by Adel Sarkozi, CARE International Rapid Response Team

Refugee children from Syria © 2013CARE

The conflict in Syria, which began in March 2011, has left more than 10.5 million people throughout the region in need of humanitarian assistance. As of May 2013, more than 1.5 million Syrians had crossed into neighboring countries, including Jordan (465,000), Lebanon (477,000) and Egypt (69,000) where CARE is on the ground working to help meet the refugee's most urgent needs. Find out more about our work with Syrian refugees >

Abud, 28, crossed the border from Syria to Jordan two weeks ago. He had to wait a week before being able to do so.

"There were about 500 people stranded at the border with some waiting for over 20 days ... I lived and slept in the street for a week while waiting to cross as accommodation was too expensive," he says.

This was the second time he’s come to Jordan. The first time, months back, he came with his family and there were no issues with the border crossing. He left his wife and three young children in Amman and went back to Syria because his in-laws have been sick, and his wife was worried about them.

Now Abud is with his wife and children again but with the larger family still separated, they continue worrying.

"It’s like being neither here nor there. We want to go back home. We can’t live like this" he says. He wants the world to help.

Maysaa and Khalil do too. But they are not Syrian refugees. They are Iraqis who have been living a life of limbo in Jordan for more than a decade. At the peak of the civil conflict in Iraq in 2006-2007, nearly 5 million people were driven from their homes. Today, nearly 1 million Iraqis are still living as refugees in neighboring countries, according to government estimates, with more than 126,000 of them registered with UNHCR. Up to 300 Iraqis still flee to Jordan every month.

The birthplaces of Khalil’s children – the first born in Iraq, the second in Kuwait and the two younger ones in Jordan – clearly mark the family’s disrupted past and in many ways its uncertain future. Although Khalil and his family received news of resettlement to the United States in 2010, they are still waiting for the final confirmation.

The waiting is becoming harder as "our problems progress," says Khalid. He means finding it harder and harder to pay rent and survive from one day to another. Most Iraqis have no residency or work permits, and live a life of poverty, insecurity and frustration.

A recent assessment by CARE Jordan found that most Iraqis rely on "subsistence-level" assistance – their expenses are exceeding their income by $236 a month. More than 40 percent of the interviewed families reported skipping one meal a day and being regularly hungry.

Maysaa, another Iraqi who has been living with her four children in Jordan since 2005, says this past year has been like a year with 10 years crammed in it. "I grew so old during this time with all the worries and the stress" she says. She hasn’t paid her rent for four months and her family is at risk of being evicted.

Both Khalil and Maysaa share their woes in CARE’s East Amman Iraqi Refugee Center, the only agency in Jordan that’s providing emergency cash assistance to Iraqi families facing increasing hardships. For 10 years, CARE has helped Iraqis with a range of emergency and long-term programs, including livelihood opportunities, psychological support and financial assistance.

"But assistance is never going to solve our problems. It helps in emergency situations but we fear for our future. The Syrian refugees face the same tragedy like us now. Perhaps the problem in Syria is more temporary than ours. I hope so. I hope they can go back home soon. But us…," says Khalid, shaking his head.

In a poor, overcrowded neighborhood in Beirut, elderly Sana raises her shoulders. "What about us?" she asks. "We have been refugees all our lives." She is Palestinian.

Note: As the Syrian crisis continues to unfold and grow, a search for long-term solution for Iraqi refugees in Jordan is currently on hold. Despite the decrease in funding to assist Iraqi refugees and scaling up of its response to assist Syrian refugees, CARE Jordan continues to ensure that the Iraqi refugees do not become invisible and their case is not forgotten.

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by Adel Sarkozi, CARE International Rapid Response Team

In this informal camp in Mount Lebanon area, 33 families live in tents and temporary shelters in an olive grove owned by a local family, headed by Mr. Ali as he is known by the refugees. © 2013 Adel Sarkozi/CARE International

The conflict in Syria, which began in March 2011, has left more than 10.5 million people throughout the region in need of humanitarian assistance. As of May 2013, more than 1.5 million Syrians had crossed into neighboring countries, including Jordan (465,000), Lebanon (477,000) and Egypt (69,000) where CARE is on the ground working to help meet the refugee's most urgent needs. Find out more about our work with Syrian refugees >

In Lebanon, 60 percent of Syrian refugees live in houses and apartments, while approximately 30 percent are forced to live in informal camps, unfinished houses, derelict buildings or garages.

About 25 miles south of Beirut, in an olive grove surrounded by rocky hills, there are patches of blue and white – they are the tents and temporary shelters that house 33 Syrian refugee families.

Mr Ali, as he is known to the refugees, is the owner of the grove. He is Lebanese. About eight months ago, after hearing the school where the refugees were taking shelter was to reopen and the families were going to be evicted, he decided to help. He offered his land and helped families erect their tents and shelters.

The first to move in was a 51-year-old Syrian refugee who prefers not to be named. He moved with his wife, six children and 18-month-old granddaughter.

"I put up the first tent. We had nothing then – no water, no electricity, just a candle," he says. He also recalls how in those early days, during a four-day-long storm, his tent was filled with water and eventually collapsed.

Week by week, more families joined them in the olive grove.

Muhamed, his wife and their newborn baby are one of the newly-arrived families to the camp. They fled Syria eight months ago, after he was jailed and beaten. Once they arrived in Beirut, the family struggled to pay the rent and Muhamed couldn’t find work.

Despite the hardships, Muhamed says life in the camp is more bearable. He says it feels like a community and people support each other.

The man who moved in first helped each new family build a tent for shelter. Mr Ali provided the materials with funding from a local organization. He also built the families a water and sanitation block and a prayer room.

The limited facilities are basic: there are only two toilets for women and two for men that are shared by more than 160 people.

More and more refugees are forced out by increasingly high rental costs and into these kinds of camps. Mr Ali’s olive grove can host more people, and he knows of about 100 families wanting to move in.

"They are on a waiting list," he says. But without help or resources to build new shelters and provide water, sanitation and electricity, they can’t be accommodated.

"We want to go back. When the bombings and the air raids stop, we want to go back. I used to be a farmer. I had my own land and house. I miss my land. I miss my home," says a man in the informal camp. "But we don’t know how long this will take. It could take long time ... longer than we thought."

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by Adel Sarkozi, CARE International Rapid Response Team

Yasmin, an 11-year-old girl, who in quiet words informs you: "My father has been kidnapped about a year ago. We heard that he was tortured…. then that he was killed." © 2013 CARE

The conflict in Syria, which began in March 2011, has left more than 10.5 million people throughout the region in need of humanitarian assistance. As of May 2013, more than 1.5 million Syrians had crossed into neighboring countries, including Jordan (465,000), Lebanon (477,000) and Egypt (69,000) where CARE is on the ground working to help meet the refugee's most urgent needs. Find out more about our work with Syrian refugees >

Meet Yasmin, an 11-year-old Syrian girl living as a refugee in Beirut, who says quietly, "My father was kidnapped about a year ago. We heard that he was tortured … then that he was killed."

It sounds so shocking that I almost don't want to hear it. I stare at her beautiful face, her bright eyes, her hands resting on her chest holding on to a necklace adorned by a plastic flower.

She lives with her three siblings, her mother, another widow called Nada and her daughter. They are all Syrian refugees. Her mother is away working and I pick up the rest of the story from Nada.

They all fled to Beirut four months ago. After three months of taking shelter in a mosque, they were evicted.

Now they are in a two-room apartment with few belongings. Nada's words echo what I've been hearing all week from refugees living in urban areas. "I earn $100 a month cleaning houses. Yasmin's mother earns about the same. How can we live on this when our rent alone is $400 a month?"

The children have to stay at home alone all day while their mothers go out and look for work. They can't go to school.

At my next destination, I arrive at a room with 10 women seated in a semi-circle, some with their children sitting at their feet and more standing in the doorway.

They are also Syrian refugees. Some have been in Lebanon as long as eight months, others only two weeks.

"When I arrived, I felt isolated, I didn't know anyone. Now there are so many Syrians here. It feels like a Syria away from home," says one of the women.

"Our home in Syria got bombed. We saw it with our eyes. That's when we decided it was time for us to leave. But, in Syria, life was much cheaper. Here we can't even afford basic things," says Amina who arrived two and a half months ago. The others nod.

A visibly distressed Hasnaa, a 25-year-old widow with two children, came two weeks ago after her husband was killed in a clash. She is staying with her sister and her family. Her 6-year-old son Ali is stretched on the floor at her feet. He is restless and rubs his red, swollen eyes every few minutes.

"The children can't sleep," she says as if reading my thoughts. "They are afraid all the time. I am too," she adds.

A man sitting in the center of the room begins to sing. Everyone stops to listen. I ask the translator what is the song about. "You're a criminal … You're a coward … You killed my father … You killed my father," comes the translation.

Silence falls over the room as a boy in the doorway area repeats, "You killed my father."

The air is filled with despair, defeat and sadness. Then the tears come – from the floor, from the chairs, from the doorway.

I keep thinking to myself, I'm surrounded by women and children who have seen their homes destroyed, their near and dear ones killed. They fled in search for safety. They might be physically safe now, but what about their souls?

They need basic things so that they can carry on living. They need healing so that in some corner of their hearts they can carry on hoping.

They are part of a shockingly large number of refugees who fled Syria – 1.5 million total and close to a half a million in Lebanon alone. They are trapped in what is the largest humanitarian crisis to date, and what seems like the dead end of history, with only the future to fully judge and find appropriate measures.

NOTE: CARE Lebanon plans to support urban refugees and host families in Beirut and Mount Lebanon, which hosts more than 90,000 refugees, to meet their most basic and pressing needs, including access to information and services; shelter; livelihood opportunities; and psycho-social support. These areas receive a flux of Syrian refugees. Though the Syrian refugees here receive some assistance, especially from local organizations and host communities, there are still many needs that yet have not been met.

Names have been changed

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by Adel Sarkozi, CARE International Rapid Response Team

Dalal spreads her remaining medication, ID, referral form on the table. Uses the tissues to wipe her constant tears. © 2013 CARE

The conflict in Syria, which began in 2011, has left more than 10.5 million people throughout the region in need of humanitarian assistance. As of May 2013, more than 1.5 million Syrians had crossed into neighboring countries, including Jordan (465,000), Lebanon (477,000) and Egypt (69,000) where CARE is on the ground working to help meet the refugee's most urgent needs. Find out more about our work with Syrian refugees >

Medication, a passport, referral forms and tissues are laid out on a table in CARE’s urban refugee center in Amman. They belong to Dalal, a 69-year-old widow.

The passport and referral forms help refugees register with the United Nations so that they can receive assistance. The tissues are for the constant tears she sheds.

"It’s getting worse in Syria," Dalal says. "I speak to relatives who are still there and they say more homes are being destroyed. They are scared. They want to leave. But they either don’t have the money or they can’t come into Jordan because of the border. So many now would just rather stay and die there."

Dalal arrived in Jordan in December 2012. She spent the first few months in Za’atari camp with her three sons and their families. Then they left for Amman. She explains, "It was too hot, there wasn’t enough food, not safe, too many problems there."

In Amman, she is staying by herself. She is not feeling well and does not want to impose on her three sons who are married and have families. She tries to survive on borrowed money and assistance she receives from CARE.

"For the first month I was in Amman, I ate only bread and thyme. My children don’t have food for their children. How can I expect them to help me? I have been a widow for 30 years and raised the children by myself. It wasn’t easy, but not as hard as now," she says. "I love Syria. I want to go back as soon as it’s possible."

In Amman, weeks passed before she ventured out, partly because her health was getting worse, and partly because she felt scared and unwanted. She cries often.

Her biggest worry is that she is running out of the medication she brought with her and she will not be able to buy more as services are overstretched and low on medication, which Dalal cannot afford anyway. She asks, "When I run out, what will I do?"

Note: Although there were fewer refugees crossing into Jordan in May 2013, there are concerns about how to best respond to the probable influx when the borders reopen. CARE acknowledges the severe stress the influx of refugees places on host governments and communities as well as on humanitarian organizations to provide sufficient health care, food, shelter, education and security. Jordan is already hosting nearly half a million Syrians refugees who have fled the conflict. Estimates show that by the end of 2013, the number could rise to 1.2 million, equivalent to one-fifth of Jordan’s population.

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by Adel Sarkozi, CARE International Rapid Response Team

Mahmoud's neighbourhood, poor, and home to about 70,000 Syrian refugees. © 2013 CARE

The conflict in Syria, which began in 2011, has left more than 10.5 million people throughout the region in need of humanitarian assistance. As of May 2013, more than 1.5 million Syrians had crossed into neighboring countries, including Jordan (465,000), Lebanon (477,000) and Egypt (69,000) where CARE is on the ground working to help meet the refugee's most urgent needs. Find out more about our work with Syrian refugees >

Most Syrian refugees fleeing their country cross the borders to neighboring countries by bus, car or foot. In Mahmoud's case, it was by ambulance.

We first meet him, grey hair falling out from underneath his yellow turban at CARE's urban refugee center in Amman, Jordan. He has the appearance of someone who has been through a lot.

One afternoon at the end of 2012 in his home town of Daara, Syria, near the border with Jordan, a bomb fell near his house. Half of the house was destroyed and Mahmoud lost two fingers off his left hand. His wife, Arabia, lost her right eye. Their elder son, in his early 30s, was injured in his right shoulder.

"But we are grateful that the younger children didn't get hit," Mahmoud says.

Three weeks after the bombing, they were in the Za'atari camp in Jordan. Mahmoud came with his wife, six children, his daughter-in-law and two grandchildren.

But Mahmoud missed his home and was worried about extended family members. Ten days later he went back home alone, leaving his family in Za'atari.

"I was worried but I will keep going back until I'm killed, if that's my fate," he says quietly.

