoes. “It is small, but deep”, he says. “But we are afraid that this water is not safe anymore with so many ill people in the village,” he confesses. But this is their only option.

Maria's neighbors are John and Yebefula, and their two children; Sida, 5, and Moses, 10 months. Yebefula was infected by cholera and was quarantined for five days with Moses. She is feeling better now, but she is afraid for her husband and the children. “I felt like dying in the last days. I just want to do anything to prevent my children from going through this illness.”

The CARE Sierra Leone team is distributing cholera prevention kits containing soap, ORS and purification tablets to the affected families and those at risk in Koli Soko. The team explains to every recipient family how to use the prevention kit, using pictures and demonstrations to make sure that everybody in the family understands that washing hands, using only boiled water and cooking food thoroughly is a matter of survival in these difficult times.

And families do understand. While the team prepares to leave Koli Soko, Yebefula gives her children a long and soapy evening bath using the soap she has just received. Hopefully they will be safe. But many families in Sierra Leone are still waiting to be better equipped in their fight against cholera. CARE in Sierra Leone is mobilizing all efforts to help with emergency aid and to seek long term solutions for villages in need.

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By Yemisi Songo-Williams
CARE International in Sierra Leone
Masongbo Village, Makari Gbanty Chiefdom, Makeni, Bombali District

A previously infected mother. Photo: © 2012 CARE/Tim Freccia

Masongbo Village, in the heart of the Makari Gbanty Chiefdom in Makeni, is the home of over 2,000 people.

At the height of the cholera epidemic, a CARE team distributed cholera prevention kits containing soap, ORS (oral rehydration solution) and purification tablets to 100 at-risk families in this village. By using pictures and demonstrations, the team showed each family how to use the prevention kits and explained the importance of washing hands, using only boiled water and cooking food thoroughly.

Two weeks after the distribution, I went with my CARE colleagues to pay an impromptu visit to the village to check whether our prevention messages were understood and applied by the inhabitants.

On the day we visit, a bustling antenatal clinic session is underway at the community health center that serves both the population in Masongbo and those from the surrounding villages. Mothers hover anxiously over the shoulders of the Maternal and Child Health aid as she weighs each baby.

We are welcomed by a smiling Fatmata, who has recognized the CARE branded vehicle from a distance, and is eager to receive us. Fatmata is a community volunteer and was part of our distribution team. She can easily recite the symptoms of cholera, and knows the ways in which it can be prevented. When asked why she became a volunteer she replies quite simply: "I want to help my community. I have only a little education, but I must use that to help my community."

And she has kept to her word: she has been diligent in sharing this information with members of her village.

There was a high level of awareness across the village on the signs of cholera. Every community member we spoke to could correctly tell us how to recognize the disease, how it could be prevented, how the items in the cholera prevention kit items were used and what to do if the disease was suspected. All the households we tested also had the expected levels of chlorine in their drinking water.

"CARE has done a big job here," beams Fatmata. "You have saved our lives by preventing this disease from coming here. Look, we are changing our habits. See how clean the village is!"

And she is right; the evidence of CARE’s cholera prevention intervention is plain to see. Masongo is a tidy, well-kept village, with garbage-free paths and neat front yards. The air is fresh and clean, with no signs or smells of inappropriate waste disposal or a lack of proper drainage.

"There were no reported cholera cases in Masongbo this year," Fatmata tells us proudly. "And for that, we are very grateful to CARE for teaching us how to change our past habits and live healthily."

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In the village of Karidi in the Birni-Lafia region of Benin lives a farmer and fisherman who is 25 years old. He is married and a father of three.

Flooded area in the north of Benin. Photo: © 2012Parfait Dovonou/CARE

Hassan Ibrahim is living in a zone that is often flooded in the rainy season but parched in the dry season. In this environment, huts are constructed from cut branches or clay. The roofs are made of thatch and are almost always built without a metal sheet because of the zone's temperature extremes.

The inhabitants of this region generally make their living through fishing, agriculture and sometimes small businesses run by the women. They also raise certain domestic animals such as poultry, goats or sheep, which they sell to cover basic needs during the lean season. The region is predominantly rural and there is very little adequate social infrastructure. Karidi, for example, has no health center, no electricity, no latrine and no source of potable water. The nearest medical care facility is miles away. The river serves as a latrine and shower, as most of the households do not have a private bathroom – and this same river is also the only source of drinking water.

Since the floods that started two month ago, the lives of many people have become extremely difficult due to the dramatic impacts of the disaster: the unusual rise in water levels caused the destruction of shelters, food reserves, crops, livestock and other property.

Hassan Ibrahim, after having assessed the danger of his home collapsing, decided to build embankments himself in order to hold back the water. On Tuesday, Sept. 4, he set off at a run to collect the ears of corn, sorghum, and millet which he would need to bury along with the sand and mud to form the barrier. He began to dig and as he reached his hand into a hole to judge its depth, he suddenly felt a sharp pain in his hand: it was a sharp object that had been previously buried and which cut off his little finger on his right hand.

He had no way to get to the hospital: all of his possessions had been swept away by the water. He settled for applying a traditional treatment using leaves. The finger did not heal, and caused him extreme pain which prevented him from finding a way to feed his children. The water overtook the land, the children were saved by other people, and he himself has had trouble finding a safe house and supporting himself. Since then he is surviving on charity. His wish is to be able to recover his health and to access microfinance services or obtain an agricultural loan to restart his farm when the water subsides.

CARE is responding in the affected areas of Malanville, Karimama, N'Dali and Tchaourou to support people with basic relief items and clean water. During the floods in 2010, CARE Benin provided emergency relief and worked with partners and local actors to support with water, hygiene and sanitation, food distribution and shelter for 150,000 persons.

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© 2012 CARE

With the help of her neighbors, Gado Fathi had been able to build herself a shelter. However, the small hut was destroyed by the terrible floods in 2010. It had been very difficult for her to rebuild it.

This year misfortune struck again: one night, the floods came again, while she and the two children were deeply asleep. She was suddenly awakened, but most of the clothes had already been washed away. Her cookware was submerged and the structure of the shelter was already beginning to give way. She did not know what to do or where to go. Most of her belongings were already damaged beyond repair. "The rain fell almost every day, and heavily. The farm animals floated on the water and died", she says. "The granaries were swallowed up by the water in the village. There were no boats for transport. Even though we wanted to take refuge on dry land, we had no way of moving." Since she has lived in the village, the floods have never been that strong.

Gado Fathi began to fight the floods by herself, trying each time to bail out the water using old basins in order to have a little bit of living space in the shelter where she and her grandchildren might survive. Indeed, the house was surrounded by water and she had no help. During this almost endless fight against the water masses, she was struck for one week by an illness that completely immobilised her. Her legs were swollen and she could no longer move.

The children barely ate once a day: the lack of food became clear. Luckily, a passing neighbor offered to move them to a safer area. She asked for help for her two grandchildren, one of which had been showing signs of a strong fever in the previous 48 hours. The health center referred the case to a more qualified clinic in the city of Malanville. But on the way to the city the boy died of the disease. In the meantime, the second boy developed visible signs of malnutrition. People joined together to help the child’s recovery in the traditional way by giving him an infused bath, because they had no more money to treat the child at the health center.

These events happened in early September 2012, when the narrator of this story passed through the village. The old woman has found a host family but she is still not able to walk.
CARE is responding in the affected areas of Malanville, Karimama, N’Dali and Tchaourou to support people with basic relief items and clean water. During the floods in 2010, CARE Benin provided emergency relief and worked with partners and local actors to support with water, hygiene and sanitation, food distribution and shelter for 150,000 persons.

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A boy pushes a bike through a flooded street in Léogâne, Haiti. © 2012 CARE

The western regions of Grande Anse and Leogane, where CARE is currently active, were badly hit. According to initial CARE field assessments, more than 6,500 homes have been flooded, damaged or destroyed, with approximately 7,500 people having been displaced. However, a complete overview is sketchy at best as access to many areas, particularly in the Grande Anse, is difficult. The main route is inundated in places with a key bridge destroyed and other routes are impassable by vehicles. Boats and airplanes are currently the only means to transport relief items quickly. The Haitian National Emergency Center reports a total of 7,627 families (approximately 38,000 individuals) have been affected, with 44 deaths and 19 grave injuries.

CARE had been preparing for a possible emergency response in Grand Anse and Leogane these areas before the hurricane hit the country. The emergency team now is planning to support affected people with clean water as in many areas. Because water points have been damaged, the population dependent on river water for consumption, which is not only dangerous due to its dangerously high levels, but the risk of cholera.

CARE will assist in distributing aqua tabs to purify water, soap and jerry cans. In order to provide clean water, CARE’s water and sanitation team may also install water bladders as needed. CARE will also assess current project sites and cholera treatment centers to determine the level of repair required to reestablish access to potable water and sanitation facilities.

In Leogane, especially in the areas of Saria and Bino, where 300 families lost their homes and all possessions, CARE is supporting other local organizations which have already response plans in place CARE has more than 40 trained staff, including social mobilizers, water and sanitation experts, as well as engineers that are available to assist organizations carrying out emergency assistance.

Kevin Fitzgerald (left) with Thomas Schwarz. © 2012 Lise Tonelli/CARE

THOMAS SCHWARZ: Syrian refugees have been coming to Jordan for a long time now. When did CARE start to support them?

KEVIN FITZCHARLES: We started in April although we did not have funds from private or institutional donors. We initially received about 70,000 Euros from CARE International's own emergency fund. Otherwise we could not have started to work. We hired someone who was responsible for the "initial aid" projects. And we started very quickly with distributing the money among Syrian refugees.

T.S.: It may sound a little strange for some to distribute money instead of food, clothing and other important things. Why did you decide on this form of assistance?

K.F.: We have been doing the same with the Iraqi refugees here in Jordan for six years now. This form of assistance is especially for those who are not in a refugee camp, but live in towns and villages. At first, they stayed with relatives or friends. But sooner or later they had to leave these apartments. Nonetheless, they have to buy clothes and food and pay their medical bills. And the only way to do this is to have money. That is normal. This kind of support is also about the dignity of refugees. They decide for themselves how they spend their money rather than being told by us. There are clear criteria for the distribution of course. We give money only once and not to everybody.

T.S.: You spoke about the refugees living in towns. Why are people hesitating to go to the refugee camp "Zaatari"?

K.F.: Well, about half of the first wave of refugees consisted of Syrians who were reasonably well off. In any case they did not need any support. They had sufficient means to help themselves or to stay with family and friends. The other half consisted of simple people, farmers and day laborers. Those who did not have a place to stay were housed in temporary camps. This went on for about a year. Many do not have their papers because the Syrian government took their passports. Once 5,000 refugees came in a single night, sometimes it is 2,000 or 1,500 refugees per night. At the moment there are fewer refugees, but it continues regardless. One cannot simply put all these people in a camp. They have to be registered and one has to be able to care for them, and so on.

T.S.: CARE has been working not only here in close cooperation with the UNHCR (UN Refugee Agency), but also in many other countries. You do not work in the refugee camp, but outside. Can you imagine that in the future, CARE will work in the camp?

K.F.: As long as many refugees continue to live in the cities and need support, we will continue with our work together with the UNHCR. Of course, it may be that we are going to work in a potentially new refugee camp. If the UN asks us, we could work in the areas water and sanitation, or help with shelter. That is what we are doing in other refugee camps around the world.

T.S.: Let us take a look into the future: I am often asked how long this refugee crisis is going to continue and when the civil war is going to end. Do you have an idea of how long this will take?
K.F.: How long? No, I have no idea. When the Iraqis came to Jordan, no one would have thought that they would stay here for so long. I do not like to say it, but it may be that this refugee crisis could go on for a very long time.

T.S.: The current situation in the refugee camp Zaatari is not perfect. However, much is being done and it is progressing well. One can say that much. How do you assess the situation in the camp? What needs to be done there still?

K.F.: It is certain that we already have to plan for the winter. Here in Jordan, temperatures will be between zero and five degrees [Celsius]. Moreover, there will be cold, icy wind in the area around Zaatari. Tents will not help much then.

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September 5, 2012

Marie-Claire, a 32-year-old single mom, who has arrived from Kasheke two weeks ago with her six kids and one on the way, is grateful for the beans, flour and oil she received from CARE, but is worried that it won’t last for long enough. © 2012 CARE

CARE is on the ground in The Democratic Republic of Congo. When the most recent fighting broke out in April, CARE projected to provide emergency relief to 60,000 people. With the intensification of the crisis, we had already reached 84,000 by early September and we have scaled up our response to cover a total of 180,000 people in need. Today, we are responding in a variety of ways – helping families access food (as you'll read below), delivering essential medicine and supplies, providing emergency psychological services and care for survivors of sexual violence and we will soon distribute shelter kits.

"We heard shooting and when we realized it was coming closer we took our baby and ran." They had no time to take cloths, cooking pots, or any other belongings with them. "I waited for a few hours until the gunfire was gone and then went back to the house to get food, but the village and my house were burnt down," Jean, the 20-year-old father recounts of his flight.

Over the past couple of months, tens of thousands of people have been fleeing similar attacks by rebels in southern Masisi territory in the province of North Kivu in eastern Democratic Republic of Congo (DRC). More than 330,000 people have been displaced in the province alone. Several rivaling armed groups are continuing to create havoc in southern Masisi, where most of the displacement is concentrated right now and CARE is present.

When the CARE team visited the spontaneous displacement camp in Kibabi on a sunny day early September, Jean, his wife and five-month-old baby, it had been three weeks since the family had left their home village Ngululu. They had walked for four days until they arrived in Kibabi where they decided to seek safety and shelter. They collected hay to construct a little hut where the family is staying. With the arrival of more than 2,310 families, more or less 13,860 individuals, the camp has grown into the size of a village.

"I don't know when we will be able to go back home," Jean says as his head is tilted down. "We are cold at night and when it rains, we are not protected because our hut has no plastic sheeting." Temperatures drop to close to zero degrees at night and the rainy season has started in full swing.

Jean continues, "We usually manage to eat [potatoes] once a day.  I work in the fields of the local community, and my wife goes around asking for donations. But it's not every day we eat and we eat very little." Luckily, Kibabi has a natural water source where the displaced collect their drinking water.  

"It came as a relief, when we received food from [CARE]. We've got beans, flour, sugar and some cooking oil. We have shared it with the people around us because not everybody received a voucher to go to the market. We can eat from it for a whole week." Jean's wife took their baby with her and walked for two hours to Rubaya, where the distribution is taking place. It is only the second food assistance in the area since the uprooting started late July.

CARE, through the Dutch Ministry of Foreign Affairs-funded project UMOJA+, and together with local partners has organized a weeklong food distribution for almost 4,000 households, or 24,000 people, through a voucher system. CARE spearheaded the innovative voucher system through which beneficiaries buy their food on the local market, which not only empowers them to choose items they need most, but also supports and safeguards the local economy.

Marie-Claire, a 32-year-old single mom, who arrived from Kasheke two weeks ago with her six children and one on the way, is grateful for the beans, flour, and oil she was able to purchase using vouchers received from CARE. But she's worried that it won't last for long enough.

"We share the food with everybody and when it is finished, we will die just like that," she says with an exhausted voice and fatigue in her eyes. 

Others echo similar sentiments of thankfulness. "Ever since we fled home, I've had difficulties feeding my six children. With the food fair, we finally have something to eat," 47-year-old Charles says with a sign of relief as one of his six kids holds his hand. They left their home village, Buoye, two months ago and took refuge in Katoyi. When Katoyi came under threat of an attack two weeks ago, they decided to pack up again and join the local population as they made their way to Kibabi. They found shelter in a primary school where up to 10 households, about 60 people, are crammed into one, small classroom filled with thick cooking smoke.

"We are going to eat for the first time since we left our home, Katoyi, four days ago," 23-year-old Julienne says as her newborn baby sleeps silently in a cloth tied around her back. Francoise, 30, expresses similarly, "with the food fair, CARE is helping displaced people, children who are suffering of hunger."  She rests on the lawn next to her bags filled with rice and beans to regain some strength before she starts her four-hour walk back to Bukumbirire where she is sheltered in a host family.

As clouds suddenly appear on the sky, wind starts blowing down the hills and chilliness overtakes the place, hundreds of women, children and men continue to stand patiently in line to receive their food coupons, which will allow them and their families to eat for up to two weeks.

CARE has also helped families establish community gardens and has distributed seeds and agricultural tools to thousands of households. CARE provides lifesaving assistance through various emergency projects in North Kivu and has already reached 84,000 people in need since the outbreak of the most recent crisis in eastern DRC. As the food distribution nears its end, UMOJA+ is already planning its next intervention in the area to provide shelter material and latrines.

By Thomas Schwarz

Breathtaking sunsets in the city: Amman calls it a day. PHOTO: © 2012 CARE/Thomas Schwarz

I speak with many Jordanians and foreigners who are here, who are living or working here. The openness of the Jordanian people against foreigners is terrific. You can be in the smallest café, in a restaurant or even along a street while waiting for the next bus: there will always be a possibility to speak with them. Even without being able to understand Arabic or them understand my English or German, there is an interaction. Be it with the eyes, gestures or facial expression.

Yesterday evening I was in a book store, in the same building you have a café as well as a restaurant. You can sit inside our outside, with a great view to the seven jamals, the mountains of Amman, the capital of Jordan. You can chose if you like to eat something, doing your work with a Wi-Fi-connected computer or just have a freshly squeezed orange juice and enjoy your time. The books@café ist kind of a melting pot for local, regional or international guests. As the New York Times put it a couple of years back: Many of those Jordanians, who studied in the US or in Europe and then came back home again, wanted to find an environment similar to the places where they had studied. In books@café they find it. Here, in Jabal Amman you also find the Rainbow Street, which could be easily found also in Paris or Barcelona, Cologne or San Francisco. It is not comparable with the huge, up to six lane, noisy roads which lead across Amman. Instead, it is a hot spot tourists of any age and modern Jordanians. You will find the British Council here as well as the embassy of Saudi Arabia as well.

No refugees, nowhere - seemingly

The sun sets in Amman and around the city are breath taking, also while sitting on a terrace in the books@café. Compared to here, where the streets don't seem to have any flat plane, one could think, that even Hill Street in San Francisco would be one single plane surface. All that, the vibrant restaurants, cafés and the mixture of cultures, nationalities and languages, the permanent hooting of taxi horn to get new customers, all the diversity of races and religions - all that makes me believe that I am in the middle of a terra incognita, in a somehow unfamiliar country, I don't know much of. Nothing here reminds me on the refugee crisis, the drama of individuals as well as families, who were forced to flee their homes back in Syria. Its is not existent, seemingly.

But as soon as I scratch on the surface, everything comes back what played such an important role in the last days and weeks, and even months. I can hear - or someone translates it to me - how in the cafés and restaurants and other public places people talk about it. Yes, sure, they say, it's important to support the Syrians. How would it be the other way round, they add with a big question mark. They would "help us as well, that's for sure", they say. Murad, a young man from Amman, told me the other day how he collected money together with friends to buy food. Then they somehow delivered it to Syrian refugees. That was in August, when Ramadan had ended. "This is a duty for each and every Muslim," he explained to me. "Everyone must share what he or she has and give it to people who are poorer than your self." That being written in the Holy Qur'an. One is studying, the other working in a bakery and so on. He has no rich friends, he says smilingly. But everyone had done his or her part. "Qur'an", they always pronounce this word in a very special way, significantly. Not, how we would say "Bible", if we were Christians. The Qur'an is holy, and it sounds like that when they name this important book.

And then the events which happened last week, the attacks on US-American and German diplomats and embassies. Because of a video which somebody put on line on the world wide web. A hater has done this. Someone who does not accept the Qur'an nor the prophet. Someone who does not even have the slightest respect for both. Those reactions of violence are not visible here in Jordan. In a very small traditional restaurant a Jordanian was sitting next to the counter where I ordered a falafel. He told me in English, even without being asked: It is not acceptable to insult the Prophet or the Holy Qur'an." then he added: "Nor violence is acceptable, this is not good." He smiles, stands up and shakes my hand strongly. He expresses what probably the majority of Jordanians are thinking. Islam here is the predominant religion in Jordan. More than 90% are Muslims. There are only approximately 50,000 Roman Catholics. They are respected and accepted.

All these very different impressions, the conversations, chats and encounters paint an overall image on its own. It is impossible to elude those impressions. Everything belongs together. A mosaic or a puzzle generates a picture only with all of its pieces. It's the same for me here, a western European in a unfamiliar, unknown country, somehow. It is possible to get to know it. To understand it fully seems to be very difficult. But its worth all efforts to give it a try. Only then one will be able to lead the testified, so called "clash of cultures" into a peaceful togetherness.

By Thomas Schwarz

Brother holding 10 months old sister, who is for three days without milk/Za'tari, Jordan. © 2012 CARE/Thomas Schwarz

We are in Za'atari, the camp for Syrian refugees, not far from the border to the war torn country. I started early morning in the capital of Jordan, in Amman, to get to Za'atari. We wanted to get our own picture about what we are reading in the international newspapers, on TV channels around the globe or in the internet. We wanted to get the "right" picture, first-hand information ourselves. Buying cheap goods in a second-hand-shop may be fun. It's a different thing to only have second-hand-information. This camp was started only six weeks ago, in the last days of July - when I first visited Jordan this year. When I came to Za'atari then, there were only between 2500 and maybe 3000 refugees. Now it is almost 40000. One must admit, that in this short period of time, the UN refugee organisation UNHCR did a really good job. Well, it's not everything working perfectly here, but given the fundings - which are still not enough -many things are working quite well.

"We would never call it home"

There is clean water for the refugees. From tent to tent we could see electricity cables along the wooden towers. Although this seems to imply that each tent has electricity, which is not the case of course.

The whole day long it looks as if we are on a huge construction site. Trucks driving around. Water tanker lorries bringing in water. From an unloading area people receive water bottles. Several hundred meters away the refugees are receiving foam mattresses. Things seem to be fully implemented here for such a camp. Even the kids are joking and playing around among the many tents and seem to be relaxed for these rare moments, somehow at least.

Ahmad and his wife are not relaxed. They have a different impression. "You know, here it is more safe, especially for my wife and our children. But this is not a home," he says. He is gesticulating heavily in a typical Arab manner - with two hands. Nevertheless he is not speaking in an aggressive way whatsoever. He pauses between his sentences, not only for the interpreter, but also to weigh his words and thoughts. In other situations this could appear somehow "theatrical", not here. He breathes deeply, when making these pauses. He smokes. Then, after a short smile, he describes. "I have nine children and my wife. One of the children is only three months old." A pause again, breathing. Then he expresses what seems to be most difficult for him: "At home I could take responsibility for all of them. I was working, I earned money to support my family. Now I can not do anything." He adds that the food they receive would not be enough for all.

There is not a single word of criticism against the United Nations. Several times he emphasises how grateful his whole family is for the hospitality of the Jordanian people, that they opened their borders for all of the refugees coming from Syria. He is praising the king of Jordan, again and again. Ahmad tries to stay neutral as well as fair when it comes to the situation he is forced to live in. But is this possible, after having fled your own country where war and terror and violence are reigning?

Sharing with others is important here

The wind is blowing constantly. This is good against the heat, but bad in a desert-like area with so much sand. Very fine grains of sand are all over the bottom of the tent. Outside they are just collecting the garbage to take it somewhere - with a truck. What they did not collect is being used by the refugees. They take the rest of the paper and use it for a little fire on which they boil water for tea. There is no wood here at all they could use. They will share THE tea with everyone in the neighbourhood, no matter who it is. Sharing, this is an important word here. While we are listening to Ahmad, his wife gives a sign to the children. While she is breastfeeding her baby, she is making some funny movements with one of her hands. Minutes later the kids come with something to drink for us, and some biscuits. We feel ashamed and agree, that we would like to accept their generous invitation in case we would visit them in Syria one day. When they are better off.

The conversation goes on and on and on. On the thin mattresses we feel quite "at home". We talk about football, about Schweinsteiger and Rooney, about Real Madrid and Barcelona, and - of course - about Messi. The boys know them all. We are laughing about this and that with the whole family. Making jokes about women and men alike. Then, out of a sudden, one sentence from Ahmad. Brutally honest from his side. He says: "If somewhere in this world a bird is threatened with extinction, the so called international community mobilises everything, the best experts and the most expensive technical equipment to save it. They do everything." Again, he is breathing deeply. He makes a pause. "But in Syria, in my home land, where i am at home... people are dying like flies. And what happens?"

They invite us to come to Syria, when peace will have come back to them. When war will finally be over. "We will show you our beautiful country," Ahmad says. He is smiling again. "And we will drink tea." His wife adds: "And we will eat something together as well." Allah may bless all of us, and our families, they say while we are putting our shoes on again. And they say "Shoukran", which means thank you. "Shoukran, and may God bless you!"

Haoua Daouda, membre de MMD et cliente de la banque de céréales de Koygourou. © 2012 CARE/ Niandou Ibrahim

"I can assure you that considering the crisis of this year 2012, I can claim that it is the women who saved our village and even families from other villages ..." says Gado Fandou, her eyes now looking up on the cloudy sky, and then laid tenderly on his wife Haoua a Daouda. It seems a kind of power emerges from this old couple who are so combative, so welded in the face of adversity.

It is 4 p.m. on this Friday, August 31. Life at Koygourou village, located 130 kilometers east of Niamey (Niger), is idling. Food crisis has been hitting the 1,500 inhabitants hard since December. In June, while hope seemed to be revived with the first rains of the season, colonies of locusts suddenly ravaged the young millet shoots. Farmers had to replant two to three times. Thus several different stages of evolution of millet can be seen in the same field. The last sowing is unlikely to produce any panicles if there is no rainfall until October. The heavy August rains have flooded the fertile lowlands. Here and there, gutted houses and uprooted trees show the violence of the recent rains. This is a difficult time through which households have to endure. Yet in this apparent desolation, Mata Masu Dubara women (ingenious women) are very active in the village. They represent the collective pride of Koygourou.

The Program Mata Masu Dubara is implemented by CARE in Niger with funding from NORAD. The impacts of the Mata Masu Dubara system in the economic and social promotion of women were already widely known in Niger. CARE collaborates through this program with 1,056 villages in 100 municipalities. CARE helped 217,839 women to create 8,209 groups of savings and credit. The evidence was made that women have now a better access to income because they got access to credit. Food security is improved in communities thanks to the banks of cereal launched by women.

"When we were establishing our cereal bank, we did not know it would be of such importance in the life of the village. Yet it feeds the most vulnerable people in Koygorou, such as my household today ... "claims Haoua Daouda, Gado Fandou's wife.

Koygourou MMD cereal bank was established after the 2005 food crisis, with one ton of corn contributed by the women of the network's three savings and loan associations, to reinforce the resilience of households.

"Already in 2010, the bank was used to alleviate food crisis by providing grains on credit. Then CARE helped us acquire a 15 ton grain subsidy from the WFP (The World Food Program). The stock which was reconstituted during the November, 2011 crops was 95 bags of maize and 200 bags of millet purchased at 18,500 f and 15000f /bag respectively, including transportation. This is the stock we have been selling at retail price to households since June. We sell the measurement of corn at 600f compared to 650f on the market. This indeed enables us to make only a narrow benefit margin, but we sell cheaper than the market and therefore at a more affordable price for the poor” explains Mariama Kimba, president of the MMD network.

Gado and Haoua's household is one of those poorest households in the village. Gado, who is over 70 and sickly, cannot work hard, though the couple cares for seven children: their own two children and five grandchildren aged 4 to 14. The latter are the children of their recently deceased daughter.

The small field cultivated by the household yielded very little in 2011. Now the whole family sleeps in one straw hut following the flood which damaged their mud house. Haoua sells condiments to feed the family. To carry out this business, she takes credit from the MMD association. With the revenue generated by this small business, she can buy daily measures of millet at the cereal bank. "What should we have done without the MMD loan and the MMD bank?" asks Haoua, adding that dozens of other households in the village like them benefit from these opportunities created by women in Koygorou.

To ensure a proper operation of the bank, the MMD network has established a sales committee: Aissa Issa is responsible for sales and Rabi Harouna is the treasurer. The committee has undergone trainings and is available to clients any time of the day and night.

"These women are so well organized they can save everyone here. Even the less vulnerable people are somewhat relieved because they receive fewer requests to assist their poor relatives. Five days ago, a man from Tcharandi, a village which is 15 kilometers away, came up here on foot to buy some measures of millet grain at the cereal bank. This is a real honor paid for our entire village." boasts Amadou Sanda, the village tailor with delight.

"With the uncertainties due to locusts and floods this year, we are going to further reinforce our network," claims Mariama, the MMD President, while all the women sitting by the cereal bank around her approved by nodding their heads. Meanwhile, the first drops of another rain of this month of August had started falling.

In this village where Mother Nature shows little leniency, women's energy is the main preserver of men's dignity.

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Receiving a cholera prevention kit. © 2012 CARE/Tim Freccia.

The disease is mostly transmitted by contaminated water sources and foods, and is closely linked to inadequate sanitation. The lack of proper systems for drainage and waste disposal, coupled with heavy rains that cause flooding and contamination of water sources, has left the population increasingly vulnerable to the spread of this waterborne disease that can kill in hours.

