In NGO jargon, they are called ‘host communities.’ Most often, they are people who, despite going through a difficult time themselves, welcome and support others who are even less fortunate. In brief, they are good people.

"We were awakened by gunfire...By the following night, we managed to flee...My husband continued to Bamako and since then I have no news from him. It's really hard for my aunt and all of us.” © 2013 CARE

Fifty-six-year-old Fatimata, a widow from Mali, is one of them. Ségou, the region where she has been living, has seen the arrival of more than 2,000 people over a period of three weeks in January alone – people who, fearing for their lives, have fled the north of the country and its recent fighting.

They are part of nearly 12,000 people displaced within the country since Jan. 11 and an addition to approximately 18,000 who have sought refuge in neighboring countries.

“We can not abandon them,” says Fatimata over the phone. “They are our brothers and sisters.” Her voice falters every few minutes – not so much because of the connection, but because what she is recounting is obviously distressing for her.

She hasn’t had an easy life, she says. She is a widow, sharing her modest pension and house with some of her children and eight of her grandchildren.

Then followed the arrival of her sister and two children, her brother with his wife and two children, and a cousin with more children. They all fled Gao­ – the largest city seized by armed groups – amidst scenes of violence and dread.

Now they all share Fatimata’s house and everything she has. Little as that is.

When asked to describe her day, she points out that most of it is focused on scraping things together, on ensuring there is some food, especially for the children. “Sometimes there is, sometimes there isn’t,” she says. “We live from one day to another. Only God knows how we manage,” she concludes after a pause.

How do they manage? They borrow money. They buy food, cook it and sell it in the street. “We try to manage with the little we have. It is not easy for anyone. For my brother especially. He is not comfortable being here with his whole family and having to rely on his younger sister. He doesn’t like the fact that he can’t work.”

But sadly, until there is full peace in their hometown, or help arrives in their host community, they are forced to continue living as they can. On scraps of food and hope.

Note: CARE has been distributing food in Ségou and Mopti. CARE supports both internally displaced people and host communities who are still recovering from last year’s food crisis. CARE is also responding with long-term development solutions that include disaster risk reduction and food security programs. Many of CARE’s activities, including cash and food, focus on women as they often suffer the most during times of crisis. CARE is particularly concerned about them.

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Following recent fighting in Mali, CARE interviewed the people of Diabaly about their experiences. Sadly, many of them had tragedies to share. The following are a few stories as told to CARE by the survivors.

Assan (left) and Awa (right) "Traumatized by the events in Diabaly, Awa doesn’t talk much now, and she is not her usual self. She is currently receiving medical treatment so that she can better deal with her distress," says Awa's sister Assan. © 2013 CARE

From Fatoumata:

“We were awakened by gunfire. Very alarmed, my husband, my three children and myself went into hiding in our room until the following day.

By the following night, we managed to flee. We reached a rice field. Soon, we were taken in by the first family we met. They were very welcoming. They gave us food and water, and did not ask many questions.

I then took a bus with my kids to Siribala to join my aunt. I did not have any money on me, and my aunt paid for our transport when we arrived. My husband continued to Bamako and since then I have no news from him.

It's really hard for my aunt and all of us.”

Red eyed from insomnia, still covered in the black burqa imposed by armed groups, Awa has a sad story to share. As she is still very distressed, it is Assan, her sister, who tells CARE Awa’s story.  

“After the January shooting in Diabaly, my sister Awa walked nearly 100 miles from Diabaly to Sibirila with two of her children and eight other unaccompanied children.

Traumatized by the events in Diabaly, she doesn’t talk much now, and she is not her usual self. She is currently receiving medical treatment so that she can better deal with her distress.

Things are tough for us now with having to look after all the children as well.”

Following the fighting on Monday, January the 11th, in Diabaly, a man in his 50s describes the longest night of his life.

“It was a nightmarish night,” he says. “We were hiding in the house, with a gut wrenching fear, but the worse was yet to come. Suddenly a bullet pierced the bedroom door of my children; it hit my 10-year-old son in the head as he was sleeping; he would never wake up again. My 12-year-old daughter was also wounded.  I confess that since then I have not been functioning well; I have been feeling very down.”

Note: to date, CARE has supported internally displaced people in Siribala with essential food distributions; over the past few weeks, CARE distributed 528 kg of food to 605 people. Overall, in the months of January-February, a total of 46,888 people in the regions of Mopti and Segou have been assisted, with 668 metric tonnes of food being distributed.

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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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As told to CARE on January 19, 2013:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How are CARE and its partner organizations responding?

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

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

Is there a high risk of an outbreak of diseases?

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

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

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

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

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

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

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

Almost everyone.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*name has been changed

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

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

By Sarah Zingg

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Syrian refugees lacking legal status are at risk of exploitation.

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

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

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

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

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

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

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

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

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

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

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

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

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

CARE family kits at distribution point. © 2012 CARE

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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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.

September 5, 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By Thomas Schwarz

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

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

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

No refugees, nowhere - seemingly

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

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

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

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

By Thomas Schwarz

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

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

"We would never call it home"

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

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

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

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

Sharing with others is important here

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By Yemisi Songo-Williams and Christina Ihle

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

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

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

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

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

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

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

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

By Marie-Eve Bertrand, CARE Canada

Although they are hungry and in the midst of a food crisis, the Malians welcomed CARE with calabas filled with baobab leaves, wild grapes and other native fruits and herbs. Later, CARE distributed food aid to the village. © 2012 CARE/Marie-Eve Bertrand

Visiting Swala
Mali, a country in the Sahel. The Sahel, or Sahil in Arabic, is the border between the Sahara and more fertile and green lands. It is a dividing zone, a mixture of cultures, odours, tastes. Here in Mali, the number of ethnic groups and tribes are too numerous to be counted. Here, they talk to me about tolerance, love and sharing. Actually, they live it before they talk about it.

In this region of the world right now, there is a food crisis, caused by a combination of events: a poor rainy season last year which causes the water level of the Niger River to stay very low and crops to wither, chronic poverty, environmental degradation, all resulting in poor harvests and a sharp increase in prices. A crisis hitting a region that already experiences chronic malnutrition and food insecurity. According to the Malian Ministry of Livestock and Fisheries, the situation of pastoral communities is at high risk, with even the livestock losing weight because of the lack of grass and water.

Follow me as I meet with the inhabitants of the Swala village in the Djenné region, an hour and a half from Mopti, a town in the middle of Mali.

There were eight of us in the vehicle, including the driver, three colleagues from CARE, the A.A.D.I (our local NGO partner). coordinator and, as well as its president, her grandson and me. And of course, since Malians are very generous, I had the honor of having the front seat to myself. When we turned the corner around the village wall, I heard the percussion instruments, a warm and joyful melody. Then songs. And then I saw them. There were hundreds of women, men and children waiting for our arrival for the second food distribution in their village in two months. The women were dancing, the men were playing tambourines. It was a party in our honour. A wave of tenderness rose within me, a wave of solidarity... a wave of humility. They are the ones who should be celebrated for their courage, their strength. They surrounded me with their warmth, their joy for life. Behind my sunglasses, tears flowed. Like when you feel unworthy of such an honour, or too small for all the love.

They danced all the way to the village chief’s hut. It is an ancient village, very old. A village with walls of mud, thatched roofs, holes for windows. And everyone was squeezed into this small space. Us, the dignitaries, on mats. Them, directly on the ground. They were all so beautiful, smiling, proud.

The village chief’s representative spoke, taking the time to greet us, to thank us. His name is Dramane Coulibaly. "We thank you for this gift of food and your visit that is so precious to us. Before you came, we had no hope, and we didn’t know what to do to continue, to be able to feed our families. The first CARE food distribution eased our empty stomachs, but it wasn’t enough. More than half of us weren’t helped. All of our village suffers from hunger," he said. "Because the women are the ones who can best tell you about the challenges we face." Dramane told me.

Then Pointou Coulibaly, the president of the women spoke. "We are so happy that you are visiting us. Our storehouses have been empty for a long time, because the rains weren’t good for us last season. Our harvests were insufficient last year, and we are suffering from it. Our people farm the land to live, and we usually sell our products. But last year, there wasn’t even enough to feed our families, so selling was impossible. Our only concern is to feed ourselves. Because without food, our children are sick. They cannot go to school because they don’t have the strength," she told us while sitting among her loved ones.

"It is true that hunger pangs make us suffer, when we are used to eating three meals per day, we become rather inefficient... now we have a meal with a little meat and potatoes in the evening and some millet or rice if we are lucky at noon," she continues.

"Half of the families couldn’t have food because of criteria and limits set by the World Food Program. But you know, we are people who stick together. Malian solidarity. It is out of the question for us to let our neighbour go hungry and suffer. So we all share what little we have. We prefer to have less, but to have peace of mind, because we helped those around us."

Generosity, solidarity. That puts the focus back where it should be, when you realise that to share, you don’t need a lot, you just need a big heart. It was the whole village that gathered to thank us, because it is the entire community who benefits from CARE’s assistance.

Their economy rests on three main thrusts in the region: agriculture, livestock and tourism. Rain didn’t fall from the skies last year, and the storehouses are still empty. And even though it has been raining recently, no one knows what tomorrow holds, and there are still four months to wait before the next harvest. The price of rice is ever-increasing. People are hungry. Thirsty. But they are proud and hard-working. Plus there is the livestock that have fallen. The animals were too hungry and thirsty too. Some died; the remaining ones are very thin. Too thin. So the sale of livestock has suffered, as well as the demand, because people don’t have much money, since tourism has fallen off. The tourists who also ate the meat are no longer coming, because they are afraid of the political insecurity in the northern region of the country. The region here, like the famous town of Timbuktu, is classified as a world heritage. Here, you find the history of centuries and centuries of hard work, majestic sites, vestiges of the past. Places that are so old, so different. But that no longer have as many tourists as before.

The oldest person in the village, as they call him, spoke, "Ma’am, I would like to make a request for our survival. Give us efficient tools to farm, seeds that will grow and knowledge to improve our harvest. We are farmers and we want to work to fill our storehouses."

And that is when I understood that these proud and courageous people in front of me had, themselves, understood the essence of development. They know that food distribution is temporary and aspire to becoming self-sufficient once again. They are capable of working; we have the resources to help them prepare for the future and build resiliency plans.

As the meeting was ending, the village chief motioned me to come forward so he could give me a packet with nuts. Kola nuts in fact. A gift that is reserved for great occasions, great celebrations. A rare gift.

I left with a heart full of hope, love and pride. I left with my hands full of a gift that touched me. But also with a full stomach. Because from the little they had, the villagers made us a meal. Malian solidarity.

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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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'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 Barbara Jackson, Humanitarian Director, CARE International

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Johannes Schoors, CARE Niger Country Director
March 2, 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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By Melanie Brooks
Jan. 21, 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Haiti – 2 year anniversary of earthquake

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Haiti – 2 year anniversary of earthquake

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

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

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

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

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

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

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

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

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

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

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

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By Richard Wecker – CARE International in Vietnam
Isolated village of Văn Giáo commune, Tịnh Biên district
December 20

Nguyen Van Ngat lives with his wife, Le Thi San, and their four daughters on the edge of Tra Su national landscape reservation, near Văn Giáo commune of Tịnh Biên district.

The tree-lined road to their home remains some four metres below the surface of what is now a lake. Water levels have remained high for six weeks after the peak of the floods in An Giang province, Vietnam.

Ngat and his neighbours had the experience and foresight to elevate their wooden floors in preparation for this flood season. Their homes are sitting just above the water, propped up by makeshift stilts. "We were aware the floods would be high this season so we helped each other to prepare," he says. Without knowing the signs to look for and without taking heed of warnings, the family of six would otherwise be stranded, homeless.

At first glance, this isolated cluster of floating houses look purpose built, however all of inhabitants tread lightly as the renovations were rushed and the support beams were weakened by termites prior to the floods. "We need to reinforce our house as it may collapse at anytime but we have no money to do this," Ngat says. Many of the houses in his area were evacuated before the peak of the floods. Some residents have returned but many cannot live in their house due to risk it may collapse.

Ngat usually works as a hire-labourer, mainly farming rice, however his usual employers have no work for him. Seasonal flooding is normal in this part of the world but this year the water has reached record highs, destroying a large amount of the season's crop and creating a risk of poor people going hungry since they are the most affected. There are many people in Ngat's position, who is now faced with the challenge of feeding himself and his family for the next 3-6 months until floodwaters recede and the next season comes around.

Ngat usually fishes to supplement the family's income but the wind and tides are in motion, unsettling what might otherwise be a surrounding bounty for his family.

Furthermore, his fishing tackle is old and worn and his boat has holes in it. What Mr Ngat might catch on a good day might fetch 20-30.000 VND (US$1-1.50) at the market, which could buy just enough rice for the whole family of six. He expects the calm to return in December but he insists: "the weather has been unpredictable in recent years and no one can say what the future will bring".

Ngat's wife San suffers from chronic heart disease and so the eldest daughter stays at home to take care of her and the younger siblings. Occasionally she will also go out fishing with her father, leaving the house early in the morning to return around lunch time.

Of the four girls only one goes to school. She had been faring the floodwaters by boat with no safety gear and would take raw rice from the family's reserve rations for her teacher to prepare her lunch. As Ngat and San cannot pick up their daughter from school they rely on other members of the community to watch after her.

The lights of this household are extinguished early and the evening meals of rationed rice are cleared quickly to avoid attracting the swarms of mosquitoes from the nature reservation - dengue is rife this time of year. It's a precarious situation for Ngat and his family but they are looking out for each other.

CARE International in Vietnam has provided immediate food support to strengthen to capacity of people affected by the floods.

