Showing posts from category Haiti.
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Natalia Machuca, USAID
New Demographic and Health Survey Shows Positive Results in Haiti
›July 30, 2013 // By Wilson Center Staff
The original version of this article, by Natalia Machuca, appeared on USAID’s Impact blog.
A newly released nationwide health survey of Haiti shows continuing positive trends on key health-care indicators in particular those of Haitian women and children. The latest survey, undertaken by the Haitian Ministry of Public Health and Population, was conducted in 2012 and compares with the prior survey done in 2006. It shows steady improvements among key indicators despite significant health challenges in Haiti due to the 2010 earthquake and cholera outbreak. Of note were improved indicators for child vaccination and malnutrition, infant and child mortality, women’s health, and contraception use. The report indicated no increase in HIV prevalence, which remained steady.
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Goldilocks Had It Right: How to Build Resilient Societies in the 21st Century
›March 5, 2013 // By Laurie MazurWhen Superstorm Sandy slammed into the U.S. East Coast last October, it was the latest in a series of “teachable moments” about our growing vulnerability to climate change.
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After the Disaster: Rebuilding Communities
›Recent history has shown that no country, developed or developing, is immune to the effects of a natural disaster. The catastrophic tsunami that struck Indonesia in 2004, the earthquake and subsequent tsunami that struck Japan in 2011, the 2010 earthquake in Haiti, and Hurricane Katrina in the United States in 2005, are all reminders of the deep and long-lasting impacts that disasters can have from the local neighborhood all the way up to the national level. Each of these disasters also garnered international attention and response, showing that globalization is a game-changer in the worldwide response to community or regional-level crises.
And yet, as evidenced by the continued challenges faced by each of the places above, the disaster response community still struggles with how to contribute most effectively to local level recovery. Recognizing this, the Wilson Center’s Comparative Urban Studies Project and Environmental Change and Security Program, and the Fetzer Institute recently brought together an international group of practitioners, policymakers, community leaders, and scholars to identify best practices and policy in disaster response that are based on community engagement. A subsequent publication, After the Disaster: Rebuilding Communities, highlights the complex nature of disaster response and explores ways to overcome the inherent tension between those responding to disasters and the local community.
Voice, Space, Safety, and Time
A key theme that emerged during the workshop was the importance of identifying the strengths of the post-disaster community and building responses based on those. So how can one identify the strengths of a community? In a previous Wilson Center/Fetzer Institute workshop on community resilience, participants emphasized the importance of civil society voice; the creation of space, both physical and political; and the assurance of safety and time.
Not surprisingly, all of these aspects of resilience emerged in the post-disaster response discussion as avenues to access the strengths of a community. Finding and listening to the voices of the community, identifying the physical spaces or “centers of gravity” around which the community operates (often spiritual and cultural activities, or gatherings that bring women together), and providing safe and sustained support for healing, are necessary steps to engage with and meet the needs of communities.
Having a voice means that people “feel that they have some way to participate meaningfully in decisions that are being made about their lives…[that] they have access, points of influence, and conversation,” explained John Paul Lederach, professor of international peacebuilding at the University of Notre Dame.
Key to listening to the voices of the local community is acknowledging them as first responders. “An involvement and control of the relief and rehabilitation process empowers communities,” wrote Arif Hasan, founder and chairperson of the Urban Resource Centre in Karachi, Pakistan. “It improves their relationship with each other, makes it more equitable with state organizations, and highlights aspects of injustice and deprivation that have been invisible.”
Technology is playing a growing role in giving local communities voice and helping relief workers to identify those centers of gravity. “Whether in conflict or even post-conflict reconstruction, technology gives us a possibility of having a collective history but also collective memory,” noted Philip Thigo, a program associate at Social Development Network in Nairobi. “I spoke in a conference where communities were able to map what was important for them and bring it to the public domain: This is who we are and what we are saying, therefore you, the government, have to interact with us within this space. In that sense technology begins to enable communities to say we exist.”