The Ministry of Health is collaborating with partners to disseminate health promotion messages about how people can protect themselves and others against the spread of disease. Messages include washing hands properly, using only boiled water, and making sure that food is cooked or washed properly before consumption. Information about how and where to seek help is also being communicated. The government has set up three emergency centers in strategic locations around the city to handle new cases, with all government clinics providing free treatment for cholera.

CARE is mobilizing resources to facilitate comprehensive cholera prevention messaging and activity in five of our operational districts: Bombali, Kambia, Koinadugu, Tonkolili and Western Area.

In collaboration with government health workers, CARE is preparing to:

• Provide information and education via radio discussions and public service announcements;
• Distribute cholera prevention kits to highly-affected and at-risk community members; and
• Conduct trainings on cholera prevention, hygiene and sanitation and community mobilization to community volunteers and existing community structures (including mother-to-mother groups, community health clubs and village savings and loan associations).

CARE also serves on the national Cholera Task Force, which regularly assesses the scale of the epidemic and discusses various resource mobilization strategies.

UPDATE: Cholera cases in Sierra Leone are on the rise. As of August 31, there were 13,934 cases and 232 deaths reported. Read more >

By Yemisi Songo-Williams and Christina Ihle

Receiving a cholera prevention kit. © 2012 CARE/Tim Freccia.

Cholera cases in Sierra Leone are on the rise. As of August 31, there were 13,934 cases and 232 deaths reported.

September 12, 2012 – Marie, 75 years old, does not feel well. For the first time in her long life she is affected by cholera, but she knows the signs of the disease very well. Last week she was taking care of her 8-year-old grandson Zechariah, helping him to survive the infection, fighting with him for his young life. Thanks to treatment, he is feeling better now and plays quietly in front of the house, as if nothing out of the ordinary has just happened to him. Although happy to see the child fully recovered, the family remains fearful for Marie’s life. Her body is not as strong as Zechariah’s and she does not seem to have the strength to resist the waterborne disease.

Forty-two people already are infected in the small village of Koli Soko, which is the home of about 2,000. Two people have already died; cholera can kill within hours when someone is not strong enough.

Koli Soko has a small health center which provides medical treatment and is managed by the government. But the lack of proper drainage and waste disposal systems, coupled with heavy rains in the last few days, has caused flooding and put the entire community at risk. Marie’s son shows us their one and only water source: a small, still pond near the village. It is dirty and teeming with mosquitoes. "It is small, but deep," he says. "But we are afraid, that this water is not safe anymore with so many ill people in the village."

Marie’s neighbors are John and Yebefula, and their two children Sida, 5, and Moses, 10 months old. Yebefula was infected by cholera and was quarantined for five days with Moses. She is feeling better now, but she is afraid for her husband and the children. "I felt like dying in the last days. I just want to do anything to prevent my children from going through this illness."

The CARE Sierra Leone team is distributing cholera prevention kits containing soap, oral rehydration solution and purification tablets to affected families – and those at risk – in Koli Soko. The team explains to every how to use the prevention kit, using pictures and demonstrations to make sure that everybody in the family understands that washing hands, using only boiled water and cooking food thoroughly is a matter of survival in these difficult times.

And families do understand. While the team prepares to leave Koli Soko, Yebefula gives her children a long and soapy evening bath using the soap she has just received. Hopefully they will be safe. But many families in Sierra Leone are still waiting to be better equipped in their fight against cholera. CARE is mobilizing all efforts to help with emergency aid and to seek long term solutions for villages in need.

UPDATE:

Today, 18.7 million people are affected by the crisis, more than 1.1 million people are suffering from severe malnutrition and an additional 3 million have moderate malnutrition.

CARE is on the ground in Chad, Mali and Niger, where millions of people are and in dire need of assistance, relief and long-term planning. Women and children are particularly vulnerable, especially those under the age of 2. CARE's emergency response and recovery program is providing access to food via cash transfer and direct distribution, and improving access to water, sanitation and hygiene. At the same time CARE's long-term development programs such as women-led savings groups and cereal banks help people build and protect assets. In CARE's experience, empowering women strengthens community resilience during crises.

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By Marie-Eve Bertrand

Koundougou, Mali. Bilta and Hawa have joined their village committe 3 months ago. It is a first for the village. They are thankful for that opportunity to have a voice. This community is affected by the drought and receives CARE food distribution support. Credit: Marie-Eve Bertrand

Here I am, thinking about my life and aspirations – wondering what I will do in two or three weeks, even a month. As for her, she can only think about tomorrow. She needs to have enough milk for her youngest baby, still depending on her breast milk. She must have enough rice for her other children, so they don't cry because of being hungry, and their father. Only if they are all fed, then she will sit and eat, even though she's pregnant and she should go first. But a mother will never let her children go to bed on an empty stomach to fill hers.

That was three months ago, before CARE started giving emergency assistance here in central Mali.

There are about 60 families here, in Koundougou, 44 of which have children under the age of 6. Almost 30 women are pregnant. As a group, they patiently wait for the food distribution to start, as soon as the local committee is ready. Standing next to me is a young lady and her friend. For the past three months they've been working as community mobilizers for the food distribution, carried out by CARE and a local partner organization. To my surprise, there are only two women in a group of ten people. "It's the first time that women have a chance to work with men – the first time that we have a voice. We are happy to be respected and our husbands are proud of us." A surprised man standing nearby says: "Two women is a lot already! We had to work hard to find a place for them." Fifi, the female director of the local organization CARE works with looks at me, smiling, and explains there's still a lot of work to do but, in the long run, things will change.

Cultural shock
A group of young girls offer me a basket filled with wild dates that they just picked up. In this part of the world, that's an offering of friendship. They are between 10 and 12 years old. They are beautiful, looking at me with deep dark eyes, waiting for an answer. Of course! Of course I agree! Thanks to a local translator I ask them a few questions. The older one represents the group and answers briefly. I learn that her dream is to grow a garden, to have a fenced piece of land where she can grow enough fruits and vegetables to feed her family without having to see her grown-up children leave the country to find work.

Djenné, Mali. Boulker (man standing) is a teacher. He and his wife have 3 kids. His mother, his sister and their kids left their home, because of the violence. IDR. They are 13 living in a 3 rooms house. He is a teacher, without salary for 2 months. Credit: Marie-Eve Bertrand

"Do you go to school?" She smiles and shies away. The closest school and the closest health center are 7 kilometers away. It would be too hard. Sometimes, there's a lucky one who is sent away to live with family members and go to school, but in all other cases, girls' parents can't afford to pay school fees... So these girls spend their life, from childhood to adulthood, looking at the sun rising, shining, burning then hiding for the night. They are able to read the weather and the seasons in the signs of nature, to recognize the wild fruits and herbs they can eat. They help each other. But, here and now, as they are offering me their friendship and a basket filled with food, they are reminding me that oftentimes, generosity is inversely proportional to the breadth of the pocket.

While we talk, the food distribution continues smoothly. CARE is also giving mothers Plumpy Nut, a nutrition supplement for kids between the age of 6 months and 6 years. Families receive different amounts depending on the family size and the children's ages.

Our staff and partners need to find ways to identify each family and track the amount of food delivered. Most of these people are illiterate, which complicates the tracking of the distribution. In some cases, people sign with a fingerprint. For this project, CARE Mali works with a local partner who liaises with the community to ensure no one is forgotten or served twice.

CARE has worked with the most vulnerable in Mali over several decades to give them the tools they need to reach self-reliance. Mali is one of the nine countries in the Sahel region affected by a severe food crisis, where almost 19 million people are without enough to eat. The current emergency assistance is important, yet temporary. It serves as a bridge between two bad seasons. But in this case we should not forget the complexity of the food crisis. The irregular rains, the higher price of food, the political tension, the low level of water of the Niger river… The entire Sahel region is affected. That is why CARE wants to be there before, during and after a crisis: to defend dignity and fight poverty.

Malians are proud and are hoping for one thing: for the rain to fall, for the grass to grow and for the lands to become green, so their family and livestock can eat again.

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June 18, 2012
By Rodrigo Ordóñez

A member of staff (right) checks registration cards during a distribution of food in the village of Warshika, in eastern Chad. CARE distributed food for 2,520 people in this area, including 336 malnourished children. © 2012 CARE

Today, CARE is distributing food for 2,520 people in Warshika, eastern Chad. The rhythm is frenetic. Members of staff carry sacks and boxes out of a temporary warehouse; women collect staples such as cereals, lentils, cooking oil, sugar, and salt. CARE is also distributing a high-nutrient supplement to feed 336 malnourished children in this remote community.

One of the women receiving food for her family is Khadija Mohamad, 24. She is one of the 3.6 million people affected by the Sahel food crisis in Chad.

Khadija has a small field where she grows millet, but production this season was very low. "Last year was better; we managed to have some food. This year, we have worked the fields but we have got nothing," she laments.

"There was little rain and birds ate some of the seeds," Khadija explains. "Locusts attacked the leaves as well."

In a good year, she gets up to 800 kilograms of millet out of her plot of land. However, this year she only harvested 110 kilograms, about one sack. This small amount of food didn’t last very long for Khadija and her three children, aged 3, 6, and 10.

When there is not enough food, Khadija cuts down rations and gives her sons two meals a day.

"Here, we suffer. We need a good well so we can drink, and some way to keep the water, so we can water the fields."

With the food distributed by CARE, Khadija can endure the lean season more easily. "It helps me to live more comfortably for a few weeks. After it’s finished, we rest in the hands of god."

"Normally when we run out of food we sell our animals, but this year prices aren’t high," she laments.

"The price of food, however, is too expensive." Khadija explains that this year food is so costly because growers had a bad season and little is available. The price of certain items has increased four-fold.

Khadija Mohamad, 24, carries a carton of a high-nutrient supplement, in the village of Warshika, in eastern Chad. CARE distributed food for 2,520 people in this area, including 336 malnourished children. © 2012 CARE

A measure of millet, which cost 350 francs CFA last year, now costs 750. A measure of okra, which cost 600 francs CFA last year, now costs 2,500. Tomatoes have gone up from 450 to 1,000 francs CFA. Cooking oil has gone up from 1,000 to 1,500 francs CFA.

Migration to Libya, about 1,000 kilometers away, is common in this area. Young men stay there for about three years, working as shopkeepers, watchman, or other small jobs. "My husband and my brother are in Libya for work. After the war, they came back, but now they have gone back, to Sirte."

"We women start the day in the morning. We work hard, go get water… and we do the work of men as well. But we don’t know how to cultivate the fields."

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'One Year On'
Food insecurity and conflict still a threat for the Horn of Africa

Mr. Mohammed Abdule, successful farmer in the West Hararghe Zone of the Oromia Region. Photo: © 2012 CARE/Audrée Montpetit

Mr. Mohammed Abdule, successful farmer
Ethiopia is a country where approximately 85% of the population relies on small-scale agriculture for their livelihoods and where most agriculture depends on rain. In the West Hararghe Zone of the Oromia Region, most farmers and their families are affected by recurrent droughts and as a result are unable to feed themselves on a regular basis.

Mohammed Abdule, age 47 and father of 6 children, is one of the farmers in that area who lives with the constant threat of droughts and climate shocks. Until recently, he has had to face this threat with very little preparation and assets. In order to cope with the 2006 to 2008 dry rainy seasons, he was forced to sell his oxen, cows and goats at a reduced price. He also had to take loans to buy more food for his family.

Photo: © 2012 CARE/Audrée Montpetit

Though he and his family survived, Mohammed was faced again with another drought in 2009. Once again, he had to sell his only assets – his oxen, donkeys and goats – in order to provide for his family.

In January 2005, Mohammed and other drought-affected farmers had the opportunity to participate in a government and CARE run safety net program that focused on environmental protection and asset creation initiatives. These farmers in return received food aid from CARE.

Because of Mohammed’s good performance in the safety net program, he was given the opportunity to join the PSNP Plus project with CARE in July 2011. This USAID-funded project aimed to link poor rural households in Ethiopia to microfinance and markets as a way of building resilience. Mohammed participated in a month-long comprehensive training on bee keeping and transitional beehive making.

Afterwards, he received materials for bee keeping including 6 transitional beehives, 50 small beehives for multiplying bees and 14 bee colonies from CARE. During this time, he also learned about savings management, animal fattening, and cultivating improved seeds.

Photo: © 2012 CARE/Audrée Montpetit

Prior to the bee keeping training, Mohammed had only two bee colonies, which did not produce enough to be his sole source of income. However, according to Mohammed, "After the training, I was able to multiply the 14 bee colonies into 42 and sell the 14 to farmers in the village at 500 birr (28 USD) each." He sold the colonies at a reduced price to attract more customers and with the knowledge that farmers in that area could not pay more. He then deposited the 7,000 birr (395 USD) he earned from the sale of bee colonies in the local bank as part of his savings plan.

Today, Mohammed keeps 14 active beehives in his compound. He notes, "I have harvested 24 kilograms of honey last November, sold it and got a total of 2,400 birr (135 USD)." He spent 1,400 birr (79 USD) purchasing sugar for the bees so that they have sustenance during the dry season when flowers are scarce and saved the rest.

Because of Mohammed’s efforts, his village has increased its bee colonies from five to 73. He also gives technical support to 73 honey producers in his locality and beyond. In this way, the knowledge he gained from the training has benefited the whole community as well as his direct family.

Mohammed claims that his life is improving because he is less dependent on rain-fed farming. He is diversifying his livelihood by engaging in bee farming, savings management, animal fattening, cultivating improved seeds and even carpentry. As a result, during the latest drought that hit the region in the past year, he has not sold any of his assets and has not taken out any loans. His family finally has the security it needs to be resilient in the face of drought.

His plans for the future are inspiring as well. "As there is demand in the market, I plan to buy 40 bee colonies this year, multiply them to 200 colonies and sell the 180 colonies in the market," explained Mohammed.

By Yonas Tafesse, Communications Advisor, CARE Ethiopia

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'One Year On'
Food insecurity and conflict still a threat for the Horn of Africa

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. Photo: © 2011 CARE/Kate Holt

CARE continues to provide life-saving assistance in Dadaab refugee camp
In the middle of 2011, the Horn of Africa region experienced one of the worst droughts for 60 years. This along with political unrest in Somalia fueled a tremendous increase in refugees into Dagahaley, Ifo and Hagadera, the three refugee camps of Dadaab. The total refugee population now stands at over 460,000 making Dadaab Kenya’s third largest population settlement.

One of the most immediate needs for new refugees has been water; the very elixir of life. After walking for days on end, parched and much in need of hydration, CARE has been at the forefront of ensuring refugees have access to adequate water supplies. But this service has not always been easy. Before the emergency, CARE was able to provide an average of 18 litres of water per person per day for drinking, cooking and bathing.

CARE's goal is to provide sufficient quantities of water to the existing and new refugee populations. This includes the maintenance of 20 existing boreholes and over 170 km of pipes.. Photo: © 2012 CARE Niki Clark

Water is provided through the construction of tap stands, boreholes and water tanks. In normal circumstances we can ensure never to have more than 250 refugees using one tap stand. But with the crisis came challenges. Refugees settled on the outskirts of the camps, where CARE traditionally did not have any water provision facilities and as more and more people arrived we had to move fast to ensure families could access water and to prevent outbreaks of disease.

CARE WASH staff worked hard by first using water tankers to bring water to refugees in areas without water points, constructing water lines and tap stands in the Influx areas and refurbishing boreholes that were over 20 years old. CARE’s interventions ensured that no refugee had to walk more than 500 metres to find water. This is especially beneficial for women and girls, who are often tasked to search for water, food and firewood for their families. CARE was also able to ensure that each refugee was continuously able to access the global minimum standard of 15 litres of water per person per day.

Water trucking in camp Dagahaley. Refugees here receive an average of 19 liters of water per day. Photo: © 2011 CARE/Sabine Wilke

'We were in desperate need of water. If CARE did not help us, and give us water, life’s most basic need, many lives would have been lost. Even though a year has passed since the crisis, we still talk about CARE every day, and we are all very grateful, 'says Zeynab Mahmud Hassan, a refugee from the Dagahaley camp.

Following the 2011 influx of refugees the Kenyan Government opened two new camps – Kambioos and Ifo 2, to relieve congestion in Dadaab. CARE has worked tirelessly from the opening of these camps to provide water at the highest standards to every single individual.

As we continue to defend dignity and fight poverty, we are pleased to say that we have been able to return to our standard of providing 18 litres of water per person per day, and this just proves to us, that together, we can be powerful!

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'One Year On'
Food insecurity and conflict still a threat for the Horn of Africa

Noor Jelle at his home in Guyo. Photo: © 2012 CARE Joseph Nderitu

Noor Jelle is a 30 year old man from the Somali community living in Fafi District, Garissa County. Garissa is located in the north eastern part of Kenya where communities have traditionally survived as pastoralists. Noor is married with children and lives with his extended family including his ageing father.

For centuries, Noor’s community has used indigenous methods to predict seasonal weather patterns. This information is based on changes observed in the behaviour of birds and insects, the condition of plants, temperature changes and wind patterns among other things. However, with the changing climate patterns, it is becoming more and more difficult for the community to accurately predict and plan for the coming seasons. Prolonged droughts and unpredictable rainfall patterns experienced over recent decades have resulted in Noor’s family losing their once large herds of camels and cattle. The family has since been forced into an agro-pastoralist way of life, keeping a few goats and practicing rain fed crop farming, growing mainly maize.

In 2011, the Horn of Africa experienced a food crisis that was described as one of the worst in the last 60 years. Noor’s family was hard hit by the crisis, which followed two consecutive poor rainy seasons and rising food prices. Aid agencies working in the area including CARE, responded by providing short term humanitarian assistance to help the community survive the drought. Although the community expressed much appreciation for this support, what they really need are longer term initiatives that will strengthen their ability to cope with the increasingly frequent and prolonged droughts as well as the changing climate pattern in the area.

For many years in Kenya, CARE has been championing the empowerment of vulnerable communities, supporting them to take their destiny into their own hands and maintain their dignity. In 2011, the Adaptation Learning Programme (ALP) in CARE discovered that climate information was not being used effectively in planning for agro-pastoral activities and that this was contributing to higher drought and climate related losses. Community members expressed a real need for simple and relevant climate information for their use.

'When we receive temperature and rain information in degrees and millimetres, for most of us it makes no sense as we don’t really know what it means. It would be better if the information was more focused on letting the community know what we could grow, when...’ says Noor.

Noor’s wife Ebla Ali. Photo: © 2012 CARE Joseph Nderitu

ALP in Kenya is using Participatory Scenario Planning (PSP) workshops as an innovative and inclusive way of communicating climate information to communities and government departments. One and a half day workshops are carried out twice a year just after the national seasonal forecast has been released by the national meteorological agency. Workshop participants include the meteorological agency, community members, local government departments and local NGOs who share their knowledge about past and future climate forecasts. The workshops integrate traditional community methods and scientific forecasts to produce simple and locally relevant climate information that is then shared throughout the community through local communication channels such as mosques and chief’s meetings.

'We have been struggling with the concept of climate change but when ALP interacted with us and talked to us about it, we gained some interest in better understanding and using climate information from the Kenya Meteorological Department’ reports Noor. ' From the workshops we received information on rainfall and temperature, additional advice on what to plant, when, where to get inputs and technical support and information on storage and even marketing in case the harvest was really good. The information is communicated in Somali, our local language, for the two main livelihoods groups- pastoralist and agro-pastoralist.’

According to Noor, at the end of the Oct-Dec 2011 rainy season, the community received a bumper harvest and minimal losses because they had received relevant information on storage and preservation of their harvest. They also received information that has enabled them to plant more drought resistant and early maturing seed varieties of maize, sorghum and cow peas as well as fodder which they can later sell to the pastoralist groups.

Ebla Ali, Noor’s wife agrees, 'it is amazing how much difference the seemingly little information we received at the community bazaar [meeting] is making in our lives- we are no longer living from hand to mouth, our diet is now varied, we are not struggling as much to educate our children and we are even discovering new markets for what we grow- such as the fodder for the pastoralists. We are no longer dependent on relief food and we have been sharing whatever reaches us, with the more needy families.’

ALP in Kenya is facilitating better use of climate information to strengthen the ability of individuals like Noor Jelle and other members of the Guyo community to cope with drought and climate related disasters. Through the program the community has discussed and agreed on its development goals, analysed its vulnerability and capacity to cope with climate related disasters and developed plans for adaptation. In north eastern Kenya, CARE is empowering this community and others to take advantage of emerging opportunities and strengthening their resilience to recurrent droughts and other climate related threats to food security.

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'One Year On'
Food insecurity and conflict still a threat for the Horn of Africa

Refugee Incentive workers setting the mould for new latrines. Photo: © 2012 CARE Nicolas Postal

Imagine not having access to a toilet. Imagine how undignified you would feel having to find a space with only a bush to give you cover. This was a common problem for Somali refugees forced to flee the violence and famine that affected their country in 2011.

Over 100,000 refugees poured into the already overcrowded Dadaab refugee camps in north eastern Kenya, in the summer of 2011. CARE has been actively supporting refugees in Dadaab since 1991. One of our strengths over the years has been our water, sanitation and hygiene services, providing refugees with the most basic needs in a very complex situation.

Not having access to a proper toilet increases the risk of cholera and other diseases when human waste is not properly disposed of and makes its way into water sources. The situation is especially dismal for women and girls, who have to sacrifice their privacy, as well as face the risk of being raped or violated on the way to the bushes at night.

CARE recognized this great need, and has worked hard to allow the women and girls to have privacy, and to enhance and sustain a healthy Dadaab. We have been working with our partners to reach our target of constructing at least 4000 new latrines in Dagalahey, one of the Dadaab refugee camps, making sure that a maximum of 20 people can use each latrine. This is by no means enough, but it’s a start.

A refugee incentive worker assists with digging to set up a latrine. Photo: © 2012 CARE Nicolas Postal

Says Zeynab Mahmood Hassan, a refugee from Dagahaley camp, 'Having a place to go to relieve ourselves has been a great need, especially for us women. Today, we are so grateful to CARE, who is working with partners to ensure that we have safe latrines.’

Just as with our other programs, CARE Kenya ensures that the refugees are part of the process - as equal partners. Together we dig a hole 5 metres deep, after which our teams install the latrine slabs and a tin shell for privacy. Using this method, at the height of the refugee influx we were able to construct 60 latrines a day.

The emergency influx of refugees highlighted the need to work smarter and more efficiently in the Refugee Camps. CARE has been working alongside the Norwegian Refugee Council (NRC) to provide water, sanitation and hygiene services to the populations. Keeping with the age of technology, we also map the latrines through a GPS system, so we can monitor and maintain them!

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By Rodrigo Ordóñez

'If we have nothing to eat, after a while we will die." The words of Hasta Abdelkarim, 46, are remarkably strong. A visitor asks her if she is afraid of dying. 'Yes. After that, it's over – there is nothing," she sentences.

The food crisis in the Sahel region of West and Central Africa is affecting more than 18 million people. Hasta is one of the 3.6 million people in Chad who are finding it increasingly difficult to eat this year due to chronic poverty, erratic rains, high food prices, and regional conflict.

For someone who has never experienced chronic hunger, it would be hard to understand what it actually means for a person, and for a family, beyond the physical distress. Hunger is about much more than just food.

Three women from the village of Djiogi, in eastern Chad, shed some light on what it feels like to be hungry, and how they cope with it.

'We don't have anything to eat. We are in the process of dying," indicates Makabahar Abdoulai, 30.

'Children ask often, ‘Why is this happening'?" accounts Zenaba Abderrahaman-Bahan, 33. 'They are hungry but I have nothing to give them. I play with them for a while until they forget."

'Before, I could at least give my children some breast milk, but not anymore – now I just try to find a way to get by," remarks Makabahar. 'When my children are hungry, I just make some diluted millet porridge."

Under these circumstances, the bland taste of the staple foods is not important. Nutrients might not be a priority either. 'We are hungry, so a good meal is something that fills the stomach – the taste doesn't matter," explains Zenaba.

Only today counts
When filling the stomach is the main concern, having plans for the future is unconceivable. It is difficult to make decisions that extend beyond the next 24 hours. 'We can only focus on our present problems," notes Zenaba. 'It is only the problems we have today that we can think about."

For a mother, it is hard to occupy the mind with something other than her children's wellbeing, especially when hunger is part of daily life. 'Children have nothing to eat – that's our main problem," complains Makabahar. 'I think about it a lot," she admits, 'and I worry."

They don't know what they will do if this year's harvest is also bad. 'We don't know. We can't do anything. We'll wait for god to decide," remarks Hasta. Makabahar and Zenaba nod in agreement.

For these women it is even difficult to express their fears for what the future might bring. Resignation might be an instinctive way to avoid frustration and to make their daily routine more bearable.

Back at home, each mother must take care of five or more children, walk several hours to fetch water, and find a way to feed their families.

'My children are not strong," says Zenaba, showing the thin arm of a boy on her lap. 'Specially the two smallest ones, 1 and 2 years old."

The effects of hunger go beyond discomfort. Not eating bears a negative toll on a child's physical and mental fitness. 'If the child is not full and tries to run and do activities, he feels tired and just wants to sleep," describes Makabahar. 'Children don't grow up," she says. 'If children don't eat enough, even their intelligence doesn't develop."

Dodging hunger
There are different ways to try and cope with the feeling of hunger.

'If it's a big meal, I serve it on a big tray and everyone picks from there," explains Zenaba. 'However, if I don't have much food, I split it and give little amounts to each child, placed separately at the edge of the tray."

Reducing portions and skipping meals are also commonplace. 'Before, we would do three meals; in the morning, at noon and in the evening. Now, only two," declares Hasta. 'We skip meals, but the amount is normal," says Makabahar.

Another indicator that people are going through difficult times is that they are eating unusual foodstuff they would normally refuse in times of relative plenty. In this region, people are now eating a bitter tree fruit known as ‘desert date.' Hasta explains the process. 'Donkeys eat the fruits, including the seeds, which they can't digest. We pick the excrements and separate the seeds. We cook them with boiling water, four times. They soften up and release the flavor."

In these communities, livestock is a valued commodity, but people are now selling their cattle as a last resort. 'I still have some cows, but there aren't many left," laments Makabahar. 'I'll sell them to have enough money to buy some food."

Hasta, the oldest woman in the group, hadn't experienced these hardships in a long time. 'When I was little, it wasn't like this. My father only had to leave to find work and pasture once, in 1984, but we hadn't seen anything like that since then."

'We used to have camels and animals at home. They grazed around here," she recalls. 'If the weather was better, we could have a vegetable garden, and grow tomatoes, lettuce… but nowadays we can't even find vegetables in the market."

A point of support until the next harvest
Hasta, Makabahar and Zenaba received food rations from CARE, including 50 kilograms of sorghum, 15 kilograms of corn and soy fortified with vitamins, and 8 liters of cooking oil.

This food gives families help at a crucial time so they don't have to sell all their livestock, their most valued possession, ahead of the next harvest.

'We have children and we are hungry. We're very happy of getting this food and your support," expresses Zenaba. 'My children are waiting. I'll go home and cook porridge for them. They will eat well and they will be happy."

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By Rodrigo Ordóñez

The words 'semiarid' and 'dusty' don't do justice to describe the landscape of eastern Chad and much of the Sahel fringe. If Brutalist architects had been commissioned to use natural materials to design open spaces, this is what they would look like: vast expanses of barren-looking soil and sand extending as far as the eye can see. Acacias, thorn trees and weeping bushes only add to the image of desolation. The horizontal monotony of the scenery is occasionally broken by sparse stretches of hills made up of big round boulders. A few broken-down armored tanks lay abandoned on the side of the road, on what used to be the battlegrounds of Chad's civil war in the late 1980s.

This is now the frontline of extreme heat and climate change. During the day, temperatures can easily reach 42 degrees Celsius. It feels like the scorching sun is capable not only of evaporating water, but also of neutralizing all colors. Any trace of green has long been drained and covered by a pale coat of ochre.

In a place where water is as scarce as this, life doesn't thrive. Against all odds, people have managed to survive in this harsh environment for generations.

Water, or rather the lack thereof, defines this place. It also marks the rhythm of life – and death.

"Water is life. Water is health," reminds the chief of the district of Noursi Adya, Souleiman Nibis, 55.

Yet on a typical day, much of a woman's time goes to fetching water. "In my community, women have to walk 12 kilometers each way to get water," he points out.

"I need to stay at the well for seven hours," explains mother of five Zenaba Abderrahaman, 33. "There is a line and it takes two to three hours to fill all my jerry cans, lifting buckets out of the borehole." She repeats this process daily.

The problem is similar for Khadija Ibrahim, 30, a mother of five children. Fetching water takes her ten hours. "I have to walk four hours to get to the well, plus three hours to collect the water, plus four hours to go back."

The quest for water
To try and tap underground water tables, people dig boreholes under the watercourses of seasonal rivers. Because of the geological composition of this land, it is difficult to drill here, yet these rudimentary boreholes are dug manually, using picks and spades.

Near the town of Iriba, a lady is collecting water from one of these water sources at six in the morning. She needs to spend several hours lifting up buckets to fill the eight jerry cans she uses daily for her family's chores: cooking, drinking and washing.

As she works patiently, a goat falls inside another borehole, just a few meters away. If the goat dies and is not removed on time, it could contaminate the entire water table and all the boreholes upon which entire villages depend.