Ngat and his family are one of over 1,000 households in An Giang province that have received immediate food support. "It's enough for us to live for a month, we are very grateful for the support," Ngat says. Follow-up distributions are intended to provide additional support during this period while livelihoods have been disrupted. Any subsistence stocks of rice that remain in his area are inaccessible. Having this staple will prevent him and his family from falling in to a credit-debt spiral that threatens to prolong this period of hardship.

CARE has also distributed non-food items funded by the United States Agency for International Development (USAID) to strengthen the coping capacity of communities at high risk from the floods, including elderly people with little family support, people with disabilities, female-headed households with dependent children and infants, as well as poor families, landless families and those reliant on casual labour.

Ngat and San's daughter can now take filtered water to school in a bottle after they received a silver-impregnated water filter and training on how to manage their water using this device. They also received mosquito nets that will help to protect them from the mosquito swarms at night; hygiene kits to reduce the risk of contracting water-borne diseases or infections; a 10 litre bucket for hauling water; blankets for the coming cool months and lifejackets.

CARE is working with communities to plan how they can provide further support to families such during this peak-flood period and over the course of the next 3 to 6 months. The plans are to focus on livelihoods support while the water levels recede and families such as Ngat and San's wait for the next rice harvest season.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Niandou Ibrahim, CARE Niger, October 21, 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By Hadia Nusrat, Senior Gender Advisor, CARE Pakistan

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

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

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

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

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

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

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

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

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

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

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

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

Doctors provide medical support, but more assistance is urgently needed

By Mujahid Hussain, Team Leader Lower Sindh, CARE International Pakistan

The monsoon floods of August 2011 have displaced millions of people from their modest huts in the areas of lower Sindh province. After almost three months stranded under open sky, many are still waiting for proper temporary shelter, water, sanitation and healthcare support. The most vulnerable are women and children, who are fighting unprotected from the health risks of exposure to hot sun during the day and mosquitoes at night.

Dr. Tabinda, age 23, female medical officer,  is providing health care services to the floods affected with the mobile health clinic, operated by CARE partner organization. Photo: CARE Mujahid Hussain.

CARE and its partners' health teams are providing primary healthcare and hygiene awareness education to some of the most severely affected people in the remote areas of district Mirpur Khas. This week the team visited a health camp organized by our partner at village Mahar Mohammad Buttar, UC Burghari. We travelled about two hours from Mirpur Khas city by road to reach the village. The road condition was very poor and in some areas it is surrounded by water. The level of water is now receding and some people have started to return to what is left of their nearby homes.

On the way to the camp village we stopped to ask questions in a local community. "We are happy to be going back to the debris of our home instead of sitting in camps on the roads and waiting for relief.  We try to survive with our own saved resources," said 55 year old Mero of village Goth Mitha Baluch.

We reached a village where a health camp had been set up by CARE local partner Takhleeq Foundation. The camp was well organized, with separate facilities for men and women, and with the active involvement of local elders.  Over 350 local people were gathered, including men, women and children, waiting for medical officers' consultation and medications. Four medical officers (two male and two female) were fully engaged in consultations.  In the waiting room staff were leading hygiene awareness sessions, focusing on how to ensure clean water and do hand washing. 

One of the female medical officers is 23-year-old Dr. Tabinda, who has been providing healthcare services in flood-affected areas for the last 15 days. Asked about her motivation, she said: "I am very happy to provide health services to these people. They are deprived, they are poor, and the way they are being neglected is inhuman. This village has a population of 20,000, and they have no health unit available for healthcare." She said she and her colleagues were travelling three to four hours on daily basis to access these remote areas. Yesterday the team had to go on foot for half an hour to conduct camp at another village. "Our motivation is high to serve these needy people, and I am sure to get their prayers." She pointed out one lactating woman sitting with her for treatment and said, "This woman is seven months pregnant.  She is weak, malnourished and shelters-less. She has had severe pain for last seven days, but her family could not afford to bring her to a checkup at Mirpur Khas city."   

Shewa, a 70-year old man, was suffering from fever and being treated by a male medical officer. "We are 16 in my family," he explained: "Five daughters, three sons, six grandsons, my wife and myself, all living in a hut with a cover made of plastic and our clothes. We lost all our standing crops -- cotton, vegetables, rice in the field and now we are looking for food and water to survive.  All our family members are ill, and have come to this camp for treatment. This medical support is blessing on us. My young grandson Rehman is studying in class 3 and he is suffering from malaria fever and not attending school.  If I could get some cash support in future, I will buy some livestock, foods, and construct a new hut for living."

I have experience working in some major disasters in Pakistan such as the disastrous earthquake in Pakistan in 2005 and the floods last year and I know that every disaster victim has different suffering and feelings of hope. But responding to the floods this year in lower Sindh, I witness that people are hopeless and frustrated after waiting for three months to get support. Many of these people will die from malnutrition and water borne diseases if a response cannot be expedited. CARE and other organizations urgently need more funding to support people in need.

Rick Perera, Horn of Africa Communications Coordinator

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Niki Clark, Dadaab Emergency Media Officer
August, 2011

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

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

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

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

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

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

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

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

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

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

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

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

She is on to her next client. There are many more waiting.

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*Identifying characteristics have been changed to ensure confidentiality.

Mohamed Maalim Gedi sits cross-legged on a floor of dusty red dirt, aimlessly fiddling with his bare, well-traveled toes. His gaze is towards the ground, but his thoughts are obviously elsewhere. He occasionally reaches out to swipe an insistent fly from the face of one of his young children, five boys. The wooden benches, set in a half circle around him, are filled with other weary travelers. They just arrived in Dadaab, a place of both hope and uncertainty. A large bus, smoke still sputtering from its tail pipe, is parked a few yards away. It is the one that transported him from the border, another group of Somali refugees escaping drought and insecurity. There have been more than 132,000 refugees who have come just since January.

Like so many of his fellow refugees, Mohamed is a pastoralist. His entire livelihood depended on his cattle. When the last one died, he decided it was finally time to escape. "I have lived like this for 20 years," Mohamed says, referring to the frequent drought and worsening security in his home country. "Enough is enough."

So, with his wife and mother, he traveled 500 kilometers via foot and donkey cart from his village of Bu'aale, Somalia to the border town of Dif, Kenya. From there, he arranged for a bus to transport his family for the rest of the journey to Dadaab. Because of limited space, he had to leave behind two of his children, his youngest, 2, and his eldest, 14, with cousins. "I hope the bus that just brought us is going back to get them," Mohamed says. "But I can't be sure."

The reception center is the first safe haven after a long and arduous journey for refugees. In the background, one can hear the shrill, high cry of children. But their cries come not from the hunger but vaccinations against polio, measles, diphtheria and pneumonia. Such vaccinations are unheard of luxuries back in Somalia, and are part of the reason Mohamed made the trip here. He hopes his sick children will get the medical attention they need.

Waiting outside the UNHCR registration tent. Once a refugee is registered, they are entitled to the regular food distribution cycle that CARE manages with food procured by the World Food Programme.

Here at the reception center, Mohamed also has access to clean water and a supply of high-energy biscuits. Because of increased efficiencies in registration, Mohamed and his family will now be registered within a three-day time period, down significantly from previous waiting times when the crisis first hit. After he registers, CARE will provide him with a plastic tarpaulin, kitchen set, soap, blankets, plastic mats and jerry cans and an initial food ration to last until the next regular food distribution cycle. As registered refugees, Mohamed's family will be entitled to a tent from UNHCR an a food ration card so they can join the bi-monthly food distribution cycle run by CARE.

On the fence surrounding the area where CARE distributes initial food rations —servings of wheat flour, Corn Soy Blend (CSB), vegetable oil, corn meal, beans, salt and sugar — hangs a sign in English and Somali. It states: "Services from Agencies are Free; Help Stop Sexual Exploitation and Abuse." CARE and other agencies that work here are continuously working to ensure refugees are aware of services and where to access them. A CARE counselor stands next to the area where new arrivals gather their high energy biscuits. "How was your journey?" she asks a fatigued family of five. She's looking to identify vulnerable populations, such as survivors of gender-based violence, widows, lactating mothers and the ill. She's help "fast-track" them so they can get to immediate help, including medical services and counseling.

As he waits to be called, Mohamed sits with uncertainty weighing on his mind. He has no relatives or friends in the camps, and is unsure of what to expect. "There is a fear of the unknown," he says. "Will I have a place to sleep tonight? Will my children get food and medicine?"

In spite of these reservations, Mohamed says he remains optimistic. "I am hopeful. Hopeful that I will get help for the first time. That, finally, we will have some relief."

He pauses for a few minutes, lost in his thoughts. "A larger question lingers, though," he finally admits. His question is one that countless others have asked, continue to wonder, even after the physical part of their journey is complete. "What's next?"

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Niki Clark
September 20, 2011

Everyone knows that water is necessary to sustain human life. People have survived for weeks, even months, without food, yet even a day without water causes the human body to suffer. Even with its critical importance, water isn't typically something that gets most people excited. That is, unless you're talking to any of the CARE staff working on water and sanitation (WASH) in Kenya at the Dadaab refugee camps. Just hold a 10 minute conversation and you'll understand how easy finding a passion for the subject can be. 

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

As the main implementing partner for water production and distribution in Dadaab's three camps and two outlying areas, CARE pumps and distributes approximately 7.5 million liters of water a day, enough to provide all residents with 15 liters of water a day. With almost 500,000 refugees in and around the camps, providing water for the entire population remains a daunting task and extending services to keep up with demand is a constant challenge.

"Dadaab is the third largest city in Kenya," says Timothy Mwangi who helps with CARE's water management. "The coordination and logistics involved in making sure that many people have enough to drink would be difficult in a normal setting. But within the context of a refugee camp, it is even more of a challenge."

CARE is meeting that challenge through a combination of boreholes and water tanks. Currently, CARE maintains 20 boreholes and over 172 kilometers of pipes throughout the camps. These boreholes tap into the reserve of groundwater that sits below Dadaab's surface. In addition, CARE provides potable water through trucking services and water tanks. Each influx area has between one and three tanks, each serving 2,500 people.  CARE also is increasing the number of water points and tap stands in the influx areas and extending water pipes from the existing camp systems.

Resources are tight. Amina Akdi Hassa is the chair of the Dagahaley camp. She serves as a refugee representative and is consulted when decisions regarding Dagahaley services are made. She has lived in Dadaab for nearly 20 years. "Share our problems," she tells visitors. 

One of those problems is storage. While CARE distributes jerry cans to all new arrivals, there often are not enough to transport and store all the water needed. The task of collecting water is time consuming, and often keeps those charged with less time to collect firewood and cook, for example. Community mobilizers employed by CARE spend their days talking with residents like Amina to assess the problems and offer solutions.

In addition to our water production and distribution work, CARE manages all hygiene and sanitation promotion programs in the three main camps — Hagadera, Ifo and Dagahaley — including each camp's influx areas, markets, schools and water points. Refugee "incentive" workers raise awareness around various hygiene issues, including reducing the spread of waterborne diseases through handwashing. These workers go door to door, demonstrating safe hygiene practices and distributing soap.  

Water trucking in camp Dagahaley. Refugees here receive an average of 19 liters of water per day.

To the outside world, it may not seem like the most glamorous of jobs, but the response of the refugees is quite different. When CARE's Public Health Promotion Officer Raphael Muli visits the influx area of Dagahaley, he is immediately surrounded by residents of all ages. Young children crowd, raising their hands, anxious to volunteer for the handwashing demonstration. Raphael flips through a "how-to" picture book walking the children through each step. Then, he hands out bars of soaps, reminding refugees that handwashing is a simple way to reduce the risk of disease. In fact, some studies show that this simple act can decrease diarrheal disease by up to 47 percent in a community. All day long Raphael will repeat this drill, one person in a CARE team of public health officers and community mobilizers. He is greeted enthusiastically everywhere he goes.

Raphael and his colleagues have reached nearly 31,500 refugees living in the influx areas with their public health promotion messaging this year alone. Their goal is to reach 60,000 by the end of the year. With each demonstration and each conversation he holds, his message about the important of water and good hygience becomes clearer to everyone.

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Theo Alexopoulos, Deputy Safety and Security Manager, CARE Pakistan
September 20, 2011

"If you want something important done, don't do it on Christmas Day – everyone will be away," I remember my buddy joking, while we were bouncing around inside a Series 3 Land Rover on a security training exercise in New Zealand some time ago. Flash forward to Pakistan in August 2011: I am driving with our CARE team leader, Karuna, in a Toyota 4x4 on a field assessment in central Sindh. It is Eid, a major holiday, the end of the Ramadan. All our staff, including the drivers, have gone to their home villages to be with their families, and the country is on standstill observing national celebrations after a month of fasting for Ramadan. The heavy monsoon rainfall and rising waters have us a little on edge. We have no idea that our response will be one of the first by an NGO - right at the heart of another emergency.

As the rain continued non-stop for almost 2 full days, Karuna would suggest areas he was interested in visiting, and we would dart around the region, hoping for access and a return route on roads that were at risk of closing. We monitored the river and swelling canals, inspecting for damage and trouble spots. I was liaising frantically back with our country office via Blackberry, snapping shots between wiper blade strokes and potholes, and taking notes in my little note-book. From time to time we would stop to stretch our legs and reflect on the disaster unfolding before our eyes.

The roads around Dadu were eerily quiet, with no sign of the infamous chaotic traffic, only the drumming of persistent rain pelting the roads. By parking next to the door of our staff house in town, we could climb into the car to avoid wading through over a foot of water mixed with garbage and stinking sewage. In rural areas, we saw mud houses melting away like chocolate ice-cream.