The morning the house was destroyed, Mahmoud talking with a few relatives and neighbors. He says, "We were talking about what's been happening, about what can happen next."

He remembers hearing the explosion. Then, he woke up in an ambulance, badly wounded in his right knee. In the ambulance with him were 13 other Syrians also wounded from the explosion. They were all transported to Jordan.

He joined his family again in Za'atari and, when he was better, they left for Irbid, a town in the north of Jordan.

"It was too hot and too dusty. My wife suffers from asthma. We were living at the outskirts of the camp, far from everything." he describes. "It was very isolating. It was hard living there."

Their journey to urban refugees is marked by searching and struggling to find a place that they can afford. Irbid turned out not to be an option. They couldn't afford the $300 a month rent. Word came from other refugees that rent in Amman was cheaper. So they set out on the road again. A month ago, the family settled in Marka Al-Janubyah, a poor neighbourhood of Amman hosting about 70,000 refugees.

The family lives in three-bedroom flat. Inside there is barely anything. Mattresses line the walls, open suitcases dominate the corners and folded blankets the family received in Za'atari are piled in one of the rooms.

Though the rent is cheaper than in Irbid, the family struggles to survive day to day. The two sons spend each day in search of work.

"We found nothing. Once we were offered a job, but it was too far from where we live and the wage wouldn't even cover the transport. They tell us that they can't hire us without work permits – they are afraid of being fined," says 25-year-old Muhamed, who has finished his first degree in English literature. Were it not for the conflict in Syria, he says he now would be studying for his master's degree.

Mahmoud also has attempted to find work, even though he has the injured knee and hand. He also has only one kidney and suffers from chronic diabetes.

While the men are out looking for work, Arabia and her daughter-in-law struggle to prepare food. They normally cook something once a day, often the only meal they have. The family eat the same thing for days.

"We haven't had fish or meat for months. We can't afford to buy any of that. Even a melon is just too expensive," says Arabia as she shows us her kitchen, and points to a pot, the only thing she bought with her from home.

"I miss my house, my kitchen and having people around," she says. "Here I don't even know the neighbors in the building."

"We had an olive grove. We had everything that we needed. Now I have the owner knocking on my door asking for the late rent. I am ashamed. When I think of our lives in Syria before this … I miss that time when we were all together, in peace," says Mahmoud.

Note: Mahmoud is one of the more than 110,000 Syrian refugees who receive assistance from CARE's urban refugee center in Amman. In Mahmoud's case, CARE has provided the family with cash to help them cover basic living costs. CARE is expanding our response in Jordan, setting up refugee centers in four other urban areas with high numbers of refugees and will be playing a key role when the new refugee camp in Azraq opens this summer.

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By Sénèq Pierre-Martelly

Alice sells candy at her door step on most days. She goes to town twice a week to sell products like rice, beans and pasta. © 2013 CARE

Haiti (May 2013) – After a one hour drive on tortuous roads outside of Dame Marie, I finally reach "Nan Sapou," a commune of Grande-Anse. Coming out of the car, I am greeted by a vivacious young woman that immediately reminds me of a bee, buzzing back and forth; she can't seem to stay in place, hopping from one foot to another. You see, Alice is a very busy woman. She juggles duties as homemaker, manages her small business … all along with plans to build a house. She is also a member of one of CARE's Village Savings and Loans Associations (VSLA).

Today, she slows down enough to share her story with me:

Initially, I was a stay-at-home mother; I would keep the house and take care of my son. On occasion, during mango season, I would buy a few baskets and sell them in Jérémie. My partner works in a field and we struggled to put food on the table and send our son to school, let alone afford the small house we rented.

One day, I was visited by two gentlemen. They spoke to me about a program called VSLA. I admit I was skeptical. It all sounded too good to be true. But their enthusiasm was contagious, and I agreed to come to a presentation; I had nothing to lose after all.

When I went to that meeting, I was intrigued by what I learned. I decided to take a chance. I used the little money I made from my sale of mangos and bought "shares." Later, I took out a loan and I started a small business. At first I would sell candies in front of my house. Then, with my profit I would repay the loan and expand my business, to include pasta, rice and beans.

I was overjoyed when, at the end of the year, came time for the profit distribution. I never had so much money in my life! I felt confident enough to invest in something bigger.

My next project was to build a house. To maximize our savings, we left the small apartment we were renting, bought a tent and set it up on a piece of land my family owned. We lived there for a few months – all the while taking out loans to expand the business, and buying more VSLA shares. With my profits, we immediately started buying sheet metal, tarp and wood. Before we knew it, we had the foundations of a house. It isn't complete yet, we still need to replace the tarp walls with wood planks. Now, may it be buying a box of nails, or a single plank of wood, any money I made from the business that didn't go to VSLA or daily expenses is used toward completing our house.

Our neighbors were amazed. They couldn't believe how quickly we were building the house. "My goodness, Alice, what's your secret?" they would ask, "Did you come into some inheritance?" I would then go on to talk to them about VSLA and how with a little discipline they too can accomplish their goals and attain relative financial security.

VSLAs allow rural poor people, particularly women, to develop capacity and pursue economic independence. Groups of about 30 people are formed, and every week members contribute savings according to a system of shares with fixed values. Amounts saved into the group fund typically range from $0.10 - $6.00. Members then can borrow from the revolving fund at a monthly interest rate decided by the group (usually 5-10 percent) for the duration of 1 to 3 months. Loan amounts depend on the availability of funds, member demand and individual repayment capacity. At the end of an agreed period or "cycle," the accumulated savings and interest earnings are shared among the membership in proportion to the amount that each member saved throughout the cycle.

"Upon hearing my story, they all became intent on joining, and today I'm in the process of starting my own VSLA group. In fact, micro-credit institutions in the area are getting worried, "Alice tells me, with a mischievous smile. "But that's our next step, linking VSLA to formal financial institutions."

"I want VSLA to reach all corners of Haiti. It became instrumental to our progression in life. It gave us this house and is filling me with hope for tomorrow."

She concludes, "I truly believe it is the key to a better, brighter Haiti, and that's all I want for my children's future."

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By Adel Sarkozi, CARE

Haussa and Komjo in the background. © 2013 Alpha Cisse/CARE

In an outer suburb of Bamako – Mali's capital - with half finished buildings on dusty dirt roads covered in litter, you enter a two-storey house. Like many other derelict houses in the neighborhood, you're told, it is inhabited by "Northerners."

They are most often women with their children, or just children, torn apart from the rest of the family and forced to flee the Timbuktu region, its violence and chaos, its dread-filled streets, empty shops, schools and health centers shut down since last April.

Their stories sound the same, with small variations, punctured by half sentences, and words, such as – "fear," "had to flee," "on the road for four days," "could not take anything with us," "husband left behind," "life turned upside down." They are probably the best summed up by Komjo, a grandmother in her 60s:

"Everything that was good in my life, I had to leave behind. I live on memories, those before the fighting," she says.

I find her seated on the floor, surrounded by younger women and their children, some her relatives, some neighbors from Timbuktu. There are about 40 of them in the house, having joint relatives or just good-hearted people. At night, they cram in two semi-bare rooms, and on a bare balcony.

As every morning since she fled to Bamako six months ago, Komjo is bending over a large plate full of small shells. ‘She is reading the future," says Haussa, a woman in her 30s, seated on her right.

"So what do the shells say today?," I ask.

I expect her to say something about her future, that of Timbuktu – liberated just the day before – or that of Mali, but she starts telling me about my own future. And from the way she touches upon my past, I cannot help believing that her predictions might be true as well.

When I ask about Timbuktu, she says, "Only God knows…We cannot be sure." She starts tossing the shells in front of her for a few seconds, and then she adds, "But I would go back straight away, this very instance if I could."

For the first time, there is passion in her voice, and a shade of smile on her face neatly lined by the trace of time, tucked under a bright headscarf.

"We will go back as soon as there is complete peace there," Haussa picks up the story.

She arrived in Bamako on January 10, after a four-day journey, most of it by boat. The story of her family's journey over the past seven months is intricate, marked by painful decisions. Last May, Haussa and her husband decided to send their three older children – between 7 and 12 years old – to Bamako, in the safe hands of helpful relatives. The parents were worried about the children's safety after violence erupted in Timbuktu last April, but they also wanted the children to continue going to school.

"In Timbuktu," she says, "there has been nothing since last April – no schools, no clinics, no electricity, no water, no services whatsoever. It was hard for the children."

They kept only their youngest son with them – Abdul, a playful, 2 year old. Then, a few weeks ago, fearing the worst, her husband insisted that Haussa leave with their little one. The two set off leaving the husband and father behind. He stayed because he was worried that their house would be vandalized.

Abdul found the journey difficult, Haussa explains, and often cried out of tiredness, pleading for them to stop.

Haussa pulls Abdul over to her lap while Abdamane, the eldest son, joins them on the floor. When asked what he misses about his life in Timbuktu, Abdamane says shyly, "Everything … my school … my friends … my father, most of all."

His story is sadly too common – of families torn apart, predicting a future just as uncertain and disrupted, they say, as their recent past.

A bright, articulate boy, Salif, is taking refuge in the same house with two of his younger brothers. School is important to him, he says. He wants to become an agricultural engineer, and is now in his last year of high school. Last year, he spent five months out of school, until he too fled from Timbuktu.

I turn back to Komjo who is still staring at her shells.

"More news?" I ask.

She pauses, eyes still cast on the shells.

"Life is hard here. Everything is expensive. We live from one day to another. We have to borrow money, cope with whatever little we have. When we heard Timbuktu was freed, we were filled with joy. It was unbelievable. There is little left there. It will be hard, but we want to go back … as soon as we can," she finally says.

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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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It was the gang rape that got the world’s attention, though that certainly wasn’t the intention of the attackers. The story has been told a thousand times, but the family speaks out for the first time in the media in the New York Times. As the family of the victim tells their story, further levels of tragedy are spelled out. We are left scratching our heads at the cruel irony of a state in conflict, where worlds collide, serving as a microcosm of the intense complexities of the nature of globalization in a world in overdrive.

Badri Nath Singh speaks to family on the phone in Medawara Kalan, after the death of his only daughter from a gang rape so brutal, her intestines had to be removed before she finally succumbed to her injuries. Image: New York Times/ Heather Timmons & Hari Kumar

Badri Nath Singh left a muddy rural town called Medawara Kalan over three decades ago to pursue the opportunities that big global cities like Delhi provide. Unlike the vast majority of fathers in underdeveloped countries, he took his daughter’s education very seriously. He worked day and night, sold land, and borrowed money to put his only daughter through school in the Indian capital.

Finally completing her medical school studies, she often showed off her white doctor’s coat to her family after receiving an internship in her career, symbolic of the rags-to-real opportunity narrative of her family’s journey. From thatched-roof huts along a one-lane dirt road to a physiotherapy degree in the biggest megalopolis in the world’s second-most populous country.

India is a country of juxtaposed high contrasts. Ultra-modern and ancient, colorful and dry, opulence and destitution, overcrowded but soulful. Thirteen years ago, places like India that possessed such unbelievable poverty appeared only mitigable, but certainly not possible of the progress we have now seen since the appropriation of the UN Millennium Development Goals in 2000.  Not only are we globally set to meet or exceed many of those goals by the goal date of 2015, we are posed to champion a brand-new era of human and economic development that may finally justify collective hope for a brave new world.

However, the key to unlocking that future only recently became clear in a popular sense: educating young girls. Empirical data gives us an idea, but it’s the real stories from the front lines of international development that really drive this point home, again and again and again. Educate a girl and you can change the world.

The key to unlocking her future: her education Image credit: Flickr/Zuhair_Ahmad

Badri Singh knew that, defying the odds and expectation of his culture well before gender-based development programs hit the front pages of the world, and sparked dialogue that would change the face of poverty.

He just dreamed that his daughter would have a better life – a good life, one that would make his suffering and hard work worth it to see his offspring prosper in ways most dare to dream of. But instead, he returned home to his family village, where he carried his only daughter’s ashes.

His wife, the mother of the victim, didn’t sit for the New York Times interview – she sat in a dark corner of the house, adjacent to a courtyard where children played. Wrapped in a blanket, she raised her hands in “namaste” to greet the reporter, but did not speak. She has not been well since the attack, said her family. The brother of the victim is also inconsolable, crying throughout the interview.

The victim’s struggle to survive was remarkable, given the brutality and horrific violence of the crime. After being beaten and raped by five men, she was also raped with a metal rod, which destroyed her uterus and intestines. They had to be removed in surgery after being transferred to a hospital in Singapore. She also suffered significant brain injury, infection of the lungs and abdomen, and extreme blood loss.

Following the rape, the assailants dumped her and her fiance’s limp bodies on the side of a Delhi road to die, but not before attempting to run her over. Her fiance, after regaining consciousness, pulled her out from underneath the bus lest she be crushed to death. Then, there they laid for nearly an hour, while people walked and drove by, sometimes pausing to peer at the naked, profusely bleeding duo.

Before the victim succumbed to her extensive injuries two weeks after the attack, the country as a whole reacted in one collective voice that demanded revolutionary change in everything from social norms and attitudes, to the justice system, to the media portrayal.

The layers of horror to this crime only compound the viciousness of its social context… The fact that rape goes unreported because women fear humiliation and backlash from law enforcement (though some that do report suffer such humiliation, such as being told to marry their rapist, that they commit suicide). The savage nature of the crime itself, the prolificness of rape and sexual assault and violence against women in India and it’s acceptability in India (see: bride burnings). Also, the confounding uselessness of the “justice system,” where rape cases sometimes take 10-15 years just to prosecute, let alone sentence.