Above and below ground, water also determines social and economic status. In this region there are two types of farmers. First, those who can cultivate for nine months; people who have land by the seasonal watercourses and can do three months of traditional agriculture and six months of vegetable gardening using the water of the stream. They do well. Second, the rest of the farmers, who can only cultivate the land for three months; they are highly dependent on the rains and generally don't do well.

In recent years, rains have become more erratic and planting is almost a matter of faith. Fatima Adam, 46, is planting the first seeds of the season near her village of Torgo, even though the rainy season has not started yet. "It has to rain in the following fifteen days for the seeds to grow," she explains.  "The season is ready; I know it's coming, so I am getting ready as well."

On the drip
Bad water breeds and carries diseases. Lack of water can lead to respiratory infections. Combined with malnutrition, medical complications can make children's survival, growth and development very difficult.

Malnourished children arrive to the therapeutic feeding center at Iriba Hospital with a combination of water- and mosquito-borne diseases.

Inda, 1, was admitted with diarrhea, gastroenteritis and malaria. She weighed 5.7 kilograms, while the standard for her height and age should be 7 kilograms. "Once she gets better, I'll take care that everything is OK," says her mother, Mariam Adam, 35. "I'll get clean water, food… I'll keep her in a good condition so it doesn't happen again."

To improve access to water, CARE is repairing water pumps in this region. A member of staff disassembles the pump in the village of Madarfok, cleans the filter and replaces a spare part. Despite being a very easy fix, this pump has been broken for years, forcing villagers to walk several kilometers to get water. CARE will also be fixing the water pump in the village of Darnang, which has been broken for five years. "Now, we use little boreholes by the river," comments villager Yakoub Ousman, 35. "If the pump is fixed we will have drinking water here and we won't need to go far to find it."

"This helps us a lot," says Tamboshe Dere, 60. It is very early in the morning and she is using one of the two water pumps in the village of Torgo. One of them was fixed by a private water technician, who is now working with CARE and also fixed the second one. "I am happy the pumps are fixed. Before, we had to walk seven kilometers to get water."

She thinks the current situation is not normal. "Before, it was better; but this year there isn't enough water," she laments. "The land is dry. There is no grass for animals to graze. A lot of people have taken their cattle and gone south."

Her words represent the uncertainty and the hope of people in this region, who rely entirely on the availability of water. "I watch for rain every day; I hope this year it will be good…"

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By Rodrigo Ordóñez

A paper-thin baby goat makes its way into the open area of a home in eastern Chad and tries to eat the millet inside a bucket. Two-year-old Ibrahim is sitting on the floor, drinking a big gulp of water, holding a cup the size of his head with both hands. When he finishes, he laughs, satisfied. Ibrahim's vitality and constant smile are surprising considering the little muscle he has; his arms and legs are skinny, and a thin layer of hair crowns his elder-looking face. He stands up and waves his hands in the air comically as he runs around to chase away the goats. Then he walks to the courtyard and defecates the water he just drank.

It is hard to tell whether Ibrahim's diarrhea and dehydration led to his malnutrition or vice versa. "He's got diarrhea for two or three months," explains his mother, Fatima Abbakar-Gedala, 30. "The doctor examined him recently and gave me some medicines, but they're finished now." She intends to take little Ibrahim to the hospital again, but it involves a 30-kilometer walk.

Families living in this semi-arid region at the edge of the Sahara desert, like Fatima's, have little resources. Their most basic needs, food and water, are constantly in peril.

The landscape in this region of Chad is brutal. Flat expanses of land are only altered by the traces of seasonal watercourses, barely perceptible to the untrained eye in this moon-like terrain. The hostile weather leaves similar imprints on people's skins. Many locals bear horizontal wrinkles on the nose from frowning under the hot bright sun. Saying this place is challenging would be an understatement.

The traditional way of life in this isolated corner of Central Africa used to be suitable to survive but, in today's context, it is extremely precarious and inadequate. Weather patterns have changed and rains have become increasingly erratic. People remain very vulnerable to changes in food prices, the effects of regional conflict, epidemics and plagues.

Livelihoods, in most families a mix of agriculture and cattle farming, used to provide enough cereals and income to get by. People managed to collect enough water to drink. In some cases, men would travel to Libya to find temporary work and send some additional money home.

However, the threshold of poverty is so low that, once one of these lines of support fails, everything else collapses. It's like running a very old factory – as soon as one of its components fails, the engine will stop and there will be no way to find spare parts to get it back up and running.

What's happening?
Getting drinking water is a big issue. Most often, people resort boreholes dug manually and use buckets and ropes to collect the water. Water points are few and far between, so women must walk long distances and wait for several hours to fill their jerry cans. Tamboshe Dere, 60, and three of her grandchildren are fetching water at a water pump repaired by CARE. "This year there isn't enough water," she explains. "The land is dry and there is no grass for animals to graze; a lot of people have taken their cattle south." She hopes the next rainy season will be good. "I watch for rain every day. Rains will come soon, I think. People in my village are starting to prepare the fields now."

If underground water conditions people's ability to drink, water falling from above determines whether they'll be able to eat. "The drought causes all the other problems; that's why things are so expensive now," states Hasta Abdelkarim-Haran, 46. Last year's wet season was subpar, and rains were scarce and irregular. The little millet families harvested only lasted for a few days or weeks – some people harvested nothing at all. "We have nothing to eat, we are in the process of dying," laments Makabahar Abdoulai, 30.

Little rainfall also meant there was no place for cattle to graze and people had to take some of their camels, cows, goats and sheep to other areas in the south, out of the semi-arid lands. "Before, we used to have camels and other animals at home, and take them out to graze around here" explains Hasta. "Now our animals are dying. Some of them can't eat, and they don't even have the energy to go find water." Little by little, people have been selling their cattle, their most valuable asset, to make some money and buy some food.

Hasta and Makabahar have just got home carrying the food they received from CARE when some neighbors show up at their door and ask if they could spare some cereals. It is another sign people are struggling to make it through the lean season.

Fatima, Ibrahim's mother, found out late about CARE's food distribution but was able to register and get the same ration. With the cereals she received, she will be able to feed her family for more than six weeks, the equivalent to selling two of her goats. Not receiving this aid would have meant the obligation to sell all of her six remaining goats and being totally exposed.

Under these circumstances, people are placing high hopes on the next harvest – it must be good. However, this is not guaranteed. The soil will need continuous rain; otherwise the millet stems won't push out.

"People in my village are talking about the rain now. I'm not sure if it will be better this year," ponders Fatima Adam, 46, as she plants millet in her plot of land. She is using a very rudimentary farming technique. First, she digs very superficial holes in the ground, using just two or three strokes on the ground with a hoe. One of her sons walks behind her, drops a few seeds inside each hole and covers them with soil using his foot.

Wire-walking to the next harvest
What is happening in eastern Chad and the other countries in the Sahel region has been a disaster in the making since late 2011. For months, signs foretold even people used to dealing with the roughest circumstances would go hungry in 2012.

In the hospital of Iriba, in eastern Chad, doctors started noticing an augmentation of cases of malnutrition in February, something that generally doesn't start until April.

At the hospital's therapeutic feeding center is Khadija Ibrahim, 30, holding her weak seven-month-old son Moutassim. Back home, he had diarrhea and vomits. "I couldn't breastfeed him, because I wasn't eating well and couldn't produce enough milk," explains Khadija. Following a traditional practice, someone cut the child's tonsils hoping it would stop the diarrhea. Moutassim's mouth got infected and he couldn't eat. "The mobile clinic brought us here," says Khadija. "The doctor told me it was wrong – next time I'll bring my child directly to the hospital."

People's stories of lack of food and water are eerily similar. It is easy to think their problems could evolve in a similar way to Khadija and Moutassim's.

As people tiptoe through the lean season, it would be easy for them to lose the balance. The first stage of malnutrition takes very little time to set in; less than 48 hours.

As the Sahara desert drifts southwards and dirt turns into sand, so it seems lives in the Sahel could quickly go from precarious to dramatic. Without help, people's existence could soon become just dust and hot air – a mirage of past times.

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by Barbara Jackson, Humanitarian Director, CARE International
July 2012

"Chad is an oasis of peace and stability" was a refrain that we heard many times over from the Minister of Plan, the Minister of Agriculture, UN partner representatives and community leaders upon the recent CARE International National Director visit to Chad to observe for ourselves the current impact and implications of the Sahel drought.  It would seem quite a paradox to describe Chad as an island of stability given its recent war-torn history and continued episodes of uncertainty. But it is, indeed, now an island in a sea of volatility emanating from its neighboring countries of Libya, Nigeria, Mali, Northern Sudan and the Central African Republic.  It is however an oasis that has been forgotten in many ways. In this current crisis, it has been the country with the least amount of funding provided by international donors in response to the Chadian government's early declaration of an emergency in December 2011.

From the sprawling, dusty city of N'djamena to the small prefecture headquarters of Biltine in northeastern Chad, where the drought has perhaps been most severe, we saw the impact of many years of neglect where potable water coverage reaches less than 3 percent of the population, contraceptive prevalence rate is about 2 percent and maternal mortality rates are amongst the highest in the world. CARE Chad's efforts to respond to this current crisis providing blanket feeding programs to those most at risk, repairing wells, and distributing seeds for agriculture given that the seeds from last year's harvest  have already been eaten as food are much needed and greatly appreciated. However, the message was clearly put to us by government authorities as well as importantly by community men and women: this is a short term approach that does not fully address the critical underlying causes and needs, which contribute to this chronic and deepening cycle of drought and emergencies in this vulnerable area of the Sahel.

We sat with village elders in a small community about 30 minutes drive from Biltine and spoke with the traditional male leaders who described that the desert is growing and the rains becoming less reliable each year. Behind us, a group of women and children sat waiting patiently until we were able to turn and talk directly with them. A young woman, with her face covered with a traditional hijab (veil), spoke eloquently of her gratefulness of actually being asked her opinion of the support provided by CARE and the impact it had upon the community.  "The food has helped as we had nothing, but we have many people to share it with including our elderly who are not able to walk to collect the food and who have not been counted." Clearly, we have much work to do to ensure that this community and many others scattered across the arid regions of this large nation and region do not find themselves in the same place next year and the year after that. 

Chad, while being a "forgotten" country, is also a country ripe for opportunity and one in which we and other partners should support to develop communities' and governments' clear recognition of concerns of building resiliency and adaptation to the climatic and economic challenges of the present and the future. We need to continue to invest now and to over a longer term to build individuals' and communities' abilities as we listen and learn from their local experience and voices to shape a strong, resilient and courageous future.

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Rio+20 Conference Center. Photo: CARE/Stefan Mielke

By Kevin Henry, Project Coordinator, "Where the Rain Falls"
June 20, 2012, Rio De Janeiro, Brazil

In addition to coming to Rio to join my voice in solidarity with tens of thousands of other people from every corner of the globe committed to making the "Future We Want" a reality, I came specifically in connection with a project I lead on behalf of CARE France. This project, called "Where the Rain Falls" and funded by the AXA Group and the MacArthur Foundation, is a research and action project seeking to better understand, and then act on, the impact of climate change (specifically changes in rainfall patterns) on food security and human migration in Africa, Asia, and Latin America. To achieve these goals, CARE, in partnership with the United Nations University Institute for Environment and Human Security, has undertaken field research in eight countries (Guatemala, Peru, Ghana, Tanzania, India, Bangladesh, Thailand and Vietnam). The findings of our research will be published later this year in a series of country case study reports, followed by a global policy report to be launched at COP18 in Doha; the research will also inform the design of community-based climate change adaptation projects in Peru, Tanzania, India, and Thailand.

Why is this research on the impacts of climate change on food security and human migration important, and what are we learning? The answer to that question starts with the fact that the livelihoods of the great majority of the rural poor remain heavily dependent on agriculture (crops and livestock) and thus rely on "Mother Nature" and a healthy natural resource base. In many developing countries, including many of those included in the "Where the Rain Falls" (WtRF) research, smallholder agriculture remains largely rain-fed. Smallholder agriculture, central to the social, food, and economic systems in many countries, is already a tenuous proposition, particularly in arid and semi-arid zones. And it will only be made more tenuous by changes in rainfall patterns and temperatures.

While the findings of our research are still being analyzed, it is already clear that households in the very diverse research communities in the eight countries where the WtRF research was conducted do report having already observed significant changes in rainfall patterns over the last 20-30 years. These changes vary from site to site, but most often involve some combination of the following: a) delayed onset of rains and/or shorter rainy seasons; b) reduced number of rainy days; c) increased frequency of severe rainfall events, sometimes leading to flooding, landslides, and riverbank erosion; and d) generally more unpredictable rainfall patterns, making it difficult to plan their agricultural activities. Community members also observe other changes in local climate that affect food production, including milder winters, hotter summers, and, in some cases, increased incidence of high winds, hail, and other extreme weather events.

Reducing the vulnerability of poor households to the negative impacts of climate change requires providing them dignified choices to: stay where they are and be provided information and resources to adapt by developing more resilient livelihoods; or when necessary, to migrate elsewhere, with dignity, to secure a better future. Migration is already a strategy used by poor households in developing countries to both cope with (short-term) and adapt to (long-term) food and livelihood insecurity. The WtRF research shows clearly that poor households are already using migration as an important strategy to cope with both seasonal and chronic food insecurity. While local migration is within the reach of most poor households, there is the risk of some populations, particularly the most vulnerable households, being "trapped" and unable to either ensure their food security in situ or migrate.

The "threat" of increased environmentally-induced migration is thus very real and is likely to grow over time unless global efforts to mitigate the worst impacts of climate change are stepped up dramatically. But the "threat" is primarily to poor households in rural communities in developing countries, who will have to struggle to either eke out a meager existence at home or migrate, often under difficult and dangerous conditions, to either urban centers or other rural areas with better agricultural conditions or other employment opportunities.

It is because of the impacts climate change is already having on poor households, and the need to take action to better understand and respond to these changes, that I have traveled to Rio to share with and learn from others.

If you want to find out more about the "Where the Rain Falls" project, please visit the website: http://wheretherainfalls.org/

Rio+20 Conference Center. Photo: CARE/Stefan Mielke

By Kit Vaughan CARE's Global Climate Change Advocacy Coordinator
Rio de Janeiro, June 20, 2012

Today it's raining outside, for the first time since I am here in Rio de Janeiro. The heat has broken but the fog remains. Helicopters are circling above us at the UN Conference on Sustainable Development (Rio+20) and security is very tight with police and military everywhere as the world's heads of state begin to arrive. Delegates and participants at Rio+20 now number above 30,000. The atmosphere has picked up, the food courts are full and there is no spare space to sit, charge a laptop or take a break. The media are here with their cameras up and the place is buzzing. But here is the thing: There is little to report about.  Journalists keep asking what the story is. There is a story but it's a very dark one and in our hearts everybody is looking for a ray of sunshine from Rio+20. But there are worrying signs of the very real and severe failure of the negotiations.

The Brazil government and its negotiating team have railroaded the negotiations to finalise an outcome text last night for heads of state to sign-off. But there have been complaints from many countries that the Brazilians have pushed the process too far so it has been stripped of any ambition and substance.  A senior negotiator from the UK delegation team stated that "there is almost nothing left now for the heads of state to negotiate and it's almost a done deal. But the real problem is this isn't a deal that anyway near addresses what we need." From analysing the text it's clear that the deal, as it stands right now, is a black hole of low ambition and little urgency. And we are all worrying that the black hole is gathering pace.

It's not just the Brazilians who bear responsibility. Leaders of the world's major economies came to Rio empty-handed with nothing to offer; no (financial) commitments and a dire lack of leadership. The current outcome text provides no clear targets for reducing climate emissions or reversing environmental degradation, there are no legally binding commitments and - more worrying - no new sources of finance.  Without these elements as a foundation the Rio+20 outcome will be an epic failure on a planetary scale. 

The science is clear: we can't continue to grow our economies by gobbling up and depleting our stocks of natural capital, be it for example fish, carbon or water.  We are undermining the very foundation of our planetary survival and its natural capital. Increasingly the impacts of climate change and resource degradation are severely impacting the world's poorest and most vulnerable people. If we don't urgently tackle climate change as well as other environmental issues we will reverse development gains and lock out future generations from the development choices they so urgently need in order to escape from poverty.

But there is a slim chance to make a huge difference,  if just a few world leaders could demonstrate  bold political leadership and state that they are not happy to commit the planet to an unsustainable future and many millions more people to a future of grinding poverty. Without tackling climate change and poverty reduction there will be no sustainable future. Whether Rio+20 will be game over for the planet remains to be seen. There are two days left until the conference closes on Friday evening. Two days for leaders to act and deliver a roadmap for a sustainable future, and I just hope they have the courage and determination to deliver the future we want rather than the future we can't live with.

A Testament to Human Kindness

IDP Rachele in her home in DRC. Picture by Julie Edwards/CARE International/2012

The humanitarian situation in the DRC is one of the world's most complex and long-standing. This is due to continuing armed conflict and general insecurity. According to UNOCHA 1.7 million people remained displaced, mostly in eastern DRC, in 2011.

In one village, Kanii, according to locals there are around 200 displaced people living amongst the 450 households. Rachele, displaced by conflict on several occasions has, this time, been here for three years. She first came to the village as a teenager when she was pregnant and fleeing mass atrocities. You might wonder why she returns home but when you have nothing and your home was once somewhere you were able to earn a living perhaps it is more understandable. "I want to return home. I have a farm, livestock and a field of bananas and beans but I know, at the moment, I can't go back."

Rachele lives in a shelter, provided by CARE, next to the family that took her in when she first arrived. The two room shelter is home to her and the 11 children she shares it with – six biological children and the five she adopted when her sister died.

Sangatia, a 50 year old widow, currently supports 24 people, including Rachele, and when you ask her why she simply replies ‘love'. There is no financial benefit for Sangatia and it is hard to understand why this woman would help so many others but she never questions the assistance she gives. "When new people arrive we see them as brothers and sisters, our feeling is to welcome them. When they arrive we welcome them and think about how we can live together. When we have food we share it."

The story of a displaced woman and the widow that has taken her and her family in is a testament to how the Congolese people help each other in times of crisis. CARE is supporting host communities and villages like Kanii with the provision of shelter kits, seeds and tools so that people can grow crops and feed their families. Community crisis management committees are set up so that people can work together and avoid conflict.

Rebuilding Lives After War

An ex-combatant, Miroro and his wife Furaha. Picture by Julie Edwards/CARE International/2012

Miroro and Furaha married in 2002 and have five children. Miroro spent 13 years in the army, leaving in 2006. When he left the army he found himself living amongst a distrustful community. "The community's reaction towards me when I returned was that they couldn't believe I was a civilian and always asked to see my discharge papers. They weren't necessarily afraid but weren't sure how to act around me as they thought I might still be a soldier."

The reaction of the community was just one part of the family's problems as Miroro explains: "When I left the army there was nothing for me to do. I couldn't send my children to school because the fees were too expensive. We lived here on the charity of the community". But since joining a CARE project and receiving business training the family has seen their fortunes change with the opening of a small shop in front of their home that is well used and supported by the local community.

Miroro's wife, Furaha, has seen changes since their involvement in the project. "Everything he gets he shares. We now have food and clothes. Each time he gets money he brings it to me and we talk about how to use it."

Miroro is also happy that he is his own boss. "I don't have to take orders from anyone else. I can support myself for the first time and send my children to school. I have learned how to generate an income, keep track of the money and reinvest it."

The project is working with ex-combatants to find viable ways to earn a living, through hairdressing, mechanics, livestock rearing and small commerce. The participants are also given kits to start their business and we have worked with local authorities to get taxes waived for the first year so that the businesses are provided with the best start possible.

When a Husband and Soldier Returns

Ex-combatant Munyaneza and his wife Matipaka in their home in Goma. Picture by Julie Edwards/CARE International/2012

During these years Matipaka would survive by finding work where she could and eventually she had to sell the one asset the family owned. "We had 7 goats before he left but I sold them one by one just to survive."

The return of Matipka's husband didn't spell the end of their hardship. Not only did they have to adjust to life back together but they still didn't have a secure income. "When he was unemployed life was very difficult, we just sold a little flour here and there. There were times when he was difficult to manage, difficult to live with."

CARE's ‘Hope Tomorrow' project is working with ex-combatants and provided Munyaneza, Matipaka's husband, with training and equipment to start his own business. Munyaneza explains how the project has helped the whole family "The project gave me four months training which included mechanics. I now have a driving licence and can repair tyres. I have also been able to buy four goats and some chickens and ducks. I can now send my children to school and feed them"

Life is now improving for the family but it is also good to see that Matipka is no longer facing the daily struggles on her own: "now when problems arise we can work together to overcome them."

The project is working with ex-combatants to find viable ways to earn a living, through hairdressing, mechanics and livestock rearing. The participants are given kits to start their businesses and we have also worked with local authorities to get taxes waived for the first year so that the businesses are provided with the best start possible.

Life in an IDP Camp

IDP Cecile outside her shelter. Picture by Julie Edwards/CARE International/2012

Cecile, 37, arrived in the camp almost a year ago. "We fled because armed groups were raising villages on the other side of the hills and they were killing people and burning everything. I was so distressed when we fled. We didn't have anything to eat."

Arriving in the camp, Cecile and her five children were taken in by another family until they could build their own shelter. Cecile struggles on a daily basis. "I face many challenges each day – to get food, maintain our shelter, to keep clothed and to even find cooking utensils. On top of that my children can't go to school."

CARE provided Cecile, and families like hers, with vouchers that could be used to buy the things she most needed, these vouchers assist families with the goods they need, while helping local markets. "We received vouchers from CARE. No NGO had given us food until then. I was miserable with hunger and when CARE gave us the vouchers I was overjoyed. I thank CARE for that. I liked getting vouchers instead of simply receiving food directly. It meant I could choose what to get and how much."

This camp is now home to Cecile and she explained why returning home isn't an option. "I can't imagine going back – people from our village have gone back and have been killed or have returned here."

CARE's funding to support families like Cecile ran out in May 2011. It is often difficult to secure longer term funding but CARE hopes to resume activities in the coming months to support new arrivals like Judith, a 47 year old widow, who arrived in the camp at the end of January. "An armed group came two weeks ago and they chased us away and killed some of us. Women were raped and their limbs were cut off with machetes. I saw this with my own eyes. While we were fleeing my sister was killed and cut to pieces."

"I live in misery. I work here and there for the villagers and get paid with plants and salt. I have nine children, four are my own and the others are my sister's children. My hope is that I receive help. Before, I had a stable life and could educate my children – now I can't do that. My children aren't well – we can't eat or keep clean."

*To protect the identity of people in this story names have been changed

The farmers of Dan Maza Idi village in Niger have a saying: "Everybody depends on the Earth to survive." But climate change is making survival more difficult in Dan Maza Idi and villages like it across Niger. Years of erratic rains and longer-than-usual dry periods have made it increasingly difficult to grow millet, a staple of the local diet.

Dan Bouga, a 55-year-old farmer in the village, works hard to feed his six children. But no amount of hard work can produce rain. Traditional millet seeds used in the region take three months to grow. With some recent rainy seasons lasting less than two months, Dan's harvests have plummeted.

In 2009, CARE began working with Dan and other farmers in the village to help them devise sustainable ways to improve millet production. Dan was one of several people who, with CARE's help, switched to new millet seeds that produce crops in just two months and can be replanted the following year. Along with new seeds, CARE trains farmers on how to successfully cultivate their new crop.

As had been the case for years, the first time Dan planted the new millet seeds, the rainy season arrived late and lasted just two months. But because he was growing a newer, quicker variety of millet, his fields filled with strong, healthy-looking cobs. Dan grew enough millet to feed his family – and had enough leftover to store and sell, despite the shortened rainy season.

"This surplus will allow me to have money to look after my family," he said in 2009. "I can pay for health care and buy clothes for my children."

The severity of this year's drought has pushed the entire Sahel region into an enormous food emergency. More than 15 million people are in need of emergency food assistance, including 1 million children at risk of severe malnutrition.

The people in Dan Mazi Idi and thousands of villages in the Sahel need outside help to endure the lean months before the next harvest. It is a humanitarian imperative to help them now and avoid an even more severe crisis in the future.

In Chad, Mali, and Niger, CARE provides access to food, work, trains nurses to identify and treat malnutrition, improves water and sanitation and promotes hygiene. And CARE provides essential household items and supplies to people displaced by conflict in Mali, as well as to refugees who fled across the border into Niger.

With more support, CARE can maintain and expand programs like the one that has helped Dan Bouga and his family support themselves. But time is running out. Families in and around Dan Mazi Idi village are so hungry they have already begun eating their seed stock to survive. Dan and his family have managed to hold on to their seeds so far. Even if they plant the seeds, there's no guarantee there will be enough rain for them to grow anything at all. But unlike some of their neighbors, Dan and his family have a chance at a healthier, more prosperous future.

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By Barbara Jackson, Humanitarian Director, CARE International

The thick calloused soles of the feet of the women with whom I sat in the tiny village of Maijanjaré in Niger, seven hours by road away from the capital Niamey, tell their own story. It is a story of many hardships, of back-breaking labour to dig a bit of land in extremely rocky, hard and dry soil in order to plant and hopefully harvest a bit of millet. It is a story of having to walk two hours each day to collect water. It is a story of women who have lost their husbands many years ago either to migration, working in another country where they have found new families, or to early death. It is a story of women who are widows and who tell us that without CARE’s cash-for-work project, they would be beggars now and are vastly relieved that for at least these few months, they do not need to beg.

These women are referred to as the elderly, and while they cannot tell us their age given that they don’t know it, they are probably in their late 40ies. The life expectancy for women in Niger is 45 years of age, an indicator of how tough life is in this part of the world. The women eagerly tell us the cash-for-work project, where they are paid a small sum of money to dig half-crescent shaped basins that will form natural reservoirs for the millet to be planted, has helped them to buy a small amount of grain that the government of Niger stores and sells at a subsidized price to community members during this very lean season.

Without food assistance and other support, over five million women, children and men in Niger are at risk of not having enough food in the coming months.

Already we are being told that people are reducing their food intake to one meal a day, and that the seeds that they have saved for the next planting season are being eaten to supplement their diets. The severe droughts of 2005 and 2010 are in very recent memory, with many people having gone into debt to survive those crises - yet people did not have enough time, productivity and stability to regain their livelihoods. The ‘elderly women’ of Maijanjaré will be amongst the first to suffer from this impending crisis if they do not receive help. But they do not want to beg for help. They are eager to work. They want to feel that they are helping themselves during this extremely difficult time.

The situation in the Sahel is a complex one and the small village that we visited is only a small microcosm of what many millions are living today in Niger. In times of hardship such as those, people used to migrate and find work as daily labourers in other countries. However, the conflict situation in Mali, the tenuous situation in Nigeria and the uncertainty and volatility of Libya does exhaust this strategy. Those in Niger are concerned, and wonder what the future holds for them.

Halima, one of the village widows shares with me: “We continue to be strong with CARE’s help and we hope that the rains will come on time.” Hope is a wonderful emotion and can carry one far, but it is not enough for the women of Niger. They must have the continuous support of CARE and others to help them through this very critical time.

It is important for us all to remember that during the food crisis in Niger in 2005, it would have cost us 1 U.S. dollar a day to prevent malnutrition among children if the world had responded immediately. By July 2005, it was costing 80 U.S. dollars to save a malnourished child’s life. Now is the time to help Niger --- not when it is too late to prevent what we know can be prevented.

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John Uniack Davis, Country Director, CARE Madagascar
March 29, 2012

Marie-Jeanne lives with two of her three children in this house that is slowly crumbling around them, closer each day to collapsing completely. Marie-Jeanne ekes out a fragile existence selling charcoal to neighbors who are only slightly better-off than she is. Location: Andovoranto, Brickaville. Photo: Katia Rakotobe

"Six weeks have passed since Cyclone Giovanna hit the east coast of Madagascar, and the humanitarian situation is becoming more and more clear. Needs assessments carried out by the United Nations, NGOs and the Malagasy Government came in and they offer precision regarding the affected population and its needs. But even without quantitative data, the passage of time has allowed us to see who is able to get back on their feet on their own and who needs outside help to return their lives to normal.

This week, I returned to the Giovanna-affected zones for the first time since February 22-23. My objectives were to thank and encourage our team, which has been working non-stop since the days immediately following the cyclone, and to get a sense of the evolution of the humanitarian situation. I traveled to Vatomandry and Brickaville Districts, those that were the most affected by the wrath of the cyclone. Accompanying me were emergency operations manager Mamy Andriamasinoro, communications officer Katia Rakotobe, and emergency officer Emmanuel Lan Chun Yang of CARE France. We made an effort to visit some of the villages that I visited five weeks ago, in order to have a clear basis of comparison and evaluate the evolution of conditions on the ground and our activities. My visit brought many issues surrounding the response into sharp relief.

In Andranofolo, a hard-hit village just south of Vatomandry, we revisited a young woman named Voahanginirina. When we had seen her previously, she was living in the precarious fallen wreckage of her house with her three daughters aged eight, four, and three. When we visited this time, the ruins of her home looked even worse. Consequently, Voahanginirina, who is barely over 20 years old, made the wise decision to move her family into a little structure that once served as their kitchen. It doesn't give the family much space, but it is safer than where they were before. The family of four makes do with Voahanginirina's meager earnings from making and selling baskets.

