"There are times I would give my remaining 10 gourds to my children, then go to church all day and tell myself I was fasting; it helped me cope with the hunger."

Every month Belmise receives 2000 gourdes ($46) through her electronic voucher. She can then buy food for her and her family at participating food stores.. © 2013 CARE

"One day," she recalls, "I was feeling desperate, the children were hungry and I had nothing to give them. I resigned myself to go begging by the mayor's office. There was a lot of commotion when I got there. I went inside to see what it was about. I met a young lady who asked me if I was there to register for theprogram.I did not know what she meant. She went on to explain to me what it was about. I could not believe my ears. I felt like the sky thought God must have listened to my prayers and guided my feet there today. "

The Food for Peace-USAID food voucher program, implemented by CARE, helps meet the needs of the poorest of the poor by them providing electronic vouchers redeemable for food. Beneficiaries exchange the vouchers with merchants to obtain nutritionally-balanced foods. The program serves to not only provide healthy foods for participants but also allows beneficiaries to use whatever earn they do earn to on additional food and/or sustainable food sources, such as the purchase of livestock or land. 

In the first phase of the project, 12,000 beneficiaries were served in nine communities; 5,708 families in five more communities are being served in the second phase.

© 2013 CARE

When asked what she will do at the end of the six month project, she replies, "I pray to God every day for the responsible of this program. I ask him to cover them with blessings so they can continue to help us."

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

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

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

Meet some of the beneficiaries:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Emmanuel recorded the stories of some of the people he met

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

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

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

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

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

CARE Distributions

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

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The name Kathmandu sounds like Kadamandu, but the similarities between these two cities in Nepal largely ends there. The former is the country's million-person national capital and a centuries-old hub of culture and commerce. Kadamandu is tiny and remote. Situated in the mountains of remote, far-western Nepal, it is home to only 4,000 people.

On sight, you wouldn’t realize it, but the big city Kadamandu has the most in common with is Mumbai.

Eager to find work to support their families, the men of Kadamandu often leave the village to find work. Three-quarters of them go to India. Tragically, money isn't the only thing the men are bringing back from Mumbai. Separated from their families, many of the men visit brothels. As a result, they're also bringing sexually transmitted diseases to Kadamandu. More than 70 people in Kadamandu have died of HIV/AIDS. As the number of men going to India for work has increased, so has the number of infections, bringing added misery to this already very poor town.

With the help of CARE Nepal, director Ramesh Khadka has produced an award-winning a documentary about what’s happening to the village and how CARE Nepal is responding. “Kadamandu” is an unflinching look at the misery HIV/AIDS has wrought on the community, as well as the bleak economic conditions and severe gender inequality that underpin this tragedy. Last month “Kadamandu” won the award for best documentary at the Kathmandu International Mountain Film Festival.

A trailer for "Kadamandu" is on YouTube and embedded below. An especially powerful scene begins at the two-minute mark.

Interview conducted by David Rochkind

Mireille Henry, 44, sits where the foundation of her home used to be on January 7, 2013. Mireille lost everything during the earthquake of January 10, 2010. © 2013 David Rochkind/CARE

Milton, Haiti (January 2013) – Three years ago, a massive earthquake destroyed Mireille Henry's home in Haiti, killing her mother and trapping her daughter under the rubble for five hours.

The mother of four lost everything she owned. Mireille didn't even have a spoon to feed her children, she says, or a blanket to keep them warm. She relocated to a field with her family. On the luckiest days, they got to sleep under a tree.

It's been a challenging – and chaotic – journey for Mireille, 44, since the earthquake that affected millions of Haitians and left hundreds of thousands in displacement camps. But Mireille has rebuilt her life, through the help of her community and an innovative microsavings program.

In 2011, CARE introduced a Village Savings and Loans Association (VSLA) in Haiti and Mireille's community. The program serves the poorest of the poor – people who do not otherwise have access to the types financial services much of the world takes for granted.

Every group of 20- 30 women receives intensive financial training. And the group's members contribute a minimum of roughly $2.00 each to the group's savings fund every week. The women can borrow from the group fund to invest in small businesses, pay for seeds and fertilizer or cover important family expenses, such as school fees and doctor's visits. The loans are repaid quickly, with a low interest rate, set by the group members. The interest is then shared with everyone in the group as profit, distributed as "pay-outs."

Today, there are nearly 5,000 VSLA participants in Haiti, and 81 percent of them are women. These groups have saved a total of $179,646.00!

Mireille received three loans through the VSLA program, which she used on her children's schooling. And she plans to use her next pay-out to restart her fabric business.

Before the earthquake, Mireille purchased fabric in bulk and then resold the material at the market near her home. When the earthquake destroyed her home, she tried to salvage the fabric that was left. She stored some at the market, but it was all stolen, leaving her with nothing.

Eager to start her business again, Mireille says the VSLA has taught her how to save funds that will bring her fabric business back to life.

"Even though we don't have a lot of money, we now have a way to save," she says. "We don't have to go to a bank. I'm very proud of that, and I want to see this continue in the future."

Mireille, like many others in her community, are making strides since the tragic earthquake. Today, she lives in a small home with walls made out of tarps and a ceiling of aluminum. Her new home sits right next to the foundation of her former home.

With hope and determination, Mireille continues to participate in VSLA in order to increase her income and strengthen her financial planning skills. She also volunteers as the group's treasurer, and the group admires her strong-willed and serious nature. Mireille is responsible for keeping track of money – counting and verifying it at each weekly meeting – and for keeping the cash box safe.
Her VSLA group has lots of big ideas, Mireille says. They've thought about opening a bakery together or starting a sewing studio.

Mireille says she especially enjoys showing other women, who are not part of VSLA, how much the program has helped her. She has encouraged many of these women to participate, and use it as an outlet for their voices to be heard within the community.

"I know that women can be strong leaders," she said. "I really believe that. I want to become a better leader, a stronger leader, myself."

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

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

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

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

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

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

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

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

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

How are CARE and its partner organizations responding?

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

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

Is there a high risk of an outbreak of diseases?

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

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

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

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

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

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

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

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

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

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

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

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

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

Happy New Year!

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

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

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

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

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

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

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

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

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

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

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

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

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

Almost everyone.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*name has been changed

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

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

My name is Safari Ngayabaseca* and I am here with my husband and children. We are living in this classroom at Don Bosco orphanage – it is the only place that we can find where we feel safe.

Everywhere now is very dangerous – there is nowhere to run to where there is not fighting or bombing. We have come from Kibumba originally, and fled to the camp at Kanyaruchina where many other displaced people went. We were told that we would get help there and that we would be safe.

We were given some food and some other things like a water container and a plastic sheet. We stayed there four months but things were not very safe. Every night we heard shooting and there were always soldiers around. Then, last week, there was some heavy fighting nearby and we were told that we had to leave the camp by rebels so we ran here to Don Bosco.

We heard from others that we would be safe here. Now all we have is this mattress and some clothes that we are wearing. We have been given a little food and there is a medical center here if we need it, but this isn’t any way to live.

All I want to do is go back to Kibumba, but we have been told that our house has been burnt down so now we have nowhere to go. This is the third time in my life that I have had to flee my home and leave everything behind. Now, I don’t even have a home to go back to.

On Monday, I think that we will decide what to do next – but we don’t know what is going on with the government or with the soldiers. So it is hard for us to make a decision. We have no money and no means of returning to Kibumba and no means to build a new house.

I am scared for my children and scared for our future.

*name has been changed

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by Sabine Wilke

This picture could have been taken in Switzerland or at any other lake surrounded by mountains, maybe in Bavaria or British Columbia. But I took this photo in Goma, the capital of North Kivu, an Eastern province of the Democratic Republic of the Congo (DRC). A place where, for decades now, armed conflicts and chronic poverty have taken an unimaginably heavy toll on the civilian population.

The news we receive about DRC are always, always terrible. Human rights abuses, deplorable poverty, unsolvable conflicts. Maybe that is why the global public has grown tired of taking a closer look. Maybe that is why DRC simply is this big, black hole to the outside world. But three weeks ago, the world laid its eyes on Eastern DRC once more, when an armed group called M23 seized the town of Goma and forced out the Congolese army. It was the peak of an escalation of violence that has raged in this region for several months and has forced more than 800,000 people to flee.
Today, Goma is frighteningly calm since the M23 has withdrawn on December 1. Frighteningly is the most suitable expression, because the people of Goma do not really want to trust this calm. What if the next storm is just around the corner?

During the latest wave of violence, 130,000 people alone have fled. Countless women and young girls have been raped and injured on their way, and the spontaneous camps and settlements around Goma are no safe haven for these survivors. Attacks and pillages are a daily ordeal. North Kivu has suffered from armed conflict, battles over commodities, chronic lack of infrastructures and ethnic rivalries for a long time; all the while, the international community mostly turns a blind eye on the region.