India Calls for Reform in Society and the Law /Image: AP

Protesters mourn the victims of gender-based violence and call for reforms in society and the law. Images from The Daily Mail

Image: The Daily Mail

Image: The Daily Mail

Image: AP/ Getty

Image: Zuma

It seems as if this specific case galvanized the public like never before, and what once seemed like contentious or controversial issues (such as women’s conduct in relation to their treatment in society, and the related problem of victim-blaming) became hot topics of yesterday’s norms, giving way to more progressive ideas (you know, like feminism). Indeed, this appears to be the beginning of a second- or third-wave feminist movement within the context of Indian national history. I am personally proud to see this exploding on a national scale, knowing it will likely lead to real and lasting, badly-needed change. But its source is ultimately tragic, and the reminders of this fact are omnipresent.

India may be ushering in a new era of humanity and history, as the national dialogue has been dominated so heavily that it has spilled into the larger global discourse of human issues. I certainly hope, as do countless others who have taken to the streets, that this is the case.

In the New York Times article, the father explains that his village never knew crime, and he had never even heard of theft until he moved to Delhi. Is it possible that the urban environment, in its rapid forward movement and alienation of those that get left behind, is partially responsible for the creation of social problems that characterize this case?

He came to Delhi to provide his children with better lives, leaving his impoverished, but relatively safe village behind for thirty years – only to be robbed of not just that opportunity, his hard work and investment, but the cruelest theft of all – his beloved only daughter and his family’s peace. The tragic irony of the intersection of poverty and crime, urban and rural life, yesterday and tomorrow, globalization and the traditions and lifestyle of previous generations dominates the undercurrent of these headlines. Perhaps the cruelest, saddest, most tragically ironic twist of all is that his daughter might still be alive and well if he had stayed in his safe little village, a world away from higher education and the promise it keeps.

In the meantime and for a long while, globalization’s impact on populously exploding societies will serve to both usher in the exchange of progress, new ideas, and economic growth, and dichotomously create new problems that only a new generation can solve.

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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(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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READ MORE ABOUT CARE'S EMERGENCY RESPONSE WORK AROUND THE WORLD >

By Elizabeth M Campa, MSc
Water, Sanitation and Hygiene Coordinator, CARE Haiti

CARE works around the world with communities to improve water, sanitation and hygiene in order to increase access to latrines, clean water and improved hygiene. Credit: © 2012 Melora Palmer/CARE

I have to go…
I’d like you to try something out for me. This morning when you wake up, you do not have access to a toilet. This might take some mental preparedness as we are so accustomed to always having access to a toilet. And, I'm not talking about remembering your rustic camping forays into the forest...here you'll have to figure out ways to relieve yourself in very public places.

This might be hiding behind a tree, in between cars, pooping into a plastic bag, into a shallow hole in the ground, but not a toilet. You will not have access to toilet paper or water afterwards (and if you do, it is not clean water) to make sure your hands are uncontaminated before you prepare food, take care of your children or conduct day to day activities. And if you do not find a place, no way of relieving yourself, you will have to hold it in for hours, possibly until the sun has set and you are able to go outside your front door and defecate there when everyone else has gone to sleep. Or walk into a dark field or alley where someone might be waiting to attack you knowing that you have to relieve yourself.

Going to the bathroom for 2.5 billion people around the world is about planning and waiting.

November 19, 2012 is World Toilet Day. Presently, over 40% of the world’s population does not have access to a toilet. By the way, I’m not speaking of the pretty white porcelain flushing kind, I mean a hole in the ground dedicated to pooping, also known as a latrine. While we in the developed world might have to think about finding a place to relieve ourselves, we can generally find a toilet in a restaurant, in a gas station, etc. 40% of the world’s population will hold it in for hours until they can find a place that is private enough to relieve themselves. While this is in itself incredibly uncomfortable, for many millions of people, particularly women, this can cause infections and other health complications that could lead to death. It is also a comfort problem in developing countries where there are very high rates of diarrhea due to poor nutrition, health and no access to clean water.

People living in rural areas around the world will go into fields and defecate openly; often contaminating water sources and or the soil around the food they grow making them and their families sick. Even more people, as in the capital of Haiti where I work, a densely populated city, will defecate in the open, again, contaminating water sources used for cooking and bathing.

The more discrete, will poop into a bag, because there is no other option. Some will use a filthy public latrine that might be available but for women, they risk being sexually assaulted as these latrines offer no security, poor lighting and doors that cannot be locked. School children around the world will defecate along the exterior walls of their school because they have no facilities and in turn millions upon millions of children will become infected with intestinal worms contracted from stepping on fecal material with their bare feet. And even more millions of girls will stop going to school all together when they begin to menstruate as they will not have a private place to clean themselves, continuing the vicious cycle of poverty and poor education.

CARE works around the world with communities to improve water, sanitation and hygiene in order to increase access to latrines, clean water and improved hygiene. Working with communities to improve sanitation and access to clean water is about giving back to people their dignity. Access to sanitation and water is a human right. So you see, building a toilet is not only about helping someone relieve themselves, it is about giving back to people their right to education, to better health and to feel safe. Should we not all have access to these basic rights?

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September 27—600 people wait patiently until CARE sets up the place to start the distribution of seeds and agricultural tools. The distribution is taking place in Luofu, South Lubero in the Democratic Republic of the Congo, but people from five surrounding villages have been registered for this assistance provided through CARE’s Dutch Ministry of Foreign Affairs and FAO funded emergency response project, Umoja+.

CARE is organizing a distribution in Luofu, South Lubero, on September 27. People from five surrounding villages have been registered for this assistance provided through CARE’s Dutch Ministry of Foreign Affairs and FAO funded emergency response project, Umoja+. Through this initiative, CARE is providing support to internally displaced people (IDPs), returnees, as well as host families.. © 2012 CARE

Through this initiative, CARE is providing support to internally displaced people (IDPs), returnees, as well as host families. While in South Lubero thousands of people remain and even continue to be displaced due to attacks by armed men, there is also a significant number of people who are returning home to restart their lives after periods of displacement. CARE is providing both types of households with enhanced means to gain a sustainable livelihood, as well as assistance for more immediate needs, including relief items and shelter.

"Thanks to this distribution, I have something to plant for this year’s planting season and we will have [something] to eat next year," 25-year old Jorgine says as she buttons together a cloth filled with seeds. Because people often go hungry, there is a danger that they will want to eat the seeds instead of planting them. "I will tell my family that the seeds contain poison so that they don’t eat them." Jorgine and her husband and two children have been displaced from their home and have been living with a host family in Mitero for six months. She will be planting the seeds in the field belonging to her host family.

A community volunteer tells the beneficiaries with a microphone that the seeds should be planted and not eaten, which requires patience, but will give them much more to eat at the end. The message resonates with most and only a few decide otherwise. "I will plant half of the seeds and eat the other half. I am already sick and need to eat today," Muhongya who is 72 years old understandably argues.

Kyakimwe, a 40-year old mother of six, who is back in her home village Kataro after having been displaced for one year, says that life continues to be unstable. "The manioc I planted last year was stolen by members of a local armed group. Even these seeds might be stolen once they are ready to be harvested," she laments as she looks at the corn, beans and soya seeds she just received.
Besides food insecurity, they also live under difficult conditions with no real roof over their heads. "The bandits have taken everything; we live in a small hut with nothing now." But Kyakimwe lightens up when she affirms that she will benefit from the shelter distribution Umoja+ is planning in the area in two weeks time.

29-years old Francoise who also lives in Kataro explains similarly, "We have learned to live with the torture of armed groups. We just give what they ask for and in most cases, they then leave us alone. One year and a half ago, they would have physically tortured us either way." Armed men often attack women working in fields and Julienne remarks, "It’s good that we received two hoes, like that my husband and I can work in the field together … The harvest will hopefully improve the life of my four children."

Despite all the insecurity and challenges, the beneficiaries smile and chant as they leave with the bags of seeds balanced on their heads and the hoes in their hands, full of hope that the harvest will provide the food their families desperately need.

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.

While in Tanzania, Melinda Gates visited a CARE Village Savings and Loan Association, led by CARE gender in agriculture expert Jemimah Njuki (in red next to Melinda). Photo: © 2012 Gates Foundation

Acknowledgment of the success of our VSLAs from Melinda Gates would be very meaningful to us under any circumstances, but it was doubly so yesterday. That’s because the same event also included the African launch of CARE’s new Pathways program to improve the food security and long-term resiliency of women smallholder farmers and their families. Supported by the Gates Foundation, Pathways will use the success of VSLAs as a platform to enable women farmers to access the skills and services they need to promote sustainable agriculture in their communities and reduce poverty and hunger.

In a session following Gates’ talk, Pathways Team Leader Dr. Jemimah Njuki explained the program's aims, and discussed how Pathways is setting standards for other CARE programs. For example, the measurement tools developed by CARE for Pathways are already being used in four other CARE programs. Over five years, Pathways will help 150,000 people in Bangladesh, Ghana, India, Malawi, Mali and Tanzania.

To learn more about CARE’s Pathways program, visit www.CAREPathwaysToEmpowerment.org. To find out more about the African Green Revolution Forum and efforts to boost sustainable agricultural growth in Africa, visit www.AGRForum.com.

And for a short photo blog detailing Melinda Gates' visit this week to a CARE Village Savings and Loan Association near Dar Es Salaam, Tanzania, visit the Gates Foundation's Facebook page.

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.

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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Photo. © 2012 CARE

CARE International: Cash relief for drought affected families in Somalia
Rahma is a 14 year old orphan girl with three siblings. Between them, the parentless family has one cow and twenty shoats remaining from a herd already decimated by previous droughts. The few livestock they have are not enough to support the whole family, so she and her older brother Muuse have had to find other ways to earn extra money.

Despite its negative impact on the environment, the only way they have been able to earn money for food has been to cut trees and produce charcoal. Together, the brother and sister look out for suitable trees that can be cut for burning. 16 year old brother Muuse, cuts the wood into pieces, digs a hole and sets fire to the wood to produce charcoal. He also then transports the charcoal into town for selling at the local market. This was their way of life, until CARE started working in their village.

CARE worked with the local elders to identify families in need and Rahma and her brothers and sisters were enrolled as cash relief beneficiaries, enabling them to earn around USD$120 a month from two projects managed by the organization.

Because of these earnings they were able to stop cutting the trees for charcoal, they also bought two extra cows, and can now produce extra milk to sell in the market. They also decided to join a village savings and loans group. They took a loan and bought fodder for their cows, this has helped increase their milk production. From the proceeds of milk sales, they managed to repay their loan.
They strongly believe that with their increased income they will be able to cope better in future droughts. The extra money has even enabled them to send their two younger siblings to school.

Rahma said " Since the death of my parents we both gave up our dream towards development, our thoughts were focused on how to find food and water, but our God sent this wonderful agency to support us, make us change our attitude, let us protect our forest. It was cutting trees as a coping mechanism during the drought that made us lose our animals. Now we have good dreams; I want to learn and become teacher, and my brother wants to be doctor. Many thanks to CARE, and its staff".

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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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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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Blog by Deborah Underdown
July 5, 2012

South Sudan 2012. Returnees in Bentiu. Story available 'Returning to South Sudan'. Photo credit: © 2012 Deborah Underdown/CARE

As I arrived in Bentiu in South Sudan and got out of the vehicle I was greeted by my CARE colleagues and a pair of Wellington boots. My trainers were going to be of no use here.

The rainy season has just started but already the roads are a huge challenge. The thick sticky mud makes getting anywhere a long process.

My driver for the day, Hassan (who also happens to manage CARE's water and sanitation programme so is multi-tasking) explains that in the coming weeks, as the rains get worse, it will be almost impossible to travel around. At the same time last year the best mode of transport was a quad motorbike- CARE used one to transport essential medical supplies.

We travel to Bentiu Port that is home to over 300 'returnees'. Since South Sudan's independence in July last year, over 400,000 people have returned to their home country from Sudan. They arrive with little and the journey can take months.

The living conditions of the returnees by the port are the worst I have ever seen.

I met a mother of five, Mayen, who told me that, on her journey to her home country, her seven month old baby girl died of malaria. She is now living with ten people, including her own children, in a shelter with one single bed. The floor is a bed of mud that the children sit and play in. I can't imagine what it will be like when it is also flooded. The fact that they won't even be able to escape the mud and water when they are inside is utterly overwhelming.

Seeing the children sitting on the floor with mud covered hands, the same hands that find their way into children's mouths is worrying. I want to reach out and tell them to keep their hands out of their mouths, as I would with my own niece when she has been crawling around on the  floor back at home in the UK, but what would be the point? It's impossible to get away from the mud and the diseases that it carries, they can't even begin to keep their hands clean. It's so frustrating to know that the likelihood of them getting sick is very high.

CARE has set up a medical facility (it actually backs on to Mayen's shelter). Paul, a clinician working in the facility, told me that waterborne diseases were already increasing with many cases of watery diarrhea and respiratory tract infections. CARE is proving treatment as well as immunizing children against polio, tuberculosis and measles.

The poor roads and already dire living conditions are only set to get worse. CARE is pre-positioning relief items as well as helping returnees in Unity State. We are also helping refugees fleeing conflict and displaced people who are searching for food.

It must be noted that a year of independence isn't a long time in terms of building up capacities and infrastructure. The country's 'to do' list is long, but the Government and aid agencies like CARE are working hard to help the 800,000 people. People just like Mayen and her children, who are in desperate need.

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.

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

Most of the delegates and participants at the Rio +20 United Nations Conference on Sustainable Development complain about the long bus rides from the city to the Rio Centro Conference center where most official activities are taking place. By contrast, I have found that the most interesting experiences, and the deepest conversations, I have had in my first five days at Rio have almost all taken place on the buses.  While the official negotiators struggle to make progress at the conference center, tens of thousands of people from all over the world have gathered to share experience and ideas for how to make sustainable development for all, including the poorest and most marginalized members of global society, a reality.