In the same village, we came upon Rose-Marie, a 73-year-old widow using the roof, which is all that remains of her home after Giovanna, as a simple lean-to-like shelter with the two grandchildren she cares for. Demonstrating that she is doing her best to make a good life for her grandchildren under difficult circumstances, she proudly showed us the neat mosquito net hanging inside her tiny makeshift dwelling. Rose-Marie makes the best living she can collecting and drying reeds from the nearby marsh, which she sells to people like Voahanginirina for basket weaving.

The next day we returned to Andovoranto, in Brickaville District, where Giovanna made landfall on February 14. Things are slowly returning to normal for many in that small seaside town. But those without extra resources or family to help them remain in quite dire straits. For example, we went back to see a widow named Marie-Jeanne, who once had a sturdy little wooden house, but a direct hit from cyclone-force winds left it a twisted, misshapen remnant of what it once was. Marie-Jeanne lives with two of her three children in this house that is slowly crumbling around them, closer each day to collapsing completely. Marie-Jeanne ekes out a fragile existence selling charcoal to neighbors who are only slightly better-off than she is.

As CARE moves forward with our response to Cyclone Giovanna, we cannot help everyone, nor should we. Many families suffered a lot in the wake of the cyclone, but have nonetheless been able to rebuild their homes and reestablish their livelihoods, thanks to their own resources or the support of family and friends. But some people, such as Voahanginirina, Rose-Marie, and Marie-Jeanne, need a little bit of outside help to regain safe and decent housing and get their lives and their livelihoods back on firm ground. These are the types of people that CARE will continue to work with in coming weeks and months as we continue helping people rebuild their lives.

Our cyclone response activities evolve over time but the principal themes remain the same, focusing on food security, restoring safe shelter, and reestablishing transport infrastructure for economic activities as well as access to vital services such as health care. We are grateful to USAID and private sector donors for giving us the wherewithal to hit the ground running and begin bringing our activities to scale. We are currently finalizing plans with other generous partners, including the Government of France, who will help us to meet the most pressing needs of those worst affected by Cyclone Giovanna."

By John Uniack Davies, Country Director, CARE Madagascar
March 6, 2012

"Just over a month has passed since Cyclone Giovanna struck the east coast of Madagascar and left thousands of lives in disarray. The day after landfall, CARE led a helicopter overflight assessment of affected zones and we have been working non-stop since then to help people put their lives back together. First, we coordinated the distribution of pre-positioned USAID plastic sheeting to 4000 households, about 20,000 people, whose homes had been badly damaged and destroyed. We are now seeking funding for longer-term work helping the poorest and most at-risk to build inexpensive cyclone-resistant homes. In the meantime, we are helping people meet their food security needs while simultaneously rebuilding key roads and such in and around where they live.

Once plastic sheeting distribution was under way, we quickly began the painstaking work of distributing food to those most in need – the elderly, handicapped, or widows and other vulnerable female-headed households are being given urgently-needed food for their families with no reciprocal obligation of any kind. But the majority of the food we distribute is given out in the context of "Food-for-Work" activities – those who are seriously affected by the cyclone but are able-bodied receive rations in exchange for making a contribution to rebuilding their communities. In the case of the Cyclone Giovanna response, we are focusing Food-for-Work on rebuilding footpaths and dirt roads that are necessary to restart economic life. For example, after Giovanna made landfall in the small oceanfront town of Andovoranto, it became even more isolated than ever, with roads cut off and economic activity interrupted. The people of the communities south of Andovoranto are working with CARE to rebuild the oceanfront road that heads 45 kilometers south to the district capital and major market town of Vatomandry. In rebuilding this road, fishermen will ensure that they have a market outlet for their catch, thus restoring their principal livelihood. While they are rebuilding the road, they will receive food rations for their whole families, thus providing essential short-term access to food. In the current phase of our response to Cyclone Giovanna, we are supporting about 32,500 people with food assistance, most of this through Food-for-Work activities. We are grateful to USAID and the United Nations World Food Program (WFP) for supporting this important support to those most in need.

In spite of all this, much remains to be done. Many families lost their entire maize and cassava harvests, and many also lost other crops, including rice, Madagascar’s main staple. Consequently, many families do not have nearly enough food to make ends meet while they replant and get back on their feet. Many families will thus need food security assistance at the same time that they are going about rebuilding homes and other infrastructure and doing the hard work of another agricultural season. We at CARE Madagascar continue to work with the Madagascar Government Disaster Risk Management Agency (BNGRC) as well as the United Nations system and other partners in order to make sure the most affected get the help they need."

By John Uniack Davies, Country Director, CARE Madagascar
March 6, 2012

"This continues to be a difficult cyclone season for Madagascar. Two weeks after Cyclone Giovanna, Tropical Storm Irina crossed the northern part of the "Grande Ile" and then parked itself off the west coast, in the Mozambique Channel, dumping lots of rain and affecting weather throughout the island. The severe weather caused extensive flooding and mudslides in the southeast part of the island, which had also been badly effected by flooding after Tropical Storm Hubert and Cyclone Bingiza in 2010 and 2011, respectively.  In one mudslide in the roadside town of Ifanadiana alone, 47 people died, and the current death toll for Giovanna, Irina, and associated weather is now at least 100. But the number of lives affected by the storms far surpasses this number.

The town of Vangaindrano in the southeast has become, for all practical purposes, an island, and populations there are cut off from assistance and at great risk of crop loss as a result of flooding. Devastation to crops would make the local populations very vulnerable in the medium term, bereft of livelihoods. Our team in Vangaindrano is assessing the impact and we expect to mount an appropriate response. We are also discussing a possible overflight with other key actors in order to ensure that necessary, coordinated assistance reaches populations in need in the southeast.

CARE Madagascar continues to be a key actor in the response to Cyclone Giovanna, which struck on February 14.  We have overseen the distribution of 397 rolls of USAID plastic sheeting distribution, which have permitted 20,000 people to escape from the elements and begin to rebuild their lives. We are grateful to our colleagues at Catholic Relief Services (CRS), who played an important role in helping us to get plastic sheeting out to the needy populations of Brickaville quickly.  We are currently stepping up efforts to provide food to those in need. We are in the process of coordinating food for work teams to rebuild roads and restore access to villages cut off by Cyclone Giovanna, primarily by fallen trees and mudslides. Through our current food for work activities, 6500 households, at least 32,500 people, will benefit from 342 metric tons of rice and other food, and we are in the process of obtaining additional commodities from USAID and the World Food Program to permit additional rebuilding of infrastructure and providing short-term food aid to families in need.

Visitors to Brickaville and Vatomandry are moved by the difficult conditions in which families are living. CARE Emergency Operations Manager Mamy Andriamasinoro says that he is most struck by seeing children sleeping in precarious, damaged homes without roofs. ‘I realize how fortunate my own kids are, and as a parent I am really affected to see the conditions in which kids have no choice but to make do,' he says.

We at CARE Madagascar are doing our best to relieve the suffering of families affected by Cyclone Giovanna and other storms this year. We want to do our best to ensure that they have adequate shelter and enough food to eat in the short term. And in the medium term, we are looking to help the poorest farmers and fishermen restore their livelihoods and regain their self-sufficiency. For this, we will need additional support from the international community."

As the Sahel region of West Africa faces a hunger crisis, Evelyne Guindon, Vice President of International Programs at CARE Canada recently visited CARE's operations in Chad to assess the situation firsthand.

You may not see many news stories about the looming food crisis in the Sahel, but my recent visit to West Africa showed me that immediate action is needed to prevent a large-scale emergency, much like that which we saw recently in East Africa, including deadly famine in parts of Somalia.

Erratic rains in West Africa's Sahel region have left over 10 million people displaced and malnourished. The drought has limited agricultural production and sent food prices soaring.

Chad is one of the countries hit hardest by the unfolding crisis.

I visited CARE's operations in Iriba, a small town in northeastern Chad providing a safe haven for thousands of refugees. Though the host community in Chad has generously welcomed the refugees from neighbouring Darfur, I was alarmed to see that the Chadians were, in some cases, more malnourished. I saw many parents making the difficult decision to pull their children out of school and sell their livestock just to afford the rising cost of food.

CARE had mobilized a team to cope with the increasing demand for aid and was already engaged in preparations to scale up to an emergency. I had a chance to see this activity firsthand -- CARE staff working hand-in-hand with community leaders, women and men, traditional leaders, government staff, and parents.

CARE's work in Chad is a reminder that when it comes to emergencies, we are often among the first to arrive and the last to leave. With limited funding and infrastructure, CARE has been working on long-term projects in Chad for over 40 years to improve conditions and provide support to residents.

Though my visit to Iriba was sobering, I kept thinking of a women's group I had met on a past trip to Dadaab, Kenya. Like the Chadians, the Dadaab women were once impoverished and lacked education, but learned to make honey and grow food and animal fodder through a CARE project. They developed skills that created businesses, which provided their families with a reliable source of income even in the face of a drought and food crisis.

The people in the Iriban camps were suffering, but my memories of the women's group in Dadaab reminded me that sustainable change is possible when people are given the tools they need to succeed.

CARE's focus on long-term solutions like enterprise and economic development, food security and female empowerment gives me hope that we can help the people of Chad become resilient and strong in the face of frequent drought and rising food prices.

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"CARE's vision is to fight against worldwide poverty and to protect and enhance human dignity. CARE Japan decided to respond to this disaster to protect and enhance human dignity of the affected population. Mega disasters, even in developed contexts, can leave people with absolutely nothing in the immediate aftermath, push self-sufficient populations into poverty, eradicate years of development and threaten people's right to life with dignity. Today, I can firmly say: If the same scale of earthquake hits Japan, we'll respond again. This is a firm commitment shared among all the staff of CARE Japan.

CARE Japan has decided to run our psychosocial program until June 2013.One year has passed since the earthquake and tsunami. Temporary housing compounds have been built. Many more stores are restarting their business. And, newly developed local organizations are now playing a major role in initiating recovery efforts. Still, the psychosocial effects of the disaster remain present. Many of the survivors are struggling to overcome the events of March 11. "I sometime do nothing but keep watching TV which is not showing anything," told an elderly lady who wanted to be anonymous to a CARE staff at a community café CARE supports.

CARE had completed the food program in June 2011, and now focuses more on community relief and psychosocial support to help people recover from the trauma. The needs of the people in the affected area will shift as the time passes. CARE continues to coordinate with local authorities and other aid agencies in order to identify the needs and reach the most vulnerable people."

Johannes Schoors, CARE Niger Country Director
March 2, 2012

Abu mahamane has credit in her village savings and loan, purchased raw material in the bank of cereals and (here) sells food prepared on the spot in the village market.

This couldn't have come at a worse time – not that there is ever a good time for brutal fighting that burns people's homes to the ground and sends them running in fear to another country. More than 130,000 people have been displaced by the fighting in Mali, and many of them have arrived here in Niger, a country that is already in the grips of a worsening food crisis.

Most families in Niger, especially in the areas along the border with Mali, are running out of food. Families have reduced the numbers of meals in a day. Children are going hungry. The refugees are adding to the strain already being suffered here. But the people of Niger are amazing – they have almost nothing, but they are helping the refugees. They are sharing what little food they have. This is the culture in Niger. They help out how they can: a Nigerien will share a cooking pot with a refugee family, and the refugee family will use it, and then pass it on to another family.

Tens of thousands of Malian refugees have fled into Niger. There was heavy fighting last night, so more refugees are crossing the border. This will get worse. And as always, the ones caught in the middle are the civilians.

Their villages were burned to the ground. They have nothing to go back to except sad memories. Already the numbers are growing. CARE plans to help the people who fled to Banibangou, and we were initially told there were 600 families – there were in fact 1,260 families (9,000 people), and more people are crossing the border as the fighting continues.

The refugees are in a bad state. Many of them are sleeping in the open. I saw a photo of a pot with brown sauce in it, and I said to my staff, 'oh, so they are eating millet?' But my staff said no – that's muddy water. The refugees are drinking muddy water, because they have no access to clean water. We need to help them filter the water, or the refugees will start to get sick. Water is a real problem.

CARE is gearing up to provide clean water, food and emergency items to the refugees. But we need to help the Nigeriens in this community, too, because they are sharing what they have with the refugees. By helping the refugees, they're running out of food more quickly.
This situation is going to get a lot worse before it gets better.

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By John Uniack Davis, Country Director, CARE Madagascar
February 23, 2011

'Today we left Vatomandry at 6 a.m. to head back up the road 90 kilometers to Brickaville, the district hardest hit by Cyclone Giovanna. As we approached Brickaville, we saw major destruction in every settlement, houses flattened and large trees uprooted. 

The large town of Brickaville was bustling, with havoc wrought by the cyclone everywhere but people going about their business. We turned down a busy side street to come upon a group of young Malagasy in Red Cross garb and then pulled up at the busy makeshift field office that CARE shares with the Malagasy Red Cross and other humanitarian organizations. After paying a courtesy call on the Catholic Relief Services (CRS) team leader and meeting up with two colleagues from OCHA (Office for the Coordination of Humanitarian Affairs) who were going to the field with us, we hit the road again.

Shortly after leaving Brickaville in a well-worn Toyota Land Cruiser for the driving portion of our excursion to Andovoranto, the town where Giovanna made landfall, we spotted a lone man rebuilding his house. We were a ways out in the country on a verdant hillside with no other homes in sight.  We found out that the young man's name was Jackie and that his wife and young daughter and he had been in their home when it was torn asunder by the cyclone.  At that point, they were forced to huddle together in the open for hours until the storm passed.  His wife and daughter are now living with relatives in the town of Brickaville for the three weeks it will take him to rebuild their home. When we asked Jackie how his new house would compare to the old one, he shook his head sadly and said it would be worse.

Once CARE's response moves from immediate post-disaster relief to longer-term recovery activities, "building back better" will be a primary objective -- we want the most vulnerable victims of Cyclone Giovanna to emerge less at-risk and less vulnerable than they were before this cyclone. And to do this we need to help them to ensure that they are housed in less-precarious structures.

After 45 minutes of driving and 45 minutes in a CARE motor boat, we arrived in Andovoranto. The town sits on a narrow spit of land between the Pangalane Canal and the Indian Ocean. We were struck by the contrast between the beauty of the natural setting and the stark destruction that we saw everywhere we looked. A two-story private nursery school and primary school had one wing leveled, the second floor pancaking on top of the first, leaving a chaotic image of torn-up walls, a broken roof, and splintered furniture, garnished with a heartbreaking jumble of children's notebooks, workbooks,  homework, and school supplies.

Around the corner from the school we met a woman named Denise Charline. She and her children slept in their granary during the storm to escape their flimsy house. They are now back in their house, living in it despite a badly-damaged roof, thanks to USAID’s plastic sheeting distributed by CARE.

The images of the past two days spent in towns and villages affected by Cyclone Giovanna will stay with me for a long time. I am daunted by scenes of raw destruction but lifted up by the courage of those most affected by it. My team and I are fully committed to an emergency response that honors the dignity of the Malagasy people and helps them to "build back better" their homes, their livelihoods, and their lives."

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By John Uniack Davis, Country Director CARE Madagascar
February 22, 2012

"I am in the field with communications officer Katia Rakotobe visiting CARE's activities to bring relief to those most affected by Cyclone Giovanna. Today, we left Antananarivo ("Tana"), the capital of Madagascar, at 7 a.m. and headed east toward the coast to the two districts most hard hit by Giovanna, Brickaville and Vatomandry. About two and one-half hours' drive east of Tana, over halfway to the coast, we started seeing fairly significant storm damage -- roofs off houses, trees down, and mudslides partially blocking the road, eight days after the cyclone hit. East of Andasibe National Park, we saw whole stands of young trees bent in half or blown down, a vivid testimonial to the power of nature, the raw force of the cyclone.

We ate lunch at a roadside stand at Antsampanana, the crossroads between Brickaville to the east and Vatomandry to the south. As we ate, we saw nimble young men on nearby roofs repairing the cyclone damage. Farther south, we saw numerous houses completely leveled by the cyclone, and yet the simple rough-hewn frames of new houses are already in evidence. We were struck by the resilience of the people, knocked down by the storm but springing back up to rebuild their lives.

CARE's post-cyclone relief activities are aimed at those who are more vulnerable and less resilient. These are often, for example, women heads of households with young children or elderly people with no means of support.

We are in the process of distributing plastic sheeting to those exposed to the elements. With plastic sheeting supplied by USAID and the UK Department for International Development (DFID) and the help of partners like Catholic Relief Services (CRS), we will keep 20,000 to 30,000 people safe and dry.  In the medium term, we expect to help those most in need to rebuild their homes in a sturdy fashion. While many families have their own resources or a social safety net that will permit them to rebuild without outside help, we want to assist those who don't quite have the means to help themselves quickly enough.

CARE will also be providing food aid to destitute households in the short term and start food-for-work programs in the short and medium term. Food-for-work means that people will help removing rubble and reopening blocked roads and will receive sufficient food for themselves and their families in return.

As I write these lines on my Blackberry while bouncing along on a remote sand track near the Indian Ocean, it is clear that a lot of work lies ahead of us in order to provide relief and help those in need rebuild their lives and regain their self-sufficiency. My colleagues at CARE Madagascar and I welcome the challenge inherent in this important work.

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Impact of previous cyclones in Madagascar, such as wind damage. Picture taken by  by Katia Rakotobe– Location : Mananara (North East)

"On Wednesday morning, CARE sent a helicopter to the areas affected by cyclone Giovanna to assess the damage. The storm made landfall on Tuesday, February 14, on the east coast of the country and it brought heavy winds and rains. Our staff have been preparing for this as we could monitor the storm coming close. Luckily, when Giovanna made landfall, it lost some speed and was therefore not quite as strong as the Category 4 storm that had been predicted. But still, it left a path of destruction through several districts.  Two districts in particular, with a total population of over  400,000 were particularly hard hit. What was really unusual was that after hitting the coast and traveling inland, the cyclone passed directly over the capital city, so I and the rest of our staff had to stay home until late Tuesday morning. There were extremely strong winds. Giant billboards were blown down and debris was flying around. I am glad that all of my colleagues are safe and accounted for. Here in "Tana", as we call the capital, there has been quite some destruction and people were not really prepared for the storm.

Tomorrow we will have a better picture of the devastation when we evaluate the data from our aerial assessment. CARE staff from our sub-office in Vatomandry report that at least 60 percent of dwellings in the town have been partially damaged or completely destroyed. Houses in these poor areas are often built of bamboo and palm leaves, so it is easy for a strong wind to rip them apart. Many families have experienced these storms before, so they usually repair their houses quickly. But especially elder people or households headed by women need our help now to provide them with construction materials. There are sixteen reported deaths so far, but I expect the numbers to rise. Many areas are still cut off and have not been reached yet.

CARE had plastic sheeting prepositioned in our warehouse that we can distribute to 6,000 households or 30,000 people as a first emergency response. Once we have clearly assessed the needs and locations, we will begin with the distribution. People will probably also need food assistance, as their stocks might be lost in the damage. And as roads are destroyed, we need to rebuild them quickly to get access to affected villages. CARE is one of the most established emergency actors in Madagascar, we have provided emergency relief to cyclones in the past years, such as Bingiza and Hubert. I hope that this time again we will get the necessary support and funding to act quickly and reach those who need our help now."

John Uniack Davis, Country Director CARE Madagascar
February 16, 2012

Impact of previous cyclones in Madagascar, such as storm surge. Picture taken by Dasy Ibrahim CARE staff -- Location : Antalaha (North East)

"Our CARE team is in the second and final day of a helicopter assessment mission to target assistance to populations in need after Cyclone Giovanna hit the country on Tuesday morning. The team is reporting that, as expected, there is substantial damage in the Districts of Brickaville and Vatomandry, which are located on the east coast of Madagascar. In the commune of Andevoranto, the point of Giovanna’s landfall, 80 percent of dwellings were damaged or destroyed. For the town of Brickaville that figure is about 70 percent, whereas 40-50 percent of houses in Vatomandry were damaged. There is a stretch of coastline of 100 kilometers or more that suffered quite serious destruction. People lack shelter as well as access to food in the short term – we need to help them soon.

The assessment team is doing everything that it can to provide assistance as quickly as possible. For example, some remote communities have experienced serious wind damage and are largely bereft of shelter. So our team is bringing in the first batch of plastic sheeting by helicopter to help them build temporary shelter and get out of the elements. But a more sustained effort of relief and recovery will be necessary in order to help populations buffeted by Cyclone Giovanna get back on their feet. Our deputy emergency coordinator will stay in Brickaville today to open a makeshift emergency operations office and begin mobilizing experienced emergency staff to move forward with providing shelter and food and reopening disrupted transport routes.  Thanks to funds provided by the CARE Emergency Group in Geneva, we have been able to hit the ground running in order to provide vital help to those most in need. However, more resources will be needed in the coming weeks to scale up relief and recovery operations."

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.

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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Haiti – 2 year anniversary of earthquake

The parents of Léogâne's Mellier community have a long history of banding together to help one another. In the chaos that enveloped Haiti following the departure of the ruling Duvalier family in 1987, a group of parents in Mellier formed the Association of Parents of Mellier (ASPAM), a PTA-like association to make sure their kids' schooling continued without interruption. Soon after, they opened a pre-school and an elementary school so their youngest children didn't have to walk for hours to facilities outside Mellier if they wanted an education.

Modsol, Leogane, one of the community of return where CARE provide people with shelter and latrines. CARE has successfully distributed nearly 2,500 transitional-shelters to families with legal access to a building site, providing these individuals with robust structures that can last from 3- 5 years or until they find a more permanent housing solution.

Léogâne was one of the areas hardest hit by Haiti's devastating January 12, 2010 earthquake. Officials estimate the tremor destroyed 80 to 90 percent of Léogâne's buildings. Among the destroyed buildings there were ASPAM's elementary and pre-schools – along with the homes of most the school's children.

Even in the immediate aftermath of the earthquake, when day-to-day survival was itself in doubt for many, parents began work to get their children back in school. For help, ASPAM turned to CARE, which has supported 78 schools since the earthquake, 20 in Léogâne alone.

"CARE was with us from the start," says Ginette Louis Jean, director of the ASPAM pre-school. "CARE provided us with school kits for teachers, students and educational materials for the class direction."

The parents soon re-opened the school in a temporary structure. CARE provided classroom supplies such as benches, blackboards and recreation kits. CARE built latrines, hand wash stations, water purification systems and held regular hygiene promotion sessions. The community pays an attendant to clean the latrines and ensures that the hand wash system is always filled with chlorinated water.

CARE's work with the school goes beyond standard educational curriculum. A CARE-led program in the school teaches children how to make attractive handbags from discarded items like bottle labels and cigarette packs. The kids earn money selling the items at a local market. Though the program includes boys and girls, it was designed in part to teach income-generating skills to at-risk girls; girls who might otherwise turn to prostitution.

Ecole les Abeilles de ASPAM (Bees of ASPAM School), Leogane. CARE Haiti’s Emergency Education Response has helped 20 schools directly affected by the earthquake in Léogâne and 58 indirectly affected schools (serving displaced children) in the areas of Gonaives, Gros Morne, and Jeremie.

CARE also provided members of the school's community with psycho-social counselling to help them cope with the intense trauma of the earthquake and its aftermath.
"The psychosocial sessions have helped us realize that we didn't only need to rebuild our houses, but also our minds," explains Ginette. After some understandably difficult months, the school's 250 students, 138 girls and 112 boys, are much happier now, she says.

Despite the extreme challenges created by the earthquake, ASPAM believes it's a stronger organization now than it was before the earthquake. With 80 percent of its students passing Haiti's standardized tests, ASPAM acquired land to build a secondary school so its graduates have a place to continue their education as they grow.

"We hope CARE can help us expand the school," says Lesly Jean-Baptiste, chairman of ASPAM. "But even if it can't, CARE helped us become much stronger. I'm sure we will find a way."

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In the highlands of Ethiopia, a group of 19 people sit in a circle in their communal field. In the middle of the circle are four coloured plates and a tin box with two locks.

This is the Water, Sanitation and Hygiene Committee of Sahvina Kebel*. They formed through CARE's Water, Sanitation and Hygiene project in late 2010.

Despite their name, this group does much more than improve access to clean water and sanitation in their community. With these simple tools, this committee and the woman leading them are also bringing new opportunities to their remote village.

It all began last year when the group built a new water pump with CARE's assistance. Less than one year later, this pump has given women more free hours in their day and reduced the amount of illness in the community, particularly the children.  

Tuesday 27 September WASH project in South Gondar, Farta and Estie Woredas. Beletech, 34 year old mother of four from Farta Woreda, Sahivna Kebel. She has four children and is the chairman of the WASHCO. Sitting on a tree stump with her child. Image: Josh Estey/CARE

Beletech, a 34-year-old mother of four, is the chairperson of the group. She explains 'Before the construction of the water pump, I would walk for one hour to collect water from the river. I lost time collecting water – walking and queuing because water is scarce. My children drank this unsafe water and had diseases. Now, the water is safe and my children can go to school and be healthy.'

The water pump was developed through a close partnership between CARE and the community – CARE provided skilled labour and the majority of the materials for the pump, and the community provided their own labour and sourced some local resources like sand and rocks.

The committee developed by-laws to protect the pump – if anyone breaks a law, they have to pay a fee. This money is then managed by the group to cover maintenance and other related costs.

That is just one of the funds the committee manages today. The committee also operates as a community savings group, with each member contributing 5 birr (30 cents) every month. As the total sum grows, members are able to take a loan out for income-earning activities, which is then repaid with interest.

The money is kept safely in a tin box under the security of two separate locks. Beletech holds one key, and the committee's treasurer holds the other.

'I am saving money, and starting to change my life,' says Beletech. The group has taken a loan already, to purchase salt and then on-sell it at the local market, making a profit of 55 birr ($3.20).

When the group meets, the money is divided amongst the coloured plates – with each one indicating a different "account" within the savings group. The green plate displays the groups' savings, yellow is the interest paid back from loans, red is the punishment fees that are paid if someone breaks a by-law; and blue is the social fund that all members contribute to and is available for anyone in the community to borrow from if they find themselves in urgent need of money.  

Beletech's role as leader of the group is another first for this community. Before, women were not usually allowed to speak in public or be involved in decision making. Now, she is leading this group of women and men towards creating a better future for their entire community.

'I am happy to be the chairperson of the group. I manage the meetings and have the power to speak in front of others and make decisions. I received training from CARE about speaking publicly, before I only ever spoke in church. Now, I speak in meetings and community discussions.'

The gender division of labour and opportunities is breaking down in Beletech's home as well as her community. She explains, 'In my home, my husband would only spend his time on farming and I would work in the house. Now, my husband shares the household chores like cooking and making coffee and there is improvement in my home.'

Now, with the opportunity to learn leadership skills and the ability to save money, the opportunities for women in Sahvina Kebel are flowing as freely as the clean water from the village's water pump.

*A kebel is an Ethiopian village

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In the red dusty landscape of southern Zimbabwe, a slight figure walks under the blazing afternoon sun with a tin bucket swinging by her side.

It looks like a difficult and tiring task, but 10-year old Agnes* is happy to collect clean safe water that is just 400 metres from her home.

Every afternoon, Agnes walks to a borehole that has been recently repaired by CARE to provide her and 300 other families with safe, clean water near their homes and school.

Collecting water is a task that is almost exclusively carried out by women and girls in developing countries like Zimbabwe. Without a safe borehole to collect water from, many females in Agnes' community used to walk for hours, several times a day, to collect enough water for their families to drink, bathe and cook with. Even after walking long distances to find water, what they would source may not necessarily be safe to drink.

The lack of access to clean water, and lack of toilets and information about sanitation have caused illness in Agnes' community – in 2009 the cholera outbreak that devastated parts of Zimbabwe claimed 4,000 lives and infected more than 100,000 people.

Since CARE's Water, Sanitation and Hygiene (WASH) project has been operating in the area, this has changed for many families.

Now, 300 toilets have been built by local communities, with assistance from CARE. Over 40 boreholes have been rehabilitated – providing access to safe water for thousands of people like Agnes.

'The borehole is closer to our house, so it's a good thing that we can get water there now. It is about 400 metres from our home and 200 metres from my school.'

Agnes has developed a new interest at school that helps her make the most of the new water and sanitation resources. She is a member of her school's health club, a group that is open to any student who would like to learn about preventing illness through sanitation and hygiene practices.

CARE encourages teachers in the community to start a health and hygiene education club at their school, and provides the teachers with support and advice on how to teach hygiene principles that will improve the health of students, and their families.

'I really like being in the health club because I get the explanation about how diseases are spread. We learn about mosquitoes, diarrhoea and houseflies. We learn through drawings and from books,' Agnes says.

'I teach my younger brother and sister what I learn as well. Now, we wash our hands after going to the toilet, we know how to store water in the house and not to play in stagnant water. '

Now, her daily routine includes sanitation principles at every opportunity – and she and her family are healthier because of the initiatives she has shared with them.

'In the morning, I make my bed, eat breakfast, sweep the house and bathe while my mother collects the first lot of water from the borehole.

In the afternoon, I bathe again, sweep, wash the dishes, collect more water with my mother and help make the fire for cooking dinner.'