Looking back at the photo from the lake shore, I think (and hope!) that this could be a glimpse into a possible future – a future where Goma will be a town of peace and recreation, where tourists can enjoy the magnificent volcanic landscape and come face to face with mighty mountain gorillas. Where the population lives in peace and safety, where children can go to school and women are protected from sexual violence and abuse.

Goma’s current reality, unfortunately, is much better portrayed in the pictures taken by photographer Kate Holt, who recently travelled to Goma for CARE.

In light of the new emergency, CARE has scaled up its programs against sexual violence, supports health centers with medical items such as post-exposure prophylaxis against sexual diseases and trains community educators in the camps. Displaced families receive plastic sheeting for a dry shelter and CARE also implements a voucher program that helps poor families to purchase much-needed goods on the local market.

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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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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© 2012 CARE

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

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

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

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

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

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

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

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

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

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

By Thomas Schwarz

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

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

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

No refugees, nowhere - seemingly

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

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

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

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

By Thomas Schwarz

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

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

"We would never call it home"

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

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

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

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

Sharing with others is important here

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By Yemisi Songo-Williams and Christina Ihle

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

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

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

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

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

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

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

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

UPDATE:

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

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

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By Marie-Eve Bertrand

Swala, in Djenne region. A group of women waiting for the food distribution. Photo credit: © 2012 CARE/Marie-Eve Bertrand

They plundered her village. They killed people, beginning with men in uniform. Soldiers, federal officials, prison guards. To sow terror, they freed prisoners. "My husband heard the gunshots. He understood. So, he told me to flee with our children, and then he joined us a few days later. I was so afraid. We fled from our village, which was located in the red zone, where armed groups have wreaked havoc. We fled to my mother's house, here in Djenne, Mali. She still has children at home and sells pancakes to earn a little money. There are ten of us now, in her home. My husband had to leave as well - he couldn't stay there. Without CARE's help, we would have never made it. We lost everything - everything - when we left home. I know I will never get back my belongings. But I still have my family here, alive. It's very hard. My name is Sarata."

Next to her was a very thin man with a blank stare. He left everything behind as well. Even his wife and children, who are in a city miles away. When he fled the violence, he may have taken his family and left physically, but his spirit stayed behind. He has been confused since that day. When I asked him why his family was not with him, he didn't even know. "I want to go back home - back to the way my life used to be." That's all he could tell me. His name? He isn't sure anymore.

Nearby, another woman. "My name is Mariama." When the armed groups invaded their neighborhood, she and her sister fled with the children. Her husband stayed, because he was afraid of losing his business and all their belongings. She's twenty years old, has a nursing 7-month-old and a 5-year-old, all staying with their grandmother. She took them in. The grandmother - who still has her own children at home - made room for them. She received a kit of essential items (cups, casserole, blanket, mat, soap) distributed by CARE and its local partner A.A.D.I., but no food, because there were no rations left. Her little girl is crying. She's hungry, but her mother's milk is lacking. "There isn't much," the beautiful Mariama tells me. "We don't have enough food." But she smiles, and tells me about her dreams for her daughters. One day, they will be educated. They'll go into medicine, or maybe they'll be teachers. "One day, we'll go back home."

They are just here temporarily, until things calm down and the violence dissipates. They are internally displaced persons, the forgotten victims of human conflicts, the forgotten ones of humanitarian disasters.

* The names in this story have been changed in order to protect the identity of the interview subjects.

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'Let's Not Make the Same Mistakes Again'
An open letter from the Horn of Africa to the Sahel region

In advance of expected rains Fatima Adam, 46 and two of her four children, her son Abderrahaman, 14 and Hawa, 11 plant millet seeds in a field at the edge of Torgo village. Early planting is a gamble. It must  rain within 15 days of planting or the seed will not  grow, according to Fatima Adam. The Sahel fringe of Chad is in the grip of a food crisis. © 2012 CARE/Brendan Bannon

Dear Sahel,

I am sorry to hear of the more than 18 million people in your region who are facing critical food insecurity. Having gone through this myself only just last year, I understand, and I thought that maybe it was time I contacted you so that together we can work out how to change things.

In many ways, I am still trying to recover; in fact, over 9 million of my people in Somalia, Kenya, Ethiopia and Djibouti are still in need of humanitarian assistance. In some regions of Ethiopia and southern Somalia children under five are already showing signs of acute malnutrition. So you may think, who am I to give you advice when my situation is clearly not much better than yours? Well, I may not have all the answers to everything but I do know one thing: droughts, even extreme ones do not come as a surprise to us. We have been here several times before. We must stop reacting to these situations the same way and learn new ways to protect our people.

My experience in 2011 taught me that our best efforts at using early warning systems and monitoring the food security situation of local communities will always be undermined if warnings are not heeded and acted upon. We've both been through droughts so many times before; we know very well when poor rains are likely to turn into something more serious. We must learn to trust this judgement and for others to trust us too.

When the situation goes from bad to worse (and I hope you don't get to this point) the right support for emergency responses is vital. For example, last year, we learned that cash interventions could help as much, if not more than food distributions and that some emergency responses could be harmful to our longer term interventions. Our people don't want to be dependent.   They have the skills and resilience to respond to drought and they know best how to cope. But even the best traditional coping mechanisms cannot withstand increasingly changing climate patterns, uncontrollable rises in food prices, and chronic conflict on top of years of under investment in these vulnerable areas.

I hope that the funds and assistance you are beginning to receive are enough. Increased financial support is vital, not only to save the millions of lives that are in immediate risk, but also to help you to  invest in longer-term interventions that protect people's assets and supports them to cope and develop resilience to future shocks. In my experience, built into this approach must also be the ability to respond quickly and comprehensively when times will, inevitably, get tough again and a commitment to continue working to prevent crises when times are good.

Over the years we've changed the labels that we use to describe the tools we use, to explain the problems, and the solutions available to us, but fundamentally the reasons behind our food security crises have stayed the same.

A real challenge I faced last year was the fact that increasingly the most vulnerable communities in my region are located in the hardest to reach areas. Conflict and insecurity means it was really difficult to reach families who needed our help the most. We have to ensure everyone respects the rights of communities in need to receive assistance. Sometimes this means we have to think outside the box and come up with new ways to reach people. But this doesn't mean we should compromise our principles. Humanitarian agencies should still deliver quality projects in a more coordinated way and be accountable for what they do.

Our Governments and their partners need to invest resources effectively in the infrastructure necessary to promote resilience in drylands areas, otherwise communities will never be strong enough to cope when times are hard. We cannot continue to neglect these areas. We must find ways to maximize their economic potential and support their traditional agricultural and pastoral methods.

We must also focus on the most vulnerable in our communities. During last year's food crisis in my region, just as in any major crisis, women and children bore the brunt of the shortages. Out of the 12 million people affected, an estimated 360,000 of them were pregnant women. Mothers are the first to sacrifice feeding themselves to feed their children, and with so many cows and goats dying without water, poor milk supplies left over 2 million children malnourished and struggling to survive.

There is a lot more I could say and a lot more we can do and will need to do, but for now my only hope is that you will keep from making the same mistakes as me. I also hope that I will be able to apply the lessons I learned last year and when (not if) the next drought comes, my people won't suffer as much as they did in 2011.

Wishing you all the best,

Horn of Africa

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By Marie-Eve Bertrand

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

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

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

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

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

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

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

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

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

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

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

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June 18, 2012
By Rodrigo Ordóñez

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Photo. © 2012 CARE

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

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

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

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

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

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

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

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

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

Photo: © 2012 CARE/Audrée Montpetit

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

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

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

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

Photo: © 2012 CARE/Audrée Montpetit

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

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

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

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

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

By Yonas Tafesse, Communications Advisor, CARE Ethiopia

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By Rodrigo Ordóñez

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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By Rodrigo Ordóñez

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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by Barbara Jackson, Humanitarian Director, CARE International
July 2012

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

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

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

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

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Blog by Deborah Underdown
July 5, 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By Rodrigo Ordóñez

(Photo: © 2012 Rodrigo Ordonez/CARE)

In the last few weeks, I have talked to families in several regions of Niger, while traveling on my own or when taking journalists to the field. Despite the variety of personal circumstances, certain elements appear often in people's stories.

Life has never been easy for these people. They've increasingly got used to enduring what others would consider unbearable. Their ability to eat has been highly dependent on weather and rains since they can remember. Most families have lost children because they couldn't feed them and they fell ill easily.

This cycle of poverty has become the ‘new normal' for them.

This is also the case for the people I talked to in Saran Maradi, a village in the region of Maradi, southern Niger.