When the rain stopped, we knew that a new deluge of work was coming our way. CARE staff and our local partners were headed back to the field office. They would need an immediate and accurate account of the situation. Media paints one story, helicopter rides another – but "eyes on the ground" can't be beat. We were there on the ground. Within days, after only a small break in the weather, Southern Sindh was hit much harder. Roadsides and school grounds became crowded with families who had lost their homes. Our nearby warehouse was packed with emergency stocks ready for distribution: tarpaulins for temporary shelter, mats, shawls, cooking utensils, hygiene sets with antibacterial soap, tanks for safe water storage. Our holiday would have to wait.

Sindh province, southern Pakistan. Just one year after an unprecedented flood affected 20 million people, new flooding is threatening lives and livelihoods in Pakistan. Sindh, a province in the south of the country, is the worst affected. Nearly one million houses have been damaged, thousands of livestock have been lost and more than five million people are struggling to rescue their livelihoods.

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.

As a humanitarian worker for the past sixteen years I have seen some pretty shocking scenes. Before this trip to East Africa, I was particularly not looking forward to witnessing suffering children. However, when I saw the dedication and commitment of the CARE staff working on our response in very difficult surroundings, it made me feel proud to work for CARE.

Villagers in Gemechis District, Ethiopia, register for food distribution by CARE. Photo: CARE/Sandra Bulling

Helping pastoralists in Borena
In Borena, Ethiopia, CARE is working with people to reduce cattle herd sizes during droughts to prevent over grazing of the pasture, and to provide the community with an income from their weakened cattle before disease robs them completely of their value.

People in Borena are well known for their strong social bonds. They are also well known for feeding their children first, a practice which is key to ensuring survival of the next generation in this toughest of times. This, along with the monitoring from CARE and the local government, ensures the program reaches those who need it most. But our program is only reaching five per cent of people living in the targeted districts ­­– further funding is desperately needed to extend this highly impactful and timely program.

A health centre in Miyo district
Distances in Miyo district are huge and mothers can travel for a long time to bring their children to the health centre for assistance. The most seriously malnourished children receive help here, accompanied by their mothers.

First they are checked for diseases like diarrhoea and given treatment. Then they start a careful course of therapeutic food, starting with low-strength milk powder. It normally takes four to five days for their weight to stabilise. Then they progress to a more nutritious formula that helps them regain weight fast. Finally, they can be discharged with two month’s ration of oil and corn soya blend to take home.

In Gemechis District, Ethiopia, CARE distributes monthly rations to villagers, who share the food between them. Food distribution benefits more than 66,000 people in East/West Haraghe and Afar. Photo: CARE/Sandra Bulling

Making sustainable change in people’s lives
Along with responding to the current situation, we also have to look at what causes the current situation and how we can prevent it from happening again. We need to understand the underlying causes of poverty and why drought keeps coming, and why children and mothers are severely affected. For example, we have linked many large households in East and West Hararghe to the long-term family-planning project in the area, as large family sizes can contribute to malnutrition.

With CARE Ethiopia already meeting the needs of over 406,000 (as of Aug. 22) people and plans to reach up to a million in the next three months, I am confident CARE is playing its part in reaching the most vulnerable during this drought, the worst in a generation. It’s our job to make things better in a tough situation and that is something I feel positive about. We need help from the Australian public so that we can extend our programs and benefit more people who are suffering from this devastating drought with long-term solutions.

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The green trees, cool mountain climate and well-stocked shopping malls of Nairobi are in sharp contrast to the camps in dusty Dadaab. The warm smiles and healthy faces of the Kenyans I meet are very different from the haggard faces of the new arrivals from Somalia I saw lining up for food just a couple of days ago.

Many Kenyans are also suffering in the terrible drought sweeping across the north and east of the country. Today I met with CARE Kenya senior staff who explained how CARE is working to improve the situation in Kenya by investing in communal management of water and pasture. They told me that most of the people affected by the drought are pastoralists who live and move with their herds. In the drought, lack of water and pasture has seen herds decimated and no rain is in sight until September.

In the north-east of the country CARE is supporting people to renew communal management of grazing lands and water pans. Where there was some local rain in April, the water pans still have water and there is still some pasture, but even they are badly off. That’s why CARE is supporting off-take of weak livestock at a reasonable price and the vaccination of stronger animals so they can withstand the drought. This should help herds to recover and people to bounce back if the rains come.

Stephen Gwynne-Vaughan, CARE’s Country Director in Kenya, visited Gafo in late July and saw the difference these investments have made. Water pans that were rehabilitated last year with community labour through CARE’s support still have water. What’s even more encouraging is that the community have managed them well, collecting small fees from users, which have allowed them to clear out the silt this year. If they continue maintenance, these should last for twenty years.

We have also supported district-level planning so that communities and the local government know when to take emergency measures such as de-stocking of livestock. Pastoralists move across the border with Ethiopia, so CARE has worked on both sides to bring communities together so they can make agreements that allow access to pasture for the animals when times are hard.

Gary McGurk, Assistant Country Director of CARE Kenya, explained why CARE will only consider water trucking and food aid in the most dire situations. “Water trucking is expensive and encourages people to stay in places that cannot sustain them rather than moving on with their herds.” By investing in community management of water and pasture, we can reduce pastoralists facing a crisis and needing expensive food hand-outs or water trucking.

But support for such interventions is hard to get. Even though studies show that a dollar invested in preparedness will save on average seven spent on crisis response like food aid, we find it hard to gain funding. With the situation so bad, we now also need to help the many who are in crisis. Tomorrow I will travel to Ethiopia to see how we are doing that there.

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Today, I spoke to a young woman who had walked for twenty days with her two children. They left their home due to the drought which has dried up all drinking water sources.

She was sitting in a makeshift tent made from rough branches and covered in bits of cardboard and scraps of cloth. She and the other new arrivals have taken refuge outside the established camps.
The influx of new arrivals has put great pressure on services in the camps, not least on the water supply. CARE has been providing water to the camps for over twenty years, but with the recent influx we have been really stretched.

Jason Snuggs, CARE Australia’s Water and Sanitation Adviser, has been working with the local team to ramp up water supply. He says, ‘We have been setting up new water tanks and tapstands so that people can easily access the water that we truck in.’

We are also supplying 19 litres of water per day to people as they arrive in Daghaley camp. We are redrilling seven boreholes so they produce more water, increasing storage capacity, and extending the piped water system out from the main camps to the influx areas next to them. This reduces the need for expensive trucking and ensuring we can meet the needs of the 30,000 new arrivals in this camp.

The ongoing drought and conflict in Somalia – where famine has been declared in several districts in the south – means the influx of refugees will probably continue for several months. CARE estimates that over 500,000 people will be in the camps by Christmas. Clearly this is a big challenge. Jason says, “We are increasing water provision in the influx areas and water in the camps to above UNHCR global standards of 20 litres per person a day, and we will keep going until we are sure we can meet the needs of further new arrivals.”

I ask him what the biggest challenge is and there’s no pause in his reply: “Funding is the biggest challenge.” It’s also a challenge to get skilled water and sanitation professionals to work in Dadaab as conditions are hard, even for the staff working there.

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It’s 6.30am on a crisp Nairobi morning. The dawn chorus has just finished and I am standing in the CARE Kenya compound. Abdi, our driver, has just arrived with a broad smile and wearing a bright cap typical for Somalis. I am joined by Alain Lapierre, Director of Emergencies for CARE Canada who has been overseeing the expansion of our activities in the region this past month.

He says the situation in Dadaab is of great concern. People are still arriving in a terrible state. Although the numbers arriving have reduced slightly in the past few days, he believes this is only temporary. CARE is scaling up to meet the needs of an increasing number of refugees. This includes recruiting more national staff and for long-term planning with existing staff, such as Jason Snuggs, CARE Australia’s global WASH Adviser, working at the strategic level to develop plans to cope with the projected influx of people.

As we reach a rendezvous point, three CARE Kenya staff who work in Dadaab join us. They are highly skilled Kenyans working in the construction team. One of them, Oumari, tells me that he has been working for nine months in the searing heat of Dadaab, providing administrative support to the construction team who build and maintain boreholes, latrines and five schools. I ask him how he feels about working in Dadaab. He replies, ”I feel really motivated. We are giving hope to people who had lost hope in life.”

We are now joined by another CARE vehicle packed with field staff and provisions for the camp. There are also vehicles with staff from UNHCR and other NGOs. It’s 6.45am and time to hit the road!

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Adam Poulter, Emergency Response Manager for CARE Australia
August 2011

As the plane took off from Canberra yesterday I looked down on the dry hills below. My thoughts turned to the dusty plains of Eastern Kenya where CARE is working in the world’s biggest refugee camp, Dadaab. We’ve been working there for twenty years leading the provision of water, food and education. While we and other agencies working in the camps are able to provide assistance to the more than 414,000 [as of Aug. 22] refugees now there, the problem is that the numbers just keep growing. I’ll arrive there on Sunday to work with the team on increasing our capacity to deal with the projected increase to over 500,000 refugees by Christmas.

Newly arrived refugees from Somalia collect water provided by CARE at Dadaab refugee camp in Kenya. Photo: Kate Holt/CARE

Yesterday I spoke with Jason Snuggs, CARE Australia’s global water, sanitation and hygiene (WASH) Adviser who has been working with the team in Dadaab to increase water supply and storage for the new people arriving since early July. He told me how they’ve managed to increase water supply for people on the edges of the three main camps. We are now providing people with up to 12 litres of water each per day. The target is to exceed 15 litres, which we have been able to provide to long-term refugees. Jason is confident we can reach this target in the coming weeks by redrilling bore holes, improving distribution lines and storage capacity for water.

Just as important is public hygiene and we are working with animators from the local community to spread simple hygiene messages like the need to use soap and to wash hands before eating. By doing this we can limit outbreaks of diarrhoea and other infectious diseases which can kill the malnourished, especially young children.

We leave at 6am sharp. I will be accompanied by CARE’s Regional Coordinator, and two global education experts. The road takes a bumpy six hours, but this is a trifle compared to the journeys of several weeks the new refugees arriving have made.

I am standing in front of the borehole well, waiting for the clicking sound of my camera. But there is no sound. The CARE engineer has just explained how ground water is pumped up and then distributed to water stations. We are wandering around Dagahaley, one of the three refugee camps in Dadaab. A photographer working for a newspaper is gathering images of how a refugee camp works. But now as we stand at the borehole I feel yesterday’s long hours creeping up on me: my camera battery has obviously run out, plus I forgot my pencil and notebook on the desk. But there are solutions to these minor problems: The photographer lends me a pen and I use the back of my permission papers for the camp to take notes. In fact, I am starting to like my day without a camera.
The frenzied activity of taking photos, writing stories and organizing your way around Dadaab helps you tune out some of the misery and extent of human suffering. But it also makes you focus on only one part of the story. For the past two weeks in Dadaab, I spent most of my days in the camps, documenting the work of CARE, accompanying journalists or interviewing colleagues. My head is still buzzing with all the information and impressions. Like any humanitarian crisis, Dadaab is fast-paced and loud.

But now, sitting down in the sand near a water tap stand, I am quietly watching the hustle and bustle going on around me. I close my eyes as the wind blows fine-grained sand my way. I gaze around in all directions. The photographer stands on top of a water tank to get a better angle. None of the women or children fetching water pay much attention to us -- water is much more important than the strange sight of a visiting foreigner. I curiously watch two young women leaving with their jerry cans full of water. But they don’t carry them on their heads; instead, they roll them across the sand. This really calls for a picture: Two women in long veils and torn sandals kicking their jerry cans full of water through the desert. But with my camera batteries empty, my eye batteries seem to be more charged than ever.

After a while I move to the side of a latrine. It’s just four walls of corrugated iron, but at least it guarantees some privacy. Standing in the shade I watch a man with his donkey cart. Bit by bit women lift their jerry cans onto the cart, tightening them with ropes and rags. Getting places here in Dadaab takes time. The three camps cover some 56 square kilometers. Owning a donkey cart is a pretty good business. It is so hot that everything here seems to happen in slow motion. Finally the cart starts to move. I wonder how much the women have to pay for their transportation and whether they will still have enough money left to buy food for their children. While I sit in the sand, their skinny legs are at eye level. I can count the children wearing shoes on the fingers of one hand.

Humanitarian aid means reaching as many people as possible with at least minimum needs, given limited resources. In Dadaab, CARE and other agencies provide about 500 grams of food and about 12 litres of water per person and day, some basic medical assistance, some counselling. Every one of these 414,000 refugees is a unique person with a particular history, hopes and sorrows – but the scale of this emergency is so vast, we can’t possibly meet all those individual, specific needs. What we can do is slow things down for a while and pay attention. Observe. Understand. And adapt our programs to what we see. For example, CARE might soon pay the owners of the donkey carts so that weak and poor women don’t have to spend the rest of their money for transportation of water and food.

It is quick and easy to take a picture, upload it to your computer and then store it somewhere in your archives. But the pictures I saved in my head today will linger on for some time before I will be able to store them anywhere.

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CARE's Emergency Communications Officer Sabine Wilke in Dadaab, Aug. 11

How does the situation compare now to the beginning of the year?

The big difference is simply the high number of new arrivals. They have stretched our capacity to deliver the essential services for humanitarian aid, especially because many families are settling in informal, undesignated areas where there is poor access to services. They are scattered around the camps, but it is hard to reach them quickly enough to prevent further suffering. After 20 years of providing humanitarian aid in the camps, CARE and other agencies are now confronted with a new complication: in order to meet the increasing needs,  we have to stretch the resources that we have as much as possible to help all new people arriving in very weak and vulnerable conditions. Another complication is that the refugees are taking up more and more space outside the formal settlements which is having a detrimental effect on the local environment; they need firewood to cook which results in the deforestation of the sparse land which in turn creates conflict with the host communities whose grazing land is being destroyed. In the first five months of 2011, we had weekly registrations of about 2,000 people on average. In July, this number went up to more than 5,000. And this only counts the individuals being registered; we currently have a backlog of about 35,000 people still waiting for registration.