With less time spent collecting water, and more activities in her home to keep her family healthy, Agnes is able to concentrate more on her studies. And what does a young girl with a passion for health and hygiene want to do when she leaves school? Help others to be healthy too, of course!

Agnes explains, 'When I finish school, I would like to be a nurse because I don't want people to get sick. I want to take care of them.'

*Names changed to protect children

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GOMA, Democratic Republic of the Congo
Allen Clinton and Jackie Kiernan 

Florance Kwinja picked up her basket filled with corn meal and beans and headed to the market outside of Goma. It's a bus commute the widow and mother of eight never used to think twice about. It was just another chore she did to earn money for her family. But it was anything but routine as the memories of the last time she made the trip two years ago come flooding back.

"We were ambushed by a group of combatants," Florance says. "They held me down and began to rape me, one by one. I was convinced I would die that day. I stopped living." 

In the Democratic Republic of the Congo, rape is routinely used as a weapon of war. Help and justice are hard to find in a country with one of the world's worst poverty rates and mass corruption. To cope with the terror, families regularly flee their home villages. Separated from their families and livelihoods, women and children turn to rummaging for scraps of food and a simple roof to sleep under. Extreme poverty and a loss of dignity have damaging effects in their lives.

Florance, 48, became a widow in 2003 when her house was ransacked and husband, a successful merchant, was killed. Having no savings, she and her children fled their remote village to the town of Goma. Florance worked tirelessly for the next few years to make money to feed and clothe her children. Then the rape happened and she fell into deep depression, an event all too common for women in the Congo. People who Florance considered her friends no longer greeted her. Shamed and scared to return to work, the once proud woman says she could no longer look people in the eyes. When things couldn't seem to get worse, two of her eight children went missing. After three years, Florance didn't think she would ever find them alive.

To understand what is happening here, you have turn back the clock to 1994, when the genocide that claimed nearly one million lives in neighboring Rwanda spilled over into Congo. Since then, the Congolese army, rebels and home-grown militias have been fighting over power and land, which is rich in gold, diamonds and coltan, a sought-after mineral vital to the manufacture of mobile phones and other popular consumer electronics. The result has been the deadliest conflict since World War II. Nowadays the most frequent casualties of war are women. Because women farm the fields and care for children, it's not uncommon to hear that when a woman is raped, her entire family and community are destroyed. Over 82 percent of displaced people turn to host communities and organizations like CARE for support. Only a fraction of families make it to under-funded cramped camps, where they depend on basic aid from the United Nations and other humanitarian groups.

"Women here are in deep pain," says Yawo Douvon, country director for CARE in the Congo. "But it's not just the type of physical pain that can be repaired in a hospital. It's psychological pain that you can't see that takes more time to heal."

Despite there being a constitutional law condemning rape and sexual violence, and newly formed mobile courts that help convict perpetrators, more work is needed to foster representative government and rule of law to bring more perpetrators of human rights violations to justice and ensure the protection of all women. The United Nations Population Fund estimates that 44 percent of perpetrators of sexual violence in the Congo are now civilians.

As women seek support for their plight to overcome gender biases, there are organizations trying to help vulnerable people get back on their feet, including rape survivors and demobilized male combatants. CARE's Espoir de Demain (Hope for Tomorrow) project organizes support groups and teaches people how to make shoes, how to cut hair – skills they can use to earn money and a chance for a whole new life.

Florance jumped at that chance. She signed up to learn to be a hairdresser, a trade almost exclusively reserved for men. Whatever difficulties she would face to break gender barriers, she knew things would change for the better. "It was as if someone had thrown me a rope to help me climb out of a deep, dark hole," she says, explaining that her children would be able to have a "normal life" once she launched her own business. "It's a good business to be in because people always need haircuts."

More importantly, Florance says she chose this trade to stay in one place and not be as vulnerable to potential attackers.
After finishing the training, Florance opened her own business in June, 2011 CARE provided her with a generator, hair cutting supplies, mirrors, lamps and other necessities to get her started. Nervous, with clippers in hand, she says she remembered to cut up instead of down like her instructor showed her when cutting the hair of her first clients. She charges 30 cents for most haircuts but favors braiding hair.

Photo by Allen Clinton

The boy sitting in her chair today was extra special. He is one of Florance's two eldest sons. Both boys had been reunited with her by the Red Cross after years of separation. They have also received skills training through CARE to become a carpenter and plumber.

Hope is not something you'd expect Congo's rape survivors like Florance to still cling to. But they do.

Looking at Florance today you could not recognize her past suffering through the proud smile on her face. She says, "I've had a lot of deception in my life. Clients, visitors and CARE are my new family," People in her neighborhood have begun greeting her again. And Florance, looking them in the eyes, greets them back.

Interview with Promboon Panitchpakdi, Executive Director Raks Thai Foundation (CARE Thailand)

Thailand has been experiencing severe floods for several weeks now. How is the situation at the moment?
Thailand has encountered the worst floods in 50 years. Almost 60 of the country's 76 provinces have been affected, impacting some eight million people. But even though the rains have stopped now, vast masses of water are flowing from the north to the south, inundating large areas and destroying homes, roads, farmlands and industrial compounds. Many businesses had to close down and I fear that after this natural disaster, Thailand will face an economic crisis.

Thailand. Female migrant worker stocking food supplies. The water level is approximately 1 meter in many living areas, hampering transportation and access to affected populations.

The main amount of water is still in the central provinces and in some areas it has risen up to three meters. People need boats or trucks to move around and provide assistance to those in need. More than 300 people died, mainly due to drowning and electric shocks. The provinces will stay inundated for at least one more month, some even longer.

How have the floods affected Bangkok?
Bangkok is located right at the southern spot where the water is flowing. So the water coming from the north flows into the Chaopraya river, which runs through the capital city. This means that eventually Bangkok will be flooded to the same extent as the other provinces, with water masses standing between one and three meters high. The government tries to divert the water to the western side, which is a suburb area, and therefore a lot of people are being evacuated. But even with all these efforts, the water gradually creeps closer; the old Don Muang airport is already half a meter under water. People are building sand bag dykes and trying to irrigate the many canals into the sea fast enough. But most calculations say that more and more areas of Bangkok will become flooded - including our office. We will need to relocate our key staff to a city outside of Bangkok.

What are the main needs of the population?
The floods have destroyed houses, crops, livelihoods. In those areas that have been flooded for almost one month now, water and sanitation conditions are very poor and people start to become sick with diarrhea and other diseases that come with dirty water. Many evacuation centers are crowded and ill-equipped without enough supplies to assist people who have lost everything.

But those affected most are marginalized groups, such as migrant workers. There are around three million migrant workers in Thailand that live here either with or without documents, most of them coming from Myanmar, Cambodia and Laos. They separate themselves from the Thai population through their language, uncertain status and fear of extortion. There is a real risk that they will be excluded from relief efforts. Migrant workers who are staying in apartment buildings are isolated, many are lacking food, water and other basic supplies and some of them have no access to public health services. They cannot travel to their homelands because their travel documents are often kept by their employer. Many have lost their jobs and their means to support their families.

Thailand. Some people managed to have a boat, an essential necessity for travelling.

How is Raks Thai assisting the migrant workers?
We conducted an initial assessment to find out their most urgent needs. Since many workers have been employed on a daily basis, they have no money to buy food. Also, in some areas outside of Bangkok most of the shops have run out of food and basic supplies. Raks Thai will therefore support almost 20,000 migrant workers, women and children in four provinces with food, clean water and essential relief items. We will organize and facilitate the transport of vulnerable people to emergency shelters and temporary accommodation. We plan to install water supply systems and implement sanitation and waste management systems.

Raks Thai Foundation was established in 1997 and became a member of CARE International in 2003. The organization employs 286 staff, 47 of which are nationalities of the migrant workers in Thailand. Raks Thai has responded to the 2004 tsunami and provided support to 113 communities in Thailand. Since then Raks Thai Foundation has implemented emergency response programs to several floods that hit the country.

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As part of a CARE's emergency response team in Cambodia I've been responding to South-East Asia's worst flooding in a decade.

The Mekong and Tonle Sap rivers have been at emergency flood levels for over a month now and unfortunately 247 people have died and 18 out of 24 provinces in Cambodia have suffered damage with Kandal, Kampong Thom, Prey Veng and Kampong Cham being the worst affected.

Whilst exact numbers are still hard to clarify it's estimated that more than 1.5 million people have been directly affected and more than 46,000 households evacuated.

The impact on livelihoods, especially for poorer rural families is looking dire with early reports suggesting that 405,686 hectares of lush rice fields have been damaged with more than 230,000 hectares reported as potentially destroyed which represents 9.4 per cent of total the crop.

I read a report in a local newspaper yesterday (Thursday 27 October) which said that some evacuated families have started returning home to their flood wrecked villages as the waters slowly recede in along the Mekong River and other parts of the country.

No such luck for Lower Mekong provinces such as Prey Veng, which is one of the worst affected areas. This is where my CARE team is working with people in urgent need of emergency supplies,
Prey Veng has been hit hard with more than 78,000 families across its 12 districts affected. Almost 7,000 families have been evacuated from their homes and 49 people have been reported dead.

In Prey Veng, the flood has affected almost 79,000 hectares of rice paddies and 45,000 hectares are estimated to have been destroyed. Many farmers take out agricultural loans for seeds and fertilizer at the beginning of the growing season, and pay the loan back following harvest. This season, many of these farmers will be significantly in debt. Requests are being received for CARE to provide seeds from fast maturing rice varieties as a matter of urgency, as well as other assistance, so that affected households can replant as quickly as possible.

At this time I believe the three greatest needs for people affected by the floods here in Cambodia are immediate food, water and hygiene and of course restoring livelihoods.

On Thursday 27 October, the CARE team distributed assistance to the most badly affected families in Prey Sneat commune, Prey Veng Province. This was part of a wider program in the same province to support more than a thousand families, who have had their homes destroyed or damaged, lost assets and had their livelihoods placed at risk due to the Mekong floods.

Distributing packages to the 337 families in Prey Sneat meant that families received essential food items, blankets, mosquito nets, hygiene kits and water filters, with nearly 17 tonnes of rice supplied by the World Food Program. Transport and logistics were assisted through a generous donation from Glaxo Smith Kline.

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Sitting three deep in a glorified canoe, I’m carefully motored across the Plane of Reeds on the Mekong Delta in south west Vietnam.

I'm told that six metres below the water’s surface sit rice fields, land which only a month ago held hope of a buster harvest, with it the offerings of a livelihood and a helping hand out of extreme poverty.

I'm wholly aware of the abnormality of the sights which surround me; the tops of thatched houses, immersed headstones of sacred graveyards and the surreal experience of being at head height with the electrical wires.

I was not prepared for the sheer number of stranded households, completely cut off by oceans of flood waters. As we drift along, a three generation family meets our gaze with a smile. Resilient and adaptive, they are finding comfort in maintaining what remains of their normal routine, washing clothes in the flood waters and children fishing from the communal living space.

Those families, whose houses are completely immersed, have been moved to higher ground by the Government but those families with only partially flooded houses are forced to stay where they are.

We drive straight into the living area of a wooden house and find two women in their mid-thirties and five children itching with boredom. The District People’s Committee has closed all the schools to prevent more drowning from children travelling in the unsafe and unpredictable flood waters.

We squeeze into the one room house and I notice the organised chaos. One corner is filled with piglets, another with baby chicks guarded by their wary mother, another corner is reserved for the storage of cooking utensils and a near empty bag of rice with the remaining area reserved for sleeping.

Just centimetres beneath the haphazard floor boards, water is lapping and a shoe floats by. I wonder if it belongs to the woman and whether I should pluck it from the flood waters?

A three year old boy lies in a deep sleep in a slung hammock, his cheeks are flushed and the mother tells me he is ill with diarrhea. With no latrine and no dry land in reach, the family is defecating in the flood waters.

The sick boy's family is surviving on rationing a 10kg bag of rice given to them by the local Buddhist pagoda. I ignorantly asked where they were getting their drinking water from and the mother points to the water beneath us.

A few house visits later, I am told to roll up my cargo pants and hop into the flood water. We are trying to access a cluster of houses in a village in Hau Thanh Dong commune.

After wading through the water, we reach a house which is partially submerged. I am directed to perch on the floor boards and am conscious of not wetting the house further with my drenched lower half.

The house occupants are an elderly disabled couple. Their legs either missing or deformed from bomb blasts during the Vietnam War. Their sinewy faces are marked with age, each wrinkle or crease telling stories of hot days in the sun, trying to make a living in this vulnerable environment. Unable to climb in and out of boats and with no source of income, the elderly couple eats only rice and survives on an occasional allocation of small fish gifted by neighbors in the village.

Too poor to move, these households living in the Mekong Delta are vulnerable to annual flooding.
What is certain is that in 2011 the floods are anything but normal.

Without immediate relief, families like these are at certain risk of food insecurity, hunger and ill health from the poor sanitation and hygiene conditions.

The quantity of water in the world never changes, it is constant. With so much water in South East Asia at the moment, I am baffled by where in the world must be equally as dry as we are wet?

Perhaps this counters the extreme we are currently seeing on our television screens from the Horn of Africa? Climate change arguments are meaningless to those families stranded now by famine or flood but both share the dilemma of where their next bowl of food will come from.

CARE International in Vietnam is responding and I am proud to be a part of this organisation.

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After a severe food crisis in 2010, women founded an association of grain banks to prepare for times of hardship

Niandou Ibrahim, CARE Niger, October 21, 2011

Moumouni Alkassoum, manager of the union of cereal banks for women of Moujia.Photo Niandou Ibrahim, CARE.

Last year, 20 percent of households in Niger were affected by a devastating food crisis. The village of Moujia, located between the cities of Konni and Tahoua in the center-west of the country, gave a picture of the situation at that times. (see story from 2010)

Drought and parasites had completely destroyed the crops, and in order to survive, people were forced either to migrate or to do menial tasks for little pay. Like in Alhou Abdou's household, made up of six children and his wife, the villagers fought day after day to feed themselves. Even though they decreased the number of meals and portion sizes, they often went hungry.

CARE provided 100 kilograms of grain to Alhou's family through a large-scale programme of free grain distribution, in cooperation with the Niger government and the World Food Programme (WFP).  The other households in the village that were suffering from the food crisis all received the same support. This external aid was combined with the stock from a grain bank that the women of the village had implemented to meet the food needs of the families.

The women's small grain bank had a huge impact on the entire community. Inspired by this victory, and knowing that food crises appear every three years, the women were motivated to expand their idea of an "association of cereal banks" in the region.

The system Matu Masu Dubara ('clever women' in the local Hausa language) is made up of savings and loans groups that are managed by the villagers. These groups enable the creation of multiple village projects in several areas, such as health (providing training and equipment for nurses), education (literacy and awareness about girls' education), environmental protection (growing trees and orchards), food security (creation of village grain banks), and even recently, entering political arenas to elect women to influence local and national decision making processes.

Alhou's wife Hadja belongs to the network of "Tammaha" (hope) groups in Moujia, which started a cereal bank in 2002. The bank served its purpose every year because even in years with good crop yields, more than 60 percent of households cannot meet their food needs with their harvests alone. However, in a year of crisis, like in 2010, the Moujia bank couldn't withstand the high demand for grain.

Hundreds of Mata Masu Dubara women from Niger also started cereal banks in their communities. Under the leadership of these women, 19 other community grain banks in the surrounding areas came together to form an association of banks: a storehouse with enough stock to come to the aid of smaller banks in case of stock shortage caused by a high demand in times of food crisis. "To do this, each of the 20 groups contributed a total of 1,000,000 cfa francs, or 2,100 USD, that was used to buy the start-up stock. CARE, with financing from the Norwegian Agency of Development Cooperation, then helped with the construction of a store and management training for the designated women, who would oversee the operation of maintaining the stock. WFP contributed 27,000 kilograms of cereals. It was a real pooling of resources," explainsMérido Moussa, director of the Matu Masu Dubara women association in Moujia.

Today, the association of Moujia banks provides a permanent stock of supplies in the area. While the market price of a 100 kilogram sack of millet is 19,000 fcfa (40 USD), the village banks can sell it for 18,000 fcfa because the union provides it at a lower cost of 16,000 fcfa.

"The women are so clever," whispers Alhou Abdou, while looking lovingly at his wife. "Normally the grain stock set aside by the women would have been enough to fill the gap left by the poor yields that we're seeing this year. But we're still facing hard times because our brothers had to come home from Libya," he adds solemnly. They had lost their jobs due to the political unrest in North Africa.

As of August 31, 2011, evaluations have shown that the crops will not come full circle in 2,496 farming villages throughout Niger, affecting an estimated population of 2,885,673 men and women. The rate of severe malnutrition among six month to five year old girls and boys is at risk of increasing in 2012.

In addition, the socio-political movements that unfolded in Cote d'Ivoire and Libya affected 200,000 migrants working abroad. The thousands of migrants who returned to Niger between February and September came home to extreme destitution, adding another challenge for vulnerable communities like Moujia. "150 village youth had to flee Cote d'Ivoire and 50 others came home from Libya empty-handed, whereas previously they were the principal source of income for Moujia," confirms Mahamadou Abdou, the Imam of the local mosque.

CARE Niger is committed to respond to the urgent challenges of this situation, while continuing to contribute to the resilience of the households in Moujia and in hundreds of other communities.

With each new flood, girls in Pakistan are at risk of quietly being sold for brides.

By Hadia Nusrat, Senior Gender Advisor, CARE Pakistan

Pakistan, southern Sindh. Water is receding slowly, and families face another month or two of displacement before they can return to rebuild their homes. Photo: CARE/Waleed Rauf

Driving through parts of Sindh is impossible, as so much of the area is underwater from new floods this year, with roads either inaccessible or crowded with families who have lost their homes. Sadly, in the far flung communities and villages of Dadu, people have lived in abject poverty for generations. Young women are particularly vulnerable. The scenery is reminiscent of last year, in the wake of the  floods where we found a young girl called Kanwal, who lives in a remote village in Dodo Birhamani. 

Displaced by the floods, Kanwal and her family of eleven members migrated to this village as they had relatives here, seeking shelter until they were able to build their own. But with no income and many mouths to feed, Kanwal's parents decided to raise funds by arranging a marriage for Kanwal, who was just nine years old at the time. Traditionally marriages take place early in the Birhamani tribe. Girls are usually married by age 15 -- any later and they would be stigmatized as being too old to be married. In Kanwal's case her parents would receive a sum of 70,000 Rupees (USD 800) as bride price that would allow them to buy a lot of land and some goats to resettle in this village.

A Stony Rescue
Kanwal was hauled away from a game of marbles she was playing with her friends by her mother, and informed that she needed to get ready for her wedding. She protested about the disruption of her game, only beginning to realize that this decision would change her life forever -- in ways she still cannot fully understand. When she resisted, her mother threatened to jump in the well and commit suicide. Her sister, who was also a young girl married at age eleven and is now the mother of two young boys, begged her not to refuse. The family's honor would be at stake. Her father would be humiliated in front of the other tribesmen. She cajoled her with promises that she would visit her often, and that she would get new clothes to wear as a bride.

Confused, scared and unwilling, Kanwal reluctantly agreed. The wedding date was set for the very next day. As the ceremony was proceeding, a police van and police officers (including a female officer) intercepted the wedding procession, took Kanwal into protective custody, and moved her to the nearby Dadu city.

It turned out to be Kanwal's special day after all. Someone from the village had called the police to report that the crime of marrying a nine year old was taking place. Normally such events go un-reported in Pakistan, but in Dadu an CARE project* funded by the European Union for protecting human rights had recently run street theatres, and shared contacts with village youth in case they wished to report crimes in the area. This small initiative had sparked an essential change in raising awareness, empowering local people with information and networks for reporting a crime in progress and intercepting it.

The rescue did not run smoothly. The police squad was stoned and their car was smashed. Kanwal's mother, who accompanied her young daughter to the police station, protested profusely. But when she learned that she, her husband and the groom's family could all be libel to fines, penalties and possible jail, she quieted, appreciating for perhaps the first time that marrying a girl so young was indeed a crime -- and seeing now how that they had been pushed in to it. At the time of the marriage agreement and exchange of bride price, Kanwal's mother explained, it was agreed that Kanwal would be wed only after puberty. But once the money was paid, the groom's family insisted she be wed quickly.

The Stigma of Shame
Now the family faces a greater challenge. Even though their young daughter has been spared the fate of being a young laborer in the guise of being a bride, she faces the stigma of shame that her marriage was stopped. Now her family is under pressure from the tribal elders' council decision that her family should return the cash or relinquish the land they bought in favor of the groom's family. The groom's family has used political connections to evade prosecution for any crime. On the contrary, they have had Kanwal's father jailed for false allegations of theft, creating greater heartache and problems for her family --who now blame her for the cycle of problems affecting them.

Kanwal is an energetic girl, who cooks the food for her family of eleven. Two of her siblings are mentally disabled, while the others are all young men and boys who leave the home to seek daily wage work. Often they return empty handed, as there is little work in the parched lands around the village. There is just one school in the village run by a local non-governmental organization and their charges make the education unaffordable for Kanwal's family. Kanwal knows there is an alternative – a young woman who is ready to teach her and other girls to read and write for much less -- and with her audience of visitors, she even dares to argue with her mother that she should be allowed to learn. Her mother is not interested in education. She needs her daughter's help in the house. Kanwal, however, remembers fondly and proudly the year she went to school in the village they used to live in before the floods. She can write the entire English and Sindhi alphabet, and can write her name in both languages. She holds up pages of her writing with the same enthusiasm she shows for her hand-stitched textile designs.

Though she has been saved from becoming a child bride, her human rights may still not be respected. Her rights to education, justice, access to information, decent living and livelihood may all still be denied, without schools, teachers, income generation opportunities, honest judiciary or law enforcement bodies that can carry the work forward. This is an unfinished story. Kanwal faces a perilous journey, as do many young girls in this region. With each new flood, they are at risk of quietly being sold for brides, as the only source of financial security for their families.

CARE has been working in Sindh since 2007, initially responding to floods, then with a Sexual and Reproductive Health and Rights program, and staying on to support these communities devastated by the 2010 and 2011 floods. CARE's priority is to work with marginalized women, providing primary health services and raising awareness on health and hygiene practices to help women help themselves.

*The EU funded CARE project works through a national partner organization called “Strengthening Participatory Organization” (SPO) which in turn forms Human Rights Forums comprised of civil society, police and judiciary. The forums organize advocacy events at village levels.

CARE International UK's Programme Director, John Plastow

Day 1
I've just arrived in Takaba, the principal town in the far north of Kenya, where CARE manages the Regional Resilience Enhancement Against Drought (RREAD) programme, promoting resilience to drought in communities that straddle the Kenya-Ethiopia border. Through the establishment of effective cross-border committees involving both traditional and customary authorities, CARE has played an important facilitative role enabling communities to move livestock over the border to areas where animals have a better chance of seeing out the drought. Scenes of mass animal death are not evident here - unlike in 2006. This is a testament to more forward-thinking agencies in the region. Lessons seem to be being learnt.

The flip side of the realities of the situation was vividly demonstrated this afternoon, with the Takaba Water Users' Association. This citizens' committee reported that water supplies from the seven large water pans that have served some 300,000 people scattered across this semi-arid region have dried up. They are now left to fall back on three boreholes. Two, though, have run dry and the third, which produces potable but unpleasantly salty water, is all that people have to rely on. The borehole is pumping 24 hours a day and there is no functioning back-up generator. Should something go wrong, the town and tens of thousands of families would literally be left high and dry.

Communities here have managed the situation with support of organisations like CARE. But the severity of this drought seems to be finally catching up with them.

Day 2
Out in the dry and dusty drought-ridden plains of Northern Kenya the acacia trees have started turning green. It is as if they, like everything else, are hoping for rain. All around there is a certain desperation spreading. The District Education Officer in Banesa told me he had panicked calls from teachers saying they had completely run out of water. The animals have long since gone in search of water and pasture, and even the bees from what was a highly lucrative CARE-supported initiative have left because it is too dry.

In Banesa, as in Takaba yesterday, there was evidence that people had coped better this time around thanks to drought mitigation measures being put in place. The water reservoir that had been dug deeper had lasted longer, and better management of water distribution at cost meant the committee was able to pay for tankers itself rather than rely on hand-outs. Detailed plans between communities and local government officials meant that pasture was better managed. Indeed, I saw a planning meeting between local leaders and government officials, facilitated by CARE, planning what to do next time rains fell.

But time really is running out. Camels are dying in large numbers - always a bad sign. The short rains are due around mid-October. If they come, this now more resilient community will be able to see out the drought without their livelihoods becoming decimated. If not, then the prospects in this border area are indeed dire. The acacia though are changing - I was told by Adan Bishar, a local elder whose bees had flown and whose camels were dying - because they sense growing humidity in the air. There is then hope from nature, but the prospect of nature failing these people again is one nobody wishes to contemplate too fully.

Day 3
Moyale is a large town at the end of a series of long bumpy roads across the drylands of northern Kenya. Its size comes as something of a surprise after journeying though large semi-arid expanses broken up by only the very occasional small settlement. In the backstreets of Moyale though, I was in for an altogether different surprise in the shape of a project that, while modest in scale and low in visibility, is one which may well be responsible for effecting some profound changes in the lives of some of the most vulnerable and overlooked people across two countries.

Moyale is at the end of the road, not only in Kenya, but also in Ethiopia. Indeed, it is the only formal crossing point across the hundreds of kilometres between the two countries. This gives it great strategic significance and makes it a magnet for all sorts of trade.

I was taken to meet an unlikely mix of traditional leaders and women's representatives from border communities alongside local government officials from both Kenya and Ethiopia. They have come together in a process being facilitated by CARE International which aims to bring people together to work through deep seated and complex challenges such as endemic conflict, hunger and destruction of the environment that besets pastoral livelihoods. Listening to the impassioned feedback from the very different interest groups it was clear that this venture has started to tackle a range of major challenges.

‘We have started to build distrust between us,' Galma Busula, an elder from across the Ethiopian border told me. ‘We were losing our animals, others would smuggle valuable trees, we would see them disappear over the border and had no way of recovering them. Now though that situation is reversing itself'.

This view point was backed up by local government officials. Tadi Wako, a livestock officer said he had seen a remarkable turnaround with people taking responsibility to apprehend poachers. In the last month he spoke of one incident where 36 cattle and 7 donkeys had been returned to owners cross border.

Such behaviour is building up trust and has enabled other forms of reciprocation. In times of drought, communities do move between Ethiopia and Kenya in search of pasture. However, the extent and volume of movement had been curtailed of late, something that has impacted on livestock deaths.

‘Confidence between us has built up as well as our ability to keep track of numbers of herds many of which are moving into the country to places like Yabello and Tertale,' Mesele Eticha, Provincial Land Administrator, told us.

This project and its cross-border committee is built on interactions between just five rural cross-border communities. It would be wrong to attribute too much to this experiment but there is no doubt that it is bringing about some very different outcomes and contributing to rebuilding relations between communities in ways that are proving highly valuable for people who all too often are living at the very edge of crisis.

Day 4
I was woken up early yesterday morning by a strange sound. It appeared to be raining. I had to get out of bed to convince myself that's what it really was. Sure enough, in a place which had barely experienced more than a day's rainfall in an entire year, it was indeed raining! Unfortunately though it was very overcast, the light rains did not last more than about fifteen minutes, no real use though hopefully an encouraging sign, for the "short rains" – an annual event that is vital to the region's subsistence farmers – are due at some point in October. Last year's so-called long rains failed completely in April and May and there hasn't been a drop since – till yesterday that is – a main reason why there is so much suffering going on in northern Kenya at present. All that is required is about three days of reasonably heavy rainfall and a lot of problems will be solved round here.

Much of the day was actually spent looking at the work that CARE has been doing supporting people in their efforts to improve their water supply. Wells are drying up and practically everywhere water pans - essentially small reservoirs - are also now exhausted. People rely on the few remaining wells that are still providing water or in a number of areas they have fallen back on expensive water trucking, something that mainly requires external humanitarian assistance.

CARE has been working with communities to help them manage their water more efficiently. Through RREAD, we help communities form water users' committees to regulate water supplies and charge user fees. These are critical to promote the upkeep of water pumps, pipes and drinking troughs for animals and to protect wells so that they are not contaminated. Dika Ibrahim, the Chair of the Godoma Cross Border Committee, took me to see work that was going on to protect one of the few remaining water sources in the area. This shallow well was supplying the water needs of both people and livestock on both the Kenyan and Ethiopian sides of the border. As we approached we came across several women driving donkeys laden with jerry cans full of water as well as large numbers of camels clearly heading in the same direction as we were. 

CARE had provided funds to supplement those of the community to help protect one of the two functioning wells. This involved several men lining the side of a very precarious looking pit with cement, essentially to stop debris falling inside and contaminating it. They were also planning to build steps down to the perimeter of this large and – to my eye – deep and treacherous facility. One shallow well had already been spoilt because baboons had fouled the water supply, leaving the communities with just one operational well. Accessing water from here was no straightforward matter. Six young men pulled up heavy buckets full of water in a human chain, perched on a rope ladder ascending from the depths. The top carrier transferred the water into troughs where thirsty camels waited patiently to satisfy their thirst. On the other side of the well two other young men were pulling up buckets on ropes to provide water to people who carried it away by donkey cart. The CARE project is designed to improve access, quality and reliability of supply and is one of a number of such initiatives we have been involved in.