The people with whom I have sat on the bus include: a South Korean professor of natural resources economics; a Swiss radio Journalist; officials from the Ministries of Environment of Ghana and Namibia; a British academic; the leader of a French non-governmental organization; and an idealistic young Canadian promoting spending six months in Brazil. Their interests range from how to engage their communities, whether government, academic or media, in global discussions about and action for a sustainable future, to promoting very concrete solutions and technologies to improve the lives of the poor through solar energy, sustainable agriculture, or low-cost housing. What does such a diverse group of people have in common? These global citizens, and many thousands more, have converged on Rio to express a common sentiment. In short, sustainable development, characterized by greater prosperity, social equity, and environmental sustainability, is not a luxury, but rather a necessity for the survival of our planet and the rights of future generations for a dignified life free of extreme poverty.

The actions of citizens from all over the world, and their passionate commitment to a better future, is perhaps the main sign of hope from this week’s gathering in Rio. Will our political leaders hear the voices of those gathered outside the closed rooms where the negotiations are taking place over the details of a text to be issued by Heads of State and Government at the end of the conference? And will all those gathered in Rio, both political leaders and members of civil society, remember that the 1.4 billion poor in today’s world deserve and expect more from all of us? To achieve the “Future We Want”, which is the theme of Rio+20, urgent and decisive action is required to address the threats that poverty, inequality, environmental degradation, and climate change pose for our common humanity.  No words in any text will be a substitute for such action.

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

It takes a lot of strength to carry 55 pounds of water for more than four hours across eastern Ethiopia’s arid highlands. It also takes particular strength to change the circumstances that force women to shoulder that burden.

Fatuma Muhammed is strong in both these ways, and more.

The 50-year-old mother of four lives in Muru Geda, a small village in Ethiopia’s chronically-dry East Haraghe zone. Water is so scarce here at women must walk huge distances to reach a small pond or stream. For much of her life, Fatuma spent at least 16 hours a week searching for water; after discussion with her neighbors, she would walk as much as four hours in the direction that held the best promise of a reliable water source, fill her large plastic container and then trudge four hours back home.

In those days, Fatuma’s best-case scenario was that she’d return with 25 liters of water that would last her family of six for three days – that’s less than a liter and a half of water per person per day. The worst-case scenario is difficult for her to discuss.

“If I ever came home without water – or with a container that wasn’t full – it was a big problem. My husband sometimes beat me,” Fatuma recalled. “It isn’t tradition for men to carry water; it falls on women. If men want it, we have to get it. That’s one of our greatest challenges here.”

Another grave challenge is health; even when women like Fatuma find water in this part of Ethiopia, it’s often dirty – open to the elements and shared with animals. When families aren’t aware of simple sanitation practices such as boiling or filtering, they run the risk of debilitating waterborne illnesses such as diarrhea and dysentery. These illnesses are dangerous and even deadly for those with weakened immune systems; three years ago, Fatuma spent 15 days at a local hospital after drinking contaminated water.

Excruciating distances, unreliable sources, the specter of illness and the threat of physical violence – an Ethiopian woman’s responsibility to bring home water both diminishes her dignity and wreaks havoc on her quality of life. That’s why CARE, with funding from the United States Agency for International Development (USAID), created an extensive water system for the area around Fatuma’s home in Muru Geda.

Over the course of five months, we harnessed the flow of a local spring and laid more than 30 kilometers of pipe. This pipe leads to distribution points in five separate villages where women can get clean water from a tap with just a turn of the spigot.  Hundreds of local families participated in the construction of this water system, contributing sand, rocks and hours of hard work.

Today, CARE still provides technical advice for the water system, but we’ve turned daily operations over to the communities the system serves – everything from maintenance to financial management. Households pay a fee of ten cents for 20 liters of fresh water; this money is placed in a bank account for future repairs and system improvements. This account is managed by a water committee consisting of four local men and three women – including Fatuma.

“People in my village nominated me to serve on this committee because I am strong, providing for my family even after my husband died,” she said. “I am resourceful, I have my own business and I can create success for myself and others.”

The committee meets every two weeks to discuss matters such as when water points will be open for use, rationing if the water supply is low, potential conflicts and community feedback. Fatuma is an active and vocal participant in these meetings, especially regarding the challenge she’s been familiar with all her life.

“I have initiated public discussions on how women suffer because of lack of water,” she explained. “We’ve organized as a group, and have gone to local government offices so that people can hear our voices as women.”

For many years, Fatuma Muhammed was strong enough to carry an unbearably heavy load of water for many hours across eastern Ethiopia’s blazing and parched terrain. Today, she’s using that strength to ease the burden for her region’s mothers, sisters and daughters.

Siaya is a town twenty miles from Lake Victoria, in Western Kenya. I am in town to visit community groups that my CARE Kenya colleagues (Alex, Lucy, and Margaret) have been working with in the last six months. The first group we visit named themselves Twelve Sisters, but they are quick to tell me they have fifteen members, as they have been growing. Six months ago, these women started working together as a community savings and loans group. The women meet twice a month, and at every meeting they contribute money to the group. They are required to contribute 20 Kenyan shillings (about 30 cents) to the group's social fund, and then they can choose the amount of money they want to contribute to the group's pooled funds. The pooled funds are lumped into shares, which cost 100 Kenyan shillings (about $1.50).

At any meeting, group members can take out loans from the group's pooled funds. In April, Dada started an embroidery business. Frances improved her poultry farm. Alice paid the secondary school fees for her children. The women repay their loans a month after they take them out, along with 10% interest.

The social fund, however, is a different matter altogether. The social fund grows every month, and if one of the women has a problem, the group votes on whether or not to use their social fund to help her. Two months ago, Frances' house caught on fire, and she lost many of her possessions. Twelve Sisters voted to nearly deplete their social fund, giving Frances a way to start over. Unlike the loan system, the social fund does not need to be repaid.

Beatrice, the group's president, tells me, "this box is a painkiller…before when we had problems we had nowhere to turn, but now we have a resource." While we only spent a day together, it was clear to see that Beatrice was a force to be reckoned with. In addition to leading Twelve Sisters, Beatrice is a community educator on clean water. Trained by CARE, Beatrice goes into rural villages armed with PUR water packets. Donated by Proctor and Gamble, these packets purify 10 liters of water. The packets cost 15 Kenyan shillings (20 cents), but thanks to Proctor and Gamble, Beatrice and other health workers can distribute samples for free when they conduct community trainings.

Beatrice shows me how she demonstrates the packets. She empties the packet into a bucket of brown water that she collected from the nearby river. As she sings a song about the process, Beatrice stirs the bucket for five minutes. Then we wait. Twenty minutes later, the water is miraculously clear. Beatrice ties a white cloth around a second bucket and uses it as a filter for the sediment that floats on top of the translucent bucket. "Now it is safe," she says. I must admit, I'm impressed.

Alex and Margaret, who run CARE's water and sanitation programs in Siaya, tell me that the funding from Proctor and Gamble will last two more years, and their clients are always asking for more PUR packets. The mortality rate from water-borne diseases has dropped significantly in Siaya since CARE started the Safe Water System Project, and families are eager to use the PUR packets because the water looks and tastes better, and they see immediate improvements in their health.

Beatrice asked me what I was going to do when I got back to the United States. I explained that my job is to tell stories to members of Congress, so they will support programs like Twelve Sisters and the Clean Water Project. I hope to make good on my promise.

There are two bills in Congress right now that could help women like Beatrice and groups like the Twelve Sisters. The Microenterprise Empowerment and Job Creation Act (H.R. 2524), and the Senator Paul Simon Water for the World Act (H.R. 3658). Please call the Capitol Switchboard at 202-224-3121, ask for the office of your member of Congress, orclick here to send him/her an e-mail in support of these life-saving pieces of legislation.

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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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Sparrow McGowan, CARE Canada
January 2012

When asked about her life five years ago, 50-year-old Dulali Begum quickly becomes shy. She and her family live in Velabari Village in the Bogra District of Bangladesh and were among the extremely poor of an already very poor community. Her husband Jamal had lost the use of his legs and Dulali had to beg to feed her family.  But ask her about her life today and she immediately lights up.  From the simple provision of 200 Taka (approx 2 to 3 USD) worth of seeds and training from CARE's SHOUHARDO program, with a small patch of land from her village, Dulali and her family now have a steady and healthy supply of food, a small business and her 14-year-old son is in school.

Dulali’s owes much of this success to her persistence and dedication to building a better life. Dulali took the seeds given to her and planted and cultivated them to produce vegetables that could be sold for an income, and also used to feed her family. From the money she earned from her vegetables, she bought hens and started a small poultry farm. She then sold hens for a profit allowing her to purchase supplies for her husband, a skilled craftsman, to start making handicrafts. Today, she sells the handicrafts locally, using market knowledge she learned through CARE's SHOUHARDO program – all this from the cultivation of seeds and support from CARE.

"When I used to go to the market to sell products, I wasn’t able to bargain. Now I have the ability to determine my proper price and say ‘this is the price – you can buy it if you want to pay that price'. I’ve become quite clever."

Dulali and her family now enjoy three meals of good food daily, compared to the one or two meals they previously managed. They eat a mixture of vegetables as well as small fish and eggs, and meat a couple of times a week. She has also purchased trees that are planted around her house that serve two purposes: Dulali lives next to a flood plain and the trees help stop erosion and keep her land elevated, but they are also an investment. In about five years, the trees will mature and their wood will command a significant amount of money at market, approx. 6000 Taka (72 USD).

The relationship with her husband has also changed substantially. "This family depends on Dulali because she is doing every job," says her husband Jamal. "Although I make the handicrafts, she is selling them and cultivating the vegetables, going to market and managing the family. I respect her for this." When asked if she is now involved in household decision making, Dulali responds, "Definitely! Why not?" They also look forward to a brighter future for their son -- that he will be well educated and go on to have a good job, a better life.

The Chairman of the Village's Development Committee points out that the village was one of the poorest in Bangladesh, but that women like Dulali are helping to improve the condition of the whole community. "Dulali is one of the influential women in the community", he says. "She is a role model."

What's more, the EKATA group has expanded the world for its members. Since joining the EKATA group, Rina has travelled across the country, carrying her goal to make life better for herself, the others in her group and her community. Referring to her group's meeting space, Rina says, "This room was not the only destination in my life. I had to explore beyond it."

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Sparrow McGowan, CARE Canada
January 2012

Rowshan Ara (right) and her husband Toiab. Photo: © 2012 Akram Ali/CARE

Five years ago, 40-year-old Rowshan Ara was making thread for a living, earning an average of 200 to 250 Taka (2 to 3 USD) a week. Coupled with her husband Toiab’s small income as a handloom labourer, they struggled to buy food and were unable to afford school costs for their children. Today, Rowshan Ara reflects on that time, saying that she knew that owning their own handloom would give them the opportunity to make change in their lives, but the 6,000 Taka (approx. 72 USD) price tag for a handloom was out of reach.

Identified by CARE’s SHOUHARDO program as being amongst the very or extreme poor, Rowshan Ara became eligible for support. She was given a grant of 1,500 Taka (approx. 18 USD). Still short of the cost of a handloom, Rowshan Ara and her husband took a loan from a local organization and were able to purchase a loom. They returned that loan and through saving and borrowing have grown their business to include six handlooms, producing 150 saris a week in their small factory. They sell the saris at the local market and earn between 24,000 and 25,000 Taka weekly. What's more, they employ six workers.

Rowshan Ara points out that the relationship between her and her husband is excellent. With him managing the purchasing and selling and her managing the factory, they are a team. The business not only ensures that they, their sons (22, 16 and 3 years old) and daughter (13 years old) are now able to eat regular, healthy meals, but her 16-year old son and 13-year-old daughter are also in school, and her eldest son is part of the family business. In the community, Rowshan Ara is now seen as a role model and business competitor.

In looking to the future, Rowsha Ara points out that currently the factory is all hand-based machinery, but they are planning to eventually bring in modern machines so they can increase the number of workers and the factory size.

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Rina Begum's soft smile belies the strength and inspiring leadership that has made her both a community and national leader in her home country of Bangladesh. Five years ago, Rina wouldn't have been able to leave her home in Lalmonirhat, Bangladesh, unless she was accompanied by a male family member. Today, she welcomes both female and male visitors as the leader of her local women's group, known as an EKATA (Empowerment, Knowledge and Transformative Action) group.

Rina's group, originally started as part of CARE's SHOUHARDO program five years ago, is made up of 20 women. Although CARE's involvement in the program ended over a year ago, the women have continued the group, making great strides for bettering not only their lives but the community as a whole. Today, they talk about everything from children's education and local dispute resolutions, to ensuring community access to government services such as immunization and birth delivery, and ensuring people receive their national identity card so they can vote.

Rina also serves on other community groups, including three school management committees, and is an executive member of the People's Organization Convention (POC), an annual meeting that brings together more than 400 community groups. Rina, through the POC, is trying to bridge the gap between the needs of local communities and the national government service providers. She is a rare leader, who has not only managed her own development, but has created a space for the other women in her group to flourish. Because of this, they are all seen as leaders in their community, and regularly turned to for support, such as resolving family disputes or going to the hospital.

The group points out that husbands are showing increased respect for their wives throughout the community. And the group now knows what their rights are – and are fully confident in asserting and accessing them. “We were worried that our intermediaries were misrepresenting us,” says one woman in reference to men who would go to the local government with their requests. So now they communicate directly with the service providers, travelling some 60km to the local government offices. “It was only because of joining this EKATA group that this is possible,” she says.

Together, the EKATA group has stopped a number of child marriages in the community, started an early child care for development program and created a savings group. They are also all employed, earning income through activities such as raising livestock, making and selling food products, running a small shop or offering tailoring services.