This year has been harsher than usual, and crops were insufficient to feed their families. They couldn't afford to buy food in the markets either, because of the high prices. Only a few people in the village have grain left, but it's only for planting. Many sold their goats or sheep to buy food, but the prices are low, up to half of the standard price.

CARE is providing income to 61 families in Saran Maradi so they can buy food during what is commonly known as the ‘lean season,' the gap between the time people run out of food stocks and the next harvest. "It's a support that came at the right moment," says Achirou Inoussa, a 42-year-old man from Saran Maradi. People receive cash in exchange for part-time work in projects identified by their community, or as a handout in the cases where nobody in the family is able to perform manual labor.

The cost of this type of emergency project is relatively low, but it has a very tangible impact.

"Normally, around this time of the year, all the young people are gone," says Moussa Garba, an elderly man who claims to be over 80, although he doesn't know exactly. Sitting under a tree, he and other men explain to a visitor that during the nine months of the dry season most men in the village go to Nigeria to work in low-qualification jobs; as porters, water sellers, or emptying septic tanks. This year, however, some came back when they found out about CARE's project and the opportunity to earn a living in their doorstep.

Apart from preventing seasonal migration, cash-for-work projects bring extra benefits to the communities. In Saran Maradi, people are turning an unused piece of land into pasture. After removing weeds, they sow grains which will germinate during the rainy season and create a new area for cattle to graze.

I was interested in knowing more about the impact of this project in the homes, so I talked to women; they are generally the ones who face directly the difficulties to feed their families in times of hardship. I wanted to know what they were eating before and after this project started.

Delou, Halima, Maka, Mariama, Sahara and Sakina benefitted from this project. They are mothers and grandmothers between the ages of 25 and 80.

All combined, they have 41 children, although their families could have been larger. Through the years, these six women have suffered the loss of 24 sons and daughters in total. Sahara Mahama, 40, lost four children; one of them was only 14 days old. "I lost the youngest one during the rains, in the lean season. I didn't have enough to eat," she laments.

All of them emphasize that this year there wasn't enough rain, and little to eat. "Two years ago at least there were people who harvested spikes of millet, but this year the crops have been worse because of the drought and the leaf miners," says Delou Ibrahim, 70.

CARE's support has allowed them to feed their families at a critical time.

"Before this support, I couldn't; I was eating leaves," explains Maka Ali, an 80-year-old widow. "Not only can we buy millet and sorghum now, but also corn and condiments," explains Mariama Oumarou, 55.

"With this support, we get to eat abundantly," explains Halima Abdou, 25. She and the other women I talked to are now able to give their children two daily meals; porridge in the morning and sorghum paste in the evening.

Clockwise from left: Delou Ibrahim, 70. Her granddaughter Latifa, 8. Delou's hands hold sorrel leaves, used as a condiment, and grains of sorghum at her home in Saran Maradi, Niger. (Photo: Rodrigo Ordonez/CARE)

Delou Ibrahim has four children and suffered the loss of nine. She has about 40 grandchildren, 16 of which live with her.

"I've seen several crises. The famine in 1984 was the hardest. Rains were very weak. The stems of millet came out but the spikes gave no grain - nothing," she recalls. "Two years ago at least there were people who harvested millet, but this year the crops have been worse because of the drought and the leaf miners."

Delou's last crop was 30kg, which only provided food for about two days. Delou and her family receive cash from CARE. "I get to buy cereal to feed my family, particularly my grandchildren." They have two daily meals, porridge in the morning and sorghum paste in the evening.

Clockwise from left: Sakina Moudi (left), 30, and Halima Abdou, 25. Their children Kassoumou (right), 4, and Massaoudou, 10 months. Sakina takes sorghum out of a sack at her home in Saran Maradi, Niger. (Photo: Rodrigo Ordonez/CARE)

Halima Abdou has five children. Sakina Moudi has six children and suffered the loss of one.

Last year they harvested 40kg of cereal. "It only lasted for five days," says Sakina. This year they didn't get any crops.

In the periods without food, their husband collects and sells wood to buy yam flour. Now their husband participates in CARE's cash-for-work project and continues to sell firewood to get additional income. "With this support, we get to eat abundantly," explains Halima. "We buy millet, sorghum, and corn." They serve their children two meals per day, one in the morning and one in the evening.

Clockwise from left: Maka Ali, 80. Her granddaughter Maria, 10. Maka's hands hold sorghum at her home in Saran Maradi, Niger. (Photo: Rodrigo Ordonez/CARE)

Maka Ali has been a widow for twenty years. She has eight children and about twenty grandchildren. She has experienced the loss of six children, four of them at an early age. "I was alone taking care of them, so I cannot say their deaths weren't related to lack of food," Maka recalls.

Nobody in her family can work, so she receives a cash transfer from CARE. "When I receive the payment, I buy sorghum and maize," Maka explains. "Before this support, I couldn't; I was eating leaves."

Clockwise from left: Sahara Mahama, 40. Her daughter Mariama, 4. A bucket of millet at Sahara's home in Saran Maradi, Niger. (Photo: Rodrigo Ordonez/CARE)

Sahara Mahama has seven sons and a daughter. She lost four other children; one of them was only 14 days old. "I lost the youngest one during the rains, in the lean season. I didn't have enough to eat."

Eating has become increasingly harder through the years, recalls Sahara. "When I was a kid, we used to have three meals: in the morning, at noon, and in the evening.” However, one meal a day has now become the norm. "It's never guaranteed, but we try."

Sahara participates in CARE's cash-for-work project. With the money she receives, she buys cereal and gives her children two meals per day.

Clockwise from left: Mariama Oumarou, 55. Her granddaughter Rakia, 4. A hand holds grains of corn in Mariama's home in Saran Maradi, Niger. (Photo: Rodrigo Ordonez/CARE)

Mariama Oumarou has ten children and three grandchildren. Through the years she has lost four children and two grandchildren. She participates in CARE's cash-for-work project. "Not only can we buy millet and sorghum now, but also corn and condiments."

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I work with members of the US Congress and their constituents to improve our foreign assistance program. While much of CARE's advocacy work involves the US government, our country office colleagues also engage in advocacy with foreign governments. I got a taste of CARE's global advocacy work last week when I was asked to join meetings between CARE, Emory University (a research partner), and the Kenyan Ministries of Education and Public Health and Sanitation in Kisumu, Kenya. The goal of the meeting was to increase the government's investment in successful hygiene and sanitation programs in rural schools.

For the last six years, CARE and Emory University have worked on a program called SWASH +, which builds latrines and hand washing stations in schools. At the moment, the program is only in the Nyganza province, in southwestern Kenya, but CARE hopes that the government will provide the resources to replicate it across the country.

Studies have found that having clean latrines has positive impacts on health and reduces absenteeism, particularly for girls. CARE hopes that future research will prove that adequate sanitation also improves school performance.

In US advocacy, we generally work toward one of three goals: passing legislation, securing funding, or working with the administration to support policies. Once the law is on the books or the budget is completed, we take implementation for granted. We assume that the legislation will be carried out; the funding will arrive.

In Kenya, the end goal of advocacy work is another matter entirely. Here, the formal policies are comprehensive and support many development programs. Education is legally free; all citizens have the right to water and sanitation. But in reality, schools are not always functional; sanitation facilities are inadequate or absent.

The Kenyan ministry officials who joined us in Kisumu were supportive of SWASH +, but Kenya is changing rapidly, and the future of social programs is uncertain. The country has a new constitution. National elections will take place in the next year. After the post-election violence in 2007-2008, Kenyans are unclear as to what will come next.

Yet after debriefing on our advocacy strategy, my CARE Kenya colleagues realized that the tools we need to advocate for effective programs are similar across cultural contexts. Before starting a program like SWASH +, we need to determine key stakeholders in the community and the government. We need to conduct research that determines the effectiveness of programs, and we need to package that research in a way that is clear, succinct, and useful to policy makers. Finally, we need to engage stakeholders throughout the process and to consider them as critical partners.

To find out more about SWASH +, go to www.swashplus.org.

To support programs like SWASH +, call the Capitol Switchboard at 202-224-3121, ask to speak to your member of Congress, and tell him/her to support the Senator Paul Simon Water for the World Act (H.R. 3658).

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 Davis, Country Director CARE Madagascar
February 22, 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Melanie Brooks
Jan. 22, 2012

Dije Ousmana, 45 years old, breastfeeding her two-month-old baby Abdulahadi. Yan Sara village, Dakoro, Niger.

When Dije Ousmana looks down at her two-month-old baby boy, Abdulahadi, she tries not to think of her three other children, all babies like Abdulahadi, who died in earlier food crises. She has seen the signs before, and she is afraid: diarrhoea, difficulty swallowing, crying for more milk when there is none to be had.