Later on I was taken to a small recently excavated reservoir, which was dry awaiting the prospect of rainfall to fill it for next year's supply. Communities have been active in desilting and deepening water sources, one factor that has seen people ride out this year's drought slightly longer than in previous years.

By this time the clouds had evaporated and the short shower of this morning had done no more than damped the dusty earth for a short while. If the rains materialise this year then people are well placed to make the most of them. Meantime the waiting goes on.

Rick Perera, Horn of Africa Communications Coordinator

Overflow classes at the crowded Illeys Primary School, run by CARE, meet in tents in the courtyard. Most new students are recent refugees from Somalia.

It's a typical day at the CARE-managed Illeys Primary School at Dagahaley refugee camp in Dadaab, Kenya. Fifty parents are lined up outside the gates, desperate to enroll their children. They're drawn not just by the prospect of an education, but by the daily meal CARE provides, in partnership with the World Food Program. The student body is swelling astronomically with the children of new refugees, mostly fleeing drought and hunger in Somalia.

This modest compound of cement-block classrooms, designed for 1,500 students, packs in more than 4,000 children in two daily shifts. Spillover classes are housed in tents, bright voices echoing in song and recitation through the sandy courtyard.

"Every child who wants to come to school here is welcome, though of course it's a strain," says principal Ahmed Hassan in his cluttered office, where a whiteboard overflows with statistics about his ever-growing student population.

Illeys school is close to the influx area for refugees, and most of the new youngsters filling the school have recently arrived from Somalia with their families. In one of the tents, Farah Ali Abdi gives a basic English lesson to a remedial class. The group encompasses children ranging from 4 to 15 years old, all of them struggling to catch up enough to enroll in regular primary grades. "The cup is on the table!" they shout gleefully – more or less in unison.

Principal Ahmed Hassan struggles to accommodate 4,000 students, in two shifts, in a facility designed for 1,500.

Most teachers here, like Farah, are refugees themselves, hired and trained by CARE. They work with patience and skill, but with as many as 130 children in one classroom it is next to impossible to give all of them the attention they deserve. The five primary schools managed by CARE in Dagahaley camp are massively overburdened, with over 15,000 students. To cope with the influx, and help those who lag behind catch up to their peers, CARE operates special accelerated learning centers during school vacation. Yet, far too many refugee children receive no education: more than 60 percent of kids in the Dadaab camps do not attend school at all.Girls face special roadblocks in the quest to learn. Only 39 percent of students at the camp schools are girls. By tradition, girls are expected to take on the bulk of chores at home. "If a family has two girls and two boys, they will send the boys and one girl to school and keep the other girl home to work," says Principal Hassan. "Even the girls who attend will have little time to do homework – unlike their brothers." Puberty brings an additional challenge. Girls may miss class for a week every month during their period, out of fear of embarrassment – and many drop out entirely. A girl is traditionally considered marriage-ready at 14, and dropout rates soar at that age.

CARE's work to improve educational opportunity starts at the grassroots. Staffers hold community orientations and go door to door in the camp's residential blocks, advising families about the benefits of learning. Teachers live among the refugees, constantly reinforcing those messages. CARE helps adolescent girls stay in school, distributing sanitary napkins and training communities in how to dispose of them safely.

Sahara Hussein Abanoor, age 17, is an eighth-grader at Illeys, and aspires to be a lawyer.

Over time, teachers say, families see the benefits their neighbors reap when daughters become educated, get jobs and help support their parents. Bit by bit, the old attitudes are changing.

Sahara Hussein Abanoor, age 17, has an exceptionally eager face, but her ambition is not unusual among the students here. She loves learning and wants to become a lawyer and help refugees like her family. "My parents see what I'm achieving and they believe that my future life will be better," she says in confident English, beaming beneath a pumpkin-colored hijab that billows in the stiff breeze. "My mother did not go to school because there was no possibility of that in Somalia. Nowadays the world has changed very much. Even my brothers say it's good that girls go to school."

Shukri Ali Khalif, a member CARE’s Gender and Development team, is a passionate advocate for girls.

Indeed, some of the most effective advocates for girls' education in Dadaab are men. One of them is Shukri Ali Khalif, a tall, skinny 29-year-old who joined CARE's Gender and Development team in 2007. Previously, he says, he had no idea of the difficulties girls face or why they are more likely to drop out. Today he is an enthusiastic spokesman for their equal access to school. "I facilitate mentoring groups for girls, and encourage them to speak out in class and ask questions, instead of sitting on the back bench and letting boys take the lead."

And how do the boys feel about all this? Shukri – who was himself a refugee boy not so long ago – grins. "They feel great!"

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Niki Clark, Dadaab Emergency Media Officer
August, 2011

CARE's goal is to provide sufficient quantities of water to the existing and new refugee populations. This includes the maintenance of 20 existing boreholes and over 170 km of pipes.

Fardosa Muse is a much fiercer woman than her small stature implies. As a CARE sexual and gender-based violence officer in the world's largest refugee camp, she has to be. She spends her day listening to other people's nightmares.

Born in Dadaab, Fardosa, 26, grew up in a polygamous family; her father married multiple wives, and had 40 children. A fluent English speaker, Fardosa studied social science in college. Upon returning to her hometown, she came to work for CARE, where she has spent the past two and a half years in the Dadaab refugee camps.

She is passionate about her work and the people she serves. "Can you imagine being gang-raped in the middle of nowhere?" she says, a steady gaze in her eyes. "This is what women and children are experiencing on their journey from Somalia. Violence against women is a profound health problem for women across the globe."

Today she visits Sultana,* a 53-year-old grandmother, who Fardoza met when she first arrived at the camps. She wants to see how Sultana is settling in.
Sultana greets Fardosa upon her arrival and, after a few minutes, she asks the six children in her care (five grandchildren and one other child relative) to go and play. She wants to speak to Fardoza alone. She doesn't want them to have to relive her story.

Sultana gestures to her tent for Fardosa to come in. With Fardosa's help, Sultana was fast-tracked through registration so as to get a more permanent shelter than the initial reception process provides. There is a thin mattress on the floor, also given to her by CARE as part of her intake process. Other than a piece of tattered fabric covering her bed, and a thin cover of red dust, the rest of the tent is bare.

Sultana was living in Dadaab when she heard that the husband of her mentally-challenged daughter had been violently killed in Mogadishu. Knowing the struggle her daughter would have raising the children alone, she traveled to Somalia. Once there, she turned back, determined to take the six children to a safer, more stable environment. Midway through her journey, Sultana was raped by seven armed men.  When sharing her story with Fardosa, Sultana's eyes squint in pain as her hands gesture how she was gagged and bound. She says that she continued her journey back to Dadaab once the men were done. She had to keep going. 

Rape affects survivors in many ways. Because of the severe social stigma here associated with rape, many cases go unreported. Women who are violated are often shunned by their neighbors and families, divorced by their husbands. For unwed women and girls, rape can mean a solitary life with no chance for marriage. There is the risk of HIV infection, too. In Somali communities, Fardosa says, there is no sense of confidentiality. With thin tent walls separating neighbors, it seems the case is the same in Dadaab. So Sultana tells her story in soft whispers. Having others know what happened to her "would be a whole set of other problems."

"It's a challenge just operating in this environment," Fardosa says. "A lot of the shame survivors feel comes from the community. Here, women are ‘the lesser sex.' Only women that are circumcised are considered marriage worthy. Marital rape is a big concern. The work that CARE is doing in Dadaab focuses on providing psychological and social support and rights education, as well as outreach to men and boys so we can start changing what is considered the social norm."

CARE is supporting newly-arrived survivors through counseling and referrals to emergency medical facilities at the reception centers and by providing psychological counseling services in the camps. Weekly sessions are conducted at settlement sites, including education on services available within the camps. To date, CARE reached approximately 8,200 new arrivals with information on violence prevention and where and how to get help. CARE also provides information through "road shows" put on by Community Participatory Education Theatre groups. Unfortunately, reported cases of gender-based violence in the camps have significantly increased since the onset of the crisis, although most violations still remain unreported.

Fardosa's visit with Sultana comes to an end. "I still have horrific nightmares," Sultana tells Fardosa. "But because of counseling provided by CARE, I am healing."
Fardosa stands and brushes off the red dirt from her clothes. She steps outside and once the children see their grandmother's meeting is over, they run back from a neighbor's tent, laughing and chasing each other. 

"Rape is not only a violation of the law," Fardosa says as she walks back towards the car. "It's also a violation of humanity."

She is on to her next client. There are many more waiting.

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*Identifying characteristics have been changed to ensure confidentiality.

Mohamed Maalim Gedi sits cross-legged on a floor of dusty red dirt, aimlessly fiddling with his bare, well-traveled toes. His gaze is towards the ground, but his thoughts are obviously elsewhere. He occasionally reaches out to swipe an insistent fly from the face of one of his young children, five boys. The wooden benches, set in a half circle around him, are filled with other weary travelers. They just arrived in Dadaab, a place of both hope and uncertainty. A large bus, smoke still sputtering from its tail pipe, is parked a few yards away. It is the one that transported him from the border, another group of Somali refugees escaping drought and insecurity. There have been more than 132,000 refugees who have come just since January.

Like so many of his fellow refugees, Mohamed is a pastoralist. His entire livelihood depended on his cattle. When the last one died, he decided it was finally time to escape. "I have lived like this for 20 years," Mohamed says, referring to the frequent drought and worsening security in his home country. "Enough is enough."

So, with his wife and mother, he traveled 500 kilometers via foot and donkey cart from his village of Bu'aale, Somalia to the border town of Dif, Kenya. From there, he arranged for a bus to transport his family for the rest of the journey to Dadaab. Because of limited space, he had to leave behind two of his children, his youngest, 2, and his eldest, 14, with cousins. "I hope the bus that just brought us is going back to get them," Mohamed says. "But I can't be sure."

The reception center is the first safe haven after a long and arduous journey for refugees. In the background, one can hear the shrill, high cry of children. But their cries come not from the hunger but vaccinations against polio, measles, diphtheria and pneumonia. Such vaccinations are unheard of luxuries back in Somalia, and are part of the reason Mohamed made the trip here. He hopes his sick children will get the medical attention they need.

Waiting outside the UNHCR registration tent. Once a refugee is registered, they are entitled to the regular food distribution cycle that CARE manages with food procured by the World Food Programme.

Here at the reception center, Mohamed also has access to clean water and a supply of high-energy biscuits. Because of increased efficiencies in registration, Mohamed and his family will now be registered within a three-day time period, down significantly from previous waiting times when the crisis first hit. After he registers, CARE will provide him with a plastic tarpaulin, kitchen set, soap, blankets, plastic mats and jerry cans and an initial food ration to last until the next regular food distribution cycle. As registered refugees, Mohamed's family will be entitled to a tent from UNHCR an a food ration card so they can join the bi-monthly food distribution cycle run by CARE.

On the fence surrounding the area where CARE distributes initial food rations —servings of wheat flour, Corn Soy Blend (CSB), vegetable oil, corn meal, beans, salt and sugar — hangs a sign in English and Somali. It states: "Services from Agencies are Free; Help Stop Sexual Exploitation and Abuse." CARE and other agencies that work here are continuously working to ensure refugees are aware of services and where to access them. A CARE counselor stands next to the area where new arrivals gather their high energy biscuits. "How was your journey?" she asks a fatigued family of five. She's looking to identify vulnerable populations, such as survivors of gender-based violence, widows, lactating mothers and the ill. She's help "fast-track" them so they can get to immediate help, including medical services and counseling.

As he waits to be called, Mohamed sits with uncertainty weighing on his mind. He has no relatives or friends in the camps, and is unsure of what to expect. "There is a fear of the unknown," he says. "Will I have a place to sleep tonight? Will my children get food and medicine?"

In spite of these reservations, Mohamed says he remains optimistic. "I am hopeful. Hopeful that I will get help for the first time. That, finally, we will have some relief."

He pauses for a few minutes, lost in his thoughts. "A larger question lingers, though," he finally admits. His question is one that countless others have asked, continue to wonder, even after the physical part of their journey is complete. "What's next?"

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Niki Clark
September 20, 2011

Everyone knows that water is necessary to sustain human life. People have survived for weeks, even months, without food, yet even a day without water causes the human body to suffer. Even with its critical importance, water isn't typically something that gets most people excited. That is, unless you're talking to any of the CARE staff working on water and sanitation (WASH) in Kenya at the Dadaab refugee camps. Just hold a 10 minute conversation and you'll understand how easy finding a passion for the subject can be. 

CARE's goal is to provide sufficient quantities of water to the existing and new refugee populations. This includes the maintenance of 20 existing boreholes and over 170 km of pipes.

As the main implementing partner for water production and distribution in Dadaab's three camps and two outlying areas, CARE pumps and distributes approximately 7.5 million liters of water a day, enough to provide all residents with 15 liters of water a day. With almost 500,000 refugees in and around the camps, providing water for the entire population remains a daunting task and extending services to keep up with demand is a constant challenge.

"Dadaab is the third largest city in Kenya," says Timothy Mwangi who helps with CARE's water management. "The coordination and logistics involved in making sure that many people have enough to drink would be difficult in a normal setting. But within the context of a refugee camp, it is even more of a challenge."

CARE is meeting that challenge through a combination of boreholes and water tanks. Currently, CARE maintains 20 boreholes and over 172 kilometers of pipes throughout the camps. These boreholes tap into the reserve of groundwater that sits below Dadaab's surface. In addition, CARE provides potable water through trucking services and water tanks. Each influx area has between one and three tanks, each serving 2,500 people.  CARE also is increasing the number of water points and tap stands in the influx areas and extending water pipes from the existing camp systems.

Resources are tight. Amina Akdi Hassa is the chair of the Dagahaley camp. She serves as a refugee representative and is consulted when decisions regarding Dagahaley services are made. She has lived in Dadaab for nearly 20 years. "Share our problems," she tells visitors. 

One of those problems is storage. While CARE distributes jerry cans to all new arrivals, there often are not enough to transport and store all the water needed. The task of collecting water is time consuming, and often keeps those charged with less time to collect firewood and cook, for example. Community mobilizers employed by CARE spend their days talking with residents like Amina to assess the problems and offer solutions.

In addition to our water production and distribution work, CARE manages all hygiene and sanitation promotion programs in the three main camps — Hagadera, Ifo and Dagahaley — including each camp's influx areas, markets, schools and water points. Refugee "incentive" workers raise awareness around various hygiene issues, including reducing the spread of waterborne diseases through handwashing. These workers go door to door, demonstrating safe hygiene practices and distributing soap.  

Water trucking in camp Dagahaley. Refugees here receive an average of 19 liters of water per day.

To the outside world, it may not seem like the most glamorous of jobs, but the response of the refugees is quite different. When CARE's Public Health Promotion Officer Raphael Muli visits the influx area of Dagahaley, he is immediately surrounded by residents of all ages. Young children crowd, raising their hands, anxious to volunteer for the handwashing demonstration. Raphael flips through a "how-to" picture book walking the children through each step. Then, he hands out bars of soaps, reminding refugees that handwashing is a simple way to reduce the risk of disease. In fact, some studies show that this simple act can decrease diarrheal disease by up to 47 percent in a community. All day long Raphael will repeat this drill, one person in a CARE team of public health officers and community mobilizers. He is greeted enthusiastically everywhere he goes.

Raphael and his colleagues have reached nearly 31,500 refugees living in the influx areas with their public health promotion messaging this year alone. Their goal is to reach 60,000 by the end of the year. With each demonstration and each conversation he holds, his message about the important of water and good hygience becomes clearer to everyone.

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Theo Alexopoulos, Deputy Safety and Security Manager, CARE Pakistan
September 20, 2011

"If you want something important done, don't do it on Christmas Day – everyone will be away," I remember my buddy joking, while we were bouncing around inside a Series 3 Land Rover on a security training exercise in New Zealand some time ago. Flash forward to Pakistan in August 2011: I am driving with our CARE team leader, Karuna, in a Toyota 4x4 on a field assessment in central Sindh. It is Eid, a major holiday, the end of the Ramadan. All our staff, including the drivers, have gone to their home villages to be with their families, and the country is on standstill observing national celebrations after a month of fasting for Ramadan. The heavy monsoon rainfall and rising waters have us a little on edge. We have no idea that our response will be one of the first by an NGO - right at the heart of another emergency.

As the rain continued non-stop for almost 2 full days, Karuna would suggest areas he was interested in visiting, and we would dart around the region, hoping for access and a return route on roads that were at risk of closing. We monitored the river and swelling canals, inspecting for damage and trouble spots. I was liaising frantically back with our country office via Blackberry, snapping shots between wiper blade strokes and potholes, and taking notes in my little note-book. From time to time we would stop to stretch our legs and reflect on the disaster unfolding before our eyes.

The roads around Dadu were eerily quiet, with no sign of the infamous chaotic traffic, only the drumming of persistent rain pelting the roads. By parking next to the door of our staff house in town, we could climb into the car to avoid wading through over a foot of water mixed with garbage and stinking sewage. In rural areas, we saw mud houses melting away like chocolate ice-cream.

When the rain stopped, we knew that a new deluge of work was coming our way. CARE staff and our local partners were headed back to the field office. They would need an immediate and accurate account of the situation. Media paints one story, helicopter rides another – but "eyes on the ground" can't be beat. We were there on the ground. Within days, after only a small break in the weather, Southern Sindh was hit much harder. Roadsides and school grounds became crowded with families who had lost their homes. Our nearby warehouse was packed with emergency stocks ready for distribution: tarpaulins for temporary shelter, mats, shawls, cooking utensils, hygiene sets with antibacterial soap, tanks for safe water storage. Our holiday would have to wait.

Sindh province, southern Pakistan. Just one year after an unprecedented flood affected 20 million people, new flooding is threatening lives and livelihoods in Pakistan. Sindh, a province in the south of the country, is the worst affected. Nearly one million houses have been damaged, thousands of livestock have been lost and more than five million people are struggling to rescue their livelihoods.

The Borana region of Ethiopia is known for its deep traditional wells that are the main water source for livestock and household consumption in the dry season and in times of drought. These wells are known as the "singing wells" -- because when people fetch water they form a long line up a ladder and sing as the water container is passed from one person to another, until it reaches the last person waiting above ground. The traditional wells have kept the people and livestock safe for generations – until this current drought, when they stopped giving water. "There was never a drought like this one that made the traditional singing wells of Borana run dry. Never in history," said an elderly man from the community, with an expression of disbelief. 

Due to the greater number of deaths of livestock recently, and migration of the remaining animals, it was normal to expect that there would at least be less pressure on the wells now, as they would serve only for human consumption. But their natural capacity to produce water has dropped precipitously, making the situation increasingly dire. 

Previously both animals and humans took water from the same source – but in the recent past CARE, through our Resilience Enhancement Against Drought in Ethiopia (READ) project, rehabilitated these 12- to 15-meter-deep traditional wells for better and more hygienic accessibility and quality of water during dry seasons and droughts. But even these improvements cannot make the wells give water when nature does not cooperate.

Currently, rationing is in place in five woredas (districts) at water points served by different NGOs. CARE has continued rehabilitating water points and providing water purification solution.

After the great number of deaths of livestock, the lifeblood of Borana pastoralists, it has become normal to hear people saying, "We have stopped thinking about our animals now. We are worried only about lives." Cereals are in short supply in markets, and prices are out of reach for many. Malnutrition for nursing mothers and children under 5 is another serious issue that is getting worse day by day. 

More and more cattle can be seen for sale at the market, but their selling price is lower than ever and few buyers can afford them. The rate of deaths has been slowing lately, but as rains fail and drought conditions persist, the situation is again deteriorating – precious herds are dying.

CARE is actively involved in preventing the loss of livestock, by providing feed and helping herders manage their herd size, culling animals while they still have some value for meat, rather than letting them starve. We are also providing supplementary feeding for malnourished children in three woredas and scaling up to reach two more, as the number of new cases soars.

The songs may not come back to the wells anytime soon, but CARE is determined to bring a note of optimism to the herders of Borana in these difficult times.

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Adulkadir Adbullahi Muya—known by his colleagues simply as Muya—is in a hurry. He hardly has time for a handshake greeting before he is off, his long stride forcing the occasional sprint in attempts to keep up.

Muya is a paracounselor with CARE in the Dagahaley camp of Dadaab Refugee camp. He identifies people in his community who have experience trauma, loss or violence and handles initial consultations.

Paracounselors like Muya are specially trained, identifying the violated and vulnerable within the community and handling initial consultations. He walks this route several times a day, going back and forth between the CARE Counseling office and the drop-in center.

Right now he is headed to meet a new client, someone a CARE community mobilizer told him about. A bus was hijacked on the journey from Somalia to Dadaab. Women were raped; people were burned. The details are fuzzy but he knows it's serious. His pace quickens, his fingers furiously texting, always working, even as he walks. He briefly turns, "Dagahaley is growing and growing," outstretched arms for emphasis. Indeed, it is. The population of Dadaab has more than doubled in just three years.  

We rush past Unity, a primary school CARE runs in Dagahaley, the sing-song chorus of children echoing from the classrooms. Past a lone donkey, munching his way through a burned refuse pile, searching for anything edible. Through shouts of "How are you?," a charming acknowledgement by refugee children of Muya's obviously English-speaking companion. By mud bricks in a yard, past a naked toddler beating an empty jerry liter, applauding himself for the rat-a-tat noise his impromptu drum makes.

A resident of Dadaab since 1991, Muya went back to Somalia in 1997 and after nearly a decade, returned once again, this time bringing his mother. He works with an unceasing determination, often working through lunch breaks in order to squeeze in just one more visit. The pride he holds in serving his neighbors in this way is evident; it comes through in his stance, the way he speaks of his "clients." The sweat beads that form on his brow in this ungodly heat remind me of a musician, just finished with a high-energy performance. It's an accurate impression. In many ways, Muya is a rock star.  

On the way to the drop-in center, Muya walks past the home of one of his current clients. A quick change of plans and Muya walks in the yard, greetings all around. An elderly refugee woman sits on a mat outside her mud hut. I smile softly in her direction but notice her blank eyes, she is blind. A lump grows in her neck glands; multiple hospital visits have answered none of her questions. Muya asks how she's doing, is she in pain, does she need him to make any calls?

"Sometimes I just stop by to say hello," Muya says about his visits. One man he stops to see has a cancerous tumor that is enveloping the back of his head, creating constant pain. His only option is chemotherapy, which he can't afford. But Muya stops by every day, every two days. "I don't want him to lose hope. Maybe one of these days, if I keep referring him to different doctors, reaching out to different people, then maybe someone can intervene and help him. Until then, I'll keep listening, searching for help. I want him to know he hasn't been forgotten." 

As he speaks, another woman walks up, complaining of constant headaches and vision problems. Can he help her? She heard he could. "New clients," Muya says with a smile. "Every day, you get a new client." He jots down her information and refers her to the medical center before he is off again. Muya has his fill of new clients today. He is stopped no less than six times on his way to the drop-in center.

One is a woman who has lived with her condition for six years, four of them in Dadaab. She, too, spends her days sitting outside on a woven mat, not walking except to the latrine, which is fortunately just a couple of feet away. Her arms and legs are thin like twigs, breakable, yet her abdomen is swollen like the belly of a mother on the brink of birth. But this woman isn't pregnant, her eldest is eight. And no one can seem to tell her what's wrong. She asks Muya to photograph her; that maybe he can show the picture to another doctor, one she hasn't seen before, and this one could help. Muya promises to follow up and then heads out.

There are more people to see.

Because the sun is fading, and the drop-in center is still far, Muya calls the daughter of the woman he originally set out to see and asks if he can meet her at the block instead. It is in fact, right next to Muya's block in Dagahaley, so he knows exactly where to go.

Muya with the some of the refugees (including a client, bottom left) with whom he interacts with regularly, not only as a paracounselor for CARE, but as their neighbor and fellow refugee.

The woman's family surrounds her as he makes his way to her house. She lifts her dress, revealing a painful and hideous wound, where the men covered her with paraffin and firewood and set her on fire. It was her punishment for resisting rape. After her bus was hijacked, women were brought into a nearby forest and raped. When she fought back, she was burned. The hijackers stole the bus, and so the woman had to be carried by the other refugees to Dadaab. Luckily—if you could call anything in Dadaab that—her daughter was here and had a mud house to offer. She visited the hospital with her husband, who could just watch as she was attacked, but they couldn't afford the recommended procedure so they returned back to her daughter's home with just pain pills and topical cream. That was two weeks ago. Yesterday, CARE had met with the men on the bus, today the women survivors. They needed to talk through the horror they had witness.

"I still feel the pain," she said, "Like my skin is on fire." When Muya asks her about her other pain, the pain that's will remain after her leg heal, she tells him, "I've accepted what has happened to me. What is disturbing me is my wound, my physical pain. If I can get treatment, and I can't see the scar, I will be able to forget about it."

In a world where violence, loss and death are an everyday norm, this may be true. But Muya will not forget. He gets her details; promising CARE counselors will follow up and ensure that the woman receives both the physical and psychological care she desperately needs. She is not alone, she will not be forgotten.

Muya and the woman part ways, nightfall is approaching quickly and he wants to get in one more visit. He shouts his goodbyes from over his shoulder; like always, he is in a hurry.

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by Niki Clark, CARE Emergency Media Officer in Kenya
September 2011

One of my "duties" as an emergency media officer here in the refugee camps in Dadaab, Kenya, is to share my perspective of CARE's work and beneficiaries through social networks such as Facebook and Twitter. And being the dutiful employee I am, I often Twitter-follow recent Dadaab visitors so that I can in turn share their perspectives of the camps.

One such recent visitor was Somalian-born, Canadian-raised singer K'naan. Although K'naan found worldwide fame only recently through his 2010 FIFA World Cup theme-song Wavin' Flag, he has been amassing fans for more than 10 years, when a spoken word performance before the United Nations High Commission on Refugees caught the ear of famed Senegalese singer Youssou N'Dour (another recent Dadaab visitor). After K'naan visited Dadaab with a World Food Programme-CARE joint delegation, which included friends of CARE Cindy McCain and retired NBA superstar Dikembe Mutombo, @Knaan became my latest Twitter-follow.

For the past week or so, I have been struggling with the two very different Dadaabs I have experienced. Then, yesterday, I read a tweet that perfectly captured what I have been trying to express:

"Somalia is overflowing with beauty." @knaan reflects on his Somalia, not necessarily the one you see on the nightly news.

In midst of the strife and turmoil, hidden between the heartache and uncertainty, and tucked away behind the dire poverty and desperation of a homeless people, the people of Somalia – the refugees of Dadaabb – are an overflowing vessel of beauty. Because the unexpected truth is: there is beauty everywhere, even in the world's largest refugee camp, where I see:

The luminous glow of a fading sun, moments before dusk, as we head back to the compound to meet our curfew.

The joy of a widow's eyes and the firm grip of her hand as I tell her about CARE's livelihoods program; that she too could learn how to operate a business of her own, to educate and feed her four young children.

The gentle touch of a small child, no older than 3, when she reaches out to shake my hand in greeting and decides, instead, to kiss my hand.

The pride and confidence of a recent graduate of CARE's Community Tailoring School as she displays the bags she made with her own two hands, which she sells in the Hagadera market, allowing her some independence in a culture of dependency.

The lines of an elderly man's face, and the stories the lines tell of loss beyond description, and of a determination that guides him forward day byday in spite of it.

The toothless grin on a 5-day-old baby girl, born on the journey from Somalia, her 10 perfect fingers, 10 perfect toes.

When I was an art student in college, I did a photography project on raw beauty – the beauty of accomplishment, the beauty of the everyday, of the unintentional. I have seen incredible poverty in Dadaab, things that people should never see, things that should never exist. Back in my Washington, D.C., office, I have CARE's vision tacked to my cubicle walls:

We seek a world of hope, tolerance and social justice, where poverty has been overcome and people live in dignity and security. CARE International will be a global force and a partner of choice within a worldwide movement dedicated to ending poverty. We will be known everywhere for our unshakable commitment to the dignity of people.

It's a constant reminder for me of the essence of CARE's purpose: Defending Dignity. Fighting Poverty. Because dignity is beautiful. People who are able to control their own destinies and raise themselves above the situations into which they are born: this is true beauty. And it's all over Dadaab.

As a native of Somalia, K'naan is able to see something that most people in the world will never see: the beauty of Somalia and its people. Dadaab may never make Travel & Leisure's "Top 10 Most Beautiful Places' but the people of Somalia – who are the refugees of Dadaab – are some of the most beautiful people in the world.

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by Rick Perera, CARE Communications Coordinator, Horn of Africa
September 2011

Janet Ndoti Ndila is a tough lady with a tender heart. She's the lead counselor at CARE's drop-in support center at the Dagahaley refugee camp in Dadaab, Kenya. Here she offers a trained ear, and a map through the maze of camp bureaucracy, to people who have suffered some of the most horrific things imaginable in their flight from hunger and despair.

Janet and her colleagues are the first resort for thousands of weary, dejected Somalis pouring out of their famine-stricken homeland into this complex of camps, the largest of its kind in the world, now sheltering nearly 430,000 people. She doesn't let the experience dampen her upbeat, take-charge personality. But there are days when it can get overwhelming.