Connecting to Community Points of Power
At the same time, new technology isn’t paramount to connecting with a community, and just having the technology is not sufficient. Leonard Doyle, country spokesperson for the International Organization for Migration (IOM), shared the story of a simple but effective effort to encourage a national conversation in Haiti by enabling “a flow of information between affected communities, humanitarian actors, and local service providers.”
IOM set up more than 140 information booths, complete with suggestion boxes, among the 1,300 camps where more than 1.5 million homeless people were housed after the 2010 earthquake. There was some doubt that the suggestion boxes would attract letters in a country with just a 50 percent literacy rate, but it didn’t take long for the letterboxes to fill up. In just three days, 900 letters were dropped into a booth in one of the poorest communities, Cité Soleil.
“Amid the flotsam of emails and text messages that dominate modern life,” wrote Doyle, “these poignant letters had an authenticity that is hard to ignore….Urgent cases received a quick response; others became part of a ‘crowd-voicing’ effort to listen to those who had been displaced by the earthquake.”
In the end, “the problem is when we NGOs [or other outside bodies] try to create new systems,” observed Thigo. “We do not look at what exists in the community as knowledge. We do not see how to plug our formal thinking into a structure that we may not understand but that we could perhaps simply try to enhance, to provide better services. We think power doesn’t exist in those communities. But there’s a structure of power. It could be leadership that is not necessarily within the formal context that we understand. The fundamental point is: How can we, even during disasters, connect to these points of power?”
Download After the Disaster: Rebuilding Communities from the Wilson Center. -
Addressing Gender-Based Violence Across Humanitarian Development in Haiti
›Women and girls living in displacement camps in post-earthquake Haiti are “the most vulnerable of a very vulnerable population,” according to Amanda Klasing, women’s rights researcher at Human Rights Watch. Klasing was joined by Leora Ward, technical advisor for women’s protection and empowerment at International Rescue Committee (IRC), and Emily Jacobi, executive director of Digital Democracy, for a November 15 panel discussion at the Wilson Center on gender-based violence in Haiti. “Unless we address the violence – the actual experience of violence that women and girls continue to experience at very high rates in Haiti – we [aren’t] going to be able to create a general environment for women and girls to participate in the rebuilding of their country,” Ward said.
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UNiTE To End Violence Against Women
›November 25, 2011 // By Schuyler NullToday is the International Day to End Violence Against Women, an awareness and advocacy campaign organized by a host of UN agencies and offices “to galvanize action across the UN system to prevent and punish violence against women.”
Gender equity and inequity play a role in a myriad of international development, health, security, and even environmental issues, from rape as a weapon of war; demography’s effects on political stability; maternal health and its impact on child development; women’s rights as a social stability issue; and the disproportionate effect of climate change on rural women.
The numbers around gender-based violence are staggering. According to the UN:
Here are some of New Security Beat’s posts on gender-based violence and inequity and their intersection with development, the environment, and security:- 70 percent of women experience physical or sexual violence from men in their lifetime.
- Approximately 250,000 to 500,000 women and girls were raped in the 1994 Rwandan genocide, and in the eastern Democratic Republic of Congo (DRC), at least 200,000 cases of sexual violence, mostly involving women and girls, have been documented since 1996, though the actual numbers are considered to be much higher.
- In the United States, one-third of women murdered each year are killed by intimate partners; in South Africa, a woman is killed every six hours by an intimate partner; in India, 22 women were killed each day in dowry-related murders in 2007; and in Guatemala, two women are murdered, on average, each day.
- Over 60 million girls worldwide are child brides, married before the age of 18, primarily in South Asia (31.1 million) and sub-Saharan Africa (14.1 million).