The results for their families and the community have been inspiring. Five years ago, young girls would often be pulled out of school at a young age. Today, the education of young girls is valued and they push for continuous education. The families of Rina and the other women in her group would previously have lived on only one to two meals a day. Today, they all get three meals a day, and their children are fed a range of healthy foods, including eggs, meat, fish and vegetables.

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BLOG FOR INTERNATIONAL WOMEN’S DAY: March 8, 2012 >

On this International Women's Day, what inspires me and gives me hope is our work to empower girls like Christa, a fourth-grader in Bugarama, Tanzania. In a class of 220 students, Christa was a shy girl who never asked a question even if there was something she didn't understand. She made average marks on exams.

However, when Christa was 10, she was among the first group of girls trained in leadership skills and peer mentoring through CARE's girls' leadership development projects. The projects aimed to assist girls to develop the specific leadership competencies of self-confidence, voicing ideas and opinions, making decisions, organization, and motivating others.

 After the training, Christa was assigned to lead a group of 40 fellow students in developing leadership skills through sports and games. The group included boys, some of them older than her.

Christa really doubted whether she could do it. She said that before the training she was just like other girls with no confidence, and not able to make decisions for herself. However, as days passed by Christa gained more confidence and made great strides in leading her group.

Christa's new-found confidence has shown in the classroom as well. Now she is able to ask teachers about anything which is not clear to her. With a smile on her face Christa recounted "by doing so I made myself the number one pupil in the class of 220 pupils including boys and girls!"  

Christa was encouraged by her peers to run for the position of chairperson to lead a discussion between the girl students and leaders from the local government council (WDC).

"We were 8 contestants but because of the leadership skills I acquired from the training and from participation in sports I won the position and led the meeting between girls and leaders from WDC," Christa beamed.

She lead the meeting with confidence, and at the end of the meeting Christa remembers that one village chairperson confessed that he has never managed meetings as successfully as Christa had.

Christa is now a confident sixth grader who has her eyes set on secondary school and has goals for her future, which include helping other girls to develop the confidence and voice that she has found.

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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.

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 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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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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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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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.

This last week was spent working from CARE’s head office in Maputo, a fairly typical developing-country capital city with slums, trash laden streets and crumbling infrastructure.   It is not unpleasant though as is sits on the ocean and usually catches a nice fresh-air breeze and is not yet completely swamped by polluting traffic.   Indeed, you can sense that the potential is there to make it special.  There is culture, some attractive colonial-time buildings and wide avenues.   There is a good music scene and some fun art galleries and bars as well.   While there was a little bit of time to check the city out, the week was spent meeting with a number of financial institutions and consultants relevant to our VSLA linkages project as well as working in the office.  

As you all know, the pleasure of going to work every day greatly depends on a few important things such as working on something that is an interesting challenge and feels personally meaningful, having good colleagues, and feeling rewarded emotionally and/or monetarily.   I have been lucky.   The bigger task at hand—helping people help themselves escape poverty, even if in a very small way—at time feels like an insurmountable challenge, but working on such puzzle can’t help but make one feel humbled but also being part of something that just has to be important.   The colleagues at CARE are also great, most  all of the ones we have been in touch with positive and very helpful with this project—having robust infrastructure and “industrial scale” capacity is essential in providing ongoing assistance.  I often puzzle how smaller organizations/NGOs (in places such as Mozambique in particular) can get more complex things done in anything approaching and economical fashion.  

I have also been lucky to get Alessandra as my colleague on this project.  Alessandra is a consultant hired in from Accenture (the big global consultancy firm some of you may have heard of that used to have a certain Tiger as their poster boy—now replaced by an elephant on a surfboard…hmm).  She is extremely capable and energetic and a pleasure to work alongside on an everyday basis.   She joined me on this project here in Maputo and we share the responsibility to get this work done by mid-December but will of course take all the blame if it doesn’t go well J.   One interesting dimension of Accenture’s involvement is that they have something called Accenture Development Partners (ADP) which is the non-profit consultancy arm of the organization and bill out—and also pay their consultants who “volunteer”—half of what they ask of commercial clients.   

Our work here involves a couple of key components.  The first and most essential, is to determine the VSLA groups’ need for access to the formal financial services sector and if so, develop the criteria used to identify which groups should be linked.  Additionally, we need to figure out how the VSLA group methodology should be “tweaked” to make the link happen while doing  no harm.  After three weeks here it is clear to us that there is a need among a number of the groups and we are finding a general interest in using banks among group members—a few are fearful of them but seem in  a great minority.  CARE has been implementing the VSLA methodology—initially developed in Niger by Moira Eknes (a fellow Norwegian)—in 33 countries in Africa over the last two decades.   One of the key sources of success of this approach has been that each group is a “closed system” meaning all the saving and lending is done within the group and that once trained, the groups become self-managing.  This allows this methodology to be scaled up and implemented just about anywhere.   The “downside” is that with the success of some groups and a modicum of prosperity, the VSLA group has clear limitations—i.e. the savings in the “box” become a real security risk for robbery or fraud and the availability of funds within the group’s resources fall short of members’ borrowing needs.   So up against these constraints, what do you do?   The key hypothesis is that while these groups may have outgrown the basic VSLA structure, the inpiduals in the group are typically not ready or in a position to approach the formal financial services sector on inpidual basis.  Here the “linkages idea” comes in—using the VSLA methodology but making some important changes to make the connection with the formal financial sector.   Figuring out how this bit should be done is a work in progress at this stage.

A second key component is to understand what financial service “delivery channels” can work in a cost efficient manner so that the implementation becomes sustainable.    What seems to make the most sense to us is to use technology as a key ingredient in linking VSLAs with the formal sector.   In countries like Kenya a mobile phone payment system where you “trade” pre-paid airtime for cash in or out, has taken off.   More than 14 million people now move money “safely” around using the M-PESA service there and tens of thousands of small shopkeepers or other “agents” effectively become “bank branches” where you can go and “deposit” or withdraw cash, and basic “banking” can thus be made available except perhaps in the most remote areas.   At this point such a service is not yet operable here, but mCel, the largest mobile phone operator in Mozambique will launch its M-KESH product over the next couple of months and Vodacom, the second operator (and sister company to M-PESA in Kenya) is not far behind.    Cellular usage is taking off and “penetration” is now well over 50%.   Indeed, one of the questions we ask of the VSLA groups we meet with is how many members have a mobile phone.  Even in the poorest groups there will typically be a handful of members with phones—in the ones we think could fit the “linkage ready” profile, the majority have them.   If this could work and the phone based payment system can be connected to the IT system of the banks, it could potentially be a very low cost option.  Another strategy (or maybe a combination thereof) may be to use very low cost branch networks and biometrics (finger print recognition and photos allow even the illiterate to be banked)  to facilitate the services connection.  BOM (Banco Opportunidad Mocambique), part of Opportunity International (a multinational charity focused on financial services for the poor), is probably the furthest along in developing such a low cost network, including using very small branches—effectively a 40-TEU container that can be put down anywhere there is a road and internet connectivity (could be mobile broadband).  These branches have as many as five networked PCs, six employees, a safe and a toilet inside.  There is an armed security guard outside.

Above: So excited about low cost banking we can hardly contain ourselves—inside a branch in the BOM network

Above: Illiterate in both Xitsua and Portuguese, this customer can still make his deposit!

The third main piece is to figure out what financial institution(s) we should be using for linkage and what products they possibly should and would be capable of delivering in a sustained fashion.  Given the regulatory framework and expertise available, VSLA group deposits can probably be taken by most banks and Microfinance Institutions (MFIs).   We think the credit piece will be more difficult, and it is already clear commercial banks simply are not in a position to deliver.   Unfortunately, there are less than a handful of MFIs in Mozambique of reasonable size and the last year was very difficult for many of them.  The global financial market  turmoil due in part, there has been lots of turnover among the top management in just about all of these institutions and one of the things we have to worry about is also finding  partners that we have confidence are financially viable.  There is also very little experience with, and willingness within these institutions to do group loans—understanding the creditworthiness of groups, while well developed in places such as Bangladesh by Grameen Bank and others, is not really something that is a very well understood here.   Some creative thinking and further research is in the works to figure this bit out.

“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 due to lack of rain.

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

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

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

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

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

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

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

Photo: © CARE 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

July 10, 2011

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

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

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

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

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

By Alexandra Lopoukhine, Emergency Media Officer
July 7, 2011

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

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

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

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

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

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

By Alexandra Lopoukhine, Emergency Media Officer
July 6, 2011

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

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

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

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

by Laura Bellinger

Bobbing in and out of his chair, a spritely six-year-old boy answers "Mignon" when asked his name. Mignon means "cute" in French. The name suits him, but unfortunately his life has become anything but cute.

Mignon and his father, Tiehi Didier, are staying a camp in Duékoué, Côte d'Ivoire sheltering 10,000 of the more than 500,000 Ivorians forced from their homes after several months of bitter, post-election fighting. And the heartbreaking story of how son and father arrived here speaks to why CARE has created a "listening center" to provide professional psychosocial support for survivors of Côte d'Ivoire's brutal violence.

Two months ago, Mignon and his mother traveled to Dabou, a coastal town where his mother regularly bought cassava to sell near their home in Abidjan. Like most Ivorians, Mignon's mother did not own a car, so, as is quite common there, they shared a ride home with a stranger. As the car neared Abidjan, they were stopped at a roadblock. Unbeknownst to Mignon's mother, the driver of their car had a gun. When the people manning the roadblock found the driver's gun, they ordered everyone out of the car.

"They cut off the driver's head," Mignon says quietly, "Then they told my mother to close her eyes. She closed her eyes and they shot her with the gun and cut her arms with a machete." Mignon gestures to his own arms to show where the men cut his mother, then gets up from his chair and runs behind his father.

"Mignon ran home to find help," Tiehi says. "And his aunt called me."

Tiehi hopes the listening center's social workers will be able to help Mignon. A school administrator, Tiehi says he understands the importance of counseling gravely traumatized children. Tiehi was traumatized during the post-election violence, too. Separated from Mignon's mother, Tiehi was living in Bloléquin during the attacks. Not only was his house burned down, but he was imprisoned as well.

"I was chained by the ankles for four days. They thought I was with a rebel group and I finally convinced them to let me go," he says. Tiehi and Mignon, along with Tiehi's wife and their four other children found shelter at the camp for internally displace people in Duékoué.

"I don't know what to do with Mignon," Tiehi says quietly. "He can't sleep. He has no distractions. He keeps asking to go back to school, but now I have no money for school. We have no home."

Working with the local partner ASAPSU, the CARE listening center offers private one-on-one sessions where these victims of violence can work through feelings of grief, fear, sadness, and revenge. The listening center also provides referrals to professional psychologists for the worst cases of severe trauma. It's a crucial first step, not only for personal healing, but for preventing further violence and working towards reconciliation.

CARE has extensive experience implementing programs that strengthen the bonds between different groups in Cote d'Ivoire: Muslims and Christians; planters and cattle farmers; Boso fishermen and local fisherman. CARE continues to believe that the forces bringing them together are stronger than those pulling them apart.

Only by listening and learning can these groups build a future in which Mignon and the thousands of other children like him can sleep soundly once again.

Tiehi Didier brings his son Mignon to CARE's listening center regularly to try to him help him deal with the loss of his mother. Photo: 2011 Laura Bellinger/CARE

Martine Johopaoudy has regular sessions with CARE listening center social worker Vlei Leontine. "I need to be heard every day," says Martine. Photo: 2011 Hortense Agnimel/CARE

• Read more: CARE Advances Cote d'Ivoire Reconciliation through ''Listening Centers''
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June 6, 2011
Stories and photos by Mildrède Béliard, CARE Haiti

On the road to Carrefour, nothing has changed. At the entrance to the town, you see the market where fruit and vegetable waste is rotting and where traders stand with their feet in water.>

You may not notice it but the town has been facing a resurgence of the cholera epidemic, which reappeared here just under two weeks ago. This morning, a 12 year old boy died. He was one of two people carried on the backs of other residents of the site to a Cholera Treatment Center (CTC). He did not make it. He was living near the camp Bel Air 3. He had been ill since the previous afternoon, but his mother refused to admit that he had cholera until camp residents, trained and sensitized by CARE, realized he was suffering from the disease.

In the car taking us to Lycée Louis Joseph Janvier, which houses more than 1,200 people, the cell phone of Naomie Marcelin, one of CARE's health promotion activities supervisors, does not stop ringing. She is told that three cases have been identified in a site that had not previously been affected by cholera.

"Last week we distributed aquatabs in sites where we work already. We have also offered HTH solutions (concentrated chlorine) to disinfect the tents where there is a risk of cholera," says Naomi. "During the week we plan to deliver oral rehydration salts (ORS) to households."

Naomie is dismayed about the death of the young boy . To avoid a similar situation, she plans to propose the installation of oral rehydration posts (ORP) on sites in remote areas. "The boy died of dehydration. If people had been able to rehydrate him before taking him to the CTC, he would have survived," she explains.

At Lycée Louis Joseph Janvier, CARE teams are ready! They have posters and leaflets to explain key practices to prevent the spread of the cholera epidemic to representatives of a number of other local camps.

Around 20 people are present. Some are members of mothers' or youth clubs created by CARE WASH and Health teams to serve as peer educators.

Brice Sodlon is a voodoo priest who performs at Lycée Louis Joseph Janvier: "It is essential to learn, especially if you are a leader in your community. My family lives in this camp. My friends live in this camp. It is a duty for me to learn how to protect them from this disease," said Brice. "CARE can't stop. CARE does not have the right to stop. If CARE had run this training at the start of the crisis at Grand'Anse, I am sure all these voodoo priests would not have been killed by the people who were accusing them of causing the disease," he says.