In her arms, baby Abdulahadi stirs, opens his eyes, and begins to cry. Dije quietly puts him to her breast, but it isn't long before the cry turns into a wail.

"There is no milk," she said. "I haven't eaten yet today."

Outside, her daughter continues to pound millet for the family's only meal of the day. Dije's six-year-old son runs in and asks when the food will be ready.

Today, Dije and her extended family of 14 will eat just one bowl of millet, mixed with a bit of goat's milk and plenty of water to make it stretch farther. It's been three months that it's been like this, she said.

"The younger children ask all the time why we aren't eating," she said, telling her son to wait. "They don't understand. They think I am just not cooking."

Niger is spiralling down into a severe food crisis. A catastrophic combination of a failed harvest, returning migrant workers from troubled neighbouring countries, and soaring food prices has left more than 5.4 million people in Niger at risk of hunger; at least 1.3 million people, like Dije and her family, are in critical need of help now.

Across Niger, there are communities that have no harvest at all, and have already exhausted their food supplies and are starting to sell their animals and household belongings just to buy food to keep their families alive. In each affected community, the prognosis is the same: this crisis is already worse than the crises of 2005 and 2010.

"It's been years since we've seen a situation this bad," said Dije. "I already sold five of my goats, and we have just one goat left. We've sold everything to buy food."

Here in Yan Sara village, a poor community of 170 people in the barren semi-desert of rural Niger, children are already showing signs of malnutrition: protruding bellies and orange hair revealing the tell-tale signs of nutrient deficiency. Children with chronic malnutrition risk permanent stunting: they will never grow as tall as other children their age, and they may have developmental challenges as well. Severe malnutrition, if not treated, can lead to death.

Nearly 300,000 children will become malnourished across Niger this year, and that figure is expected to rise as the country's food crisis worsens.

But if help is provided now, we can prevent children from becoming severely malnourished, said Amadou Sayo, CARE's Regional Emergency Coordinator for West Africa. CARE has already started a cash-for-work program in partnership with the World Food Programme, which will help families buy food. But more is needed. CARE is raising funds to start an emergency food program for families like Dije's, who are already in dire need. High-energy, nutritious food for children, such as Plumpy'nut, a peanut-butter-like emergency food used to treat mild malnutrition, can help prevent children from becoming severely malnourished.

"Prevention is more effective, and less costly, than allowing children to become malnourished in the first place," said Sayo. "In a food crisis, helping the children is critical, as well as pregnant women and breastfeeding women. The adults can survive a hungry season, but young children are very vulnerable. If they don't have proper food, they start to get sick, they lose weight, and they are at risk of death."

For Dije, the situation is frighteningly clear.

"We need help," she said simply. "I don't want to lose another child."

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Mandefro Mekete, Emergency Operations Coordinator, CARE Ethiopia
Jan. 30, 2012

The case of Ashenafi, 35, illustrates how it is not a single event, such as a drought, that deeply affects people, but rather the cumulative impacts of a number of previous shocks.

I clearly remember July 2011 when the world started to focus its attention on the food crisis in the Horn of Africa. At that time, more than 4.5 million people in Ethiopia were in need of food assistance and water shortages were putting millions at risk of waterborne diseases.

I remember July 2011 because by then it had been almost a year since I released a drought alert for the Horn of Africa to our key partners. In August 2010, la Niña, a meteorological phenomenon that usually provokes dry weather conditions, was forecasted. As an Ethiopian who grew up in the north-eastern part of Ethiopia and who has been affected by drought, I knew the potential consequences of such a forecast.

In response to this, we at CARE immediately started to prepare ourselves to respond to the potential crisis. We launched our first relief interventions in February 2011 with activities to provide water to drought-affected communities in Borena, located in the southern part of Ethiopia. We also provided food assistance in East and West Hararghe in Oromia region and in Afar region in eastern Ethiopia. We later complemented our drought response with nutrition and livelihoods interventions in order to have an effective, comprehensive and integrated approach.

Chronic food insecurity is, however, commonplace in rural Ethiopia in any year, irrespective of unusual climatic or economic shocks. Many factors contribute to this, including land degradation, limited access to basic social services, population pressure, and near complete dependence on rain-fed, subsistence agriculture.

The vast majority of the Ethiopian population relies on agriculture for their livelihoods. As most agriculture is rain-fed, reliable and sufficient rainfall is critical for the country's economy, livelihoods and food security. Each year, depending on the location, Ethiopia has two rainy seasons and one or two dry seasons. The most difficult period of the year is called the "lean season", when food stocks are low and the new crops have not been harvested yet. This usually happens at the height of the rainy seasons. Food prices tend to rise during that period while livestock prices significantly decline.

People use different mechanisms to cope with the lean season, such as reducing the number of meals per day, buying less preferred food and selling key assets (e.g., livestock). Once key assets are sold, it takes a very long time for people to rebuild their capital. They therefore become increasingly vulnerable over time and are trapped in a cycle of poverty.

So, when the drought hit Ethiopia in 2011, people were not only affected by this event but by the cumulative impacts of previous events (droughts, floods, economic shocks or lean seasons).

Nothing illustrates this better than listening to the people affected by the drought. When asked about the impacts of the 2011 drought, many start recalling the interrelated chain of events over past years that have pushed them over the edge this year. The story of one man in West Hararghe last November is particulalry striking. Ashenafi, a 35 year-old farmer and father of eight children, explained to CARE how he progessively sold his productive assets over the years to cope with the drought or lean seasons. As result, he was backsliding each time a little bit more into the cycle of poverty.

In 2005, Ashenafi was in a position to provide a decent life for his family and send all his children to school. He owned a house with a corrugated roof and had three oxen, one cow, three sheep, three goats and thirty chickens. Then, during the 2006 drought he was forced to sell one of his oxen and three sheep. A year later, he had to sell another ox and his three goats to cope with the lean season. The last ox was sold in 2008, along with all his chickens. And then in 2009, he had to sell his cow that provided milk for his children. Moreover, every time Ashenafi sold his livestock, he did so at the peak of the lean season, which meant that he had to sell at a reduced price.

When the drought hit in 2011, with no other assets on hand, Ashenafi was forced to sell his house. He now lives in a hut with his family and has started to receive food assistance, initially from the Government and later from CARE.

My own family story is very similar to Ashenafi's. We were also farmers, and during the severe drought in 1984, my family lost all their assets. We had to sell our cows, plow oxen, horses and goats in order to survive. During that year and the one that followed, we received support from NGOs. My family participated in cash-for-work projects, where they worked on soil and water conservation activities in exchange for a salary. We also received funds to buy plow oxen that helped us to restart our agricultural activities.

Two years later, my father was able to secure a position as a guard in a government seedling nursery. As a result, we were less vulnerable. We still continued to farm, but a low harvest no longer had the devastating impact it did before.

Progressively, my family was able to rebuild its capital and buy plow oxen, sheep, goats, cows, donkeys and horses. Recovery was a long process, but eventually all my siblings were able to graduate from college and find good jobs. Today, we are in a position to resist shocks, such as drought, and we can also support other family members and friends.

Ashenafi's family can follow a similar path if they also receive timely and appropriate support. Receiving seeds and small ruminants will help his family to restart their agricultural activities in the short term. Water system rehabilitation/development will ensure that his family has reliable and easy access to water, which will positively impact the health of all the members of his household. Since women typically bear the main responsibility for fetching water, this will also free up time for his wife and daughters – time that can be better used for school and productive employment.

Other initiatives, like village savings and loans associations, will help his family to accumulate savings, improve their cash management skills, and enhance their access to credit. Such projects, which focus on gender equality, will also help Ashenafi's wife to be more active in her community and engage in income-generating activities, therefore increasing her family's income.

We know how to support people to improve their resilience against recurrent shocks, thereby avoiding future crises. Ideas abound, but recovery support will be critical. Ashenafi and his family will get back on their feet only if we immediately support them in recovering from the drought and continue to do so in the medium/long term. This way, in a few years Ashenafi's family can also succeed like my family did and become independent and resilient. Let's work together to make this happen.

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

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

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

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

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

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

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

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

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

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By Melanie Brooks
Jan. 21, 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Haiti – 2 year anniversary of earthquake

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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"I see her growing up and developing physically and I worry," she says. "When you become a mother at a young age, without any other asset available, you live the rest of your life in misery. No mother would like to see her child living in a similar situation."

Maude is attending a meeting at CARE's reproductive health center in the community of Santo, Léogâne. Officials estimate Haiti's devastating January 12, 2010 destroyed 80 to 90 percent of the buildings in Léogâne. This included not only homes but also the infrastructure of the normal life people rely on: markets, schools, government offices, and health clinics.