Gender-Based Violence in the DRC: Research Findings and Programmatic Implications:
Dr. Lynn Lawry, senior health stability and humanitarian assistance specialist at the U.S. Department of Defense, presented findings from the first cross-sectional, randomized cluster study on gender-based violence in the DRC at the Wilson Center this year. The first of its kind in the region, the population-based, quantitative study covered three districts in the DRC and a total of 5.2 million adults, comprehensively assessing gender-based violence, including its prevalence, circumstances, perpetrators, and physical and mental health impacts.
Pop Audio: Judith Bruce on Empowering Adolescent Girls in Post-Earthquake Haiti: “The most striking thing about post-conflict and post-disaster environments is that what lurks there is also this extraordinary opportunity,” said Judith Bruce, a senior associate and policy analyst with the Population Council. Bruce spent time last year working with the Haiti Adolescent Girls Network, a coalition of humanitarian groups conducting workshops focused on the educational, health, and security needs of the country’s vulnerable female youth population.
The Walk to Water in Conflict-Affected Areas: Constituting a majority of the world’s poor and at the same time bearing responsibility for half the world’s food production and most family health and nutrition needs, women and girls regularly bear the burden of procuring water for multiple household and agricultural uses. When water is not readily accessible, they become a highly vulnerable group. Where access to water is limited, the walk to water is too often accompanied by the threat of attack and violence.
Weathering Change: New Film Links Climate Adaptation and Family Planning: “Our planet is changing. Our population is growing. Each one of us is impacting the environment…but not equally. Each one of us will be affected…but not equally,” asserts the new documentary, Weathering Change, launched at the Wilson Center in September. The film, produced by Population Action International, explores the devastating impacts of climate change on the lives of women in developing countries through personal stories from Ethiopia, Nepal, and Peru.
Sajeda Amin on Population Growth, Urbanization, and Gender Rights in Bangladesh:
The Population Council’s Sajeda Amin describes the Growing Up Safe and Healthy (SAFE) project, launched in Dhaka and other Bangladeshi cities last. The initiative aims, to increase access to reproductive healthcare services for adolescent girls and young women, bolstering social services to protect those populations from (and offer treatment for) gender-based violence, and strengthen laws designed to reduce the prevalence of child marriage – a long-standing Bangladeshi institution that keeps population growth rates high while denying many young women the opportunity to pursue economic and educational advancement.
No Peace Without Women: On October 31, 2000, the UN Security Council adopted Resolution 1325, which called for women’s equal participation in all efforts to maintain and promote peace and security; however, little progress has been made over these last 10 years and women remain on the periphery when it comes to post-conflict reconstruction and development. A report from the humanitarian organization CARE concedes that “much of the action remains declarative rather than operational.”
Addressing Gender-Based Violence to Curb HIV: At last year’s International AIDS Conference in Vienna an astonishing development in the campaign to stem the spread of HIV/AIDS was unveiled – a microbicide with the ability to reduce the risk of transmission of HIV. This welcome development coincides with an intensified focus on women’s health and security needs among donors, especially the United States.
The Future of Women in the MENA Region: A Tunisian and Egyptian Perspective: Lilia Labidi, minister of women’s affairs for the Republic of Tunisia and former Wilson Center fellow, joined Moushira Khattab, former minister of family and population for Egypt, this summer at the Wilson Center to discuss the role and expectations of women in the Egyptian and Tunisian revolutions, as well as issues to consider as these two countries move forward.
Sources: UN Secretary-General’s Office. -
Failed States Index 2011
›“The reasons for state weakness and failure are complex, but not unpredictable,” said J.J. Messner, one of the founders of the Fund for Peace’s Failed States Index, at the launch of the 2011 version of report in Washington last month. The Index is an analytical tool that could aid policymakers and governments seeking to prevent and mitigate state collapse by identifying patterns of underlying drivers of state instability.
The Index ranks 177 countries according to 12 primary social, economic, and political indicators based on analysis of “thousands of news and information sources and millions of documents” and distilled into a form that is meant to be “relevant as well as easily digestible and informative,” according to the creators. “By highlighting pertinent issues in weak and failing states,” they write, the Index “makes political risk assessment and early warning of conflict accessible to policymakers and the public at large.”