What is the difference between those refugees who have been here for some time and those who are new arrivals?

Most refugees here are quite resourceful, that is natural in any setting. People are not going to sit around for 20 years; they want to get on with their life. There are thriving markets in each of the three camps where you can charge your phone for 25 Kenyan shillings at a shop that has a small generator, you can find tailors and hairdressers and so on. Those who have a little bit of money buy products from the local markets in the area and sell them in the camps. But the newly arrived families, those who have fled drought, poverty and instability in Somalia within the last few weeks, they come here with next to nothing, barely carrying clothes on their backs. So, the provision of basic emergency services such as food, water, health and shelter are very important to sustaining life. As a measure of how serious this crisis is, the refugee community that has been long settled here in Dadaab have come together to compliment the international response. A Muslim charity created from within the camp population is now providing clothes and shoes at the reception areas to help the aid agencies. This is really encouraging for us to see because it demonstrates this crisis affects everyone. And help comes from many directions.

The areas around the camps are also suffering from drought and chronic poverty. How can you balance assistance for refugees and Kenyans?

This is a very important concern. People outside the camps are also in dire need of assistance, and of course they see the services provided in the camps and want to receive similar support. CARE has been working in the region for years, and we are now scaling up our emergency regional response to meet the ever increasing need beyond the Dadaab refugee camps. But we cannot feed and water everyone in and around the camps… we simply don’t have the capacity. The mere existence of the camps, offering relative safety and security and access to basic essential services, that is like a beacon of hope in an otherwise bleak and desolate environment for all those Kenyans who also suffer from the impacts of severe drought. Ready markets and access to trade and business offer alternative livelihoods or income generation opportunities for families no longer able to continue their pastoralist lifestyle. The refugee operations bring jobs, businesses and contracts. The area of Dadaab has grown from 30,000 people to more than 200,000 people over a twenty year period. This said, the camps are stretching the existing resources and the environment to a point where it will be very difficult and slow to recover. CARE has always engaged with the host community, they have always been a part of our response in this region. Our support to the cost community has included activities such as borehole maintenance through repairs of the generators and pumps, chlorination of the boreholes to reduce contamination; we created water pans for livestock watering, built classrooms and trained teachers. And we are currently looking into ways to provide even more support. But we also have to think in terms of how this can be sustainable in some way, because there will always be droughts in this area. We need to find ways to build resilience; boreholes can only be a part of the solution.  The key is to support the communities to help themselves. Let’s say through cash transfers so that they can hire their own water trucking, by training to maintain boreholes, by conflict-resolution forums. But all of this costs money and unless there is a severe humanitarian crisis and people here about it in the news, aid agencies really struggle to obtain funding for these activities.

What role does the Kenyan government play?

Kenya has had its doors open for 20 years, and continues to keep it open. They are not turning people away. The international community has provided some support, but nowhere near enough, and before pointing a finger at the Kenyan authorities we have to remember the impact this refugee population has on both the communities and the environment. And with Somalia still lacking security and governance, there is no solution for the refugees to go home again. Kenya has a right to continue ringing the warning bell, and the country cannot carry the burden by itself for another 20 years.

What are the biggest challenges right now?

As for food distribution, WFP and CARE have done an exceptional job to provide food when and where necessary. Every refugee receives an average of more than 500g of food per day. But it remains a challenge to disseminate information about how much and where food is available for the new arrivals. When so many people are coming in, we don’t know where they are coming from and where they end up. Before, when the number of new arrivals was still manageable, the information focused on reception centers. But now we need to do outreach into the so-called influx areas around the camps, where people settle while waiting for registration.

As I’ve mentioned before, there is also a backlog of people received but not yet officially registered as refugees.  Since there is no screening center at the border, people arrive here and have to go through the registration process, which takes time. People who have been received, but not yet registered, get food for 21 days and some supplies such as water cans, blankets, cooking items, soap etc. But if they have to wait longer than those 21 days to get registered, we have to organize a second round of distributions. Another problem is transport, because many families settle quite far from the reception areas. So many single mothers or people suffering from weakness and malnourishment have to pay someone to carry their food home. This is a big concern for us, so we are working very hard to fill that gap.

And then there is water: CARE has done quite well in providing water to the influx areas to new refugees, where we can we’ve been able to extend piping from the existing water lines out, so that pressured water is provided from boreholes to temporary taps. CARE is also trucking water to temporary tanks and taps. But we still face challenges in that some of the current borehole systems bordering the influx have insufficient pressure to fill up the water tanks more quickly, so in some cases this leads to long queues. We are replacing these low pressure boreholes so we can provide enough water to the refugees. Technically, it is always a challenge to bring in the equipment and set up a structure in the middle of nowhere. But water is such a crucial part of the response that we cannot slow down now.

Protection is also a big issue. The families arriving here, especially single mothers and young children, are often very tired, malnourished and sometimes sick. They are the most vulnerable having traveled many weeks in the sun with little food and or water with barely enough clothing to cover their back. They need to get support as soon as they arrive. The health agencies are trying to keep up but the malnutrition rates are still high. We need to help them settle in a more secure community environment where they are not exposed to sexual violence or banditry and close to essential services. However, we simply don’t have the people-power to reach all of them with the information they need to know to help them. In an effort to address this issue, CARE has set up temporary kiosks at strategic locations in the outskirts of camps where people can come and seek help and information. It also acts as a base from which our community development mobilisers move out on foot into the influx areas to talk with as many new arrivals as possible giving them basic information: where to get food and water and that both are provided for free, where to seek counseling services for those who are survivors of conflict and or violence etc.

What are you most worried about for the months to come?

At current rates of arrival we will still have significant challenges to meet the needs. We have new extension areas where people will relocate to, but if the influx continues, those will be full by the end of the year, so we will not have been able to decongest the current camps as hoped. We also don’t know where all of the refugees are going when they arrive here, some go into the camps so that the density increases, there’s encroachment around schools, youth play areas, community centers and so on. This puts an extra burden on the existing refugee communities. Another thing we are very worried about is the levels of malnutrition seen in the new arrivals. Food needs to have sufficient caloric value to reduce malnutrition rates, but this is also more expensive.

 How do you ensure that women are protected in the camps?

Just as in any city of this size around the world, we cannot fully ensure that women are protected in the camps. There are too little police officers per person and camp, protection remains a major challenge. Women generally don’t go out after dusk, but there is some community patrolling during day time. There are police stations in the camps. Imagine a city of 400,000 people without enough police. But previously settled refugees have been able to form community support networks and work well with the religious and community leaders. The most serious challenge we face now are the new arrivals. They are exhausted, uninformed about where to get help and an easy target for abuse and violence. CARE works directly with the communities and religious centers themselves to prevent violence through information sharing, educational sessions on conflict management, and to support existing community structures, neighbors watching out for each other. For example there are referral systems: if a woman feels threatened, she can come to a CARE office and seek refuge and may be brought to a safe house. We also have helpdesks in the police stations. But we want to extend our services, currently there is about 1 counselor for 30,000 refugees.

It is impressive to see our counselors in action. We have this one very confident young woman, Fardoza, and I recently accompanied her to one of the communities. She goes to one of the camp neighborhoods and sort of holds court, meeting with young men and women who have very set ideas about women’s place in society. And she challenges it in a very positive way and generates discussion. People can connect to her because she is their age, and since she is a Somali Kenyan, she speaks their language.

Do you lobby for the refugees to be granted citizenship or work permits in Kenya?

This is an issue for the Government of Kenya. Our focus is on providing services and working to reduce refugee vulnerability and to maintain their dignity as much as possible. The best case scenario, what we are all hoping for, is of course a return to peace in Somalia. But would all refugees go home then? There is now a second generation born in the camps who have been educated with Kenyan curriculum, and who have never been to their home country. But I still think that many of them would like to go home. And then they will have the unique chance to build their nation with the skills they have acquired here in the camp schools. We are now seeing the same in South Sudan: Refugees who were educated in Dadaab and Kakuma refugee camps as well have now returned home and are a vital part of nation building.

What other issues are important for you to communicate to everyone who is now interested in Dadaab?

I have been saddened by the voices from home who say things like charity begins at home, and that we shouldn’t be helping because there is so much corruption, or that we have already given too much. Every person in the camps of Dadaab is a refugee. But let’s not forget that people don’t want to be here, they want their freedom to move like anyone else, to be free to access higher education, better business opportunities. Even though there is no fence around the camps, they are legally not allowed to work in Kenya and are restricted to the regions of the camps. And what is most heartbreaking is the daily struggle for dignity. Put yourself in their shoes and imagine having to line up for food twice a month, for 20 years now. These are highly proud people, and a man in this culture who cannot provide for his family – well, that is just very hard for everyone. A couple of weeks ago I was introduced to a refugee who was previously a full time employee for CARE in Somalia and now cannot work legally here in Kenya. Though we cannot give them legal jobs, every agency employs workers from among the refugee committee to help with distributions, translations, housekeeping of the compounds etc. They receive a salary and can thus support their families. But like I said, it is not a regular job. He would be very well qualified to be a part of our operation, with all his skills and knowledge of CARE. But all we can do is employ him as an incentive worker. That is one of the many limits they are constantly facing in Dadaab.

Early morning in Dadaab, a nice breeze announces a day that will most likely not be too hot. Outside of the CARE canteen, people are scattered at tables under trees, taking their breakfast. CARE’s 270 members of staff live and work in so-called compounds, one in each of the three refugee camps of Dadaab, one in the main part of town, attached to the compounds of UN agencies and other aid organizations.

I sit down with a group of four colleagues who are having what seems to be a lively discussion in Swahili. As much as we speak the same “language” as part of the CARE family, I sometimes wish for a button I could push to be able to speak the local languages of the countries I am deployed to. But there’s no button, so I just watch and listen before they change into English. As a newcomer, it’s hard to figure out who does what here, with so much buzz and activity everywhere. So I start asking around what their jobs are.

“I work in maintenance of our vehicles, making sure that they function properly”, tells me one the guys. “I’m part of the WASH team”, says another. WASH is one of our most common acronyms and everyone who uses it tends to forget that the outside world needs interpretation for it. WASH sums up all activities in Water, Sanitation and Hygiene promotion, one of the most crucial programs in any emergency to prevent disease outbreaks and ensure that people have sufficient potable water to survive. “We get called when there are problems with the boreholes, pipelines or water stations”, he adds. So is he going out to one of the camps today? “That depends, I am basically on call for any emergency. Otherwise I stay in the office and catch up on paperwork.” Paperwork in a refugee camp? Yes, sure. Quality management, accountability and proper information management are crucial for any successful operation, even more so in the fast-paced environment of a humanitarian crisis. If we don’t document what we are doing and how things are working out, we cannot communicate our needs and plan for the upcoming months. Moving on to the third person at the table: “I work in construction.” Constructing what? “Anything that is needed, whether that be new rooms or sanitation facilities in our compounds, or services for the refugees in the camps. We just rehabilitated some classrooms in a school.”

This conversation gets me thinking as I wander off to the office: There are two faces to the humanitarian work CARE is doing: One face consists of the men and women who appear in the photos and TV images, those who get interviewed by newspapers and radio stations: doctors treating patients, staff distributing food to refugees, and of course the spokespeople of our organizations. But behind the scenes, there is a whole army of workers managing the operation every day. They work from early morning till late at night, lacking private life and comfort, missing their friends and families. Journalists often ask whether we employ Western volunteers who have given up their life of comfort to help people in need. As honorable as this is, humanitarian assistance demands expertise, local knowledge and a long-term presence. All over the world, CARE’s staff is over 95 percent local, speaking the language, understanding the social dynamics, and committing to these difficult working conditions for longer periods of time.

When I leave Dadaab, my colleagues will still be here. And when the cameras leave and the public eye wanders off to the next crisis, they will continue to do their jobs to provide water, food and social assistance to the more than 400,000 refugees here. And I hope they will have many more laughs in Swahili at the breakfast table to start their day with a smile.

The realities of a refugee camp are hard to explain to the outside world. Many people think of Dadaab as a fenced-in area, overcrowded with tents, and people lining up for assistance. Some of this is true, to a certain extent. But Dadaab has grown for over 20 years now, and developed into an almost urban settlement of huge dimensions. There are actually three refugee camps in Dadaab, Dagahaley, Ifo 1 and Haghadera. And we spend about 10 to 20 minutes in the car getting from one camp to another. There are no fences around the camps, so people are generally free to go from one place to the next and into the town of Dadaab. But with long distances to walk in the sand under the blazing sun and no legal rights to actually leave the camps and settle outside, freedom is not the right term to use. Tents can be seen everywhere, but many new arrivals in the outskirts have simply put up wooden sticks and cover the structure with tarps, for now. Those who have been here for decades, who have raised their children here, have grown old in Dadaab and still see no way to return, those families have built more solid houses, constructed of bricks or mud, fenced and well-maintained. When I enter one of those homes, it reminds me of other places I have visited in some countries in Africa. Clothes hang up to dry, children play around in the court, the elders sit together in the shade of a tree.

But whether settled or just arrived, all 400,000 refugees in Dadaab depend on assistance to meet their basic needs. They cannot legally work or leave the camps, and the sandy soil and lack of water make it difficult to plant vegetables or other staples. This is where CARE, the UN Refugee Agency UNHCR, the World Food Program WFP and others come in: Many of us have been here from the start and it is encouraging to see the level of cooperation. I think of critical media coverage about how aid agencies compete for funding and don’t coordinate their work that usually comes up with any emergency. But everyone who has been to Dadaab quickly understands that our humanitarian mandate is a much stronger bond than any talk of money, influence or popularity. Over 400,000 refugees are in need of assistance, there is enough to do for all of us. CARE manages two cycles of food distribution per month and hands out food and relief items to new arrivals; our engineers maintain and extend the water supply systems; counselors and social workers help the most vulnerable, mainly women and children suffering from violence and exhaustion; teachers are trained and schools set up.
Currently everyone here is worried about the bad state of newly arrived families. Exhausted, malnourished, traumatized: When I look into the faces of women, children and men in the reception areas, I can only begin to imagine what they have been through. With the increasing stream of refugees arriving, there is a backlog of around 35,000 people who have not yet been registered. CARE distributes food and other relief items to them, but they cannot settle permanently yet. Much of the first help is information: Many newcomers simply don’t know that the food and water is free, where the next clinic is, some don’t even know where exactly they are.