"I've worked in worse places – places where there's immediate, ongoing bloodshed. That's not the case here, but the things people have lived through…" Her voice trails off.

Providing Physical and Emotional Rest

Janet leads the way to CARE's distribution center for new arrivals, a large tent where refugees collect initial rations to tide them over until they are registered as camp residents. An efficient operation whisks them through as they collect plastic mats, jerry cans, cornmeal, beans, salt, oil and other essentials. Nearby, a set of taps offers plenty of safe water for washing and drinking.

More than physical hunger and thirst are looked after. Janet and her staff usher in group after group of tired, bewildered families and sit them down on rough-hewn benches in the shade of a canvas tent. Janet – a native of Kangalu in eastern Kenya – speaks to them reassuringly through a Somali interpreter. Here they get their first orientation to Dadaab: how to negotiate the labyrinth of services available, register for food distributions and shelter, and gain access to medical care for the weak, the malnourished, the sick and those injured during the harsh journey.

There are wounds to the spirit, too, and these are Janet's most important responsibility. Most of the refugees have seen and experienced terrible things before arriving here. Not just the suffering of poverty, hunger and warfare back in Somalia, but the trauma of being uprooted from home and family, and the loss of loved ones: the elderly, frail and children who did not survive the trip. Many fell prey to bandits along the way, robbed of everything when they were at their most vulnerable. And in every group of new arrivals there are women bearing terrible secrets, of brutal violence and rape suffered in the lawless wilds they were forced to cross in search of safety.

Refugees Counseling Refugees

CARE's paracounselors are a team of 18, as energetic and outspoken as their boss. They are all refugees themselves, recruited in the camps by CARE and specially trained to handle initial consultations. They are familiar, compassionate faces, fellow Somalis who understand what their compatriots have been through. The paracounselors quickly identify survivors of sexual violence and other particularly vulnerable people, "fast-track" them for special assistance including food and essential household items, and refer them if needed for medical attention. Women who are in immediate danger from domestic violence can take shelter in a community-based "safe haven" until they have somewhere safe to go.

Nearly 4,700 refugees have come to CARE for counseling and support in just over three months – 1,111 during the week of Aug. 28-Sept. 3 alone. The women who seek Janet's help have suffered more in a few weeks than anyone should bear in a lifetime.

Responding to the Different Needs of Men and Women

Today Janet met a client, who arrived two months ago and set up housekeeping on the outskirts of Dahagaley camp, in a crude hut made of cardboard boxes on a frame of bundled sticks. Before leaving Somalia, as her family's meager farm shriveled to nothing, the woman watched two of her three children die of hunger and disease. Crossing the desert on foot, she was robbed of everything – even her precious supply of water – then gang-raped. It is a horrifying story, but the woman speaks with a steady tone. She wants to give voice to the terror, to speak out on behalf of those who must remain silent in fear.

Men, too, suffer their own nightmares. Initially many stayed behind in Somalia to watch over homesteads and herds. But as famine continues to spread, crops have been decimated. When their last cattle starve, men are forced to make the trek to Dadaab in search of help. For those from proud, ancient pastoralist traditions, who measure wealth in terms of how many cattle a person owns, the loss of a sense of identity is devastating.

"Not quite as many men come as women, for cultural reasons, but they do come," said Sharif Ahmed Abdulahi, a CARE paracounselor trained in community development, life skills and counseling. He and his colleagues are careful to respect tradition and work in harmony with community norms. "Sometimes people ask me to tell them what to do. I say: I can counsel you, but I can't advise you. If you want advice, you should go to an elder."

Janet is busy recruiting additional staff to reach more people in need. She wants to hire and train more female counselors – just under half of the current refugee workers are women – but it's hard to find candidates who are literate, and many young girls are married off at age 14 or so.

But Janet is not someone who gives up easily. She thrives on challenge, and finds this work incredibly rewarding. One thing is clear: she's not going anywhere soon. "I plan to stay as long as I still like it. It will be a few years."

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When I told my family and friends that I was leaving for six weeks to work with CARE on temporary assignment in Dadaab, the world's largest refugee camp, I was immediately bombarded with Facebook messages, e-mails and calls along the lines of "I'm so proud of you. You're going to save the world!" and "You're making such a difference!"

To be honest, besides being a bit exaggerated, it makes me a bit uncomfortable. Now, don't get me wrong, I cannot emphasize how much I appreciate the good wishes and thoughts of my loved ones. Their support has allowed me to take this journey. But nothing — absolutely nothing — compares with the dedication and passion of CARE's employees in the field. And to even be put in the same category as these colleagues seems more than a bit ludicrous.

This past weekend, for example, I took part in my first real Dadaab celebration —complete with grilled goat (a rather tasty treat, if you're curious) — a send off for long-time CARE employee, Julius. Julius is leaving Dadaab for a new CARE post in Nairobi after nearly 19 years in Dadaab. Nineteen years! That's the equivalent of 133 years in a normal career, as I'm convinced Dadaab years should be counted like dog years. He joined CARE when the refugee population in the camps was around 35,000. Today, nearly 400,000 additional people have been added to that number.

For 19 years he has lived here away from his family. He most likely has shared a room and used a communal bathroom and shower. Because space is at a premium, when a staff member goes on leave, people exchange rooms, some moving every few weeks. There are no hanging photographs, no personal mementos. In many ways, the staff is unsettled as the new arrivals. They are nomads without a home. They work for hours on end in the unforgiveable combination of heat and dust.

I am here for six weeks, and even in that relatively brief time, I have succumbed to heartache and homesickness. I assumed that unlike me, the devoted staff in Dadaab must have solitary lives, free of the commitment of relationships. Until I met Maureen, a new coworker who casually mentioned her three-year-old son and husband back in Nairobi. Or another colleague who mentioned how he was planning some quality time with his wife during his next break. CARE staff work eight weeks on, two weeks off. Because of limited resources, sometimes even those brief breaks get shortened. But I have yet to hear a complaint. I have yet to see a frown. There is a Jewish proverb that says, "I ask not for a lighter burden, but for broader shoulders." CARE staff in Dadaab are star athletes in that regard.

In addition to the tough environment in which they work, the actual work they carry out is difficult. Imagine feeding 427,000 people. Getting clean water to them. Educating them. Training them. These jobs are difficult no matter the circumstances – but in these conditions, accomplishment is an amazing feat. Many that have made the long trek from Somalia have experienced personal violence or loss, each tale of tragedy and horror more unfathomable than the one before. CARE's sexual and gender-based violence officers have the colossal task of helping the survivors heal, start their lives anew. Day after day after day.

I asked a colleague why staff that work so hard, so tirelessly. And why are the people that CARE serves, people who have been through the most of trying of times, always smiling? Why despite everything that surrounds them, do they always greet me with a handshake, with a sense of joy? He answered, "Because we are Africans. We have been through so much and we survive. We have hope now."

No individual is saving the world. But here among CARE's dedicated staff, I have met a lot of people who are doing their part.

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by Niki Clark, Emergency Media Officer in Kenya
September 2011

I’ve been in Dadaab for nearly two weeks now. I have seen mothers and daughters, fathers and sons. They have been old and weak, young and weak, their faces lined with struggle. I have seen the faces of children who have eaten their first meal in weeks and the resulting transformation back to childhood, full of giggles and smiles and impromptu games of tag. When people think of Dadaab – now with its three camps considered the third largest city in Kenya – they think crisis. They think emergency. Humanitarian efforts and funding tend to focus on the immediate, looking ahead no more than a year. As soon as another emergency hits, the spotlight will move on. But, as they have for the past 20 years, the refugees of Dadaab will remain.

This thought particularly struck me during a visit to the reception center, the first place where refugees find help after a long and arduous journey. Here they receive medical assistance, and aid workers identify the most vulnerable for immediate attention. A chorus of wails echoes from the vaccination room: the occasional child slipping from the grips of the nurse, running to the dirt yard in tears. Each family collects a 21-day ration of food and supplies (cooking pots, mats, a tarp, soap, jerry cans) to tide them over until they can register.

Today, I see a young mother waiting for her high energy B-5 biscuits, a box of which is given out to new arrivals. Tucked under her garbasaar – a traditional shawl – a set of tiny toes poked out into the sunlight. I approached her gently, and she pulled back her wrap so I could see his miniature features. He is 10 days old, she tells me with a smile. She gave birth to him halfway through her journey to Dadaab. Most likely, I thought to myself, he will become part of the second generation that has spent their entire lives within this camp.

CARE has worked in Dadaab since 1991. Refugees who were educated as children here are now teaching refugee children themselves. That’s why the long-term investment that CARE is making here is so critical. It’s not just an investment in immediate needs, although we’re doing that, too. On an average day of food distribution, CARE passes out 389 metric tons of food to 45,000 people. And every single day, CARE pumps and distributes approximately 7.5 million liters of water, enough to provide more than 446,000 people with 15 liters of water every day.

But we’re also working toward long-term solutions. We’re investing in people. In Dadaab there is a thriving economy – butchers and bakers and, yes, probably candlestick makers. They own restaurants and bookstores and barber shops. People are being trained by CARE in trades from dressmaking and tailoring to computer technology. CARE directly employs 1,600 refugees, who serve as counselors, food distributors, chefs, teachers and drivers. They grow up in Dadaab, are educated in Dadaab and work in Dadaab.

After the “emergency” has passed, hundreds of thousands of people will remain here in the refugee camps. As my colleague told me today, they need more than food, water and shelter. They need a future. CARE is committed to helping them prepare for tomorrow, whether they continue to build their lives here, or one day, return home to start anew.

The drive to the Galbet Farm in Garissa, Kenya, looks strikingly similar to the land around Dadaab, site of the world’s largest complex of refugee camps. It is dry and barren. The bush remains brown and leafless after months upon months without rain. It seems like an unlikely environment for a farm – one that will thrive, anyway.

But thrive is exactly what the farmers at Galbet Farm are doing. While the drought is killing the livestock and destroying people’s livelihoods in neighboring regions, this one small patch of land in Garissa is literally an oasis in the desert. It’s not just through happenstance. The people of Garissa knew a drought was coming so, with CARE’s help, they prepared.

For the past two and a half years, CARE’s Arid and Marginal Lands Recovery Project Consortium (ARC) has worked to promote drought-resilience in the Garissa, Moyale, Wajir and Mandera districts. The three-year project reaches more than 85,000 people, in a region where the drought is affecting half of the population – some 2.4 million people. In a region where 80 percent of the population is dependent on livestock, the death of animals is devastating.

CARE’s objective in launching the project in the aftermath of the 2008-2009 drought was to help vulnerable rural people gain sustained access to food and become more resilient in the face of future crises.

Maka Kassim is one of those people. As a pastoralist, she and her family followed their livestock wherever pastureland and water could be found. After a severe drought five years ago, her herd died and she was left with nothing. “I decided I needed to plan so I could provide for my family – so we could get our daily bread.” she says.

Today, Maka is flourishing. CARE taught her how to farm and diversify her crops to protect against disaster. As part of the Galbet Farm cooperative, she and the other farmers grow fodder grass, bananas, tomatoes and mangos. In addition to providing enough food for her family, including her six children, the farm has been so successful that she is able to supplement her income by selling extra produce at the market.

CARE also is helping improve water canals. Previously, farmers collected water from the Tana River, a time-consuming and dangerous task considering the river’s high population of crocodiles. The old canal cut through loose soil and experienced frequent breakages and high seepage that resulted in a large loss of water. Now, an abundant supply of water comes to the community to irrigate the land and provide fresh drinking water at tap stands.

Galbet Farm is just one of several ARC projects. CARE’s work through the project includes teaching beekeeping, fodder production, milk marketing and basic veterinary skills. We’ve also helped foster a relationship between First Community Bank and the Kenya Meat Commission. Farmers now purchase weakened cattle from drought-stricken districts, bring them back to the farm to fatten them up and then sell them for a profit.

“We want to serve as role models,” Maka says. “Because of CARE’s assistance, I am able to feed my family. I am able to educate my children. I am able to plan for my future.”

Niki Clark, CARE Emergency Media Relations Officer
30 August 2011

Here I sit, 7,500 miles away from home. I’m a week in. Over the course of just a few days, my life has completely changed. On a Monday I reported to work at CARE’s Washington, D.C. office. By Thursday I was on a plane bound for Nairobi where my final destination would be Dadaab Refugee Camp, the world’s largest. I will spend the next six weeks here as CARE’s emergency media officer. It is a position that both thrills and terrifies me. As an employee of one of the most prominent global humanitarian agencies, there is always an excitement that surrounds “going to the field.” But this is different.

Unlike my colleagues who have preceded me in this position, and most likely the ones that will follow, I have not been in a humanitarian emergency crisis situation before. I haven’t seen the devastation of a Haiti or a Pakistan. The closest I’ve come was the fall of 2005, when my grandmother came and lived with us after Hurricane Katrina. Her Biloxi home had been destroyed. But even then, I witnessed the situation only through my constant refreshing of CNN.com, and through my grandmother’s stories, not firsthand. And Dadaab is unlike other emergency situations. It is established. There are second generation refugees that have grown up in the camps. I’m not quite sure what to expect. Or how what I experience, the people I meet, will forever impact me.

CARE has worked in Dadaab since 1991, as the main implementing partner for the distribution of food and water and as well as a lead provider of education and psychosocial support and rights education for sexual and gender-based violence survivors. We’ve been here for decades. But with the recent declaration of famine in five regions of southern Somalia, coupled with ongoing conflict and instability, a surge of new arrivals have flocked to the camp, and a global spotlight has been shone on the region, particularly on Dadaab. Dadaab’s population stood at 423,361 as of August 28th. Every single day, it grows by 1,200.

As we landed—my colleague Michael Adams, the Senior Sector Manager for the Refugee Assistance Program in Dadaab, and I flew in on a small UNHCR humanitarian aid plane—the pilot circled around towards the gravel airstrip. A bird’s eye view of Dadaab and its three main camps became visible below me. It was a breathtaking site, a massive settlement that’s now effectively Kenya’s third largest city. It’s hard to fathom until you’ve seen it. And even then, when it’s right in front of you, and you’re face to face with women and children and families that have traveled 80 kilometers or more to get here, there’s still something surreal about it all. Something that makes putting it into words seem a sort of insurmountable task.

But that’s what I’m here to do. To share the lives of the people I meet, people up against incredible odds, some who have thrived and some who are struggling to survive. To share the stories of the unwaveringly committed CARE staff whose dedication to the people they serve is first and foremost. To share the successes of CARE’s programming, and its far reaching impact. I’m not sure if I’m up to the challenge; if I can accurately portray the scale and struggles or the unexpected hopes and triumphs. But I do know one thing. I’m going to do my best. There are too many lives at stake not to.

For updates on my experience and CARE’s work in Dadaab, follow me at @nclarkCARE. I can also be reached at nclark@care.org

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As a humanitarian worker for the past sixteen years I have seen some pretty shocking scenes. Before this trip to East Africa, I was particularly not looking forward to witnessing suffering children. However, when I saw the dedication and commitment of the CARE staff working on our response in very difficult surroundings, it made me feel proud to work for CARE.

Villagers in Gemechis District, Ethiopia, register for food distribution by CARE. Photo: CARE/Sandra Bulling

Helping pastoralists in Borena
In Borena, Ethiopia, CARE is working with people to reduce cattle herd sizes during droughts to prevent over grazing of the pasture, and to provide the community with an income from their weakened cattle before disease robs them completely of their value.

People in Borena are well known for their strong social bonds. They are also well known for feeding their children first, a practice which is key to ensuring survival of the next generation in this toughest of times. This, along with the monitoring from CARE and the local government, ensures the program reaches those who need it most. But our program is only reaching five per cent of people living in the targeted districts ­­– further funding is desperately needed to extend this highly impactful and timely program.

A health centre in Miyo district
Distances in Miyo district are huge and mothers can travel for a long time to bring their children to the health centre for assistance. The most seriously malnourished children receive help here, accompanied by their mothers.

First they are checked for diseases like diarrhoea and given treatment. Then they start a careful course of therapeutic food, starting with low-strength milk powder. It normally takes four to five days for their weight to stabilise. Then they progress to a more nutritious formula that helps them regain weight fast. Finally, they can be discharged with two month’s ration of oil and corn soya blend to take home.

In Gemechis District, Ethiopia, CARE distributes monthly rations to villagers, who share the food between them. Food distribution benefits more than 66,000 people in East/West Haraghe and Afar. Photo: CARE/Sandra Bulling

Making sustainable change in people’s lives
Along with responding to the current situation, we also have to look at what causes the current situation and how we can prevent it from happening again. We need to understand the underlying causes of poverty and why drought keeps coming, and why children and mothers are severely affected. For example, we have linked many large households in East and West Hararghe to the long-term family-planning project in the area, as large family sizes can contribute to malnutrition.

With CARE Ethiopia already meeting the needs of over 406,000 (as of Aug. 22) people and plans to reach up to a million in the next three months, I am confident CARE is playing its part in reaching the most vulnerable during this drought, the worst in a generation. It’s our job to make things better in a tough situation and that is something I feel positive about. We need help from the Australian public so that we can extend our programs and benefit more people who are suffering from this devastating drought with long-term solutions.

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The green trees, cool mountain climate and well-stocked shopping malls of Nairobi are in sharp contrast to the camps in dusty Dadaab. The warm smiles and healthy faces of the Kenyans I meet are very different from the haggard faces of the new arrivals from Somalia I saw lining up for food just a couple of days ago.

Many Kenyans are also suffering in the terrible drought sweeping across the north and east of the country. Today I met with CARE Kenya senior staff who explained how CARE is working to improve the situation in Kenya by investing in communal management of water and pasture. They told me that most of the people affected by the drought are pastoralists who live and move with their herds. In the drought, lack of water and pasture has seen herds decimated and no rain is in sight until September.

In the north-east of the country CARE is supporting people to renew communal management of grazing lands and water pans. Where there was some local rain in April, the water pans still have water and there is still some pasture, but even they are badly off. That’s why CARE is supporting off-take of weak livestock at a reasonable price and the vaccination of stronger animals so they can withstand the drought. This should help herds to recover and people to bounce back if the rains come.

Stephen Gwynne-Vaughan, CARE’s Country Director in Kenya, visited Gafo in late July and saw the difference these investments have made. Water pans that were rehabilitated last year with community labour through CARE’s support still have water. What’s even more encouraging is that the community have managed them well, collecting small fees from users, which have allowed them to clear out the silt this year. If they continue maintenance, these should last for twenty years.

We have also supported district-level planning so that communities and the local government know when to take emergency measures such as de-stocking of livestock. Pastoralists move across the border with Ethiopia, so CARE has worked on both sides to bring communities together so they can make agreements that allow access to pasture for the animals when times are hard.

Gary McGurk, Assistant Country Director of CARE Kenya, explained why CARE will only consider water trucking and food aid in the most dire situations. “Water trucking is expensive and encourages people to stay in places that cannot sustain them rather than moving on with their herds.” By investing in community management of water and pasture, we can reduce pastoralists facing a crisis and needing expensive food hand-outs or water trucking.

But support for such interventions is hard to get. Even though studies show that a dollar invested in preparedness will save on average seven spent on crisis response like food aid, we find it hard to gain funding. With the situation so bad, we now also need to help the many who are in crisis. Tomorrow I will travel to Ethiopia to see how we are doing that there.

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Today, I spoke to a young woman who had walked for twenty days with her two children. They left their home due to the drought which has dried up all drinking water sources.

She was sitting in a makeshift tent made from rough branches and covered in bits of cardboard and scraps of cloth. She and the other new arrivals have taken refuge outside the established camps.
The influx of new arrivals has put great pressure on services in the camps, not least on the water supply. CARE has been providing water to the camps for over twenty years, but with the recent influx we have been really stretched.

Jason Snuggs, CARE Australia’s Water and Sanitation Adviser, has been working with the local team to ramp up water supply. He says, ‘We have been setting up new water tanks and tapstands so that people can easily access the water that we truck in.’

We are also supplying 19 litres of water per day to people as they arrive in Daghaley camp. We are redrilling seven boreholes so they produce more water, increasing storage capacity, and extending the piped water system out from the main camps to the influx areas next to them. This reduces the need for expensive trucking and ensuring we can meet the needs of the 30,000 new arrivals in this camp.

The ongoing drought and conflict in Somalia – where famine has been declared in several districts in the south – means the influx of refugees will probably continue for several months. CARE estimates that over 500,000 people will be in the camps by Christmas. Clearly this is a big challenge. Jason says, “We are increasing water provision in the influx areas and water in the camps to above UNHCR global standards of 20 litres per person a day, and we will keep going until we are sure we can meet the needs of further new arrivals.”

I ask him what the biggest challenge is and there’s no pause in his reply: “Funding is the biggest challenge.” It’s also a challenge to get skilled water and sanitation professionals to work in Dadaab as conditions are hard, even for the staff working there.

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It’s 6.30am on a crisp Nairobi morning. The dawn chorus has just finished and I am standing in the CARE Kenya compound. Abdi, our driver, has just arrived with a broad smile and wearing a bright cap typical for Somalis. I am joined by Alain Lapierre, Director of Emergencies for CARE Canada who has been overseeing the expansion of our activities in the region this past month.

He says the situation in Dadaab is of great concern. People are still arriving in a terrible state. Although the numbers arriving have reduced slightly in the past few days, he believes this is only temporary. CARE is scaling up to meet the needs of an increasing number of refugees. This includes recruiting more national staff and for long-term planning with existing staff, such as Jason Snuggs, CARE Australia’s global WASH Adviser, working at the strategic level to develop plans to cope with the projected influx of people.

As we reach a rendezvous point, three CARE Kenya staff who work in Dadaab join us. They are highly skilled Kenyans working in the construction team. One of them, Oumari, tells me that he has been working for nine months in the searing heat of Dadaab, providing administrative support to the construction team who build and maintain boreholes, latrines and five schools. I ask him how he feels about working in Dadaab. He replies, ”I feel really motivated. We are giving hope to people who had lost hope in life.”

We are now joined by another CARE vehicle packed with field staff and provisions for the camp. There are also vehicles with staff from UNHCR and other NGOs. It’s 6.45am and time to hit the road!

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Adam Poulter, Emergency Response Manager for CARE Australia
August 2011

As the plane took off from Canberra yesterday I looked down on the dry hills below. My thoughts turned to the dusty plains of Eastern Kenya where CARE is working in the world’s biggest refugee camp, Dadaab. We’ve been working there for twenty years leading the provision of water, food and education. While we and other agencies working in the camps are able to provide assistance to the more than 414,000 [as of Aug. 22] refugees now there, the problem is that the numbers just keep growing. I’ll arrive there on Sunday to work with the team on increasing our capacity to deal with the projected increase to over 500,000 refugees by Christmas.

Newly arrived refugees from Somalia collect water provided by CARE at Dadaab refugee camp in Kenya. Photo: Kate Holt/CARE

Yesterday I spoke with Jason Snuggs, CARE Australia’s global water, sanitation and hygiene (WASH) Adviser who has been working with the team in Dadaab to increase water supply and storage for the new people arriving since early July. He told me how they’ve managed to increase water supply for people on the edges of the three main camps. We are now providing people with up to 12 litres of water each per day. The target is to exceed 15 litres, which we have been able to provide to long-term refugees. Jason is confident we can reach this target in the coming weeks by redrilling bore holes, improving distribution lines and storage capacity for water.

Just as important is public hygiene and we are working with animators from the local community to spread simple hygiene messages like the need to use soap and to wash hands before eating. By doing this we can limit outbreaks of diarrhoea and other infectious diseases which can kill the malnourished, especially young children.

We leave at 6am sharp. I will be accompanied by CARE’s Regional Coordinator, and two global education experts. The road takes a bumpy six hours, but this is a trifle compared to the journeys of several weeks the new refugees arriving have made.

I am standing in front of the borehole well, waiting for the clicking sound of my camera. But there is no sound. The CARE engineer has just explained how ground water is pumped up and then distributed to water stations. We are wandering around Dagahaley, one of the three refugee camps in Dadaab. A photographer working for a newspaper is gathering images of how a refugee camp works. But now as we stand at the borehole I feel yesterday’s long hours creeping up on me: my camera battery has obviously run out, plus I forgot my pencil and notebook on the desk. But there are solutions to these minor problems: The photographer lends me a pen and I use the back of my permission papers for the camp to take notes. In fact, I am starting to like my day without a camera.
The frenzied activity of taking photos, writing stories and organizing your way around Dadaab helps you tune out some of the misery and extent of human suffering. But it also makes you focus on only one part of the story. For the past two weeks in Dadaab, I spent most of my days in the camps, documenting the work of CARE, accompanying journalists or interviewing colleagues. My head is still buzzing with all the information and impressions. Like any humanitarian crisis, Dadaab is fast-paced and loud.

But now, sitting down in the sand near a water tap stand, I am quietly watching the hustle and bustle going on around me. I close my eyes as the wind blows fine-grained sand my way. I gaze around in all directions. The photographer stands on top of a water tank to get a better angle. None of the women or children fetching water pay much attention to us -- water is much more important than the strange sight of a visiting foreigner. I curiously watch two young women leaving with their jerry cans full of water. But they don’t carry them on their heads; instead, they roll them across the sand. This really calls for a picture: Two women in long veils and torn sandals kicking their jerry cans full of water through the desert. But with my camera batteries empty, my eye batteries seem to be more charged than ever.

After a while I move to the side of a latrine. It’s just four walls of corrugated iron, but at least it guarantees some privacy. Standing in the shade I watch a man with his donkey cart. Bit by bit women lift their jerry cans onto the cart, tightening them with ropes and rags. Getting places here in Dadaab takes time. The three camps cover some 56 square kilometers. Owning a donkey cart is a pretty good business. It is so hot that everything here seems to happen in slow motion. Finally the cart starts to move. I wonder how much the women have to pay for their transportation and whether they will still have enough money left to buy food for their children. While I sit in the sand, their skinny legs are at eye level. I can count the children wearing shoes on the fingers of one hand.

Humanitarian aid means reaching as many people as possible with at least minimum needs, given limited resources. In Dadaab, CARE and other agencies provide about 500 grams of food and about 12 litres of water per person and day, some basic medical assistance, some counselling. Every one of these 414,000 refugees is a unique person with a particular history, hopes and sorrows – but the scale of this emergency is so vast, we can’t possibly meet all those individual, specific needs. What we can do is slow things down for a while and pay attention. Observe. Understand. And adapt our programs to what we see. For example, CARE might soon pay the owners of the donkey carts so that weak and poor women don’t have to spend the rest of their money for transportation of water and food.

It is quick and easy to take a picture, upload it to your computer and then store it somewhere in your archives. But the pictures I saved in my head today will linger on for some time before I will be able to store them anywhere.

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CARE's Emergency Communications Officer Sabine Wilke in Dadaab, Aug. 11

How does the situation compare now to the beginning of the year?

The big difference is simply the high number of new arrivals. They have stretched our capacity to deliver the essential services for humanitarian aid, especially because many families are settling in informal, undesignated areas where there is poor access to services. They are scattered around the camps, but it is hard to reach them quickly enough to prevent further suffering. After 20 years of providing humanitarian aid in the camps, CARE and other agencies are now confronted with a new complication: in order to meet the increasing needs,  we have to stretch the resources that we have as much as possible to help all new people arriving in very weak and vulnerable conditions. Another complication is that the refugees are taking up more and more space outside the formal settlements which is having a detrimental effect on the local environment; they need firewood to cook which results in the deforestation of the sparse land which in turn creates conflict with the host communities whose grazing land is being destroyed. In the first five months of 2011, we had weekly registrations of about 2,000 people on average. In July, this number went up to more than 5,000. And this only counts the individuals being registered; we currently have a backlog of about 35,000 people still waiting for registration.

What is the difference between those refugees who have been here for some time and those who are new arrivals?

Most refugees here are quite resourceful, that is natural in any setting. People are not going to sit around for 20 years; they want to get on with their life. There are thriving markets in each of the three camps where you can charge your phone for 25 Kenyan shillings at a shop that has a small generator, you can find tailors and hairdressers and so on. Those who have a little bit of money buy products from the local markets in the area and sell them in the camps. But the newly arrived families, those who have fled drought, poverty and instability in Somalia within the last few weeks, they come here with next to nothing, barely carrying clothes on their backs. So, the provision of basic emergency services such as food, water, health and shelter are very important to sustaining life. As a measure of how serious this crisis is, the refugee community that has been long settled here in Dadaab have come together to compliment the international response. A Muslim charity created from within the camp population is now providing clothes and shoes at the reception areas to help the aid agencies. This is really encouraging for us to see because it demonstrates this crisis affects everyone. And help comes from many directions.

The areas around the camps are also suffering from drought and chronic poverty. How can you balance assistance for refugees and Kenyans?