Common Threats: Demographic and Natural Resource Pressures
The Index reveals that half of the 10-most fragile states are acutely demographically challenged. The composite “Demographic Pressures” category takes into account population density, growth, and distribution; land and resource competition; water scarcity; food security; the impact of natural disasters; and public health prevention and control. Additional population indices are found in “Massive Movement of Refugees or Internally Displaced Persons (IDPs),” and health indicators, including infant mortality, water, and sanitation, are spread across several categories.
Not surprisingly, some of the most conflict-ridden countries show up at the top of the list. The Index highlights some of the lesser known issues that contribute to their misery: demographic and natural resource stresses in Afghanistan, Iraq, Nigeria, Pakistan, and Yemen (a list that would include Palestine, if inclusion in the Index were not contingent on UN membership); the DRC’s conflict minerals; and Somalia and Sudan’s myriad of environmental and migration problems, which play major roles in their continued instability.
Haiti, with its poor health and lack of infrastructure and disaster resilience, was deemed the Index’s “most-worsened” state of 2011. The January 2010 earthquake and its ensuing “chaos and humanitarian catastrophe” demonstrated that a single event can trigger the collapse of virtually every other sector of society, causing what Messner termed the “Humpty Dumpty effect” – while a state can deteriorate quickly, it is much harder to put it back together again.
The inclusion of natural resource governance within the social and economic indicators would render the Index a more complete analytical tool. In a 2009 report, the UN Environment Program (UNEP) found that “since 1990, at least eighteen violent conflicts have been fueled by the exploitation of natural resources,” and that effective natural resource management is a necessary component of conflict prevention and peacebuilding operations.
The Elephant in the Room: Predicting the Arab Spring
Why did the Index fail to predict the Arab Spring sweeping the Middle East and North Africa? Many critics assert that the inconsistent ranking of the states, ranging from Yemen (ranked 13th) to Bahrain (ranked 129th), demonstrates that the Index is a poor indicator of state instability. Particularly, critics argue that many of the countries experiencing revolutions were ranked artificially low.
“Of course, the Failed States Index did not predict the Arab Spring, and nor is it intended to predict such upheavals,” said Messner at the launch event. “But by digging down deeper into the specific indicator analysis, it was possible to observe the growing tensions in those countries.” The Index has consistently highlighted specific troubling indicators for the region, such as severe demographic pressures, migration, group grievance, human rights, state legitimacy, and political elitism.
Blake Hounshell, a correspondent with Foreign Policy (long-time collaborators with the Fund for Peace on the Index), wrote that the Index was never meant to be a “crystal ball” – even the best statistical data cannot truly encapsulate the complex realities that lead to inherently unpredictable events, such as revolutions. “It’s thousands of individual decisions, not rows of statistics, that add up to political upheaval,” Hounshell continued.
Demographer Richard Cincotta’s work on Tunisia’s revolution illuminates how the Index’s linear indicators can mask a complex reality. Whereas the Failed States Index simply measures “demographic pressure” as a linear function of how youthful a population is, Cincotta pointed out at a Wilson Center event that it was actually Tunisia’s relative demographic maturity that paved the way for its revolution and gives it a good chance of achieving a liberal democracy. Other countries in the region are much younger than Tunisia (Yemen being the youngest). The Arab Spring demonstrates that static indicators alone often do not have the capacity to predict complex social and political revolutions.
Sources: Foreign Policy, The Fund for Peace, UNEP.