It’s also hard to describe to the outside world how aid workers cope with the suffering and misery they are confronted with every day. Over the years, I have had many discussions with colleagues, and although it is a very personal affair, I feel like we have a common understanding: Most of the time, you cannot look beyond the crowd to acknowledge the individuals, your work needs to be about quantity: Handing out food to as many people as possible as quickly as we can. Disseminating information about counseling services and support for women victims of gender based violence to a whole area as fast as possible. Hurrying to a bursting pipe to get the water supply going again.

But this line of work would not be called humanitarianism if you would not care deeply for every single person. And every now and then, you cannot blend out one of the faces in the crowd. At the reception center of Dagahaley, I catch the eye of a young father; he sits at the reception area with his three kids, his wife next to him. It is impossible to explain how and why this connection happens, but his smile is so inviting and their relief of arriving here safely, their family intact, is almost palpable. We exchange smiles, I ask for a photo. Then I just sit next to the reception table and watch them for some time. Then something else comes up, I leave. When I turn around again, the family has gone. Back to be a part of the crowd. But I know that they now have food to last them for 21 days, water, and have met people who can assist them with their needs. And that must be enough, for now.

I have just visited Balich Village in Garissa district, North Eastern Province of Kenya. Inhabitants of Balich belong to the Somali-Bantu community, an ethnic minority which is highly marginalized. The region is experiencing a severe drought, as many other areas in the Horn of Africa currently. According to some estimates, 2.4 million people are affected in the North Eastern Province, where Garissa district is located – this is more than 50 percent of the province’s population. But amidst the drought, there is a glimmer of hope, because in Balich villagers were prepared for the drought. They are able to plant and harvest food and animal feed as they have a functioning irrigation system. But let’s start from the beginning:

Some areas of the North East Province are difficult to reach because very bad roads and long distances of up to 1,000 kilometres, and in those far away places, children, pregnant women and lactating mothers and elderly people are mostly affected. I heard of some men who had to migrate in search of pasture for their livestock or for work in the towns. Women and children staying behind depend on assistance from relatives, the Kenyan government and humanitarian organizations.

As the drought goes on water pumps cannot keep up with the demand. People use it during the day, animals at night. People rely on mechanised pumped water more than ever, and because of the over-usage the pumps often break down. Ground water levels are dropping, and some areas that were once sustained by pumped water now have to be served by expensive water trucking, which can only be a short-term solution. In some villages, pastoralists had to wait for three days to get water for their animals. Some had to walk for 30-40 kilometres to reach water points. Many of their livestock died while looking for water – and that means their source of income has perished. Garissa is mostly a pastoralist area; animals mean everything. One colleague said to me: "Animals are meat, milk, and cash. If they are gone, everything is gone”. Prices of livestock have decreased and often pastoralists have to sell their animals for very unfavourable prices. Once they make it to the market they have to sell their animals at any price offered because they do not have the means to transport them back home. Livestock might even die on the way back, because they are too emaciated. Approximately half a million people and 90 percent of all cattle already migrated out of some areas in search of water, pasture and food. And naturally, these movements cause conflicts.

Resilience is key

However, Balich village showed me a picture of strength and perspective. CARE’s long-term support in Balich has helped people to resist the impacts of the drought and to prepare for times of hardship. CARE assisted the community to plant animal feed and crops by erecting water pumps and canals for better irrigation. Before, fetching water was a dangerous job: “My children are safe now when they get water. Before, they were threatened by crocodiles living in the nearby Tana river”, on woman told me. The key is resilience: empowering vulnerable people to overcome drought without losing all assets. With access to credit facilities, market linkages and a sustainable livestock marketing model, people are able to generate an income and save assets.The CARE projects in Balich show how important Disaster Risk Reduction initiatives are. But it has a side effect: Pastoralists from nearby villages are now increasingly bringing their livestock to Balich, putting pressure on the valuable water sources.

My visit to Balich reiterated what we know in theory and what we need more in practice: emergency support and long-term development initiatives that focus on creating resilience need to go hand in hand. This is the only way to break the hunger-cycle in chronic emergencies. However, funding for emergency is often easier accessible than funding for disaster risk reduction. I hope that the example of Balich shows how much we have achieved and how much money we can actually save when we invest in preparedness.

“It is unfortunate that the rains have decided to not fall for the last two years.” The Kenyan man sitting next to me on the plane to Nairobi has a very poetic choice of language, which makes for a rather stark contrast when you consider what he refers to: His country and the whole region are in the middle of a humanitarian crisis triggered by a severe drought, which is affecting almost 11 million people. And yes, some parts of this region have not seen rainfall in two years. My neighbor continues: “It is all about water. If you don’t have water, you cannot raise animals. And without animals… well, that is their life insurance.”

Touching down in Dadaab the next morning, I remember that friendly voice. The refugee camp in the North of Kenya is now home to more than 400,000 mostly Somali refugees. Their numbers have risen immensely in the last weeks, due to the ongoing drought and insecurity in their own country. The landscape is dry and plain up here, and one wonders how any group of people, let alone such a high number of refugees, can survive in these difficult circumstances.

This is my first time to Dadaab, but weirdly enough, everything seemed very familiar. Maybe that’s a CARE thing: The refugee assistance program for Dadaab is one of our longest humanitarian missions, many colleagues have worked here at one time or another. And for years, we have continuously talked about it to the public, launched appeals and tried to get journalists interested. But now, with an average of more than 1,000 new arrivals every day and extremely high numbers of malnutrition, Dadaab has become something like the epicenter of the current humanitarian crisis in the horn of Africa.

But a walk through Dagahaley, one of the three camps, also shows the impressive efforts by all the agencies on the ground to provide basic services to all these people. We pass by the reception area where CARE distributes food and other relief items to new arrivals, we see trucks delivering water, and visit the service tents – all of this I have heard about before, but it is still a whole different story to see the work with your own eyes and listen to the admirably energetic colleagues explaining their work.

And we meet Amina Akdi Hassa, who serves as chairlady for the camp Dagahaley. She has been living here for 20 years and is a leader and an advocate for her community. “I want the world to know that they should please share our problems with us”, she explains. “We have had five schools here since the 1990’s, but now there are so many more children.”

The people of Dadaab are talking. But is the world listening?

By Sandra Bulling

Green plots of land cover the lush mountains of East Haraghe in Ethiopia. Small brown huts dot the landscape, their owners busy working in the fields. Thick grey clouds hang above the peaks as high as 3,000 meters, seemingly bursting with rain any moment. On a first look, East Haraghe looks like postcard idyll, perfectly suited for agriculture that yields enough crops to sustain the farming families. On a second, the area is the scene of a severe drought. Malnutrition cases East and West Haraghe zones increased steeply in the past months. The reasons: insufficient rainy seasons, high food prices, chronic poverty and a weather phenomenon called La Nina.

The large majority of Ethiopian households, 87 percent, relies on agriculture as source of income and nutrition. A good rainy season brings relief, a failed one desperation. The past twelve months were determined by worry; the Meher rains that usually arrive from June to September in East Haraghe ceased prematurely last year. As a consequence, the complete harvest was lost. The following Belg rains which are scheduled by nature from March to May were delayed for about two months, insufficient in amount and erratic in distribution. For many farmers it was impossible to plant; and those who did are still waiting for their maize to ripen. One month ago, in June, farmer would have normally started to harvest. But instead, people have no food left in their homes. Scientists credit the insufficient rains to La Nina, a weather phenomenon that changes weather patterns and causes drier conditions in East Africa.

Maize porridge, twice a day

Kado Kaso came with her son Sabona to a government run health center in Kurf Chele district. “My son was vomiting, he had diarrhea and could not hold any of the food I fed him”, she says. Sabona was diagnosed as severely malnourished. The three year old has lost his appetite. His feet, legs and eye lids are swollen – characteristic signs of edema, a medical complication of severe malnutrition. He stares into the room, there is no energy left in the little body to play or move around. Sabona arrived one day ago and the therapeutic food provided by CARE has not regained his energy yet.

When the Belg rains began this spring, Kado started to plant barley and beans on her small land. But the rains stopped earlier and all her crops withered. “We have barely anything to eat. During normal years, we eat three meals a day. Now we are lucky if we eat twice a day,” the 30 years old mother says. She takes Sabona into her arms. “We only eat maize porridge, I cannot afford anything else.”

On the bed next to Kado sits Abdi Mahommed with his five year old daughter Milkiya. She has been here for one week, has recovered her strength and appetite. Both father and daughter will leave the center the next day. They will continue receiving weekly rations of therapeutic food, to ensure Milkiya’s condition stays stable. But Abdi has sold his ox to buy food for his family of eight. “I don’t know how to plant for the next season, I have no ox and no seeds,” he says. He is glad his daughter has regained her appetite and started playing again. “All that matters is saving my daughter’s life.”

Searching for labor

Kado’s husband has moved to the nearest town in search of work. But he is not alone. Fathers stream into the towns offering their labor – and salaries have dropped by 50 percent. “My husband now earns 10 Birr a day, in normal years he can earn 20 Birr”, says Kado. Ten Birr are USD 0.60; and that is how much a kilo of maize costs. A price, that has risen significantly over the past months. “My husband comes back every four days, giving me money to buy food. My four children and I are dependent on him, we have no other income.” She now stays with Sabona in the health center, until the little boy can eat again and reaches a stable condition.

Kado’s other children are at home, alone. Neighbors look after them, but they have no meals to share either. And the health center has run out of resources to hand out food to mothers like Kado coming to stay with their children. “CARE is now starting to provide food for the mothers in the health centers. Because if they don’t get anything to eat, they might be forced to leave or refrain from coming here with their malnourished children,” says Jundi Ahmed, CARE Ethiopia’s Emergency Nutrition Advisor.

A malnourished generation

Today, almost every tenth pregnant woman or lactating mother in East Haraghe is malnourished due to the insufficient rainy seasons. However, malnutrition is a chronic condition for many Ethiopians. Even during years with normal rainfall, the small plots owned by households in East Haraghe do not yield enough to cater for balanced and sufficient meals. Malnourishment during pregnancy determines the entire life of a child. Sons and daughters, who do not receive sufficient nutrition in the first five years of their life will not fully develop their mental and physical capabilities. “It is a chronic hunger cycle that can last for generations. Malnourished mothers give birth to malnourished children and have no means to feed them with most needed vitamins, iodine and iron. Children are smaller in height than well-fed children their age, they are stunted. And it is very likely that they will also have malnourished children,” says Jundi Ahmed.

CARE started food distributions to reach 66,000 people in the zones of East and West Haraghe and Afar. Kado’s family and others in her district receive monthly rations of sorghum, vegetable oil, supplementary food such as corn-soy-blend and beans whereas pregnant mothers and lactating women get special supplementary food. But CARE also has long term development programs in the area, supporting families to overcome poverty and hunger. Through Village Savings and Loan Associations, for example, women can contract small loans to open shops and small businesses. With an additional income families can save assets that protect them in times of drought.

Drought comes in different shapes in Ethiopia. But whether in the dry areas of Borena in southern Ethiopia or the lush green mountains of East Haraghe – the pain and consequences of drought and hunger are the same throughout.

Muna* is the envy of her friends in Dagahaley camp. She is also a newly arrived refugee, in fact just nine days in the camp, but unlike her friends who have to live in the outskirts, she has what seems like the comfort of a room within the camp. As soon as she arrived, she managed to trace some of her clan members, who let her use the room in their homestead. Muna is 40 years old, and arrived in Dadaab with her seven children.

Her story, however, is nothing to envy.

She left her husband behind because bus fare for all of them was too expensive. They had to pay Ksh 15, 000 each for the journey on a bus, so he let them go ahead, remaining behind to raise more money for his own trip. “I will join you soon,” he said as he waved them goodbye.

Muna’s journey from Somalia took her 18 long days, having to feed her children wild fruits and look out for wild animals and hyenas. Her children are all safe, and they did not come across any wild animals on the way. However, what her friends would not envy about her is that she was raped on her way to Dadaab. It was midway through their journey, bandits (shiftas) stopped their bus and ordered all the women to step out. “We were eight women on total, so they separated the older women from the younger ones, and told them to get back into the bus. The five of us stayed behind, with our children, and the bus driver was ordered to drive off and leave us behind. That is when they raped us,” she said.

They were in the middle of nowhere, with their children, and strange armed men. The children were pushed away behind some bushes and instructed to be quiet by one of the men, as the others went back to the women and raped them. Some of the other women were gang raped.

Although it was in broad daylight, no other vehicle passed by, and even though they all screamed for help and their children were crying in fear, nobody came to help them. “Afterwards they told us to take our children and keep walking,” Muna and the other women ended up walking 17 kilometres before coming to Dif, where they told some village elders what had happened to them, and they raised some money so the women could go on their journey.

Muna and the other ladies finally came to Dadaab, and she is happy to stay away from her fellow newly arrived refugees, in some private space with her children, among her larger clam. She has gone through reception, and her registration date is set for November 11th. “I am glad we arrived here, and all my children are ok. We finally got some food and water and I have a tent. There are so many people here, even those who came with us, but it is still like we are alone, because my husband is not here.”

