by Adjie Fachrurrazi, CARE emergency coordinator in Indonesia
October 5, 2009

It has been raining non-stop for the past six hours. Heavy, heavy rain.

People are traumatized. They are asking for help. Everyone is suffering. People say to me, "Don't count the number of destroyed houses. Count the number of houses still standing. It will be faster." In most villages I have seen, only 15 percent of houses are still standing. Some houses are totally flattened. The roof is flat on the ground. People lost everything. Their houses are destroyed, everything in them is destroyed. And everyone is afraid so those with houses will not go inside. There have been aftershocks over the past few days but today was mostly quiet. Everyone is afraid of another earthquake.

So people are sleeping outside, living outside. We are all wet. They have no shelter. Some people are sleeping under broken pieces of roof. Shelter is the main issue. People also need mosquito nets. They are sleeping outside, and with all this rain, there will be mosquitoes and malaria. Children are already starting to get sick. They need blankets, mosquito nets and plastic sheeting for shelter.

***

People are drinking coconut juice, or river water. People in these village used to get their water from springs, but the pipes are broken. In Padang city, the municipal water is not running yet.  The water from the river is not clean, and people don't have stoves to boil water. They need clean drinking water or there is going to be a rise in waterborne illness. We have supplies to help 5,000 people to start, but we need funds to help more.

***

There are many injured people and people still buried under buildings. It is very hard to reach the affected areas. Landslides have blocked roads and there is debris everywhere. Our team went out by motorbike today. We have 20 people on the emergency team, including staff from our local partner. This damage looks worse than the Yogyakarta quake in 2006.

It has been five days now. It's not clear how many people are affected yet. We don't have all the information from the rural areas. There are many dead bodies. And the smell is coming.

Helene Gayle, president and CEO of CARE, blogs from her trip to Kenya.

August 10, 2008

Well, we arrived last night to Nairobi around 9 p.m. and settled in. Most of the Learning Tours group ended up on the same flight to Nairobi from Amsterdam, which was great as it gave us a bit of time to connect with each other and get focused on the Learning Tour trip.

This morning after a breakfast briefing we loaded up in a van and headed to a drop off point to get to Kibera Tabitha Clinic. Kibera is a densely populated "informal settlement" or slum area of Nairobi. Population estimates for Kibera are as high as 1 million people. It's probably the largest and most studied slum in Africa – nearly the size of Manhattan's Central Park. From our drop off point at the top of a hill, it looks like a corrugated sea of rusted tin roofs and open sewers.

Reaching the clinic involves walking through a maze of muddy walking paths as there are no streets. While there we were briefed by Dr. Rob Breiman of the Centers for Disease Control and Prevention (CDC), who is a former colleague from my days at CDC, and the clinic's director, Salim Mohammed. The clinic took two years to build and was completed this year. The bricks to build it were all carried by hand down the same narrow, windy path to the site and was built by the community.

The clinic partners with the CDC to identify trends in infectious diseases and develop programs to meet the highest priorities for improving health. They also integrate HIV training, reproductive health and antenatal care. About 150-200 people visit this clinic every day.

Staff also do home visits to households every other week, asking questions to identify possible health issues. For example, if someone has a cough or potential complications with a pregnancy, it initiates a specific set of questions to help determine the whether there is a problem that needs attention. I had the chance to go on a home visit to meet with a woman named Cynthia, a mother of five. It was interesting to see how the local health worker, Jaciuta, gathered surveillance information on Cynthia's family that was logged on a handheld PDA – technology put to good use. This allowed the home health worker to go back to the office and upload household health information on a daily basis. Sure beats old fashion paper record keeping!

From there, we walked through another part of Kibera to meet with a group of women. They told us about the daily struggles they face as well as some of the support they receive from a woman named Judy, a retired nurse who started her own organization that CARE supports as a local partner through our Local Links program. Judy helps the women start small businesses, like selling vegetables, to earn their own income.

The story of one woman, Mwinza Mwema, especially impressed me. She has seven children and two orphans in her care. Her vegetable stand was burned to the ground during the post-election violence in Kenya last year but she didn't give up hope. She takes on jobs washing clothes and dishes, making a little over a dollar a day. It never ceases to amaze me the resilience of women like Mwinza, who continues to have a positive attitude despite the hardship she faces. This is a woman who survived home childbirth, cutting the umbilical cords herself because she couldn't afford to go to a hospital. She was lucky to have survived and that her children still have a mother. She mentioned other women she knew who didn't survive home childbirth, a common practice in poor areas. Hopefully as more clinics like Tabitha go up, more people will start accessing health and family planning services.

During lunch we spoke with Peter Anyang Nyong, minister for medical services, who noted health challenges in Kenya, and how improving infrastructure and human resources are critical to the country's development.