Like other participants at the training, Brice knows the essential actions to take to protect himself against cholera: wash hands regularly, treat drinking or cooking water, cook food well, wash fruit and vegetables thoroughly with chlorinated water, treat human waste. Simple actions that save lives.

The cholera outbreak, which had decreased a few months ago, returned in force two weeks ago, affecting areas in which it had not previously been seen. CARE has started training and awareness sessions in camps, and also plans to distribute hygiene kits, water purification tablets, oral rehydration salts and concentrated chlorine solutions.

On Saturday, May 4, CARE donated sanitation equipment – wheelbarrows, shovels, rakes, trash cans – to Carrefour City Hall, which had organized activities to mark International Environment Day. These materials will be used to clean camps and public areas to avoid the worst.

Béatrice Jean-Louis and Magdala Saint-Ange, CARE staff members, holding a training session on cholera prevention at Lycée Louis Joseph Janvier, an IDP camp housing approximately 1,200 people. The cholera outbreak hits Carrefour where more than a thousand people are hospitalized.

Brice Sodlon, a voodoo priest in Carrefour, participating in the training session

A CARE mother's club member showing to the group how to use purification tablets to clean water at the training session.

• Read more about CARE's work in Haiti
• CARE scales up activities to respond to resurgence of cholera
• Donate now to help CARE respond to emergencies and fight poverty worldwide
  

by Andisheh Nouraee
May 24, 2011

Access Africa’s second annual learning event opened today in Accra, Ghana.

Today through Thursday, we plan to review Access Africa’s strategy and methodology in the 28 African countries where CARE's signature program now operates.

Just as the name suggests, the agenda is improvement through learning. With 2.5 million participants in 28 countries across the continent, the people at this meeting have had a wide diversity of experience to share with each other.

“It’s an African movement for African people,” said Access Africa program director Lauren Hendricks in her opening remarks. “Everything we know about how to do [savings-led microfinance services] and how to reach the people most in need, we’ve learned from the people in this room.”

Today’s agenda: reviewing Access Africa’s growth targets and best practices for our continued expansion. With 2.5 million participants, Access Africa is already the largest non-governmental organization providing savings-led financial services in Africa. CARE with our Access Africa program is on pace to reach 30 million women and men in Africa with financial services by 2019. With the entire household benefiting from these services, that’s 150 million people moving out of poverty!

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IESC India: Arrival in Delhi and Visit to the First School in Hathras by Balaji Srinivasan

Our team had known each other for only a few short weeks but we had become a good working team already. We are diverse in our jobs at Intel and locations around the globe: K N Harsha from Intel IT in Bangalore, India is our technical leader on the project; Arvind Amin from Intel’s Software and Solutions Group in Dallas, Texas is serving as a teacher; Gary Motyer from Intel’s Technology and Manufacturing Group in Shannon, Ireland is serving as a teacher; Darrin Donithorne from Intel IT in Portland, Oregon is our team Project Manager; and I, Balaji Srinivasan, from Intel Sales & Marketing Group in Cary, North Carolina am serving as technical backup.

All the planning by the team prior to departure is paying off. We arrived at the Delhi YMCA Tourist Hotel on Saturday March 26th and got the first of many lessons to be had during this amazing journey on how things are done in India. For example, in India, always halve the first offer for service or product as haggling over price is expected for all transactions; none of us paid the same amount for a cab ride from Delhi Airport to our hotel. Gary Motyer, a seasoned traveler and “first ascent” mountain climber was able to get his taxi ride for far less than any of us. He seemed to have a knack for haggling with the local merchants throughout the trip.

After a fitful sleep in what is considered an average hotel (imagine Motel 6 quality), we spent only a bit of time on Sunday 27th finalizing our preparations for Tuesday’s visit to Hathras, Uttar Pradesh. Confident we were well prepared to train the teachers, we used the afternoon to go see Delhi for the first time. Seeing amazing places like the Red Fort and Jamal Masjid (See photo: Jamal Masjid Mosque and Darrin in the foreground) and eating at world renown Kareem in a rundown poor part of Old Delhi were incredible experiences that stimulated all our senses to the fullest. This was our second lesson: to take it all in and try hard not to judge what we were witnessing for the very first time as India would show us a tremendous variety of old and new and test all of our assumptions formed prior to our visit.

The kickoff meeting at the Delhi office of CARE, our partner organization on the project, on Monday, March 26th gave us a good overview of what to expect at the Hathras and Mainpuri KGBV schools. We then boarded our very first train to Agra as it would be our home base for the first week of our 14-day adventure. (See photo: Harsha and Balji sampling platform food on the train to Agra.)

Once we arrived in Agra, we made it an early bedtime as key to our trip success was to ensure we got ample rest as each day would bring a long drive to the KGBV schools, hot temperatures and smog and dust that most of us were not used to back home. Tuesday morning March 29th, we purposefully arrived with low expectations but found the school was actually well maintained, equipped and organized; in fact we would later learn Hathras was one of the best ranked KGBV schools! The girls went through their morning assembly which included calisthenics, singing, praying and reading the daily news. The guiding principal, Prathibha-Ji, has a doctorate in Hindi studies and was singularly focused on making our visit successful while treating us like “God as we were guests in their school.” The girls are provided with room and board for an entire year as the principal and supporting four teachers focus on educating these girls to age-appropriate literacy goals for the 6th, 7th and 8th grade. These are girls who had dropped out of their local schools for various reasons in rural Uttar Pradesh. The teachers were very energetic, eager to learn and had accomplished much more than we had expected since the Intel Learning Series classmate PCs were installed in mid-year 2010.

Our lesson plan involved introduction to computers, basic PowerPoint and spreadsheet skills, and advanced topics like classroom collaboration software. Each of us took turns leading and supporting the various lesson plans. At this school the English proficiency was quite low. The language barrier was eased by excellent translation support by Harsha, Arvind and Shaleen-Ji. The girls at Hathras were ever so curious and eager to interact with such strange visitors as us. We were told the girls would be shy but it was not true as we quickly made many friends. Darrin broke down the communication barriers by joking with the girls. When I showed them pictures of my family, they were entranced by the pictures of America, snow skiing and pictures of the earth from an airplane. They tried hard to pick up our English and some of the girls would on their own continually translate to the other girls what we were saying to them.

The girls’ proficiency level with the classmate PCs was pretty good considering how little time they had used the PCs and some even knew shortcuts like ctrl-alt-delete and could navigate better than some of the teachers! This proved to us that given a powerful new tool like an Intel Learning Series PC, kids of any age and education level could quickly learn and make great use of them. The girls (and some teachers) could surf, search and download pictures and information from the Internet. Each day was split in half by a wonderful lunch prepared by the mess hall crew. They lived and cooked from the same building within the school grounds, and they would prepare all the required meals each day for more than 100 people. The elaborate midday meals were a welcome break for the teachers as we were teaching a lot of information in three short days, and it gave us a great chance to build our relationship with the teachers.

Our final day at the Hathras KGBV school and departure ceremony taught us our next lesson about India. Goodbyes are never short and sweet! The kids performed many songs for us, they gave us beautiful homemade cards and we even got in a game of handball with the teachers and girls. (See photo: Gary receiving his greeting card at the closing ceremonies). It was more than we could have imagined from our Hathras visit. We saw incredible potential in these teachers and students and we hoped their KGBV education supported by CARE and Intel, using classmate PCs, would propel them to achieve great things when they grow up in rural Uttar Pradesh. As we drove back to Agra, we were exhausted, amazed and thrilled at being afforded this golden opportunity from Intel (as part of our core value of Great Place To Work) to make a difference in so many lives with our volunteer effort.

P.S. Click here to catch up on the adventures, experiences and learnings from the 14 previous Intel Education Service Corps teams and the other two teams who are working right now in Kenya and Vietnam.

Photos: Kristian Bertel

India is a country which is rich in heritage, culture, cuisine, nature and history. It has so much diversity that is hardly seen anywhere else in the world. It is an ideal blend of the modern culture and history.

With one of the world’s fastest-growing economies, India has certainly made giant strides over the past decade. However, despite averaging an annual growth rate of around 9% in recent years, vast sections of the country’s billion-plus population have seen little benefit from the economic boom.

Poverty in India is a big a problem now as it has ever been with well over 200 Million people living below the poverty line. A third of the global poor now reisde in India and the shocking statistics are highlighted by the huge disparity between the rich and poor.

An Indian girl is collecting things in Varanasi, India.

Poverty can be classified into rural and urban types. Rural poverty is caused due to various factors like dependence of rural population over the agriculture which is highly dependent on rain; injustice towards people of lower caste, lack of education, large family size with many mouths to eat and lesser hands to earn and unequal distribution of income.

Main reasons responsible for urban poverty is the scarcity of job opportunities caused due to migration of rural families to cities and lack of proper housing facilities.

About the photographer
I'm a Danish photographer focusing on global issues such as poverty and life conditions in Asia. I think photography can have a strong impact on society, and by taking photographs humanity can have a voice in the work I do.

By Robert Laprade
April 1, 2011

Otsuchi--duplex houses occupied by two families or individuals. This is an area where people did not have much to begin with, where younger ones have moved to the cities to find better paid work and where only the old ones are left. Photo: CARE/Robert Laprade

Today we distributed hot meals to evacuees in Yamada. Since the tsunami hit northern Japan, many survivors have not received balanced, hot meals on a regular basis. They are mostly surviving on just rice and some occasional fruit. In a situation like this, with cold temperatures and many older people in poor health condition, it is important to get nutritious food in order to stay healthy. Trained cooks and cafeteria staff helped us to prepare the food to ensure cleanliness. We are providing two meals a day in three locations of one big school compound here in Yamada. The evacuees were really happy and thankful. In this rather positive mood we set off to do some further assessment in Otsuchi, a fishing town south of Yamada. When we arrived there, my good mood was suddenly replaced by pure shock. Described by some newspapers as one of the worst hit towns, Otsuchi was in dreadful condition. Here again we could see the destructive force of a tsunami: debris everywhere for kilometers as far as the eye could see—houses, cars, parts of large concrete bridges, large electrical turbines, even a few fire engines strewn across the muddy landscape as if a giant child had emptied his set of Legos and children's toys into a muddy, dirty sandbox. In the areas where the waves had reached their maximum incursion inland, some houses were but left with one to two meters of grey, ugly mud that now covers everything. Within that mud, everything imaginable is mixed. Driving through the area of Otsuchi where some of these houses survived, we saw elderly people digging in the mud, trying to find even just a few belongings that can remind them of the world they once knew.

We talked to one woman, who was picking around the smelly mud. She was around 70 years old. The tsunami took her husband away. When we approached her, she had just dug a few dishes out and squatted around a plastic bowl where she cleaned them in water. It was cold outside but she wanted to rescue her few little things; it was all that she had left. She told us that even though a few volunteers came to help, she was really doing the cleaning all by herself. Her house was still standing, but everything inside was destroyed. It was really heart-wrenching. The tears from my CARE Japanese colleagues ran down their cheeks for five minutes; I think it was a blessing that I required a translation and could not understand everything she said. We were so far away from the glittery, high-tech world of Tokyo that we see from the movies and TV about Japan. People here did not possess much to begin with, most lived in small duplex houses, provided by the government and which looked like trailers. This was a fishing area. Those young, agile, and educated enough have long gone to the cities to find better paid work. Only the old ones were left.

We met another woman together with her husband. Both were also digging through the mud, looking for a few valuables. She told me she was the youngest around here – and she was already 60 years of age. She pointed to some of the houses, saying that almost all of the inhabitants are 80 years and older. Most of them are just physically not able to clean the mud from their houses. They need help. They were questioning why the municipality did not help them. When we drove about a kilometer over a hilly outcropping and gazed out over a small bay we realized why nobody would help for a very, very long time. The entire commercial and downtown residential area of Otsuchi was gone. Washed away. The mayor died—so did anybody else who remained behind or couldn't run fast enough when the warning sirens went off. From the hill, it looked like a bomb hit this town. Probably only one in twenty buildings were even recognizable as buildings—just foundations or a post or two of metal, maybe a half wall here and there. When entering this burned out ghost town of mangled metal, concrete, and mud, I noticed an overhead highway sign that remained standing. It indicated that Sendai is 230 kilometers away--230 kilometers to the center of tsunami impact. How in the world could it look worse than here?

After this awful excursion into hell, we went back to Yamada. I am glad that we could provide the people here nutritious food. And we'll do more of it elsewhere. Afterall, it's people like the women we met who are the residents of the evacuation centers. There is so much work to do.

Story and photo by Marie-Eve Bertrand, CARE Haiti
November 11, 2010

Yveline walks up to me with a nice smile, but I can tell she is reserved. As we walk into her parent's house, I notice that all of her family's belongings are stored on the table, on the higher cupboards or shelters.

"When Tomas approached, CARE staff brought a speakerphone to the community and told us to get prepared. We stored our things and, therefore, did not lose too much," Yveline says. "The rain and water filled the streets and our house." She shows me the mark on the wall, indicating the water level: three feet high.

Yveline is one of the 333 children that CARE sends to school here in Gonaïves. She has been in the project for six years and is really thankful for the help her family gets from CARE. She is smart and caring.

"My dream is to be a doctor because I want to help my community and other people who are disadvantaged. I know it is a lot of work, but thanks to CARE's generous donors, I have been able to concentrate on my studies," Yveline tells me. "My family supports me, and I know that one day I will do good work."

I asked her about cholera and the situation in Gonaïves. She tells me about what they have learned so far through CARE's prevention training."Cholera is an illness that is treatable and preventable. People need to wash their hands, disinfect their house if someone is sick and give them rehydration salts. And we need to make sure that we should not abandon those who are sick. They need help!"