The earthquake turned Santo into a tent city of almost 10,000 people. CARE quickly moved in to help, distributing delivery kits and supplies for pregnant mothers and newborn babies, and offering counseling sessions to lower the risk of gender-based violence in this traumatized community.

More recently, CARE built the Santo health center, one of two it has constructed so far and one of 10 planned in all. CARE staff and nurses from a nearby hospital offer education on overall sexual health, contraceptive pills and injections, condoms and group informational sessions for men and women on the prevention of gender-based violence.

Maude often brings her daughter to the center because she's determined her daughter will avoid the hard life she has had. At 36, Maude is the mother of eight children.

"I have four children with a man I didn't love," Maude says. "He didn't want to use contraception and I didn't know how to protect myself." Maude eventually got married and had four more children with her husband. She and her husband attend CARE-sponsored sessions at the center because they've agreed they do not want to have more children.

Nurse Marie Kencia Dulorme is preparing a vaccine at one of the women's centre setting up by CARE in Leogane to provide reproductive health and referral services.

"My husband participated in numerous session organized by CARE's staff," Maude says. "He is now aware of the risk I run by multiplying pregnancies and has decided to protect me by using condoms."

Maude's daughter attends sessions on teaching her about birth control, prevention of HIV and other sexually transmitted diseases, as well as classes on preventing gender-based violence. Maude says the classes have relaxed tensions between her and her daughter. Her daughter now understands her worries, she says. And she now has the right words for explaining to her daughter how and why to be cautious.

Maude expresses gratitude for the center, and she is not alone.

"Even when CARE staff is not here, women from Santo who were trained by CARE are inside sharing their knowledge with their peers," says Willio Sainvilus Latagnac, president of the Santo community association. "The community made this space their own and women have their own area where they can discuss their problems, find solutions together, and regain strength."

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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.

Richard Wecker – CARE International in Vietnam
Thạnh Mỹ Tây commune - Châu Phú district
December 20, 2011

Le Thi Dieu is 72 years-of-age but she possesses the sharp wit of a curious teenager. She offers her warm smile and laughs aloud, speaking candidly of her life in An Giang province - one of the most flood-prone areas of the Mekong Delta in Vietnam.

For many years Ba Dieu had resided under a makeshift shelter on the banks of the river only 10 minutes by boat from the centre of Thạnh Mỹ Tây Commune. She recounts stories of trudging through floodwaters, her house being uprooted and searching for food.

In her recent years, Ba Dieu has supported herself by collecting morning glory (an Asian vegetable) and selling it at the market to buy rice to eat. A day's collection might amount to VND 10.000 (US$0.50).

The Mekong Delta is her home and she has lived in this region her whole life.

An Giang is the northern most province of the Mekong Delta in Vietnam, which borders with Cambodia - the start of the floodplain. The floods are the source of livelihoods in this region as rich sediment and ample water moving downstream creates a nourishing environment for rice production. However, every so often – like this season – the floods are beyond normal levels, destroying the current crop and disrupting farming for some time after. This year the water has peaked at levels that were last recorded during the devastating floods in 2000, putting people like Ms Dieu in a serious situation. "I hadn't eaten rice for 2-3 days," Ba Dieu says.

Ba Dieu received a fortnight's worth of rations in an immediate distribution of food from CARE International in Vietnam. "I was so happy when I received the invitation to collect my rice. It means I now have enough to eat and I don't need to borrow from other people in the area. It's enough to support myself and my family for my family during the most difficult time of this flood," she says.

Ba Dieu says that she decided to give one of the three 10 kilogram rice bags she received to her adult son. "His eyesight is poor and it's difficult for him at this time too. It's hard to catch fish as the winds are still strong," she says, "he helps me tend to the garden and lift heavy things."

CARE's food distribution aimed to provide assistance for the most vulnerable people - the poor, women-headed households, people with disabilities and the elderly in flood-affected areas of An Giang. The food rations were intended to strengthen the coping capacity of the community while floodwaters remained high.

The area where Ba Dieu lives is surrounded by a ring dyke that has protected her from the full force of the floods, however she recounts when the floodwaters of previous years would rise between the cracks of her house. Ba Dieu smiles as she says: "if the dyke holds, I can survive like this".

It's a difficult time for many people living with the floods, especially this year, but Ba Dieu refrains from complaining about her own circumstances. Her strong character and charm has kept her in good stead with the community as a support network.

CARE International in Vietnam will provide additional food distributions to strengthen the coping capacity of at-risk communities in An Giang province. Livelihood interventions are also being planned in consultation with local communities to assist with the recovery period for 3 to 6 months from now.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*A kebel is an Ethiopian village

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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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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.

CARE International UK's Programme Director, John Plastow

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Rick Perera, Horn of Africa Communications Coordinator

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Niki Clark, Dadaab Emergency Media Officer
August, 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

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*Identifying characteristics have been changed to ensure confidentiality.

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

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

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

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

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

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

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

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

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

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

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Niki Clark
September 20, 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Borana region of Ethiopia is known for its deep traditional wells that are the main water source for livestock and household consumption in the dry season and in times of drought. These wells are known as the "singing wells" -- because when people fetch water they form a long line up a ladder and sing as the water container is passed from one person to another, until it reaches the last person waiting above ground. The traditional wells have kept the people and livestock safe for generations – until this current drought, when they stopped giving water. "There was never a drought like this one that made the traditional singing wells of Borana run dry. Never in history," said an elderly man from the community, with an expression of disbelief. 

Due to the greater number of deaths of livestock recently, and migration of the remaining animals, it was normal to expect that there would at least be less pressure on the wells now, as they would serve only for human consumption. But their natural capacity to produce water has dropped precipitously, making the situation increasingly dire. 

Previously both animals and humans took water from the same source – but in the recent past CARE, through our Resilience Enhancement Against Drought in Ethiopia (READ) project, rehabilitated these 12- to 15-meter-deep traditional wells for better and more hygienic accessibility and quality of water during dry seasons and droughts. But even these improvements cannot make the wells give water when nature does not cooperate.

Currently, rationing is in place in five woredas (districts) at water points served by different NGOs. CARE has continued rehabilitating water points and providing water purification solution.

After the great number of deaths of livestock, the lifeblood of Borana pastoralists, it has become normal to hear people saying, "We have stopped thinking about our animals now. We are worried only about lives." Cereals are in short supply in markets, and prices are out of reach for many. Malnutrition for nursing mothers and children under 5 is another serious issue that is getting worse day by day. 

More and more cattle can be seen for sale at the market, but their selling price is lower than ever and few buyers can afford them. The rate of deaths has been slowing lately, but as rains fail and drought conditions persist, the situation is again deteriorating – precious herds are dying.

CARE is actively involved in preventing the loss of livestock, by providing feed and helping herders manage their herd size, culling animals while they still have some value for meat, rather than letting them starve. We are also providing supplementary feeding for malnourished children in three woredas and scaling up to reach two more, as the number of new cases soars.

The songs may not come back to the wells anytime soon, but CARE is determined to bring a note of optimism to the herders of Borana in these difficult times.

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Adulkadir Adbullahi Muya—known by his colleagues simply as Muya—is in a hurry. He hardly has time for a handshake greeting before he is off, his long stride forcing the occasional sprint in attempts to keep up.

Muya is a paracounselor with CARE in the Dagahaley camp of Dadaab Refugee camp. He identifies people in his community who have experience trauma, loss or violence and handles initial consultations.

Paracounselors like Muya are specially trained, identifying the violated and vulnerable within the community and handling initial consultations. He walks this route several times a day, going back and forth between the CARE Counseling office and the drop-in center.

Right now he is headed to meet a new client, someone a CARE community mobilizer told him about. A bus was hijacked on the journey from Somalia to Dadaab. Women were raped; people were burned. The details are fuzzy but he knows it's serious. His pace quickens, his fingers furiously texting, always working, even as he walks. He briefly turns, "Dagahaley is growing and growing," outstretched arms for emphasis. Indeed, it is. The population of Dadaab has more than doubled in just three years.  

We rush past Unity, a primary school CARE runs in Dagahaley, the sing-song chorus of children echoing from the classrooms. Past a lone donkey, munching his way through a burned refuse pile, searching for anything edible. Through shouts of "How are you?," a charming acknowledgement by refugee children of Muya's obviously English-speaking companion. By mud bricks in a yard, past a naked toddler beating an empty jerry liter, applauding himself for the rat-a-tat noise his impromptu drum makes.

A resident of Dadaab since 1991, Muya went back to Somalia in 1997 and after nearly a decade, returned once again, this time bringing his mother. He works with an unceasing determination, often working through lunch breaks in order to squeeze in just one more visit. The pride he holds in serving his neighbors in this way is evident; it comes through in his stance, the way he speaks of his "clients." The sweat beads that form on his brow in this ungodly heat remind me of a musician, just finished with a high-energy performance. It's an accurate impression. In many ways, Muya is a rock star.  