Image Credit: Failed States Index 2011, Foreign Policy. -
Preparing for the Impact of a Changing Climate on U.S. Humanitarian and Disaster Response
›Climate-related disasters could significantly impact military and civilian humanitarian response systems, so “an ounce of prevention now is worth a pound of cure in the future,” said CNA analyst E.D. McGrady at the Wilson Center launch of An Ounce of Preparation: Preparing for the Impact of a Changing Climate on U.S. Humanitarian and Disaster Response. The report, jointly published by CNA and Oxfam America, examines how climate change could affect the risk of natural disasters and U.S. government’s response to humanitarian emergencies. [Video Below]
Connecting the Dots Between Climate Change, Disaster Relief, and Security
The frequency of – and costs associated with – natural disasters are rising in part due to climate change, said McGrady, particularly for complex emergencies with underlying social, economic, or political problems, an overwhelming percentage of which occur in the developing world. In addition to the prospect of more intense storms and changing weather patterns, “economic and social stresses from agricultural disruption and [human] migration” will place an additional burden on already marginalized communities, he said.
Paul O’Brien, vice president for policy and campaigns at Oxfam America said the humanitarian assistance community needs to galvanize the American public and help them “connect the dots” between climate change, disaster relief, and security.
As a “threat multiplier,” climate change will likely exacerbate existing threats to natural and human systems, such as water scarcity, food insecurity, and global health deterioration, said Vice Admiral Lee Gunn, USN (ret.), president of CNA’s Institute for Public Research. Major General Richard Engel, USAF (ret.), of the National Intelligence Council identified shifting disease patterns and infrastructural damage as other potential security threats that could be exacerbated by climate change.
“We must fight disease, fight hunger, and help people overcome the environments which they face,” said Gunn. “Desperation and hopelessness are…the breeding ground for fanaticism.”
U.S. Response: Civilian and Military Efforts
The United States plays a very significant role in global humanitarian assistance, “typically providing 40 to 50 percent of resources in a given year,” said Marc Cohen, senior researcher on humanitarian policy and climate change at Oxfam America.
The civilian sector provides the majority of U.S. humanitarian assistance, said Cohen, including the USAID Office of Foreign Disaster Assistance (OFDA) and the State Department’s Bureau of Population, Refugees, and Migration. These organizations provide leadership, funding, and food aid to developing countries in times of crisis, but also beforehand: “The internal rationale [of the Office of Foreign Disaster Assistance] is to reduce risk and increase the resilience of people to reduce the need for humanitarian assistance in the future,” said Edward Carr, climate change coordinator at USAID’s Bureau for Democracy, Conflict, and Humanitarian Assistance.
The U.S. military complements and strengthens civilian humanitarian assistance efforts by accessing areas that civilian teams cannot reach. The military can utilize its heavy lift capability, in-theater logistics, and command and control functions when transportation and communications infrastructures are impaired, said McGrady, and if the situation calls for it, they can also provide security. In addition, the military could share lessons learned from its considerable experience planning for complex, unanticipated contingencies with civilian agencies preparing for natural disasters.
“Forgotten Emergencies”
Already under enormous stress, humanitarian assistance and disaster response systems have persistent weaknesses, such as shortfalls in the amount and structure of funding, poor coordination, and lack of political gravitas, said Cohen.
Food-related aid is over-emphasized, said Cohen: “If we break down the shortfalls, we see that appeals for food aid get a better response than the type of response that would build assets and resilience…such as agricultural bolstering and public health measures.” Food aid often does not draw on local resources in developing countries, he said, which does little to improve long-term resilience.
“Assistance is not always based on need…but on short-term political considerations,” said Cohen, asserting that too much aid is supplied to areas such as Afghanistan and Iraq, while “forgotten emergencies,” such as the Niger food crisis, receive far too little. Furthermore, aid distribution needs to be carried out more carefully at the local scale as well: During complex emergencies in fragile states, any perception of unequal assistance has the potential to create “blowback” if the United States is identified with only one side of a conflict.
Engel added that many of the problems associated with humanitarian assistance will be further compounded by increasing urbanization, which concentrates people in areas that do not have adequate or resilient infrastructure for agriculture, water, or energy.
Preparing for Unknown Unknowns
A “whole of government approach” that utilizes the strengths of both the military and civilian humanitarian sectors is necessary to ensure that the United States is prepared for the future effects of climate change on complex emergencies in developing countries, said Engel.