This is a very important concern. People outside the camps are also in dire need of assistance, and of course they see the services provided in the camps and want to receive similar support. CARE has been working in the region for years, and we are now scaling up our emergency regional response to meet the ever increasing need beyond the Dadaab refugee camps. But we cannot feed and water everyone in and around the camps… we simply don’t have the capacity. The mere existence of the camps, offering relative safety and security and access to basic essential services, that is like a beacon of hope in an otherwise bleak and desolate environment for all those Kenyans who also suffer from the impacts of severe drought. Ready markets and access to trade and business offer alternative livelihoods or income generation opportunities for families no longer able to continue their pastoralist lifestyle. The refugee operations bring jobs, businesses and contracts. The area of Dadaab has grown from 30,000 people to more than 200,000 people over a twenty year period. This said, the camps are stretching the existing resources and the environment to a point where it will be very difficult and slow to recover. CARE has always engaged with the host community, they have always been a part of our response in this region. Our support to the cost community has included activities such as borehole maintenance through repairs of the generators and pumps, chlorination of the boreholes to reduce contamination; we created water pans for livestock watering, built classrooms and trained teachers. And we are currently looking into ways to provide even more support. But we also have to think in terms of how this can be sustainable in some way, because there will always be droughts in this area. We need to find ways to build resilience; boreholes can only be a part of the solution.  The key is to support the communities to help themselves. Let’s say through cash transfers so that they can hire their own water trucking, by training to maintain boreholes, by conflict-resolution forums. But all of this costs money and unless there is a severe humanitarian crisis and people here about it in the news, aid agencies really struggle to obtain funding for these activities.

What role does the Kenyan government play?

Kenya has had its doors open for 20 years, and continues to keep it open. They are not turning people away. The international community has provided some support, but nowhere near enough, and before pointing a finger at the Kenyan authorities we have to remember the impact this refugee population has on both the communities and the environment. And with Somalia still lacking security and governance, there is no solution for the refugees to go home again. Kenya has a right to continue ringing the warning bell, and the country cannot carry the burden by itself for another 20 years.

What are the biggest challenges right now?

As for food distribution, WFP and CARE have done an exceptional job to provide food when and where necessary. Every refugee receives an average of more than 500g of food per day. But it remains a challenge to disseminate information about how much and where food is available for the new arrivals. When so many people are coming in, we don’t know where they are coming from and where they end up. Before, when the number of new arrivals was still manageable, the information focused on reception centers. But now we need to do outreach into the so-called influx areas around the camps, where people settle while waiting for registration.

As I’ve mentioned before, there is also a backlog of people received but not yet officially registered as refugees.  Since there is no screening center at the border, people arrive here and have to go through the registration process, which takes time. People who have been received, but not yet registered, get food for 21 days and some supplies such as water cans, blankets, cooking items, soap etc. But if they have to wait longer than those 21 days to get registered, we have to organize a second round of distributions. Another problem is transport, because many families settle quite far from the reception areas. So many single mothers or people suffering from weakness and malnourishment have to pay someone to carry their food home. This is a big concern for us, so we are working very hard to fill that gap.

And then there is water: CARE has done quite well in providing water to the influx areas to new refugees, where we can we’ve been able to extend piping from the existing water lines out, so that pressured water is provided from boreholes to temporary taps. CARE is also trucking water to temporary tanks and taps. But we still face challenges in that some of the current borehole systems bordering the influx have insufficient pressure to fill up the water tanks more quickly, so in some cases this leads to long queues. We are replacing these low pressure boreholes so we can provide enough water to the refugees. Technically, it is always a challenge to bring in the equipment and set up a structure in the middle of nowhere. But water is such a crucial part of the response that we cannot slow down now.

Protection is also a big issue. The families arriving here, especially single mothers and young children, are often very tired, malnourished and sometimes sick. They are the most vulnerable having traveled many weeks in the sun with little food and or water with barely enough clothing to cover their back. They need to get support as soon as they arrive. The health agencies are trying to keep up but the malnutrition rates are still high. We need to help them settle in a more secure community environment where they are not exposed to sexual violence or banditry and close to essential services. However, we simply don’t have the people-power to reach all of them with the information they need to know to help them. In an effort to address this issue, CARE has set up temporary kiosks at strategic locations in the outskirts of camps where people can come and seek help and information. It also acts as a base from which our community development mobilisers move out on foot into the influx areas to talk with as many new arrivals as possible giving them basic information: where to get food and water and that both are provided for free, where to seek counseling services for those who are survivors of conflict and or violence etc.

What are you most worried about for the months to come?

At current rates of arrival we will still have significant challenges to meet the needs. We have new extension areas where people will relocate to, but if the influx continues, those will be full by the end of the year, so we will not have been able to decongest the current camps as hoped. We also don’t know where all of the refugees are going when they arrive here, some go into the camps so that the density increases, there’s encroachment around schools, youth play areas, community centers and so on. This puts an extra burden on the existing refugee communities. Another thing we are very worried about is the levels of malnutrition seen in the new arrivals. Food needs to have sufficient caloric value to reduce malnutrition rates, but this is also more expensive.

 How do you ensure that women are protected in the camps?

Just as in any city of this size around the world, we cannot fully ensure that women are protected in the camps. There are too little police officers per person and camp, protection remains a major challenge. Women generally don’t go out after dusk, but there is some community patrolling during day time. There are police stations in the camps. Imagine a city of 400,000 people without enough police. But previously settled refugees have been able to form community support networks and work well with the religious and community leaders. The most serious challenge we face now are the new arrivals. They are exhausted, uninformed about where to get help and an easy target for abuse and violence. CARE works directly with the communities and religious centers themselves to prevent violence through information sharing, educational sessions on conflict management, and to support existing community structures, neighbors watching out for each other. For example there are referral systems: if a woman feels threatened, she can come to a CARE office and seek refuge and may be brought to a safe house. We also have helpdesks in the police stations. But we want to extend our services, currently there is about 1 counselor for 30,000 refugees.

It is impressive to see our counselors in action. We have this one very confident young woman, Fardoza, and I recently accompanied her to one of the communities. She goes to one of the camp neighborhoods and sort of holds court, meeting with young men and women who have very set ideas about women’s place in society. And she challenges it in a very positive way and generates discussion. People can connect to her because she is their age, and since she is a Somali Kenyan, she speaks their language.

Do you lobby for the refugees to be granted citizenship or work permits in Kenya?

This is an issue for the Government of Kenya. Our focus is on providing services and working to reduce refugee vulnerability and to maintain their dignity as much as possible. The best case scenario, what we are all hoping for, is of course a return to peace in Somalia. But would all refugees go home then? There is now a second generation born in the camps who have been educated with Kenyan curriculum, and who have never been to their home country. But I still think that many of them would like to go home. And then they will have the unique chance to build their nation with the skills they have acquired here in the camp schools. We are now seeing the same in South Sudan: Refugees who were educated in Dadaab and Kakuma refugee camps as well have now returned home and are a vital part of nation building.

What other issues are important for you to communicate to everyone who is now interested in Dadaab?

I have been saddened by the voices from home who say things like charity begins at home, and that we shouldn’t be helping because there is so much corruption, or that we have already given too much. Every person in the camps of Dadaab is a refugee. But let’s not forget that people don’t want to be here, they want their freedom to move like anyone else, to be free to access higher education, better business opportunities. Even though there is no fence around the camps, they are legally not allowed to work in Kenya and are restricted to the regions of the camps. And what is most heartbreaking is the daily struggle for dignity. Put yourself in their shoes and imagine having to line up for food twice a month, for 20 years now. These are highly proud people, and a man in this culture who cannot provide for his family – well, that is just very hard for everyone. A couple of weeks ago I was introduced to a refugee who was previously a full time employee for CARE in Somalia and now cannot work legally here in Kenya. Though we cannot give them legal jobs, every agency employs workers from among the refugee committee to help with distributions, translations, housekeeping of the compounds etc. They receive a salary and can thus support their families. But like I said, it is not a regular job. He would be very well qualified to be a part of our operation, with all his skills and knowledge of CARE. But all we can do is employ him as an incentive worker. That is one of the many limits they are constantly facing in Dadaab.

Early morning in Dadaab, a nice breeze announces a day that will most likely not be too hot. Outside of the CARE canteen, people are scattered at tables under trees, taking their breakfast. CARE’s 270 members of staff live and work in so-called compounds, one in each of the three refugee camps of Dadaab, one in the main part of town, attached to the compounds of UN agencies and other aid organizations.

I sit down with a group of four colleagues who are having what seems to be a lively discussion in Swahili. As much as we speak the same “language” as part of the CARE family, I sometimes wish for a button I could push to be able to speak the local languages of the countries I am deployed to. But there’s no button, so I just watch and listen before they change into English. As a newcomer, it’s hard to figure out who does what here, with so much buzz and activity everywhere. So I start asking around what their jobs are.

“I work in maintenance of our vehicles, making sure that they function properly”, tells me one the guys. “I’m part of the WASH team”, says another. WASH is one of our most common acronyms and everyone who uses it tends to forget that the outside world needs interpretation for it. WASH sums up all activities in Water, Sanitation and Hygiene promotion, one of the most crucial programs in any emergency to prevent disease outbreaks and ensure that people have sufficient potable water to survive. “We get called when there are problems with the boreholes, pipelines or water stations”, he adds. So is he going out to one of the camps today? “That depends, I am basically on call for any emergency. Otherwise I stay in the office and catch up on paperwork.” Paperwork in a refugee camp? Yes, sure. Quality management, accountability and proper information management are crucial for any successful operation, even more so in the fast-paced environment of a humanitarian crisis. If we don’t document what we are doing and how things are working out, we cannot communicate our needs and plan for the upcoming months. Moving on to the third person at the table: “I work in construction.” Constructing what? “Anything that is needed, whether that be new rooms or sanitation facilities in our compounds, or services for the refugees in the camps. We just rehabilitated some classrooms in a school.”

This conversation gets me thinking as I wander off to the office: There are two faces to the humanitarian work CARE is doing: One face consists of the men and women who appear in the photos and TV images, those who get interviewed by newspapers and radio stations: doctors treating patients, staff distributing food to refugees, and of course the spokespeople of our organizations. But behind the scenes, there is a whole army of workers managing the operation every day. They work from early morning till late at night, lacking private life and comfort, missing their friends and families. Journalists often ask whether we employ Western volunteers who have given up their life of comfort to help people in need. As honorable as this is, humanitarian assistance demands expertise, local knowledge and a long-term presence. All over the world, CARE’s staff is over 95 percent local, speaking the language, understanding the social dynamics, and committing to these difficult working conditions for longer periods of time.

When I leave Dadaab, my colleagues will still be here. And when the cameras leave and the public eye wanders off to the next crisis, they will continue to do their jobs to provide water, food and social assistance to the more than 400,000 refugees here. And I hope they will have many more laughs in Swahili at the breakfast table to start their day with a smile.

The realities of a refugee camp are hard to explain to the outside world. Many people think of Dadaab as a fenced-in area, overcrowded with tents, and people lining up for assistance. Some of this is true, to a certain extent. But Dadaab has grown for over 20 years now, and developed into an almost urban settlement of huge dimensions. There are actually three refugee camps in Dadaab, Dagahaley, Ifo 1 and Haghadera. And we spend about 10 to 20 minutes in the car getting from one camp to another. There are no fences around the camps, so people are generally free to go from one place to the next and into the town of Dadaab. But with long distances to walk in the sand under the blazing sun and no legal rights to actually leave the camps and settle outside, freedom is not the right term to use. Tents can be seen everywhere, but many new arrivals in the outskirts have simply put up wooden sticks and cover the structure with tarps, for now. Those who have been here for decades, who have raised their children here, have grown old in Dadaab and still see no way to return, those families have built more solid houses, constructed of bricks or mud, fenced and well-maintained. When I enter one of those homes, it reminds me of other places I have visited in some countries in Africa. Clothes hang up to dry, children play around in the court, the elders sit together in the shade of a tree.

But whether settled or just arrived, all 400,000 refugees in Dadaab depend on assistance to meet their basic needs. They cannot legally work or leave the camps, and the sandy soil and lack of water make it difficult to plant vegetables or other staples. This is where CARE, the UN Refugee Agency UNHCR, the World Food Program WFP and others come in: Many of us have been here from the start and it is encouraging to see the level of cooperation. I think of critical media coverage about how aid agencies compete for funding and don’t coordinate their work that usually comes up with any emergency. But everyone who has been to Dadaab quickly understands that our humanitarian mandate is a much stronger bond than any talk of money, influence or popularity. Over 400,000 refugees are in need of assistance, there is enough to do for all of us. CARE manages two cycles of food distribution per month and hands out food and relief items to new arrivals; our engineers maintain and extend the water supply systems; counselors and social workers help the most vulnerable, mainly women and children suffering from violence and exhaustion; teachers are trained and schools set up.
Currently everyone here is worried about the bad state of newly arrived families. Exhausted, malnourished, traumatized: When I look into the faces of women, children and men in the reception areas, I can only begin to imagine what they have been through. With the increasing stream of refugees arriving, there is a backlog of around 35,000 people who have not yet been registered. CARE distributes food and other relief items to them, but they cannot settle permanently yet. Much of the first help is information: Many newcomers simply don’t know that the food and water is free, where the next clinic is, some don’t even know where exactly they are.

It’s also hard to describe to the outside world how aid workers cope with the suffering and misery they are confronted with every day. Over the years, I have had many discussions with colleagues, and although it is a very personal affair, I feel like we have a common understanding: Most of the time, you cannot look beyond the crowd to acknowledge the individuals, your work needs to be about quantity: Handing out food to as many people as possible as quickly as we can. Disseminating information about counseling services and support for women victims of gender based violence to a whole area as fast as possible. Hurrying to a bursting pipe to get the water supply going again.

But this line of work would not be called humanitarianism if you would not care deeply for every single person. And every now and then, you cannot blend out one of the faces in the crowd. At the reception center of Dagahaley, I catch the eye of a young father; he sits at the reception area with his three kids, his wife next to him. It is impossible to explain how and why this connection happens, but his smile is so inviting and their relief of arriving here safely, their family intact, is almost palpable. We exchange smiles, I ask for a photo. Then I just sit next to the reception table and watch them for some time. Then something else comes up, I leave. When I turn around again, the family has gone. Back to be a part of the crowd. But I know that they now have food to last them for 21 days, water, and have met people who can assist them with their needs. And that must be enough, for now.

I have just visited Balich Village in Garissa district, North Eastern Province of Kenya. Inhabitants of Balich belong to the Somali-Bantu community, an ethnic minority which is highly marginalized. The region is experiencing a severe drought, as many other areas in the Horn of Africa currently. According to some estimates, 2.4 million people are affected in the North Eastern Province, where Garissa district is located – this is more than 50 percent of the province’s population. But amidst the drought, there is a glimmer of hope, because in Balich villagers were prepared for the drought. They are able to plant and harvest food and animal feed as they have a functioning irrigation system. But let’s start from the beginning:

Some areas of the North East Province are difficult to reach because very bad roads and long distances of up to 1,000 kilometres, and in those far away places, children, pregnant women and lactating mothers and elderly people are mostly affected. I heard of some men who had to migrate in search of pasture for their livestock or for work in the towns. Women and children staying behind depend on assistance from relatives, the Kenyan government and humanitarian organizations.

As the drought goes on water pumps cannot keep up with the demand. People use it during the day, animals at night. People rely on mechanised pumped water more than ever, and because of the over-usage the pumps often break down. Ground water levels are dropping, and some areas that were once sustained by pumped water now have to be served by expensive water trucking, which can only be a short-term solution. In some villages, pastoralists had to wait for three days to get water for their animals. Some had to walk for 30-40 kilometres to reach water points. Many of their livestock died while looking for water – and that means their source of income has perished. Garissa is mostly a pastoralist area; animals mean everything. One colleague said to me: "Animals are meat, milk, and cash. If they are gone, everything is gone”. Prices of livestock have decreased and often pastoralists have to sell their animals for very unfavourable prices. Once they make it to the market they have to sell their animals at any price offered because they do not have the means to transport them back home. Livestock might even die on the way back, because they are too emaciated. Approximately half a million people and 90 percent of all cattle already migrated out of some areas in search of water, pasture and food. And naturally, these movements cause conflicts.

Resilience is key

However, Balich village showed me a picture of strength and perspective. CARE’s long-term support in Balich has helped people to resist the impacts of the drought and to prepare for times of hardship. CARE assisted the community to plant animal feed and crops by erecting water pumps and canals for better irrigation. Before, fetching water was a dangerous job: “My children are safe now when they get water. Before, they were threatened by crocodiles living in the nearby Tana river”, on woman told me. The key is resilience: empowering vulnerable people to overcome drought without losing all assets. With access to credit facilities, market linkages and a sustainable livestock marketing model, people are able to generate an income and save assets.The CARE projects in Balich show how important Disaster Risk Reduction initiatives are. But it has a side effect: Pastoralists from nearby villages are now increasingly bringing their livestock to Balich, putting pressure on the valuable water sources.

My visit to Balich reiterated what we know in theory and what we need more in practice: emergency support and long-term development initiatives that focus on creating resilience need to go hand in hand. This is the only way to break the hunger-cycle in chronic emergencies. However, funding for emergency is often easier accessible than funding for disaster risk reduction. I hope that the example of Balich shows how much we have achieved and how much money we can actually save when we invest in preparedness.

“It is unfortunate that the rains have decided to not fall for the last two years.” The Kenyan man sitting next to me on the plane to Nairobi has a very poetic choice of language, which makes for a rather stark contrast when you consider what he refers to: His country and the whole region are in the middle of a humanitarian crisis triggered by a severe drought, which is affecting almost 11 million people. And yes, some parts of this region have not seen rainfall in two years. My neighbor continues: “It is all about water. If you don’t have water, you cannot raise animals. And without animals… well, that is their life insurance.”

Touching down in Dadaab the next morning, I remember that friendly voice. The refugee camp in the North of Kenya is now home to more than 400,000 mostly Somali refugees. Their numbers have risen immensely in the last weeks, due to the ongoing drought and insecurity in their own country. The landscape is dry and plain up here, and one wonders how any group of people, let alone such a high number of refugees, can survive in these difficult circumstances.

This is my first time to Dadaab, but weirdly enough, everything seemed very familiar. Maybe that’s a CARE thing: The refugee assistance program for Dadaab is one of our longest humanitarian missions, many colleagues have worked here at one time or another. And for years, we have continuously talked about it to the public, launched appeals and tried to get journalists interested. But now, with an average of more than 1,000 new arrivals every day and extremely high numbers of malnutrition, Dadaab has become something like the epicenter of the current humanitarian crisis in the horn of Africa.

But a walk through Dagahaley, one of the three camps, also shows the impressive efforts by all the agencies on the ground to provide basic services to all these people. We pass by the reception area where CARE distributes food and other relief items to new arrivals, we see trucks delivering water, and visit the service tents – all of this I have heard about before, but it is still a whole different story to see the work with your own eyes and listen to the admirably energetic colleagues explaining their work.

And we meet Amina Akdi Hassa, who serves as chairlady for the camp Dagahaley. She has been living here for 20 years and is a leader and an advocate for her community. “I want the world to know that they should please share our problems with us”, she explains. “We have had five schools here since the 1990’s, but now there are so many more children.”

The people of Dadaab are talking. But is the world listening?

By Sandra Bulling

Green plots of land cover the lush mountains of East Haraghe in Ethiopia. Small brown huts dot the landscape, their owners busy working in the fields. Thick grey clouds hang above the peaks as high as 3,000 meters, seemingly bursting with rain any moment. On a first look, East Haraghe looks like postcard idyll, perfectly suited for agriculture that yields enough crops to sustain the farming families. On a second, the area is the scene of a severe drought. Malnutrition cases East and West Haraghe zones increased steeply in the past months. The reasons: insufficient rainy seasons, high food prices, chronic poverty and a weather phenomenon called La Nina.

The large majority of Ethiopian households, 87 percent, relies on agriculture as source of income and nutrition. A good rainy season brings relief, a failed one desperation. The past twelve months were determined by worry; the Meher rains that usually arrive from June to September in East Haraghe ceased prematurely last year. As a consequence, the complete harvest was lost. The following Belg rains which are scheduled by nature from March to May were delayed for about two months, insufficient in amount and erratic in distribution. For many farmers it was impossible to plant; and those who did are still waiting for their maize to ripen. One month ago, in June, farmer would have normally started to harvest. But instead, people have no food left in their homes. Scientists credit the insufficient rains to La Nina, a weather phenomenon that changes weather patterns and causes drier conditions in East Africa.

Maize porridge, twice a day

Kado Kaso came with her son Sabona to a government run health center in Kurf Chele district. “My son was vomiting, he had diarrhea and could not hold any of the food I fed him”, she says. Sabona was diagnosed as severely malnourished. The three year old has lost his appetite. His feet, legs and eye lids are swollen – characteristic signs of edema, a medical complication of severe malnutrition. He stares into the room, there is no energy left in the little body to play or move around. Sabona arrived one day ago and the therapeutic food provided by CARE has not regained his energy yet.

When the Belg rains began this spring, Kado started to plant barley and beans on her small land. But the rains stopped earlier and all her crops withered. “We have barely anything to eat. During normal years, we eat three meals a day. Now we are lucky if we eat twice a day,” the 30 years old mother says. She takes Sabona into her arms. “We only eat maize porridge, I cannot afford anything else.”

On the bed next to Kado sits Abdi Mahommed with his five year old daughter Milkiya. She has been here for one week, has recovered her strength and appetite. Both father and daughter will leave the center the next day. They will continue receiving weekly rations of therapeutic food, to ensure Milkiya’s condition stays stable. But Abdi has sold his ox to buy food for his family of eight. “I don’t know how to plant for the next season, I have no ox and no seeds,” he says. He is glad his daughter has regained her appetite and started playing again. “All that matters is saving my daughter’s life.”

Searching for labor

Kado’s husband has moved to the nearest town in search of work. But he is not alone. Fathers stream into the towns offering their labor – and salaries have dropped by 50 percent. “My husband now earns 10 Birr a day, in normal years he can earn 20 Birr”, says Kado. Ten Birr are USD 0.60; and that is how much a kilo of maize costs. A price, that has risen significantly over the past months. “My husband comes back every four days, giving me money to buy food. My four children and I are dependent on him, we have no other income.” She now stays with Sabona in the health center, until the little boy can eat again and reaches a stable condition.

Kado’s other children are at home, alone. Neighbors look after them, but they have no meals to share either. And the health center has run out of resources to hand out food to mothers like Kado coming to stay with their children. “CARE is now starting to provide food for the mothers in the health centers. Because if they don’t get anything to eat, they might be forced to leave or refrain from coming here with their malnourished children,” says Jundi Ahmed, CARE Ethiopia’s Emergency Nutrition Advisor.

A malnourished generation

Today, almost every tenth pregnant woman or lactating mother in East Haraghe is malnourished due to the insufficient rainy seasons. However, malnutrition is a chronic condition for many Ethiopians. Even during years with normal rainfall, the small plots owned by households in East Haraghe do not yield enough to cater for balanced and sufficient meals. Malnourishment during pregnancy determines the entire life of a child. Sons and daughters, who do not receive sufficient nutrition in the first five years of their life will not fully develop their mental and physical capabilities. “It is a chronic hunger cycle that can last for generations. Malnourished mothers give birth to malnourished children and have no means to feed them with most needed vitamins, iodine and iron. Children are smaller in height than well-fed children their age, they are stunted. And it is very likely that they will also have malnourished children,” says Jundi Ahmed.

CARE started food distributions to reach 66,000 people in the zones of East and West Haraghe and Afar. Kado’s family and others in her district receive monthly rations of sorghum, vegetable oil, supplementary food such as corn-soy-blend and beans whereas pregnant mothers and lactating women get special supplementary food. But CARE also has long term development programs in the area, supporting families to overcome poverty and hunger. Through Village Savings and Loan Associations, for example, women can contract small loans to open shops and small businesses. With an additional income families can save assets that protect them in times of drought.

Drought comes in different shapes in Ethiopia. But whether in the dry areas of Borena in southern Ethiopia or the lush green mountains of East Haraghe – the pain and consequences of drought and hunger are the same throughout.

Muna* is the envy of her friends in Dagahaley camp. She is also a newly arrived refugee, in fact just nine days in the camp, but unlike her friends who have to live in the outskirts, she has what seems like the comfort of a room within the camp. As soon as she arrived, she managed to trace some of her clan members, who let her use the room in their homestead. Muna is 40 years old, and arrived in Dadaab with her seven children.

Her story, however, is nothing to envy.

She left her husband behind because bus fare for all of them was too expensive. They had to pay Ksh 15, 000 each for the journey on a bus, so he let them go ahead, remaining behind to raise more money for his own trip. “I will join you soon,” he said as he waved them goodbye.

Muna’s journey from Somalia took her 18 long days, having to feed her children wild fruits and look out for wild animals and hyenas. Her children are all safe, and they did not come across any wild animals on the way. However, what her friends would not envy about her is that she was raped on her way to Dadaab. It was midway through their journey, bandits (shiftas) stopped their bus and ordered all the women to step out. “We were eight women on total, so they separated the older women from the younger ones, and told them to get back into the bus. The five of us stayed behind, with our children, and the bus driver was ordered to drive off and leave us behind. That is when they raped us,” she said.

They were in the middle of nowhere, with their children, and strange armed men. The children were pushed away behind some bushes and instructed to be quiet by one of the men, as the others went back to the women and raped them. Some of the other women were gang raped.

Although it was in broad daylight, no other vehicle passed by, and even though they all screamed for help and their children were crying in fear, nobody came to help them. “Afterwards they told us to take our children and keep walking,” Muna and the other women ended up walking 17 kilometres before coming to Dif, where they told some village elders what had happened to them, and they raised some money so the women could go on their journey.

Muna and the other ladies finally came to Dadaab, and she is happy to stay away from her fellow newly arrived refugees, in some private space with her children, among her larger clam. She has gone through reception, and her registration date is set for November 11th. “I am glad we arrived here, and all my children are ok. We finally got some food and water and I have a tent. There are so many people here, even those who came with us, but it is still like we are alone, because my husband is not here.”

The most dangerous period for refugees is when they are on the move. Women and girls are especially vulnerable to rape, abduction, illness and even death on the journey. Many women set out on the journey alone with their children, leaving husbands behind and they may walk for weeks in search of safety.

According to UNHCR reports, the numbers of sexual and gender-based violence cases have quadrupled in the last six months in Dadaab: 358 incidents reported from January until June 2011, in comparison with 75 during the same period in 2010.

CARE has set-up a screening tent at reception centers in Ifo and Dagahaley camps in Dadaab to help identify survivors of sexual abuse or other violence on their journey. In the first six months of this year, since the refugee influx began, 136 cases have been documented, compared to 66 in the same period in 2010. Upon identification, counseling and referred emergency medical attention is administered.

“The deep psychological affects that drought, conflict and subsequent movement can have on woman refugees is immense. We have witnessed high levels of anxiety, panic and trauma due to loss of family members along the way and women are sharing stories of rape, violence and hunger,” said Wilson Kisiero, CARE’s Gender and Community Development manager in Dadaab. “CARE is providing immediate psychological support to the newly arrived women and girl refugees and we are doing all we can to ensure follow-up visits.”

Muna was referred to the MSF clinic by the CARE staff that interviewed her, but she has not gone to the clinic yet, she is afraid she may be pregnant from the ordeal, or she may have a disease. She said she would wait a few more days and then go, but not just yet.

*Not her real named

In Hagadera camp, Fatumo Osman Abdi, 50 has just settled into her tent. She is weary from the journey of 20 days from Somalia. She came with her three grandchildren (aged 13, 5 and 4), her son and pregnant daughter-in-law. Back in Somalia they were farmers, in a place called Kurdun where they grew food for her family. The lack of food became a bigger and bigger problem with time, until they decided to leave.

“Every night as we traveled here, we slept out in the open land, under the stars. We were very afraid, we did not know what was out there, or if there were people coming. We had heard many stories of man-eating lions so we could not even sleep,” she said.

The journey was a difficult one, but Fatumo is thankful that they did not meet any robbers. On their way to Dadaab, they were given food by Muslims on the way, just well wishers who decided to lend a helping hand.

“We arrived here so hungry, so tired. My grandchildren were so tired, I was afraid they would die on the way. Even my daughter-in-law. We slept out in the open for many days, we were under the stars again, but we were safe. After so many days I finally have my tent,” she said.

Seventy year old Habibi* came to Kenya as one of 72 people who traveled together from Somalia. That was almost her entire village, she says, and was made up of her family and friends. Her son had heard of Dadaab and told them about it years ago, he had said that they could run to it because of the fighting. Habibi’s husband had declined, opting to stay in Somalia longer.

Back home they were farmers and pastoralists, growing sorghum, and keeping cows, goats and sheep. They left Somalia because of drought, came here with her friends and neighbours, children and grandchildren. She describes the journey to Dadaab as the ‘worst thing she has ever experienced’.

“We were attacked by strange men, they looted all our belongings, women were raped and men were beaten, but we thank God nobody died,”. Habibi was also raped, and manages to talk about it openly, her anger and confusion still evident. “Our husbands and sons were all there to see it happen to us, it was very bad!”

She is still in the influx area of Dagahaley camp, with only 16 other friends and relatives. The others settled in another camp, Hagadera. One of her relatives gave up his tent for her so she could have shelter with her four grandchildren. All they had to eat on the way was maize, and more maize as they traveled the long journey to Dadaab.

“I do not want to go back to Somalia, all our problems are still there! I am here with nothing, but I would rather stay here. Life here is hard, the food they give us is little because now we have to wait for registration, but I would rather stay here than go back,” she said.

*Not her real name.

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