On the way to the drop-in center, Muya walks past the home of one of his current clients. A quick change of plans and Muya walks in the yard, greetings all around. An elderly refugee woman sits on a mat outside her mud hut. I smile softly in her direction but notice her blank eyes, she is blind. A lump grows in her neck glands; multiple hospital visits have answered none of her questions. Muya asks how she's doing, is she in pain, does she need him to make any calls?

"Sometimes I just stop by to say hello," Muya says about his visits. One man he stops to see has a cancerous tumor that is enveloping the back of his head, creating constant pain. His only option is chemotherapy, which he can't afford. But Muya stops by every day, every two days. "I don't want him to lose hope. Maybe one of these days, if I keep referring him to different doctors, reaching out to different people, then maybe someone can intervene and help him. Until then, I'll keep listening, searching for help. I want him to know he hasn't been forgotten." 

As he speaks, another woman walks up, complaining of constant headaches and vision problems. Can he help her? She heard he could. "New clients," Muya says with a smile. "Every day, you get a new client." He jots down her information and refers her to the medical center before he is off again. Muya has his fill of new clients today. He is stopped no less than six times on his way to the drop-in center.

One is a woman who has lived with her condition for six years, four of them in Dadaab. She, too, spends her days sitting outside on a woven mat, not walking except to the latrine, which is fortunately just a couple of feet away. Her arms and legs are thin like twigs, breakable, yet her abdomen is swollen like the belly of a mother on the brink of birth. But this woman isn't pregnant, her eldest is eight. And no one can seem to tell her what's wrong. She asks Muya to photograph her; that maybe he can show the picture to another doctor, one she hasn't seen before, and this one could help. Muya promises to follow up and then heads out.

There are more people to see.

Because the sun is fading, and the drop-in center is still far, Muya calls the daughter of the woman he originally set out to see and asks if he can meet her at the block instead. It is in fact, right next to Muya's block in Dagahaley, so he knows exactly where to go.

Muya with the some of the refugees (including a client, bottom left) with whom he interacts with regularly, not only as a paracounselor for CARE, but as their neighbor and fellow refugee.

The woman's family surrounds her as he makes his way to her house. She lifts her dress, revealing a painful and hideous wound, where the men covered her with paraffin and firewood and set her on fire. It was her punishment for resisting rape. After her bus was hijacked, women were brought into a nearby forest and raped. When she fought back, she was burned. The hijackers stole the bus, and so the woman had to be carried by the other refugees to Dadaab. Luckily—if you could call anything in Dadaab that—her daughter was here and had a mud house to offer. She visited the hospital with her husband, who could just watch as she was attacked, but they couldn't afford the recommended procedure so they returned back to her daughter's home with just pain pills and topical cream. That was two weeks ago. Yesterday, CARE had met with the men on the bus, today the women survivors. They needed to talk through the horror they had witness.

"I still feel the pain," she said, "Like my skin is on fire." When Muya asks her about her other pain, the pain that's will remain after her leg heal, she tells him, "I've accepted what has happened to me. What is disturbing me is my wound, my physical pain. If I can get treatment, and I can't see the scar, I will be able to forget about it."

In a world where violence, loss and death are an everyday norm, this may be true. But Muya will not forget. He gets her details; promising CARE counselors will follow up and ensure that the woman receives both the physical and psychological care she desperately needs. She is not alone, she will not be forgotten.

Muya and the woman part ways, nightfall is approaching quickly and he wants to get in one more visit. He shouts his goodbyes from over his shoulder; like always, he is in a hurry.

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by Niki Clark, CARE Emergency Media Officer in Kenya
September 2011

One of my "duties" as an emergency media officer here in the refugee camps in Dadaab, Kenya, is to share my perspective of CARE's work and beneficiaries through social networks such as Facebook and Twitter. And being the dutiful employee I am, I often Twitter-follow recent Dadaab visitors so that I can in turn share their perspectives of the camps.

One such recent visitor was Somalian-born, Canadian-raised singer K'naan. Although K'naan found worldwide fame only recently through his 2010 FIFA World Cup theme-song Wavin' Flag, he has been amassing fans for more than 10 years, when a spoken word performance before the United Nations High Commission on Refugees caught the ear of famed Senegalese singer Youssou N'Dour (another recent Dadaab visitor). After K'naan visited Dadaab with a World Food Programme-CARE joint delegation, which included friends of CARE Cindy McCain and retired NBA superstar Dikembe Mutombo, @Knaan became my latest Twitter-follow.

For the past week or so, I have been struggling with the two very different Dadaabs I have experienced. Then, yesterday, I read a tweet that perfectly captured what I have been trying to express:

"Somalia is overflowing with beauty." @knaan reflects on his Somalia, not necessarily the one you see on the nightly news.

In midst of the strife and turmoil, hidden between the heartache and uncertainty, and tucked away behind the dire poverty and desperation of a homeless people, the people of Somalia – the refugees of Dadaabb – are an overflowing vessel of beauty. Because the unexpected truth is: there is beauty everywhere, even in the world's largest refugee camp, where I see:

The luminous glow of a fading sun, moments before dusk, as we head back to the compound to meet our curfew.

The joy of a widow's eyes and the firm grip of her hand as I tell her about CARE's livelihoods program; that she too could learn how to operate a business of her own, to educate and feed her four young children.

The gentle touch of a small child, no older than 3, when she reaches out to shake my hand in greeting and decides, instead, to kiss my hand.

The pride and confidence of a recent graduate of CARE's Community Tailoring School as she displays the bags she made with her own two hands, which she sells in the Hagadera market, allowing her some independence in a culture of dependency.

The lines of an elderly man's face, and the stories the lines tell of loss beyond description, and of a determination that guides him forward day byday in spite of it.

The toothless grin on a 5-day-old baby girl, born on the journey from Somalia, her 10 perfect fingers, 10 perfect toes.

When I was an art student in college, I did a photography project on raw beauty – the beauty of accomplishment, the beauty of the everyday, of the unintentional. I have seen incredible poverty in Dadaab, things that people should never see, things that should never exist. Back in my Washington, D.C., office, I have CARE's vision tacked to my cubicle walls:

We seek a world of hope, tolerance and social justice, where poverty has been overcome and people live in dignity and security. CARE International will be a global force and a partner of choice within a worldwide movement dedicated to ending poverty. We will be known everywhere for our unshakable commitment to the dignity of people.

It's a constant reminder for me of the essence of CARE's purpose: Defending Dignity. Fighting Poverty. Because dignity is beautiful. People who are able to control their own destinies and raise themselves above the situations into which they are born: this is true beauty. And it's all over Dadaab.

As a native of Somalia, K'naan is able to see something that most people in the world will never see: the beauty of Somalia and its people. Dadaab may never make Travel & Leisure's "Top 10 Most Beautiful Places' but the people of Somalia – who are the refugees of Dadaab – are some of the most beautiful people in the world.

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by Rick Perera, CARE Communications Coordinator, Horn of Africa
September 2011

Janet Ndoti Ndila is a tough lady with a tender heart. She's the lead counselor at CARE's drop-in support center at the Dagahaley refugee camp in Dadaab, Kenya. Here she offers a trained ear, and a map through the maze of camp bureaucracy, to people who have suffered some of the most horrific things imaginable in their flight from hunger and despair.

Janet and her colleagues are the first resort for thousands of weary, dejected Somalis pouring out of their famine-stricken homeland into this complex of camps, the largest of its kind in the world, now sheltering nearly 430,000 people. She doesn't let the experience dampen her upbeat, take-charge personality. But there are days when it can get overwhelming.

"I've worked in worse places – places where there's immediate, ongoing bloodshed. That's not the case here, but the things people have lived through…" Her voice trails off.

Providing Physical and Emotional Rest

Janet leads the way to CARE's distribution center for new arrivals, a large tent where refugees collect initial rations to tide them over until they are registered as camp residents. An efficient operation whisks them through as they collect plastic mats, jerry cans, cornmeal, beans, salt, oil and other essentials. Nearby, a set of taps offers plenty of safe water for washing and drinking.

More than physical hunger and thirst are looked after. Janet and her staff usher in group after group of tired, bewildered families and sit them down on rough-hewn benches in the shade of a canvas tent. Janet – a native of Kangalu in eastern Kenya – speaks to them reassuringly through a Somali interpreter. Here they get their first orientation to Dadaab: how to negotiate the labyrinth of services available, register for food distributions and shelter, and gain access to medical care for the weak, the malnourished, the sick and those injured during the harsh journey.