The most dangerous period for refugees is when they are on the move. Women and girls are especially vulnerable to rape, abduction, illness and even death on the journey. Many women set out on the journey alone with their children, leaving husbands behind and they may walk for weeks in search of safety.

According to UNHCR reports, the numbers of sexual and gender-based violence cases have quadrupled in the last six months in Dadaab: 358 incidents reported from January until June 2011, in comparison with 75 during the same period in 2010.

CARE has set-up a screening tent at reception centers in Ifo and Dagahaley camps in Dadaab to help identify survivors of sexual abuse or other violence on their journey. In the first six months of this year, since the refugee influx began, 136 cases have been documented, compared to 66 in the same period in 2010. Upon identification, counseling and referred emergency medical attention is administered.

“The deep psychological affects that drought, conflict and subsequent movement can have on woman refugees is immense. We have witnessed high levels of anxiety, panic and trauma due to loss of family members along the way and women are sharing stories of rape, violence and hunger,” said Wilson Kisiero, CARE’s Gender and Community Development manager in Dadaab. “CARE is providing immediate psychological support to the newly arrived women and girl refugees and we are doing all we can to ensure follow-up visits.”

Muna was referred to the MSF clinic by the CARE staff that interviewed her, but she has not gone to the clinic yet, she is afraid she may be pregnant from the ordeal, or she may have a disease. She said she would wait a few more days and then go, but not just yet.

*Not her real named

In Hagadera camp, Fatumo Osman Abdi, 50 has just settled into her tent. She is weary from the journey of 20 days from Somalia. She came with her three grandchildren (aged 13, 5 and 4), her son and pregnant daughter-in-law. Back in Somalia they were farmers, in a place called Kurdun where they grew food for her family. The lack of food became a bigger and bigger problem with time, until they decided to leave.

“Every night as we traveled here, we slept out in the open land, under the stars. We were very afraid, we did not know what was out there, or if there were people coming. We had heard many stories of man-eating lions so we could not even sleep,” she said.

The journey was a difficult one, but Fatumo is thankful that they did not meet any robbers. On their way to Dadaab, they were given food by Muslims on the way, just well wishers who decided to lend a helping hand.

“We arrived here so hungry, so tired. My grandchildren were so tired, I was afraid they would die on the way. Even my daughter-in-law. We slept out in the open for many days, we were under the stars again, but we were safe. After so many days I finally have my tent,” she said.

Seventy year old Habibi* came to Kenya as one of 72 people who traveled together from Somalia. That was almost her entire village, she says, and was made up of her family and friends. Her son had heard of Dadaab and told them about it years ago, he had said that they could run to it because of the fighting. Habibi’s husband had declined, opting to stay in Somalia longer.

Back home they were farmers and pastoralists, growing sorghum, and keeping cows, goats and sheep. They left Somalia because of drought, came here with her friends and neighbours, children and grandchildren. She describes the journey to Dadaab as the ‘worst thing she has ever experienced’.

“We were attacked by strange men, they looted all our belongings, women were raped and men were beaten, but we thank God nobody died,”. Habibi was also raped, and manages to talk about it openly, her anger and confusion still evident. “Our husbands and sons were all there to see it happen to us, it was very bad!”

She is still in the influx area of Dagahaley camp, with only 16 other friends and relatives. The others settled in another camp, Hagadera. One of her relatives gave up his tent for her so she could have shelter with her four grandchildren. All they had to eat on the way was maize, and more maize as they traveled the long journey to Dadaab.

“I do not want to go back to Somalia, all our problems are still there! I am here with nothing, but I would rather stay here. Life here is hard, the food they give us is little because now we have to wait for registration, but I would rather stay here than go back,” she said.

*Not her real name.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dama Godana	Darara Women	Darara Hay pens	Darara Pressing Hay

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

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

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

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

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

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

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

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

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

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

A whole day to fetch water

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

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

One meal per day

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

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

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

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

By Audrée Montpetit, CARE Senior Humanitarian Program Quality Advisor

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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''
• Donate now: Make a difference for children, families and communities around the world

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
  

CARE distributes hot meals twice a day in three evacuation centers in Yamada, northern Japan. Photo CARE Japan

By Futaba Kaiharazuka, (Assistant Program Director, Emergency Response, CARE Japan)

In one of the evacuation centers where CARE Japan is providing hot meals, there is a man with perfectly groomed hair who wears a certain jacket. The man is in his late 60s or early 70s and always joins in the aid work at the center, volunteering to help with the heavy lifting. He is one of those people who is always courteous and never stops smiling.

One member of the CARE team had the chance to chat with him a few days ago during the food distribution. His house, like many of the disaster victims, and all his household possessions were washed away. When the tsunami struck he was wearing the same jacket he now wears all the time. He explained that he wears the jacket not because he cannot change his clothes; the evacuation center has received many relief items including clothing and underwear, rather, he wears it because out of all his personal possessions, his jacket is the only item that survived the tsunami. “Everything I had was washed away, but I am a fighter”, he said with his usual smile whilst chatting to the kitchen staff. There is a mountain of relief goods such as clothes and new items that have been delivered, but despite this, he feels wearing his own jacket gives him the strength and courage to go on.

In the midst of such great post-disaster disorder, CARE sees countless examples of people helping each other through the chaos, despite the severity of their own circumstances. The old man’s story shows the strength and courage of these people who are determined to pick themselves up again.

Otsuki town hall(total 18staffs including the mayer have been died by the Tsunami. Photo: CARE/Yoshio Kondo

By Yuko Ota, (Assistant Program Officer, Emergency Response, CARE Japan)

The CARE Japan team visited a family of 11 members including a grandfather, his daughter and her husband (in their 50s), a grandchild, two great-granddaughters (eight and two years old) as well as five relatives who had lost their house. The lived in Kirikiri district in the city of Otsuchi in Iwate Prefecture, one of the regions that was most destroyed by a massive tsunami on March 11. The sun was setting as the CARE team arrived so there was a chill in the air – but this area hasn't yet had the water or gas supply restored so the family could not use the heater in the living room. The temperature indoors was almost the same as outside.

We talked to the mother and she told us that electricity has still not been restored. ''A few days ago our neighbors let us share some of their power supply. For the first time in one month we saw the extent of the damage on TV'', she said. ''Until then we had no information at all, and since seeing the vast scale of destruction in Tohoku on TV, I cry everyday.'' She described witnessing the sheer might of the tsunami approaching: ''I thought tsunamis were noisy splashing waves. But the tsunami last month crept in silently and in an instant swept away houses and everything else in its path.''

When the earthquake struck, her grandmother was on her way to collect the great-grandchild from Kirikiri elementary school. ''She was swept away by the tsunami, was missing, and then nine days later her body was found'', described the mother through her tears. They finally found a crematorium and were told that usually bodies would be cremated within three days of being found, but there were so many bodies in that area that a regional mass funeral is scheduled to be held at a temple on 29th April.

The mother continued explaining how the first three nights after the tsunami the family of six slept in their car in case they had to suddenly escape. ''We are still so worried that there might be another earthquake in the night, so we slept fully clothed in case we have to flee.''

The only granddaughter is heavily pregnant. ''As she is in her final month of pregnancy, she should be growing bigger, but she hasn't really grown. I wish she could have bath in clean water, but there is still no water supply'', the mother described, looking very worried. The Japanese military set up simple bathing facilities in the Kirikiri elementary school nearby, but it is very exhausting for the granddaughter to go there.

The mother runs a barber shop next door, but as there is no water, gas or reliable electricity supply, she doesn't know when she will be able to reopen. ''We have no daily income. I am very unsure of our future. But we are the lucky ones. Many neighbors have lost family members, their houses and their possessions. The town mayor also died so we will have to join hands and work together and restore the town.''

It has now been one month since the disaster struck. The disaster victims, despite experiencing great hardship, are determined to encourage and help each other to grow stronger and step by step restore their lives. In order to support the strength of the local people, CARE assessed the situation in the disaster zone so we can provide the people with the aid they really need. We provide food to evacuees in three centers – 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.

By Robert Laprade
CARE Emergency Team in Japan
April 6, 2011

Robert Laprade, CARE Emergency Team Leader in northern Japan. Photo: CARE

These are my last days in Japan. I am back in Tokyo now and will leave the country on Friday. It has been almost four weeks since the tsunami hit the coast of northern Japan; in many areas it was more than 30 meters high. There are still so many humanitarian needs. Even though infrastructure is getting repaired by the government, with roads being cleared, ports functioning again, and the lights coming back on, it is apparent even to those unfamiliar with emergency work that it will take five to ten years to rebuild the area--at least. Survivors living in evacuation centers or with host families face huge challenges. They will not be going back home anytime soon as many of their houses are now nothing more than a foundation. Others’ homes are partially damaged with windows and doors torn off, filled with a meter of a mixture of mud and miscellaneous, smashed rubbish. The initial shock of the disaster has receded – now it is dawning on many people just how bad their situation really is. They realize that they will not be able to live in their homes soon, if ever, again. It’s a huge challenge for the government. In the first weeks, the focus has rightly been on searching for survivors and remains of victims, putting a roof over the affected people as quickly as possible, and getting basic infrastructure back up and running. Now the government needs to determine how to house people for a longer period before permanent housing can be built. In the fishing towns of Yamada and Otsuchi and many others, most buildings are destroyed—only the wood, metal siding, beams, and contents remain, strewn across the hideous landscape kilometers from where they once stood as offices, houses, and schools. Much of the coastline where the tsunami hit is mountainous. The only flat area is the land lining the coves and inlets wiped almost clean in the disaster. There is not much space to build temporary houses for all evacuees.

When I visited the evacuation centers I saw that many survivors had nothing to do. Many just sat there traumatized. Others conversed with friends and relatives. Being in close quarters—sleeping, eating, and talking to the same group of people in very cramped space—can be a stressful experience after some time. Many people are still clearly grieving as it is only now becoming clear that they will probably never see their missing loved ones again. In some of the centers, we have been looking at helping with recreational and cultural activities that can help reduce some of the stress and monotony, especially for elderly people who may have extra challenges of mobility. These need to be things that are culturally and socially familiar to them, and that they identify as giving comfort or providing a bit of fun.

The evacuation centers in Yamada where CARE provides hot meals two times a day are located in a school compound. But the school year starts in the next few weeks. That’s another challenge. We have already been told that we need to remove our kitchen and storehouse as they were located in the classrooms. Evacuation center residents are sleeping in the gym and will not be forced to leave. My Japanese CARE colleagues now have to identify new places to store food and supplies and a place to cook. But that’s the nature of humanitarian operations. It is our duty to act in the best interest of those affected. In this case, we want the kids to go back to school, the people who don’t have a home to have a place to live, and to ensure that we can still serve nutritious food for the residents. We need to be flexible in a dynamic environment, finding ways to bring help to survivors and meet the many different needs they have.

The past weeks in Japan have shown me how fragile life is. Whether we live in developed or developing countries, whether in cities or villages, we can never be too secure. I also think we should respond to the humanitarian needs of survivors, no matter in which region of the world they live, even if they happen to come from a “rich” country. The tsunami in Japan also really underlines the importance of disaster risk reduction and early warning systems. Had those systems not been in place, clearly casualties would have been much higher. It was also great to see how people helped each other out in their time of greatest need. The Japanese people have all pulled together, everyone doing their own part to in some way show their support for the victims and survivors. There were numerous donations and offers to host homeless survivors. Inhabitants of Tokyo try to save energy whenever they can. The hotel where I am staying in Tokyo turns out the lights in the lobby when breakfast is over. All the glitter and glamour that you visualize when you think of Japan is toned down. Excessive celebrations during this important time of traditional cherry blossom festivals are even frowned upon. The CARE team in Tokyo is still working long hours, until 10 p.m. every day. Everyone seems content making sacrifices, knowing that in some small way they are paying their respects to the inhabitants of the ravaged Northeast coast and making a difference in the lives of survivors.

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.

After we had an early morning planning session over Japanese breakfast, we drove to the coast of Iwate prefecture. We came to a small city called Miyako, and while we were driving around the corner of what seemed like a normal street, all of sudden we arrived in hell. Before us lay total destruction. Cars were upside down, metal parts were scattered everywhere. The bizarre thing was that we looked on one side of the road and there was a supermarket, perfectly standing without a scratch. On the other side of the road, it was total destruction. But it got worse. We drove into Yamada town and there almost the entire downtown area was wiped out. Yamada is a fishing town, and some people farmed oysters and seaweed.Amongst the rubble and mud, fishing gear, nets and floats were strung everywhere. What was once the professional equipment of fishermen now lay like garland on a Christmas tree, but the ‘trees’ were mangled pieces of houses. Heaps of furniture and personal belongings and just about anything one could imagine stuck out of the mass of muck. The area of destruction was three to four square kilometres; we could not see the end of it. I was amazed how quickly the Japanese government has cleared the main roads. We drove through Yamada on perfectly clean, paved roads, but rubble and debris were piled up to ten metres on both sides.

While working our way through the maze of roads, I noticed through gaps in the debris that all houses built higher than 20 metres above sea level stood untouched by the wave. The city hall stood on a small hill and it survived without a scratch. However, right in front a field of cars, house parts, and machinery were burnt almost beyond recognition – black, burnt heaps of debris. I remember the pictures on television when the tsunami came in with rafts of burning rubbish; this now was how it looked after the water receded. Much of it reminded me of the post-apocalyptic world described in the novel The Road.