She adds, "Cholera should not kill so many people. The problem is that we have little sanitation infrastructure, and now with Tomas' flooding it is even worse. We have very poor land management. We cut too many trees with no plans, and did not pay attention to our natural resources. Now, it is our infrastructure that is missing. We do not have enough gutters, and we do not care enough for our environment." "

When looking at her, you see that she does care for her neighbors. She is volunteering with CARE – attending meetings and training. She wants to make a difference in her world.

We walked outside of her parent's house, and jumped on stones to avoid stepping in the mud that covers their yard. The streets are filled with waste and mud. But, Yveline is off, helping spread information on how to prevent cholera.

Once she's gone, I can't help wonder how many out young Yvelines did not have the chance to go to school, live their dreams and build a better life for themselves and their communities.

• Read more blogs from Haiti
• Find out more about CARE's emergency response work in Haiti
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Story and photo by Marie-Eve Bertrand, CARE Haiti
November 11, 2010

The sun is shining, dogs are barking and the wind is blowing. This could be a normal day in Gonaïves. But it's not. Streets are empty, kids are not in school and mothers are concerned.

As I was with a community volunteers team, we were training women on how to purify the water they sell with bleach that CARE is providing them. A woman showed up. Wearing a mask, she was scared to approach me, scared to touch anyone.

Our team then visited an area called Descoteaux. This part of Gonaïves was flooded by Hurricane Tomas a few days ago. Now mud and garbage are covering streets. We stopped at Rosette Noël's house situated in a zone where CARE's volunteers and staff have distributed aid. A little girl is looking at us. Suddenly, another one joins her, then a grandma, a dad, two teenagers and a mom. Rosette is the mother of many kids she tells me. Her family includes her sister, her brother, and many siblings. I tried to get an exact figure. I don't think she knew.

Rosette tells me that when Tomas struck, they did not have enough time to gather their belongings. I could tell this was true by looking at the clothes and miscelleous household items drying on the brick wall between the houses.

"There was mud everywhere," she says. "We sought refuge with our neighbors. In this neighbourhood, we take care of one another. But what concerns me now is that my niece was sick yesterday. And now it is my sister. They are resting in bed, and we give them rehydration salts and clean them. We do what we hear on the radio messages." CARE's public information campaign via radio instructing Haitians on how best avoid and prevent cholera has reached at least 200,000 people to date. I am glad Rosette has hear them.

When I asked her why she was not taking them to the hospital, she turns her head. She is concerned about the fact that the hospitals are already over capacity and that the staff does have the ability to take care of her loved ones.

"We know that some people were left on the streets because they were sick. I don't want that to happen to my family. We can take care of them. I am afraid that they will get more sick in the hospital," Rosette explains. "Family is everything."

Her youngest looks at me. She is gorgeous and smiling. Her eyes are full of life and joy. I just wish I could do something to help them. But they know what to do.

"CARE helped us a lot. They came here to tell us how to protect ourselves before Tomas, and then after [explaines how to help]avoid being sick. We received soap bars and aquatabs," Rosette says.

As I leave the house, they wave goodbye to me. The grandma tells me to take good care and to stay healthy. These people are generous, and I am so proud I got to meet them.

• Read more blogs from Haiti
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by Dr. Franck Geneus, CARE health manager in Haiti
November 10, 2010

The situation here in Artibonite is all but reassuring. You can feel the angriness rising slowly but surely. In Raboto, it was reported that the dead were being abandoned in the streets. Hospitals are already at capacity with patients infected with diarrhea. Others who are infected are being discharged or discouraged not to go to the hospital in the first place. The police have assigned a car that transports infected people both dead and alive. This car is not being disinfected.

Protests in the streets were reported by the press. The fear of illness is everywhere. The sick are not adequately being taken care of and are seen as pests. Babies have been abandoned. Those that have children in schools are thinking of keeping them at home.

The number of new cholera cases have increased to 15 per day up from 3-5 cases before the hurricane struck. In the Hospital of Marmelade, over 200 cases have been reported since the beginning of the epidemic on October 20. Dead bodies are not being properly disposed of. Support staff are reluctant to come into contact with them because they don't have appropriate protective outfits.

CARE is supporting communities where we have our presence by providing early detection and management of cases; medically assisting rehydration; and conducting proper evacuation of cases. CARE's main focus is in helping facilities use proper hygiene and sanitation. CARE was approached by the Ministry of Education, for example, to clean a school which was flooded near a cemetery where bodies were wrongly disposed of. The cases are increasing and it wouldn't be a surprise if we see a boom in the epidemic in the coming days.

• Read more blogs from Haiti
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by Marie-Eve Bertrand, CARE Haiti Emergency Team

09:00, Nov. 6, 2010

Saturday was a busy day for CARE's team. I spent the day with CARE teams on their field visit to Léogâne. When we arrived in the downtown area, I was shocked by the level and the strength of water in the streets. The Rouyonne River had overflowed. Once again. And it has washed away a substantial part of downtown.

People are walking in the knee-deep water filled with garbage, human waste, bugs, and what else...

Women and men were cleaning their houses or shelters, removing the mud and trying to make it look clean. Truth is, I am concerned that a broomstick is not enough to sanitize a place that was filled with filthy water.

Yet, amazingly, not everyone we met was in despair. Indy, a young women living with her mom, was cleaning their little brick house. Her mom was telling me it was enough, it had to stop. She was cleaning her clothes as Indy was removing the muddy water from the one room they use as a kitchen, living room, dining room and bed room. Indy was smiling to me, and I asked her if she was upset. She said, "No ... What would it change?"

(Indy cleaning her house in Léogâne after Hurricane Tomas flooded the town. Photo: Marie-Eve Bertrand/CARE)

I stopped to visit the family living in CARE's first temporary shelter. I remember meeting her this summer, as she was just about to move in. It would have been great to meet her in a better situation. She lost everything but her family in January. This time, their belongings were pilled up, the mattress was wet, the walls were dirty, and her ti-moun (child) was hungry.

She looked at the sky and said: "This is an act of God, what else can I say? But it's enough. I want fresh food for my kids, I don't want them to be sick. There are very few latrines here. People do their things in bags and throw them in the canal. It was always like that. Now the canal is overflowing."

(Read more about CARE's work helping survivors have a sturdy roof over their heads and a strong foundation to rebuild their lives. Photo: Marie-Eve Bertrand/CARE)

Yes, it is. And I saw those bags floating around. Filled with human waste. While kids were playing around ...

Cholera, of course, is on the mind of everyone, including the CARE staff. Sunday, our CARE team distributed help to 9500 beneficiaries in Léôgane. We gave them aquatabs, Hygiene kits or BP5 (high energy biscuits) based on their needs. The response is done in partnerships with the other NGO's on the ground.

In Bino Lester, a grandma walked up to me. Her crops had flooded. She was frustrated. Enough, she said. This has to stop. Even the strong people of Haiti have their limits.

Tomorrow, I head to Gonaïves, where a CARE team will continue distributions and raise awareness of health risks such as cholera. The flooding was quite serious there. I might see another smile like Indy's. But given the triple-dose of disaster in Haiti these days, it would not surprise me if I did not.

• Read more blogs from Haiti
• Find out more about CARE's emergency response work in Haiti
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by Marie-Eve Bertrand, CARE Haiti Emergency Team

06:00, Nov. 5, 2010

I woke up to dark grey clouds. There is no sun in Port-au-Prince today. It was pretty quiet first thing this morning as the storm was 'stopped' by the mountains, but then suddenly, it was as if someone opened the tap. It is loud now... very loud! The rain sounds as if you're standing next to a waterfall. For a moment I thought we would be okay. Now I am really concerned about our staff and friends living in camps or shelters. You don't want to be outside at this time...

Yesterday the staff and people in our neighbourhood were getting ready for the storm - packing up food, water supplies. I was at the market yesterday and you could tell that people were nervous. Everyone was filling up their baskets, talking loud, moving fast ...

Usually the market it's pretty relaxed, but yesterday everything changed. People were in the streets, the traffic was heavier much sooner as everyone tried to get home to their families, and the businesses closed much earlier.

People were asking: "Why this? Why us? Why again?"

The rain is getting harder. The wind hasn't picked up yet, but if this gets worse, I can only imagine how bad it will be for the people in the camps.

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by Chloé Dessemond
July 28, 2010

The village of N'Guelbély, 170 kilometers north of Diffa, is surrounded by sand dunes. Scattered houses made of straw look naked because the straw has been eaten by the few cows that survive. The food crisis, caused by a poor rainy season in 2009, is escalating herein Niger.

Usually, pastoralists of N'Guelbély move around their village, but this year, they had to go further to find pasture land to feed their livestock. In October, they started moving north until they reached an area known here as "angle of death." The land, located between the territories of two ethnic groups, has no supply market or local authorities and the land was not fruitful. Pastoralists tried to go back south in February. But many animals, too weak to move, died on the way or were left behind.

Omarou Moumouni lost one third of his livestock in the north or on the way back. Coming back to N'Guelbély was not a relief. Without pasture land, another third of his original livestock died in the village. He's situation is no unique – 80 percent of the total livestock is estimated to have died here.

A couple of weeks ago, Omarou received animal feed distributed by CARE in the area. The 150 kilograms will enable him to hold out until the rain falls.

CARE, the only operating non-governmental organization in this remote land, is carrying out food distributions, and has plans to reach the vulnerable pastoralists in the north soon.

South of the region, in Goujou, rain has started to fall. Except for the sand dunes, the landscape in Goujou is green. There, makeshift camps – or rather small piles of items under tarpaulins – prove that hundreds of pastoralists brought their livestock to the site. The pasture land is covered with goats and cows but this picture is misleading. There is not enough grass to support the high concentration of pastoralists. Moreover, this grass is mixed with sand, which can bring on death for already-weak animals.

Idi Abdou had 42 animals before the crisis. Now, he has only 17 left. He comes from Bonsoro, about a hundred kilometers north of Goujou. He traveled to Nigeria with his son to find pasture land before coming to Goujou. Because of the bad condition of the cattle, the price of the animals has fallen. Therefore, in order to buy food, Idi had to sell all of his goats and more cows than usual.

A few days ago, CARE launched an operation to help. CARE is purchasing weak animals at a higher price than they would be bought on the market, thereby, helping pastoralists maintain their purchasing power. CARE bought an animal from Idi Abdou who received eight times the money he would have had on the market.

"If CARE wasn't there, there wouldn't be many people helping us," asserts the chief of N'Guelbely village. "We experienced big crisis before, like in 1973, and we had less assistance then. But this year, the situation is worst than ever."

This crisis raises many questions concerning the future of pastoralists. In N'Guelbély, discussions on the topic are lively.

"Pastoral life is different nowadays," says one villager. "We need to find other solutions, diversify our activities." Other people suggest alternatives to pastoral life.

Hadamou Moumouni lost 79 animals this year. He has only one left. "For me, pastoral life is over. My children will have to make their own way. They can do anything, except livestock farming. They will probably go to the urban centers and start a small business."

Boucar Souley has only 10 animals left out of 70. His breeding animals died, which put a threat on the replacement of the herd – and on the life of his family for whom milk is a staple food. Boucar travels with seven of the 20 members of his family, and thinks about moving again in his constant search for pasture land. After that, he admitsm "I really don't know what to do."

For these pastoralists and so many others in the Shahel region of West Africa, and in Niger in particular, the crisis has just begun ...

by Deborah Underdown, CARE media specialist in Pakistan
September 3, 2010

As I left Islamabad for Swat I can't deny that I wasn't a little apprehensive. Most people have only heard about this region because of conflict and Swat's association with militant groups.

Swat has been hit hard by the floods with some people – a month after the rains – having still received nothing. Many roads and bridges have been destroyed making areas, and the people that live there, unreachable.

CARE, through our partner organization IDEA, is targeting the families who have yet to receive help. Families were identified last week and given a token and informed of the time and place they could collect essential goods such as soap, towels, pots and pans and a tent.

Today, I saw these people receive their goods. Arz, 60, said, "I walked for three hours to get here. I am happy to receive these goods. This is the first time we have had anything since the floods."

I am struck by the organization of the distribution – no one is fighting or pushing. People are calmly waiting in line to receive these precious goods and then sit, with what looks like relief, before picking up the goods and starting the long journey home.

CARE is also providing people with 2000 rupees to help them transport their goods home; the methods of transport include donkeys and mules. Arz told me that he is going to use the money for something else, "I am going to use the money that was given for the transport on new clothes for my children." He'll walk the return journey that will take 4-5 hours as he will be carrying a heavy load.

As we literally reach the end of the road, a huge chunk of it was washed away. But I am struck but the sheer determination of the people here. A zip wire has been strung across the vast Indus River and people and their goods are able to get from one side to the other. I look at people going across and at how high up they are, sitting in a small metal cage, and think how brave they are – it then hits me that they have no other choice.

Arz, 60, said, "I walked for three hours to get here. I am happy to receive these goods. This is the first time we have had anything since the floods."

A zip wire strung across the vast Indus River carries people from one side to the other.

Photos: 2010 Deborah Underdown/CARE

Read more about the floods and CARE's relief efforts in Pakistan >

by Jonathan Mitchell, CARE International's emergency response director
August 28, 2010

This blog entry is part of an e-mail that Jonathan sent to co-workers at CARE:

Dear Colleagues,

I have just returned from Pakistan, where I saw the flood situation and CARE's response first-hand, and worked with the country office and CARE USA's Asia regional director, Nick Osborne, to support scaling-up CARE's response.

As you will know, the devastation caused by the floods in Pakistan is unprecedented with an estimated 17 million people affected - stretching from the Himalayas in the North to the Arabian Sea in the South of the country. An estimated 1.2 million people have lost their homes and 3.4 million are displaced.