There are wounds to the spirit, too, and these are Janet's most important responsibility. Most of the refugees have seen and experienced terrible things before arriving here. Not just the suffering of poverty, hunger and warfare back in Somalia, but the trauma of being uprooted from home and family, and the loss of loved ones: the elderly, frail and children who did not survive the trip. Many fell prey to bandits along the way, robbed of everything when they were at their most vulnerable. And in every group of new arrivals there are women bearing terrible secrets, of brutal violence and rape suffered in the lawless wilds they were forced to cross in search of safety.

Refugees Counseling Refugees

CARE's paracounselors are a team of 18, as energetic and outspoken as their boss. They are all refugees themselves, recruited in the camps by CARE and specially trained to handle initial consultations. They are familiar, compassionate faces, fellow Somalis who understand what their compatriots have been through. The paracounselors quickly identify survivors of sexual violence and other particularly vulnerable people, "fast-track" them for special assistance including food and essential household items, and refer them if needed for medical attention. Women who are in immediate danger from domestic violence can take shelter in a community-based "safe haven" until they have somewhere safe to go.

Nearly 4,700 refugees have come to CARE for counseling and support in just over three months – 1,111 during the week of Aug. 28-Sept. 3 alone. The women who seek Janet's help have suffered more in a few weeks than anyone should bear in a lifetime.

Responding to the Different Needs of Men and Women

Today Janet met a client, who arrived two months ago and set up housekeeping on the outskirts of Dahagaley camp, in a crude hut made of cardboard boxes on a frame of bundled sticks. Before leaving Somalia, as her family's meager farm shriveled to nothing, the woman watched two of her three children die of hunger and disease. Crossing the desert on foot, she was robbed of everything – even her precious supply of water – then gang-raped. It is a horrifying story, but the woman speaks with a steady tone. She wants to give voice to the terror, to speak out on behalf of those who must remain silent in fear.

Men, too, suffer their own nightmares. Initially many stayed behind in Somalia to watch over homesteads and herds. But as famine continues to spread, crops have been decimated. When their last cattle starve, men are forced to make the trek to Dadaab in search of help. For those from proud, ancient pastoralist traditions, who measure wealth in terms of how many cattle a person owns, the loss of a sense of identity is devastating.

"Not quite as many men come as women, for cultural reasons, but they do come," said Sharif Ahmed Abdulahi, a CARE paracounselor trained in community development, life skills and counseling. He and his colleagues are careful to respect tradition and work in harmony with community norms. "Sometimes people ask me to tell them what to do. I say: I can counsel you, but I can't advise you. If you want advice, you should go to an elder."

Janet is busy recruiting additional staff to reach more people in need. She wants to hire and train more female counselors – just under half of the current refugee workers are women – but it's hard to find candidates who are literate, and many young girls are married off at age 14 or so.

But Janet is not someone who gives up easily. She thrives on challenge, and finds this work incredibly rewarding. One thing is clear: she's not going anywhere soon. "I plan to stay as long as I still like it. It will be a few years."

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When I told my family and friends that I was leaving for six weeks to work with CARE on temporary assignment in Dadaab, the world's largest refugee camp, I was immediately bombarded with Facebook messages, e-mails and calls along the lines of "I'm so proud of you. You're going to save the world!" and "You're making such a difference!"

To be honest, besides being a bit exaggerated, it makes me a bit uncomfortable. Now, don't get me wrong, I cannot emphasize how much I appreciate the good wishes and thoughts of my loved ones. Their support has allowed me to take this journey. But nothing — absolutely nothing — compares with the dedication and passion of CARE's employees in the field. And to even be put in the same category as these colleagues seems more than a bit ludicrous.

This past weekend, for example, I took part in my first real Dadaab celebration —complete with grilled goat (a rather tasty treat, if you're curious) — a send off for long-time CARE employee, Julius. Julius is leaving Dadaab for a new CARE post in Nairobi after nearly 19 years in Dadaab. Nineteen years! That's the equivalent of 133 years in a normal career, as I'm convinced Dadaab years should be counted like dog years. He joined CARE when the refugee population in the camps was around 35,000. Today, nearly 400,000 additional people have been added to that number.

For 19 years he has lived here away from his family. He most likely has shared a room and used a communal bathroom and shower. Because space is at a premium, when a staff member goes on leave, people exchange rooms, some moving every few weeks. There are no hanging photographs, no personal mementos. In many ways, the staff is unsettled as the new arrivals. They are nomads without a home. They work for hours on end in the unforgiveable combination of heat and dust.

I am here for six weeks, and even in that relatively brief time, I have succumbed to heartache and homesickness. I assumed that unlike me, the devoted staff in Dadaab must have solitary lives, free of the commitment of relationships. Until I met Maureen, a new coworker who casually mentioned her three-year-old son and husband back in Nairobi. Or another colleague who mentioned how he was planning some quality time with his wife during his next break. CARE staff work eight weeks on, two weeks off. Because of limited resources, sometimes even those brief breaks get shortened. But I have yet to hear a complaint. I have yet to see a frown. There is a Jewish proverb that says, "I ask not for a lighter burden, but for broader shoulders." CARE staff in Dadaab are star athletes in that regard.

In addition to the tough environment in which they work, the actual work they carry out is difficult. Imagine feeding 427,000 people. Getting clean water to them. Educating them. Training them. These jobs are difficult no matter the circumstances – but in these conditions, accomplishment is an amazing feat. Many that have made the long trek from Somalia have experienced personal violence or loss, each tale of tragedy and horror more unfathomable than the one before. CARE's sexual and gender-based violence officers have the colossal task of helping the survivors heal, start their lives anew. Day after day after day.

I asked a colleague why staff that work so hard, so tirelessly. And why are the people that CARE serves, people who have been through the most of trying of times, always smiling? Why despite everything that surrounds them, do they always greet me with a handshake, with a sense of joy? He answered, "Because we are Africans. We have been through so much and we survive. We have hope now."

No individual is saving the world. But here among CARE's dedicated staff, I have met a lot of people who are doing their part.

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by Niki Clark, Emergency Media Officer in Kenya
September 2011

I’ve been in Dadaab for nearly two weeks now. I have seen mothers and daughters, fathers and sons. They have been old and weak, young and weak, their faces lined with struggle. I have seen the faces of children who have eaten their first meal in weeks and the resulting transformation back to childhood, full of giggles and smiles and impromptu games of tag. When people think of Dadaab – now with its three camps considered the third largest city in Kenya – they think crisis. They think emergency. Humanitarian efforts and funding tend to focus on the immediate, looking ahead no more than a year. As soon as another emergency hits, the spotlight will move on. But, as they have for the past 20 years, the refugees of Dadaab will remain.

This thought particularly struck me during a visit to the reception center, the first place where refugees find help after a long and arduous journey. Here they receive medical assistance, and aid workers identify the most vulnerable for immediate attention. A chorus of wails echoes from the vaccination room: the occasional child slipping from the grips of the nurse, running to the dirt yard in tears. Each family collects a 21-day ration of food and supplies (cooking pots, mats, a tarp, soap, jerry cans) to tide them over until they can register.

Today, I see a young mother waiting for her high energy B-5 biscuits, a box of which is given out to new arrivals. Tucked under her garbasaar – a traditional shawl – a set of tiny toes poked out into the sunlight. I approached her gently, and she pulled back her wrap so I could see his miniature features. He is 10 days old, she tells me with a smile. She gave birth to him halfway through her journey to Dadaab. Most likely, I thought to myself, he will become part of the second generation that has spent their entire lives within this camp.

CARE has worked in Dadaab since 1991. Refugees who were educated as children here are now teaching refugee children themselves. That’s why the long-term investment that CARE is making here is so critical. It’s not just an investment in immediate needs, although we’re doing that, too. On an average day of food distribution, CARE passes out 389 metric tons of food to 45,000 people. And every single day, CARE pumps and distributes approximately 7.5 million liters of water, enough to provide more than 446,000 people with 15 liters of water every day.

But we’re also working toward long-term solutions. We’re investing in people. In Dadaab there is a thriving economy – butchers and bakers and, yes, probably candlestick makers. They own restaurants and bookstores and barber shops. People are being trained by CARE in trades from dressmaking and tailoring to computer technology. CARE directly employs 1,600 refugees, who serve as counselors, food distributors, chefs, teachers and drivers. They grow up in Dadaab, are educated in Dadaab and work in Dadaab.

After the “emergency” has passed, hundreds of thousands of people will remain here in the refugee camps. As my colleague told me today, they need more than food, water and shelter. They need a future. CARE is committed to helping them prepare for tomorrow, whether they continue to build their lives here, or one day, return home to start anew.