We entered the city hall looking for officials to whom we could explain our work and get permission to start looking for a base for operations. On the ground floor of the city hall, we sighted a billboard where people left notes for their lost loved ones in case they miraculously showed up looking for them. In another room, the search teams had placed wet and ragged photo albums they had found in the rubble. For some people, these memories are all they have left. We found the mayor on the second floor; he was a very friendly man who told us with a big hospitable smile that he lost his home. However, this was not the first time he experienced a large tsunami. In the 1960s, an earthquake in Chile triggered a series of waves which also smashed the coast of Yamada. He told us that Yamada has 21,000 inhabitants and that around 7,000 people are displaced living in about 30 shelters in schools, temples, and community centres. Around 1,500 families still live in their houses but cannot get out due to lack of gasoline or roads blocked by trash left by the tsunami. Currently there is no functioning grocery store anywhere to be found in Yamada itself so walking for food is not an option.

After meeting the mayor we went to an elementary school. Around 100 people were sheltered there. They told us that in the evenings inhabitants of the surrounding villages come by and the evacuees share their meals with them because they have no means to go and buy food. In one of the rooms used clothing lay on the floor and was being sorted. These were certainly donations, waiting to be distributed. However, we also heard that the food arriving at the shelter is not enough and often a meal of just rice. We talked to a group of women, all of them sitting on their mattresses. One woman told me that she and her family survived the tsunami but her home is completely gone. All her neighbours are dead. She was around 60 years old and the youngest of the group. She said they are all fishermen here but now have lost their boats, their nets and their income. She also did not know whether her insurance will cover her losses, since all her papers were washed away. “Our lives have fallen apart”.

When we drove to another evacuation centre, it started snowing again. Giant white snow flakes fell down. It is still freezing here. In this high school, 800 people have sought shelter. In the gym, mattress lay next to mattress. This place was really crowded. Although orderly, it did not look very comfortable. There was a stage which was now the office of the centre. We passed by the kitchen where three shifts of evacuees cooked whatever was delivered by the local government from donations from around Japan. Army trucks arrived and helped in delivering relief items; we were told the troops also regularly cooked rice for the evacuees.

Tomorrow we plan to go further north but tonight I will focus on putting together a strategic plan for a CARE emergency response while my colleagues Alain and Futaba will begin to write an operational plan to scale up our assistance. We need to locate key relief items and how to get them to the people who need them the most. We are looking at beginning a program to ensure that the nutritional value of meals prepared for evacuees is improved through the introduction of vegetables and fish or meat. Authorities have been overwhelmed in the search for survivors, getting roads cleared, and looking for missing people and just haven’t had the time. Japanese people are used to having good hot food for every meal just as we are at home, so it’s quite a hardship when they’ve lost loved ones, are suffering through incredible trauma, and can’t even get a decent meal. Many evacuees are elderly or children and good nutrition is especially important to keeping up their health in crowded, cold conditions.

By Robert Laprade
CARE Emergency Team in Japan
March 23, 2011

“Today we have arrived in Northern Japan. We flew from Tokyo, Japan’s capital city, to Aomori and then drove down to the city of Morioka in the Iwate prefecture. It is freezing here, like a blizzard. There is one meter of snow and it is really, really cold. My Canadian colleague Alain said to me:” I feel like we are in Canada!” We have heard that there are Japanese who have lost their homes but who have not sought shelter in the collective centres. I don’t want to imagine how it must be for those who live in their destroyed houses, without windows, without any electricity, without heating. At the moment, the elements are clearly not in favour for Japan.

Morioka looks like a normal modern city in a rich developed country. It is unbelievable that just a few kilometres from here such massive destruction from the earthquake and the tsunami took place almost two weeks ago. After we have arrived we went to the Disaster Prevention Centre. People were buzzing around, doing all kinds of coordination, managing the emergency response. It looked like a command centre, and we also saw many Japanese military walking through the halls. Search and rescue teams were there; one person was wearing a T-Shirt that read “Christchurch New Zealand”. He must have come straight from New Zealand, where another earthquake struck the country just a few weeks ago.

At the Disaster Prevention Centre we met with local authorities and got a voucher for fuel. Getting fuel is still an enormous challenge. On the way, we passed by a line at the gas station that stretched for many kilometres. It went over a bridge and up a hill and it was so long, we could not even see the end of it. Since CARE is involved in the emergency response, we were entitled to receive one tank of fuel and whenever we need more, we have to go back to the centre, which is open for 24 hours every day. I sincerely hope that the fuel will last long enough to bring us to the coast and back tomorrow!

After receiving our fuel, we went to the Volunteer Coordination Centre and talked to the staff for quite a while. It was our aim to get a sense of the challenges for the emergency response and to find out how CARE can fill the gaps. In coordinating with other organizations and the local authorities we will ensure not to duplicate any efforts and only assist in those areas where the Japanese emergency response is stretched and simply needs our help. We learned that many areas are indeed now accessible. But we also learned that some local authorities are wiped out, they basically don’t exist any longer. And even though Japan has great emergency response measures in place a disaster like this would overwhelm any government. This is a very tough situation.

In the same building where the volunteer centre is located a couple of hundred survivors of the disaster have found shelters. I just peeked into the room but saw people sleeping on thin mattresses placed on the floor. In the lobby, some kids were playing soccer. We heard people in some centres may not be receiving adequate hot meals, or nutritious meals. Tomorrow, we will visit some more of these collective centres in Yamada and Otsuchi, two affected cities along the coast. There we will find out what people need and how CARE can help the Japanese emergency effort to ensure that no survivor is left out.”

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.

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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.

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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.

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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.

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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 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 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!" They point to a village, less than 200 meters away. It is completely flooded – all we see are roofs. We know that these people will not be able to return to their village as long as the rains continue and the stagnant water refuses to recede.

We are relieved to hear that the villagers are receiving food. When we ask from whom, and they reply, "People from Moltan are coming every day to deliver food.” The people from Molten are strangers, but the villagers know they can rely on them.

Today, as the holy fasting month of Ramadan has now started, the strangers arrive in the evening after sunset. Tomorrow, Pakistan celebrates its independence from the British empire. People help people in Pakistan. This is the true Pakistan I know and appreciate.

By the way, Zahid, the sick little boy I met in Charsadda, is back home and playing again! My colleague, Mujahid, just sent me an e-mail to let me know.

Another question often asked by journalists comes to mind: “Does the help reach people?” Yes, it does.

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

by Thomas Schwarz, CARE Media Specialist in Pakistan
August 10, 2010

When we started out early this morning from Islamabad, I didn't exactly know what would be awaiting me in the region of Mardan. I had seen many reports on TV, read the papers, listened to the radio and spoken with my CARE colleagues. The whole weekend, I spent meeting with United Nations representatives as well as other international humanitarian organizations.

We drove the motorway No. 1, direction northwest. This highway is cut into three pieces, almost through half of the whole country, from Lahore in the South to Karachi in the northwest. On both sides there are fields and women and men alike are working them. Everything seems to be okay at first – at least it looks like it's okay. No flooding, no water, not even rain.

Then, after about 50 kilometers, we saw the Indus River. Aggressive, powerful, and threatening. It has doubled in size. We cross it, over a long bridge, and all of a sudden it disappeared, as if it were trying to hide from us, in the fog. But there it is, the monster that has claimed lives and stolen everything from millions of flood victims. And, as always, it was taken from the poorest and most vulnerable.

The water has stolen everything

After the bridge and the fog, maybe 60 to 70 kilometers later, we see tents, again and again. They stood in fields, along the highway. People put them anywhere they found a space without water. There they live now, those who have lost their homes and almost lost their lives. After another 30 kilometers, we arrive in a town where 26,000 people live in normal times.

There, we meet Nambarj. She's 65 years old and a widow. "See here, this house. It disappeared," she says. "It is simply not there anymore."

When the flood came, the water jumped more than two meters above the wall of the courtyard. What is left? "Look there," she says. She shows the old kitchen, where she used to have all her kitchen utensils. "There, this is everything I have now. Two small machines. Everything else, the water has stolen from me."

CARE has provided her with a tent. We promise to bring the woman kitchen utensils within a few days. When one has lost everything, even small things can make a really big difference.

Terrible pictures, unbelievable poverty

In this area, CARE is cooperating with local partners. Imran Inan of the Community Research and Development Organisation, or CRDO, is a person who deserves my deepest respect. The way he accompanies me and translates impresses me. He has a word for each and every remark of the survivors. His patience and humble work is really something I admire. CRDO is just one of several partner organizations of CARE in Pakistan.

I have an idea about poverty. I have seen it in many different countries; it is a reality. What I have seen now, though, leaves me stunned. Not only the situation of the widow, but also the one of the old man, who tells us simply: "I don't even have shoes anymore." He lives with his children and grandchildren in a tent next to his son's house, which is still standing. Imran is listening carefully. "He will get them tomorrow," he says. "We just received shoes. He will get them tomorrow. Promised."

The people in the northwestern part of Pakistan are poor, even poorer than many in other parts of Pakistan.

Is there a boy like Zahid in rich countries, too?

But it is the small boy laying on the wet, muddy floor of his family's small, simple house that shocks me. Zahid is only four years old. His coughing and a high fever has exhausted him so much that he is sleeping, his chest is slowly going up and down. It is 3:30 in the afternoon. The mother cries, when she sees not only me, but also the others coming to her house. It is empty aside from Zahid laying on the floor.

The mother does not have enough money for the transportation to the hospital or for the medication he urgently needs. Someone gives her some money for the transport. "Do you know, Thomas," my CARE colleague, Mujahid, says, "there are many cases like this one in this region. We will find a solution."

I find it profoundly shaming, how we – the rich countries – are coping with one of the biggest natural disasters in decades. At the same time I try not to become unjust. Also in our countries are poor people, of course. There is poverty, yes. But I wonder, if there is a boy like Zahid in the United Kingdom, the Netherlands, France or Germany. I am not sure.

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

by Thomas Schwarz, CARE media specialist in Pakistan
August 9, 2010

This week is a very special one in the flooded nation that is Pakistan. August 14 is the national Day of Independence. On August 14, 1947, the British colonial rulers granted independence to their former colony. At the same time as India, by the way. On top of the national Day of Independence, Pakistan's majority Muslim population will also begin the holy month of Ramadan this week, which includes praying and fasting.

Mmedia reports are full of pictures showing people who are fasting, yet have nothing to eat. Thousands of hectares of agricultural land are completely flooded. If nothing is done, this will mean widespread hunger. Even Prime Minister Yousaf Raza Gilani spoke on Sunday about a "second monsoon" that is likely to hit the south, the breadbasket of the country, soon. This country knows the meaning of hunger – and a large number of people are frightened of it.

Postive news

Too many of the 180 million inhabitants of Pakistan have virtually lost everything. The country is already one of the poorest in the world. And what is more, Pakistan mainly gets attention when there is talk of terrorism. Positive news from this region is rare, although we do encounter good news here every day.

We meet neighbors helping neighbors, and people whose houses are not destroyed helping those who lost their homes. We see college students walking through the city of Islamabad raising funds for the victims.

"We know that it will not be more than a small sum," says one of them, pointing at the cardboard box with the money he collected. "But we do this on our own initiative instead of waiting for help to come from outside."

Every day shows clearly that this help is urgently needed. But relief work is difficult.

CARE's partner organizations have delivered medication and medical supplies to pregnant women, who could not make it to the hospital for childbirth. The women were reached with the aid of donkeys and mules because so bridges and streets remain impassable.

Plates, forks, cutlery – nothing left

There are some distributions of kitchen supplies, bandages and other relief items. Nothing is left of the house that has been swept away by the floods. But at least the people have some relief now. And tents, the affected families also need tents. It does not stop raining.

CARE focuses its work on women and children. About a dozen CARE trucks are transporting doctors and other aid workers to the affected areas. They treat those that are most in need, and they try to get an overview of the needs in order to plan their work.

Today, Zahid from CARE Pakistan and I will drive up to Mardan in the northwestern part of the country. During the next couple of days, he will plan and coordinate CARE's relief operation for the area. I will get a firsthand look in order to report back to my colleagues and the world. I need to see things with my own eyes. Images on TV and the reports we hear reports cannot accurately reflect the immense suffering.

I know I am repeating myself, but I have to say it repeatedly: what is missing still, and foremost, is money. It is that simple. If humanitarian organizations like CARE do not get enough funding, there will be too little help. I cannot bear the thought that the fate of 12 million people is being ignored by the world simply because they are living in Pakistan.

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

August 7, 2010

On a cable TV network I can watch the recorded World Cup match between Germany and Uruguay. Football. It's a draw right now. I switch to DAWN-TV, a Pakistani TV channel: Two anchormen talking about food support activities in their mother tongue, Urdu.

I have just arrived in Islamabad, much later than expected. The airplane was not able to land in the capital of Pakistan due to bad weather conditions on the ground. We had to fly to Karachi, wait there for a couple of hours, then head back to Islamabad. Karachi is the biggest city in Pakistan and close to the estuary of the Indus River. Now the river is twice as broad as usual. With a population of almost 13 million people, Karachi is one of the biggest cities worldwide. It ranks third place in the list of the world’s biggest cities. I have only seen the airport building, of course. No clue where to find the famous stock exchange, which is also based in this big city. Finally, after five hours we can fly to Islamabad, where the CARE country office has its headquarters.

The DAWN also has an English print version. The newspaper and its website deliver around-the-clock news about the situation in the flooded areas of the country. Reading the paper, I am reminded of last year in May when a huge number of people fled from violence in the Swat valley. At that time, just like today, the numbers of internally displaced people were rising by the hour. More than 12 million people are affected by this horrible flood. Can anyone really grasp this number?

A colleague tells me that the website of the National Disaster Management Authority would be a good source. She was right. The authority is directly linked to the prime minister's office. On the website the government informs about the actions undertaken to help the flood victims. As a first step, bridges are provisionally repaired. It's a nightmare for all aid workers: the infrastructure is so heavily damaged that there are still people out there who have not been reached yet.

Far too little has been done so far, but ...