In order to “cut long-term costs and avoid some of the worst outcomes,” the report recommends that the United States:
Cohen singled out “structural budget issues” that pit appropriations for protracted emergencies in places like Iraq, Afghanistan, and Darfur against unanticipated emergencies, like the 2010 earthquake in Haiti. Disaster-risk reduction investments are not a “budgetary trick” to repackage disaster appropriations but a practical way to make more efficient use of current resources, he said: “Studies show that the return on disaster-risk reduction is about seven to one – a pretty good cost-benefit ratio.”- Increase the efficiency of aid delivery by changing the budgetary process;
- Reduce the demand by increasing the resilience of marginal (or close-to-marginal) societies now;
- Be given the legal authority to purchase food aid from local producers in developing countries to bolster delivery efficiency, support economic development, and build agricultural resilience;
- Establish OFDA as the single lead federal agency for disaster preparedness and response, in practice as well as theory;
- Hold an OFDA-led biannual humanitarian planning exercise that is focused in addressing key drivers of climate-related emergencies; and,
- Develop a policy framework on military involvement in humanitarian response.
Edward Carr said that OFDA is already integrating disaster-risk reduction into its other strengths, such as early warning systems, conflict management and mitigation, democracy and governance, and food aid. However, to build truly effective resilience, these efforts must be tied to larger issues, such as economic development and general climate adaptation, he said.
“What worries me most are not actually the things I do know, but the things we cannot predict right now,” said Carr. “These are the biggest challenges we face.”
“Pakistan Floods: thousands of houses destroyed, roads are submerged,” courtesy of flickr user Oxfam International. -
Quality and Quanitity: The State of the World’s Midwifery in 2011
›Each year, 350,000 women die while pregnant or giving birth, as many as two million newborns die within the first 24 hours of life, and there are 2.6 million stillbirths. Sadly, the majority of these deaths could be prevented if poor and marginalized women in developing countries had access to adequate health facilities and qualified health professionals. In fact, according to the new UNFPA report, State of the World’s Midwifery 2011: Delivering Health, Saving Lives, just doubling the current number of midwives in the 58 countries highlighted in the report could avert 21 percent of maternal, fetal, and newborn deaths.Launched last week, the report is the first of its kind, using new data from 58 low-income countries with high burdens of maternal and neonatal mortality to highlight the challenges and opportunities for developing an effective midwifery workforce.
“Developing quality midwifery services should be an essential component of all strategies aimed at improving maternal and newborn health,” write the authors of the report. Qualified midwives ensure a continuum of essential care throughout pregnancy and birth, and midwives can help facilitate referrals of mothers and newborns to hospitals or specialists when needed:Unless an additional 112,000 midwives are trained, deployed, and retained in supportive environments, 38 of 58 countries surveyed might not met their target to achieve 95 per cent coverage of births by skilled attendants by 2015, as required by Millennium Development Goal 5.
There is a total shortage of 350,000 skilled midwives globally, with some countries, like Chad and Haiti, needing a tenfold increase to match demand, according to the report. But quantity isn’t the only issue; there has also been an insufficient focus on quality of care. Additionally, most countries do not have the capacity to accurately measure the number of practicing midwives, and national policies focusing on maternal and newborn health services often do not view midwifery services as a priority.
To help overcome these challenges, the report outlines a number of “bold steps” to be taken by governments, regulatory bodies, schools, professional associations, NGOs, and donor agencies in order to maximize the impact of investments, improve mutual accountability, and strengthen the midwifery workforce and services. Of course, the needs of each country are unique, and the report ends with individual country profiles that highlight country-specific maternal and neonatal health indicators.
While this report does much to highlight the critical importance of midwives in promoting the health and survival of mothers and newborns, real impact will only come when governments, communities, civil society, and development partners work together to implement these recommendations.
Sources: UNFPA.
Video Credit: UNFPA.