The drive to the Galbet Farm in Garissa, Kenya, looks strikingly similar to the land around Dadaab, site of the world’s largest complex of refugee camps. It is dry and barren. The bush remains brown and leafless after months upon months without rain. It seems like an unlikely environment for a farm – one that will thrive, anyway.

But thrive is exactly what the farmers at Galbet Farm are doing. While the drought is killing the livestock and destroying people’s livelihoods in neighboring regions, this one small patch of land in Garissa is literally an oasis in the desert. It’s not just through happenstance. The people of Garissa knew a drought was coming so, with CARE’s help, they prepared.

For the past two and a half years, CARE’s Arid and Marginal Lands Recovery Project Consortium (ARC) has worked to promote drought-resilience in the Garissa, Moyale, Wajir and Mandera districts. The three-year project reaches more than 85,000 people, in a region where the drought is affecting half of the population – some 2.4 million people. In a region where 80 percent of the population is dependent on livestock, the death of animals is devastating.

CARE’s objective in launching the project in the aftermath of the 2008-2009 drought was to help vulnerable rural people gain sustained access to food and become more resilient in the face of future crises.

Maka Kassim is one of those people. As a pastoralist, she and her family followed their livestock wherever pastureland and water could be found. After a severe drought five years ago, her herd died and she was left with nothing. “I decided I needed to plan so I could provide for my family – so we could get our daily bread.” she says.

Today, Maka is flourishing. CARE taught her how to farm and diversify her crops to protect against disaster. As part of the Galbet Farm cooperative, she and the other farmers grow fodder grass, bananas, tomatoes and mangos. In addition to providing enough food for her family, including her six children, the farm has been so successful that she is able to supplement her income by selling extra produce at the market.

CARE also is helping improve water canals. Previously, farmers collected water from the Tana River, a time-consuming and dangerous task considering the river’s high population of crocodiles. The old canal cut through loose soil and experienced frequent breakages and high seepage that resulted in a large loss of water. Now, an abundant supply of water comes to the community to irrigate the land and provide fresh drinking water at tap stands.

Galbet Farm is just one of several ARC projects. CARE’s work through the project includes teaching beekeeping, fodder production, milk marketing and basic veterinary skills. We’ve also helped foster a relationship between First Community Bank and the Kenya Meat Commission. Farmers now purchase weakened cattle from drought-stricken districts, bring them back to the farm to fatten them up and then sell them for a profit.

“We want to serve as role models,” Maka says. “Because of CARE’s assistance, I am able to feed my family. I am able to educate my children. I am able to plan for my future.”

Niki Clark, CARE Emergency Media Relations Officer
30 August 2011

Here I sit, 7,500 miles away from home. I’m a week in. Over the course of just a few days, my life has completely changed. On a Monday I reported to work at CARE’s Washington, D.C. office. By Thursday I was on a plane bound for Nairobi where my final destination would be Dadaab Refugee Camp, the world’s largest. I will spend the next six weeks here as CARE’s emergency media officer. It is a position that both thrills and terrifies me. As an employee of one of the most prominent global humanitarian agencies, there is always an excitement that surrounds “going to the field.” But this is different.

Unlike my colleagues who have preceded me in this position, and most likely the ones that will follow, I have not been in a humanitarian emergency crisis situation before. I haven’t seen the devastation of a Haiti or a Pakistan. The closest I’ve come was the fall of 2005, when my grandmother came and lived with us after Hurricane Katrina. Her Biloxi home had been destroyed. But even then, I witnessed the situation only through my constant refreshing of CNN.com, and through my grandmother’s stories, not firsthand. And Dadaab is unlike other emergency situations. It is established. There are second generation refugees that have grown up in the camps. I’m not quite sure what to expect. Or how what I experience, the people I meet, will forever impact me.

CARE has worked in Dadaab since 1991, as the main implementing partner for the distribution of food and water and as well as a lead provider of education and psychosocial support and rights education for sexual and gender-based violence survivors. We’ve been here for decades. But with the recent declaration of famine in five regions of southern Somalia, coupled with ongoing conflict and instability, a surge of new arrivals have flocked to the camp, and a global spotlight has been shone on the region, particularly on Dadaab. Dadaab’s population stood at 423,361 as of August 28th. Every single day, it grows by 1,200.

As we landed—my colleague Michael Adams, the Senior Sector Manager for the Refugee Assistance Program in Dadaab, and I flew in on a small UNHCR humanitarian aid plane—the pilot circled around towards the gravel airstrip. A bird’s eye view of Dadaab and its three main camps became visible below me. It was a breathtaking site, a massive settlement that’s now effectively Kenya’s third largest city. It’s hard to fathom until you’ve seen it. And even then, when it’s right in front of you, and you’re face to face with women and children and families that have traveled 80 kilometers or more to get here, there’s still something surreal about it all. Something that makes putting it into words seem a sort of insurmountable task.

But that’s what I’m here to do. To share the lives of the people I meet, people up against incredible odds, some who have thrived and some who are struggling to survive. To share the stories of the unwaveringly committed CARE staff whose dedication to the people they serve is first and foremost. To share the successes of CARE’s programming, and its far reaching impact. I’m not sure if I’m up to the challenge; if I can accurately portray the scale and struggles or the unexpected hopes and triumphs. But I do know one thing. I’m going to do my best. There are too many lives at stake not to.

For updates on my experience and CARE’s work in Dadaab, follow me at @nclarkCARE. I can also be reached at nclark@care.org

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Adam Poulter, Emergency Response Manager for CARE Australia
August 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What role does the Kenyan government play?

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

What are the biggest challenges right now?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Resilience is key

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

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

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

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

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

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

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

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

By Sandra Bulling

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

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

Maize porridge, twice a day

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

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

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

Searching for labor

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

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

A malnourished generation

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

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

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

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

Her story, however, is nothing to envy.

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

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

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

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

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

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

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

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

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

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

*Not her real named

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

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

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

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

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

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

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

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

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

*Not her real name.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dama Godana	Darara Women	Darara Hay pens	Darara Pressing Hay

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

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

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

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

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

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

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

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

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

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

A whole day to fetch water

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

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

One meal per day

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

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

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

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

By Audrée Montpetit, CARE Senior Humanitarian Program Quality Advisor

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Photo: © CARE 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

July 10, 2011

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

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

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

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

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

By Alexandra Lopoukhine, Emergency Media Officer
July 7, 2011

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

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

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

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

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

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

By Alexandra Lopoukhine, Emergency Media Officer
July 6, 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

800 people have sought shelter in a high school in Yamada. In the back is the "office" of the shelter where staff sort items and distribute medical supplies. Photo: CARE/Robert Laprade

The CARE Japan team returned for the second time to the disaster zone in the northeast of Japan and have now been here for a week.Whilst setting up CARE Japan's aid program, we have had days where we have made great progress, but also some days of setbacks and few advances- this is the reality of an emergency relief site.

Yamada town in Iwate Prefecture, the chosen town for CARE Japan's new relief programme, is one of the towns to have been very badly damaged by the earthquake and tsunami. I had never visited Iwate Prefecture until now, and didn't know much of the area, but the first time I visited Yamada and saw the sheer devastation, I was lost for words and my heart stopped. Many of the houses had been washed away and destroyed by the tsunami. A town of rubble, as far as the eye can see, with strangely shaped fragments in every nook and cranny, cars in outrageous places and a burnt odour looming over the houses that weren't washed away but burned down. Although I can't believe I am looking at a Japanese landscape, I was reminded that this is the present undeniable reality.

I looked out beyond the tsunami-scarred coastline, and saw the contrast of the tranquil and beautiful ocean. When we first came to conduct a survey, the beauty of the ocean caught my eye. I am sure the people of Yamada must have been proud of the ocean. It is easy to imagine the sea rich in marine life, such as oysters and seaweed. Everyone we have met who lived by the sea has had their house or people they loved, and their hometown's beautiful view engulfed by the tsunami in an instant. I keep asking myself 'what on earth can I do to help?'

However, everyone here is determined to overcome the devastation; the town hall officials working 46hours straight; the mothers who despite having damaged houses themselves, go to the evacuation centres everyday to help out in the soup kitchen; the high school students moving boxes as their small contribution, the people who wrote 'Smile!' in big colourful letters to encourage the children; everyone is playing their part towards the restoration. We were very encouraged by these people as we made our preparations to begin CARE Japan's relief cooperation.

The people of this town are determined to survive. Even though they face such great insecurity as to how they will live from now on, and questioning what will happen next, they all support and care for each other living as evacuees. The CARE Japan staff, our international colleagues who came to assist us and I aim to support the admirable people of Yamada to help restore their once beautiful town and their individual livelihoods.

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

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

Dear Colleagues,

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

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

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

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

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

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

There are many other critical needs in the displaced people's camps as well. A camp that we visited had no water supply, to