Meanwhile, CARE has supported thousands of people with tents, clothes, mosquito nets and other important emergency items. Eleven trucks were sent out to the affected areas. They are also transporting tablets to clean dirty water. Today, a radio reporter asked me, “Is that enough or is it just a drop in the ocean?“ No, of course it is not enough. Far too little has been done for the victims so far. But even this little bit means survival for many of them.

However, there is an immense lack of funding; many, many millions of dollars are needed to increase the speed and scale of the response. The rich states are still hesitant. That is a common assumption here in Pakistan, not just a gut feeling. Whoever sees and hears how desperate people in this area are simply cannot understand how slowly money is coming in.

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

By Mujahid Hussain, emergency program manager for CARE in Pakistan

August 6, 2010

Nowshera has been declared one of the calamity areas of Khyber Pakhtunkhwa. Entire villages and farms have been swept away. Homes have disappeared under flood waters and livestock have been left to rot in the mud.

CARE’s team has responded to the needs of the affected population through our local partners with basic non-food items to the locals, who were able to come to the accessible highland areas and roads. Through our partners and relief team's rapid assessment, surveys have been conducted to ascertain facts and figures about the damages and losses of the people in the area.

As the floods have caused extensive damage to crops, livestock and other food sources in the affected regions, food supply issues remain paramount. People are in desperate need of food and shelter and, as the days pass by, health issues are getting worse.

Here’s what we heard from some of the people:

• "Thousands of lives could be lost if food aid and shelter do not reach the affected communities within the coming days."
• “My six acres of land washed out in front of my eyes and I couldn’t do anything. All my crops have vanished. My whole family is homeless; now we are sleeping on the road.
• "The flood has left no difference between rich and poor; every one is suffering losses and striving for their lives”.
• “I had a four-story big house in Nowshera. My daughter was suppose to get married this month and all her dowry items were ready, including furniture, gold, clothing, appliances along with her wedding dress. Now we are left with nothing except the hope of getting the basics to survive”.
• “There is so much mud due to the devastation."
• "The situation is getting even worse as people are throwing all the food waste nearby. It is causing more pollution in the vicinity and will turn out to be a major reason of health and hygiene issues.”
• “Oh God, why we have to suffer again and again ..."
• “We have become migrants in our own homes.”
• "There is nothing but just water all around us.”
• “We don’t have even clean drinking water as all wells have been contaminated and waterborne diseases are spreading.”
• "I've lost my house and everything, including food.”
• “Food and water comes in every day from local donors but they don't know when or how much there will be -- and there's never enough.”

By Umaz Jalal, security manager for CARE in Pakistan.

August 5, 2010

On the eve of August 4, I was tasked to deliver a convoy carrying relief goods to flood-affected areas of Pakistan. We started our journey for the distribution point at a little past 7:00 p.m.

As usual, we communicated the departure to the security unit and the field staff. The convoy traveled through the Grand Trunk Road as the motorway was badly damaged in the recent floods. When we reached Nowshera (in the Khyber-Pakhtunkhwa Province of Pakistan), we were told by the police that the Grand Trunk Road was also blocked by the floods and we had to take a detour to get to our final destination -- the city of Mardan.

Our convoy was going slowly when I could saw the reflection of water on both sides of the road. I asked if we were still crossing the Kabal River. To my shock, the driver told me, "It’s not the river; it’s the flood water that we are passing."

I remembered that there were lots of small towns on both sides of Grand Trunk Road, which use to be full of life even at night time.

While crossing a small village, which was badly affected by the rain and floods close to 3:00 a.m., no life was present as far as eye could see. Then, I saw a woman who was undergoing labor pains and in need of urgent medical help, being carried by a girl and old man towards the nearest hospital.

I asked the driver to stop the vehicle so I could ask the old man if he needed any help. He told me that they have been walking for two hours trying to take his daughter to the hospital in Mardan as the all medical facilities in Nowshera were damaged by the floods. We told them that we were headed to Marden, which was 17 Kilometers away, and would drop them at the hospital.

The condition of the woman looked serious, but she safely reached hospital and was provided medical care.

After that, our convoy reached Mardan and all of the relief goods we were carrying were distributed.

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

By Jamshed Naseer, security officer for CARE in Pakistan, who witnessed the devastation in Khyber Pakhtunkhwa province.

There are plans that we make, and there is God’s plan. The truth of this phrase has never hit me as hard as it did on July 28, 2010.

The day before started off like any other summer day. The sun was shining bright, and our enthusiastic team of five set off to visit Swat.

Swat was a hot spot for all tourists once upon a time, not long ago. I remember Swat, and the people of this beautiful valley, who offered a smile and warm welcome to anyone who came there. I knew how the smiles had been replaced by lines of worry due to the recent political situation these brave people had faced. People are still warm and welcoming, but the air of this place once known to be "heaven on earth" tells a tale of its own.

My team and I were following our trip schedule, meeting local authorities, going to a CARE project site , and discussing areas we needed to focus on for the trip. We all went to bed satisfied, our heads filled with plans for the next day. I remember falling asleep with the sound of the rain drop's pitter-patter echoing in my ears like a lullaby.

July 28, 2010. A date engraved in my memory for the years to come. It was 8:15 a.m. when Waleed, Mujahid and I were sitting in the lobby of the hotel, enjoying hot breakfast and admiring the rain, and how it made the valley look fresh and clean.

Despite the rain, we started our day's journey as planned, visiting a health project. Sitting comfortably in the front seat of our car with the air conditioner blasting, I could see people running around covering their heads with newspapers, shopping bags or their hands.

Some of the women were carrying their children and men were carrying household items -- I wondered, why are they out in the rain? The question came and left my mind fleetingly. Concentrate, my mind said, as I tried to focus on my duties for the day.

The rain was pouring, visibility was poor and our cars were crawling along the road, when we heard that the Gwaliari Bridge had collapsed. We went as near as we could to the bridge and assess the damage caused.

I stood there watching what the rain we were all praying for had done.

The sound of the water gushing, wood cracking, and amongst the havoc, people leaving everything that they had worked so hard for -- running, saving their very lives. The people on the road came back to my mind. I saw, how the fathers were trying to keep their young ones safe, hauling them on the shoulders, how mothers, not caring for their own security, were protecting their children. I saw a landslide wipe away homes and bury them in mud.

The water, not caring who and what it took with its force, pushed on.

The road was cracking and giving way to the force of the water. I moved my team to safety. Everyone was busy getting information, planning what to next.

With every second that passed by, I felt worse. Here we were, safe and warm, with a roof over our head, food in our stomachs, a soft bed to sleep on. The sound of the rain that was lullaby to my ears yesterday seemed to turn into cry for help. I felt responsible for the rain that we had all been praying for.

I tossed and turned in my bed at night and I asked myself over and over again, “Is this what we prayed for?”

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

Sharing the stories of Haitians struggling in the aftermath of January's earthquake is a crucial part of CARE's work to help heal and rebuild the nation. The woman who leads the effort to bring that information to the world could easily write volumes about her own life.

By Sabine Wilke

March 2010

Standing in the middle of the dusty parking lot surrounded by huge trucks, you find yourself right in hustle and bustle of the logistics center supporting CARE's emergency response. Planes are roaring over the site every couple of minutes – Port-au-Prince's airport is only a couple of blocks away from the warehouse. And there is another particularity to this location: "We're right in the middle of the red zone," says Geoffroy Larde from the CARE logistics team. The warehouse borders on Cité Soleil, the infamous slum that has been neglected for years and has experienced severe damage from the January 12 earthquake.

High in the hills above Léogâne, near the epicenter of the earthquake that struck Haiti on January 12, the signs of both devastation and courage are everywhere.

Womens Radio Network, www.womensradionetwork.com, has launched a fundraiser for CARE for Haiti.

It involves an online art auction and ongoing sales of women's art through an online art booth located at: http://www.fine-art-on-demand.com/Partners/nonprofits/womensradio.htm

Womens Radio Network does not take any fees for this great program. The other sponsors and artists have donated siginificant amounts of time, energy and hard money to make this new idea work. Buy some great art by great women artists, and 65-100 percent of your purchase goes to helping survivors of Haiti's January 12 earthquake through CARE for Haiti.

Learn more about CARE for Haiti at www.careforhaiti.org.

by Sabine Wilke, CARE Media Officer in Haiti

Monday, March 8, 2010

Her first life was that of a teacher at a nurse's training school in Port-au-Prince, teaching skills to make sure that women have a healthy delivery. Today, Carline Morney spends her days in and around the earthquake-stricken capital of Haiti, helping expecting and young mothers to cope with the difficult situation. She is one of more than 70 new CARE staff members who have been hired in addition to the existing team to ensure a timely and efficient emergency response.

by Rick Perera, CARE Media Officer in Haiti

Monday, March 1, 2010

We're watching from Haiti with shock and sadness as the news comes from Chile: another merciless earthquake, more powerful than ever. So soon after the devastation here in and around Port-au-Prince. (Was that only a few weeks ago? It feels like an eternity.)

by Anne Larrass, CARE in Haiti's Information Management Officer

Friday, February 12, 2010

"Mèsi Bondye paske ou bann lavi ankò"

It is 6 p.m. and the sun has just set, leaving behind a gentle trail of pink and orange. We are on our way back to the office, driving on a road that takes us past the now very common picture of broken homes and mountains of rubble of Port-au-Prince.

Today is the last day of three days of official mourning, which explains the thousands of Haitians we've encountered on the streets chanting hymns and calling out slogans of hope and gratitude.

by Melanie Brooks, CARE International Media Officer in Haiti

Saturday, February 7, 2010

Night falls, and one by one, the candles flicker on in the camps – tiny pinpricks of light in a city clad in darkness. As the sun retreats, the muffled cries begin. And the women creep deeper into their flimsy shelters of bed sheets and plastic tarps, praying for the morning to come.

Excerpted from a note to CARE staff
by Jonathan Mitchell, CARE International's Emergency Response Director

Sunday, February 7, 2010

Dear Colleagues,

A week ago, I returned from a joint visit to Haiti together with CARE USA regional director, Peter Buijs. Peter and I visited Haiti to understand the situation first-hand and offer support and guidance to CARE's response to the extensive humanitarian suffering caused by the January 12 earthquake. Peter stayed-on in Haiti for an additional week while country director Sophie Perez was traveling.

Story by Rick Perera, CARE Media Officer in Haiti

Saturday, February 6, 2010

In earthquake-ravaged Haiti, where broken bones and open wounds far outnumber doctors, people have grown accustomed to long waits for medical attention. But many who turn up at Saurel Saintie's mud-brick home have waited longer than most. These patients have traveled five hours or more along a rutted, dirt road -- aboard battered old buses, in backs of trucks or perched by threes and fours on motorbikes – to escape the ruined capital, Port-au-Prince. Many have gone weeks without having their injuries attended to.

by Elizabeth Babister, CARE Senior Shelter Advisor

Friday, February 5, 2010

In the mornings, as the little tent circle of staff in the garden of CARE's office wakes up our most precious items here the small padlocks for locking the tents. A token gesture towards security since anyone could cut through the fabric, but with the garden busy with CARE staff this would be noticed immediately. We are relieved from the inconvenience of staying with our possessions while I work. Many of the camps in the city are congested with people, strangers to each other situated in the same place by necessity because open land is so scarce. There are no locks or fences between families. CARE will be supporting community leaders to organise committees in order to empower families to work for their recovery as community.

by Rick Perera, CARE Emergency Media Officer in Haiti

February 1, 2010

We're all starting to feel a little safer, and more relaxed – though that's a relative term, of course. We've noticed that there have not been aftershocks in a week or so. The mass distribution of rice that got underway yesterday has gone smoothly so far – a huge relief since many survivors have had nothing to eat since the quake. Of course it will take a long time to reach everyone in need, but the system is working well so far.

by Rick Perera, CARE Emergency Media Officer in Haiti

Saturday, January 30, 2010

I've just returned from one of the most heartbreaking visits of my two weeks here: to meet the family of Dr. Franck Geneus, CARE's gentle, dedicated health program director. Their homes destroyed, his extended family of 30 is packed into Franck's brother's tiny house and yard -- from the littlest niece, five-month-old Joelle, to grandmother Inosie, who says she's 94.

by Rick Perera, CARE Emergency Media Officer in Haiti

Monday, January 25, 2010

You can handle a lot if you keep busy, but watch out when you get a chance to stop and think. On a long drive last night I had a talk with an exhausted CARE driver, and felt for a moment what it must be like to be Haitian.

by Rick Perera, Emergency Media Officer in Haiti

Saturday, January 24, 2009

"I can't describe how frightened I was," recalls Joanie Estin, remembering that terrible day barely a week ago when her world fell apart. "We've lived through a lot in Haiti, but this is the first time anything like this ever happened."

But Joanie doesn't look scared. Sad, yes – but resolute, confident, and committed. Every inch the Girl Scout. "I always keep a cool head, because otherwise you won't be able to help other people," she says calmly.

Thursday, January 21, 2010

You might expect to see Wilner Ulysse helping a little old lady cross the street. That's the classic image of a dutiful Scout. But Wilner, age 23, has a much more important good deed for today.

by Loetitia Raymond

Thursday, January 21, 2010

At the fragile moment in time when a life enters the world, when a child leaves the warm, protective cocoon of her mother's womb, one gesture can change everything. It can transform what could have been a happy occasion into the saddest of all.

by Steve Hollingworth, CARE USA COO and EVP, Global Operations

Wednesday, January 21, 2010

I received an e-mail today that I deeply appreciated. It also made me proud to be a part of CARE!!

by Patrick Solomon, CARE USA SVP, Global Support Services

Thursday, January 21, 2010

Yesterday, the CARE staff went to the Place Saint Pierre in Pétion-ville extremely close to the CARE office to do pre-work for today's distribution of hygiene kits. The team did an assessment and registration process to identify pregnant and elderly women to make sure they were recipients of the distribution. Today, the team ensured that these women were given priority in the distribution process.