(L to R: Admiral Fallon, Minister for Medical Services Peter Anyang Nyongo and me at lunch)

From there we drove to Pumwani Maternity Hospital for our final visit of the day. According to the director, Dr. Charles Wanyoni, it's the busiest maternal health hospital on the continent. This year, he said they've experienced seven maternal deaths for some 11,000 deliveries. He noted that "when it's this busy you can expect complicated cases." The hospital has two operating rooms, one antenatal clinic, family planning services, services to prevent mother-child transmission of HIV and comprehensive care. Because it's located right next to Kibera, many women and girls who deliver there have to work out with a hospital committee how they will pay for services – approximately $40 for a normal delivery and double that if a caesarean-section is needed.

(Here I am visiting the Pumwani Maternal Health Hospital's neonatal unit.)

Because the hospital was built in 1926, it was obvious they've have to expand, which is a constant struggle when facing high demand and low funding. It was good to see that the CDC is supporting the hospital with a laboratory, and it also receives PEPFAR (the U.S. President's Emergency Plan for AIDS Relief) funding. The hospital staff has aspirations for developing their infrastructure during the next five years to include things like a new water system and more skills training workshops for staff.

I really hope for the day when poor women can focus on getting the care they need without putting themselves in precarious financial positions that deepens their poverty. This is what I will continue to push for: more investment in maternal health and family planning. These issues really need to become a priority, not just in Kenya, but  on a global scale.

Tonight, I have to brush off the dust from today's trip to wear another hat: meeting with health leaders and key donors at the residence of U.S. Ambassador Ranneberger. More tomorrow!

Blog by Allen Clinton, CARE staff, currently on a Learning Tours trip to Kenya.

There's a lot involved in putting together a Learning Tours trip. Right now I'm in Kenya as part of a team doing an advance run-through. I'll hold back on all the program details until the trip starts but I will say we've been on the road a lot visiting numerous communities, hospitals and clinics to make sure delegates have a safe, well managed and well informed trip.

On the way to one clinic in the slums of Kibera to review the schedule and time the walk, we were instructed to keep moving along a narrow one lane pathway so we don't hold up anyone coming from the other direction. As parts were muddy, black rubber boots were provided. Some who didn't have the right shoes on wore the boots. For the majority of us who didn't try out the black boots, we did survive walking through or stepping over drainage ditches. I took a few photos to show you what I mean.

Along the way children would walk with us for a few steps asking, "How are you?" When we respond we're fine and returned the same question, they would always smile and giggle. Some even asked the folks with the boots on when it was going to rain.

Blog on her recent trip to Ghana by Sarah Blizzard, Development Writer, CARE

Today, I received one of the most meaningful gifts I have ever been given – a bouquet of flowers from the Girls' Club in the village of Manso Nkwanta in the Ashanti region of Ghana.

Blog on her recent trip to Ghana by Sarah Blizzard, Development Writer, CARE

CARE works with farmers in the Ashanti region of Ghana to help improve cocoa yields and educational opportunities for children. How do these two seemingly-disparate things go together?

by Rick Perera, Media & Communications Officer

Just 12 years old, he carries the weight of the world on his narrow shoulders. The eldest of five children of a widowed mother, Sajjad Ahmad feels responsible for his family. It’s not easy being the man of the house at such a young age.

Blog by Rick Perera, Media Officer, CARE International in Pakistan:

ISLAMABAD – It’s become depressingly familiar: a tragic attack on civilians. Tuesday’s hotel bombing in Peshawar is just the latest in a string of events marring this beautiful country.

Blog by Rick Perera, Media Officer, CARE International in Pakistan: 

Blog by Thomas Schwarz of CARE Germany-Luxemburg, May 28, 2009: 

It is about noon up here in the northwestern province, or maybe a little later. In one of the camps for displaced people we meet a teacher, who is now volunteering to help his fellow countrymen. He tells us his story: "When all of the refugees arrived, I did not hesitate. I contacted the government to register as a volunteer. 'What can I do,' I asked them. 'How can I help?'"

Blog by Thomas Schwarz of CARE Germany-Luxemburg
May 27, 2009

While travelling to places like Pakistan, I naturally meet many different people. All of them have their own story and background, their traditions, cultures and personal experiences. Talking to the displaced people in Pakistan, I realized right away how different their path of life is compared to my own. Living in Buner, Kohistan, Dir and the village of Swat bears no resemblance at all to lifestyles in so many western countries. The gap could not be much bigger.

Blog by Thomas Schwarz of CARE Germany-Luxemburg
May 23, 2009

This is my first time at the International AIDS Conference, and I have to admit it's a bit overwhelming!  But I'm learning a lot, especially about how we can improve our work with children affected by the epidemic.