Together with CARE's country director Waleed Rauf, regional director Nick Osborne, other colleagues from CARE Pakistan and one of our local partners, we visited affected areas in Swat and Nowshera districts in Northwest Pakistan – one of the first areas hit by the floods four weeks ago.

In the Swat valley, the swollen river had cut huge swathes out of the river banks, destroying many homes, businesses, roads, bridges and other infrastructure, as well as agricultural land. Displaced people are mainly staying in school buildings or with host families. One of the main problems for aid delivery in areas like this is lack of access due to roads being cut. To get up the Swat valley, we had to leave vehicles behind at several points where there were no roads and hike by foot across steep hillsides to the next intact section of road.

In Swat, CARE has supported our local partner to quickly set up mobile health units providing badly-needed primary health services to the communities. Each unit moves around to different sites and includes both a female and a male doctor. The urgent priority now is to find alternative ways to overcome the access difficulties so that CARE and our partners can deliver other relief supplies such as tents, household kits, and materials for water and sanitation.

The situation in Nowshera district, which we also visited, is quite different. It is located south of Swat where the land opens into the plains. Here, the river flooded entire villages, washing away houses and livestock, and inundating agricultural land. Many displaced people are living in makeshift camps on higher ground close to their flooded or destroyed houses. CARE and our partners have set-up mobile health units here as well. In addition, CARE Pakistan quickly provided, through our partners, all of the tents and household kits that CARE Pakistan had stockpiled to people in Nowshera and another neighboring district. But this only met the immediate shelter needs of a small proportion of those needing help in these districts; CARE is working hard to procure the much larger quantities of supplies still needed. Three hundred additional tents were received from vendors last week, but with so much demand, all humanitarian agencies are experiencing serious delays getting enough supplies from vendors in Pakistan. Where appropriate, we are, therefore, looking at sourcing relief supplies from outside the country.

There are many other critical needs in the displaced people's camps as well. A camp that we visited had no water supply, toilets or other sanitation facilities. The situation for women, who have no access to private sanitation facilities, is particularly bad. CARE and our partners are focusing with urgency on the need to address the awful sanitation and water situation. Construction of toilets is starting, a shipment of water purification supplies has arrived, and two water purification plants are being set-up in Nowshera and the neighboring district.

The sanitation issues also illustrate why focusing on gender must be an important aspect of our response, and one that we need to address with sensitivity in the conservative social environment of many of the communities we are working in. The country office is hiring a full-time gender advisor to support our work in this area.

In addition to these districts in the northwest of Pakistan, CARE is also responding in South Punjab and Sindh Provinces further south.

During the visit, we worked with the country office to revise its emergency response strategy. The revised strategy plans for a scaled-up emergency response to reach 300,000 people in the three operational areas over an 18 month period. The response will be in two phases: the first relief phase will last up to nine months and will include interventions in health, shelter, non-food items and water/sanitation; the second recovery phase will overlap with the relief phase and will continue until around December 2011 and will include interventions in livelihood recovery, transitional shelter, etc.

I would like to sincerely appreciate the hard work of colleagues in CARE and our partners in Pakistan, under the strong leadership of country director, Waleed Rauf, who are doing so much to respond to this humanitarian crisis. The great support of many CARE International members is also most valued, and we look forward to continuing to work together with all involved to ensure that CARE's response to this crisis provides significant assistance to the people of Pakistan affected by these devastating floods.

Best regards,
Jon

Read more about the floods and CARE's relief efforts in Pakistan >

2010 Waleed Rauf/CARE

by Deborah Underdown, CARE media specialist in Pakistan
August 24, 2010

The word flood has taken on a new meaning for me. Last month, a flood was a burst water pipe in my flat in London, a few ruined carpets and the inconvenience of sleeping in my lounge. Today, a flood means your entire home being submerged with water. A flood is all your possessions being washed away. A flood is something that forces you to live in a tent wondering where fresh water and food will come from.

Nowshera is about an hour and a half drive from Pakistan's capital, Islamabad. When I arrived I was shocked to see the floods waters hadn't receded. On my left were the submerged houses and on the right, overlooking what used to be their homes, were families living in tents.

I met Khayal Marjan. She smiled at me from inside her tent, provide by CARE, and spoke to me about the floods.

"Our sewing machine was damaged in the flood – it was our only source of income," she said. "I also had 40 chickens and some goats and cows; they all drowned. We only had time to save ourselves."

Approximately 400 families are living in tents provided by CARE – a shelter from the monsoon rains that continue to fall. The needs of the families in these camps are numerous, ranging from shelter to medical care and food to clean water. CARE continues to help. There is a mobile health clinic treating skin diseases and the growing number of diarrhea cases.

The scale of this disaster is overwhelming and unimaginable. Nowshera is just one area of Pakistan affected by these floods. There are many other cities, towns and villages in the same situation - all needing more support.

Flood waters are still present on Nowshera, where some people told us that their homes are still submerged in 4 feet of water.

Children in Nowshera wade through flood water to salvage what they can from their homes.

A camp set up by CARE and local partner IDEA in the village of Nowshera.

Photos: 2010 Deborah Underdown/CARE

Read more about the floods and CARE's relief efforts in Pakistan >

By Faiz Paracha
August 24, 2010

It was my first day working with CARE, and I visited one of the worst affected areas of Khyber-Pakhtoon-Khaw, Nowshera and Charsada. Both districts have been devastated severely by the flood. Traveling along the Motorway M-1, you cannot realize the wreckage that the torrential flood water has caused.

When we left the M-1 through the Nowshera interchange, I was shocked to see the destruction caused by the flood. The river Kabul flows side-by-side to the road to Nowshera, and there are a lot of villages constructed sporadically alongside the banks of the river. This has affected people living in those villages tremendously.

We stopped at a village called Zareenabad.

The local people told us that the flood water came in a two-meter-high wave. All of it was so sudden that they had no time to gather their valuables – but could only run for their lives. Many of them got swept away by the water and others are still missing, heir families believing them to be dead.

The water has taken away their belongings and their houses. Many houses collapsed when the flood wave came and the rest broke down due to standing water. Their entire household lost in water. People remained under the open sky with nothing – until CARE reached them. CARE was the first organization to provide them with shelter.

CARE has established a camp with our local partner IDEA for the affected people of this village. This camp is accommodating some 400 families. The camp has been provided with tents, non-food items, kitchen utensils and hygiene kits. Drinking water tanks are provided twice a day.

People here need more help. The damage that we see now is only the beginning. The basic source of livelihood in this region was agriculture, daily wage labor or cattle farming. All have been engulfed by water. New homes will be needed to be built for them. Funds will be needed to help rebuild their livelihoods so that they can make it on their own. People, especially children, will require psychosocial support.

It is vital that the pledges by international donors materialize. Concrete and fulfilling promises regarding aid are needed so that the people of Pakistan are saved from their worst humanitarian crisis.

CARE and partner organization IDEA has provided tents to around 400 families in Nowshera.

Read more about the floods and CARE's relief efforts in Pakistan >

CARE Media Specialist in Pakistan Thomas Schwarz interviews CARE Pakistan's Country Director Waleed Rauf

August 17, 2010

Q. After more than two weeks, how would you describe the situation in Pakistan as of today?

A. It still raining and we are in the midst of the second phase of the monsoon – and there are always three phases. The overall situation is worsening, and the United Nations meanwhile spoke about up to 3.5 million children in danger of waterborne disease.

Q. That sounds as if the aid agencies are not able to help?

A. CARE and other aid agencies are working up to their limits. Even now during the fasting Ramadan period, they are working around the clock. Together, with our partners in the northwest of the country as well as in the south, we are contributing to the people.

Q. What is it exactly, what CARE is doing? What kind of support are you providing?

A. There are different regions of Pakistan we work in. CARE is supporting mobile health units through our partners in Khyber Pakshtoon Kwa (KPK) and Sindh Provinces. We are providing access to basic medicines and first aid care. We emptied all of our warehouses immediately after the floods started. They were the stocks CARE maintains for emergencies such as this one. These included stocks of basic items such as tents, clothing, kitchen sets and hygiene kits, which as of today, have all been distributed in the worst-affected areas of Nowshera and Charsadda. More will be distributed in Punjab and Sindh as soon as possible.

Q. Many people have fears that the aid do not reach the victims but instead go to hidden channels. What is your opinion on that?

A. Well, the challenges here are enormous but aid is getting through to those who need it. I can assure each and every donor who is ready to support CARE. Our long experience in the field and the passion of our partners on the ground guarantee this, and we have rigorous systems in place to ensure that aid goes directly to the people in need. Undoubtedly, there is much more to do and international organizations, including CARE, are committed to doing so. Even through the fasting month of Ramadan, our colleagues continue to work around the clock to ensure aid reaches those in need.

Q. So, what is needed most? What is the priority number one?

A. There are three priorities – all at the same time because they are interdependent. As we see the rising numbers of hungry flood survivors, food is an urgent need. Hygiene is a priority, too. Stagnant water in 100-plus degree heat and humidity provides the perfect breeding ground for waterborne diseases so health is a major issue. Children and women especially are threatened here. The United Nations announced this week that as many as 3.5 million children are at risk of disease. The third priority is shelter. Many of the tents sent to Haiti after the earthquake came from Pakistan suppliers, and stocks here in Pakistan are not yet back up to the needed levels.

Q. What is your overall expectation about the next two to three weeks?

A. If we – and I am not only talking about CARE – receive sufficient funding and donations, Pakistan could respond much more quickly. We could do much more, broaden our response, reach more people more quickly. If not, I would not want to guess what could happen to the millions of survivors who haven't yet received any assistance and are struggling alone.

Read more about the floods and CARE's relief efforts in Pakistan >

By Anu John, Program Development Coordinator, Disaster Risk Reduction and Conflict
CARE Afghanistan
August 13, 2010

I have just completed 10 years with CARE. On World Humanitarian Day 2010, I wanted to share the joy and the significance of this journey in my life.

Yes, it's been 10 years with CARE for me – I still remember the day the human resources director of CARE India told me after the interview that I was selected for the job. That day changed my life. Coming from a working class family with a rural background in India, the biggest gift my parents could give me was a good education. But it was up to me to make something of it. All I knew is that I wanted to be in the "helping" profession. CARE opened up the doors for me. I got one opportunity after another at CARE to do what I liked to do best, with all my passion.

I always believed in nonviolent means of achieving results. I feared physical pain of any form; it was too close to home for comfort, I guess. Then, how could I be okay with conflict, especially violent conflict? I could never see sense in having armies and troops and missiles and guns. I wanted peace, and wanted to work with people who had lived their lives in a conflict context. CARE gave me the opportunity to work with conflict-affected people and to work on conflict-sensitive programming. Today, I am in a war-torn country working with the people of Afghanistan. And it's been achieved with CARE as my employer.

I am sure there are other organizations that do the same, but for me, it was CARE that did it. I have to add that, as a girl from rural India, some of the material comforts were a first for me. I traveled in an air conditioned railway compartment for the first time in March 2000, on the ticket that CARE gave me to attend the interview in New Delhi. I flew for the first time in August 2000. A few years later, I traveled abroad for the first time with the opportunity that CARE gave me to go on a visit to Bangladesh.

They may sound materialistic, but for an average young Indian girl, a decade back, these were unimaginable rewards. No doubt, they came with a lot of hard work (as it is for anyone else), and even heartache …difficult bosses, eccentric colleagues, unplanned work, short deadlines and what not. But now it doesn't seem to matter.

For me, CARE was not just an employer; CARE became my hope. I only say this because I truly believe CARE not only strives to make a difference in the lives of people it works for, but also makes a difference of the people who work in the organization. For me, Gender Equity and Diversity (a CARE program to ensure equity among men and women, and provide opportunities for overseas staff) is not jargon, but a reality, as it is for many others working with CARE, especially in this part of the world.

And I thank CARE – and all my colleagues – for making our lives beautiful. I am sure that very many staff out there in the country offices, on the front line, working with the communities will have the same to say. I wanted to take this opportunity to remind ourselves of this change; we are making in the lives of our staff members.

Salaam to a great decade with CARE. Shukriya (thank you), CARE!

by Thomas Schwarz, CARE media specialist in Pakistan
August 16, 2010

The Taliban helps flood victims and then publicly praises its own work. This is what I read in the news. In interviews, journalists ask if it is true, and I say yes. Of course they publicize their good works. Everybody who does good deeds for others publicizes it. But, is this the question we should be asking right now? Not for me.

This debate about the Taliban has nothing to with the reality we face here everyday across the country. The debate is a Western obsession, not one of the flood-affected people in need.

Frankly, I barely understand the connection between the topic and the biggest natural disaster of our time. We should be focusing our attention on how we can provide immediate relief efficiently and effectively to those in need.

I witnessed in Moltan just how CARE is supporting mobile health clinics so that primary health care is accessible to those who need it.

The temperature here is a humid 104 degrees, and flies are everywhere. A man shoos them away. Flood survivors queue patiently for their turn to registrater and receive medical assistance. The process is quick and efficient, and the people here are directly benefiting from this intervention because of generous donations to CARE.

Moltan lies to the south of Punjab Province, where new floods are predicted as monsoon rains continue.

CARE's warehouses here are all now empty and, as more donations come in, we are procuring more supplies to distribute to those in need. Since the floods began we have distributed tents, hygiene kits, mosquito nets and kitchen sets. It is not true that humanitarian assistance is not reaching those in need. It is – but simply not enough!

Along the main, four-lane road out of Moltan, we see tents, one after another like a string of pearls. Tents? That's an exaggeration. They are really just plastic sheets held up by wooden poles. The fronts and backs remain open, offering no privacy for those who seek shelter. But they at least provide some protection from the fierce sun.

A 70-year-old man sits alone, staring into space. Around him children sit likewise.

When we arrive, we are surrounded by people immediately. Everybody wants to say something. They all say the same thing, "We have no tents. Look!" Th