Sudan Northern States: Helping Bring Safe Motherhood to South Kordofan

No. 1 | 2010 | www.medair.org

Somalia & Somaliland: Thousands of Malnourished Children Receive Emergency Food Supplies

A Worrying Time for ParentsThere are thousands of children like Zainab across Somalia and Somaliland who do not have enough to eat. Parents throughout these troubled countries often have no choice but to uproot their families because of famine or war to go in search of food and security. It’s a journey families must make to survive and often it leads to dirty and crowded camps, like the one in Burao, where Medair is urgently helping the most vulnerable.

Feeding Hungry ChildrenBecause of supporters like you, we’re able to respond to this growing crisis by providing essential, life-saving treatments to severely malnourished children. At our mobile nutrition clinics, mothers stand in line with their children, waiting for their turn to be assessed. The children are weighed and the circumference of their arms measured to check for malnutrition. The severely malnourished children are

Little Zainab is one of the many children treated at a Medair nutrition clinic during the past six months. The picture above (left) was taken as she arrived at our clinic in a severely malnourished condition. It’s a shocking sight we see every day. But thanks to you, the picture is changing for good.

given PlumpyNut (a nutritious paste) and will return weekly to have their progress checked and receive further supplies until they reach a healthy weight. To prevent siblings, who are not malnourished,

from eating these special supplies, we provide mothers with extra porridge — so the whole family benefits.

Changing the Picture for GoodThe treatment usually takes between eight and sixteen weeks. During that time, an amazing transformation takes place — children too weak to run around or play, often too weak even to feed

themselves, are restored to health. The second photo of Zainab, taken six weeks after the first, shows just what a difference the treatment makes. Can you imagine the joy her parents felt seeing their daughter healthy and smiling again?

It’s such a simple treatment and costs very little to administer – but it saves children’s lives in one of the harshest environments on earth — and you are making it possible. Thank you.

from Anne Reitsema, Country Director for Sudan (Northern States)

Editorial

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Thanks to you

Somalia & Somaliland: Thousands of Malnourished Children Receive Emergency Food Supplies

20 years old

Forged in the Fire

Special report

Sudan (Northern States): Helping Bring Safe Motherhood to South Kordofan

Welcome to Medair News, reporting from where your support is saving lives.

This edition covers the urgent work in Sudan’s Northern States where I oversee projects to bring ‘Safe Motherhood’ to women facing unacceptable risks during pregnancy and childbirth. Find out more on pages six and seven, including a field report posted by Rebekka Frick, one of our Reproductive Health Managers working with communities in desperate need.

You can also read about the ongoing success of the work you have supported in Somalia and Somaliland (see opposite). Through this emergency intervention, thousands of children are being treated for malnutrition in a part of the world that has suffered so much from famine and fighting. Your help is making a huge difference today!

I really hope you’ll be encouraged when reading this edition of Medair News by the life-saving impact you can provide to the world’s most vulnerable people. For twenty years Medair has been serving people in forgotten crises throughout Africa, Asia and the Middle East. Please continue to support this important work in 2010 with your gifts and prayers.

Thank you,

Tackling Unacceptable Risks in Childbirth

8 Field staff interview

Bringing Safe, Clean Water to Mountain Communities

Medair U.K.Unit 3, Taylors Yard67 Alderbrook RoadLondon SW12 8ADTel: +44 (0)20 8772 0100Fax: +44 (0)20 8772 0101www.medair.org

Photo credits:Images were taken by Medair staff with the exception of : TBC

Sources:Medair, unless otherwise stated.

Partners:Funding partners for Somalia/Somaliland• World Food Programme• UNICEF• SDC (Swiss Government)• EO-Metterdaad• Tearfund N.Z.• ECHO

Funding partners for Sudan (Northern States):• DFID (British Government)• USAID• SIDA (Swedish Government)• CHF• UNICEF• SDC (Swiss Government)• And wonderful private donors like you!

Charity registered in England & Wales no. 1056731Limited Company registered in England & Wales no. 3213889

© Medair 2010

3January | 2010

My child was seriously sick. He is cured now. My child is changing. He was in serious condition when I admitted him, now he is getting better. The family was given a ration as well. No more starvation.

- A mother from Madina tells us about her child who is 21 months old.

Thanks to you

Zainab upon arrival at the Medair clinic.— Zainab, six weeks into her treatment for malnutrition.

Forged in the Fire

In 1999, Medair enters its second decade with a growing level of assurance in its capacity and professionalism. But that capacity is tested, as the world is rocked by conflicts that impact our work.

A massive war rages in D.R. Congo and Medair is often the only NGO / charity in some of the hottest spots — the only source of medical aid for three million people.

Medair establishes a new base in Isiro to co-ordinate medicine distributions across vast, northeastern D.R. Congo. For 11 months, no one has been able to find medicine, not even an aspirin, so our team sends in a DC-8 loaded with 22 tonnes of medicine. “The medicine was quickly dispatched to 80 hospitals and health centres, using all kinds of means: trucks, bush taxis, motorcycles, and even bicycles,” says Medair’s Denise Blum, the visionary founder of our work in D.R. Congo. “The lives of tens of thousands of sick people, completely isolated by war, were at stake.”

Medair responds swiftly when war erupts in the Balkans, and 800,000 people flee from Kosovo to Albania. We are one of the first NGOs on-the-ground, managing a reception tent for refugees, and helping co-ordinate the overall NGO effort.

As we continue our series on Medair’s 20th anniversary, we look at the period between 1999 and 2003 and some of the important events that helped forge the substance and character of our work today.

“On the first day alone, Kukes was overrun with 60,000 refugees,” says Medair’s Alain Jaccard. “Local authorities panicked — how could they select who to help first? After three days, new teams of specialists came to replace those like me who lived through the first shock.”

Later in the year, Medair helps returnees in Kosovo rehabilitate damaged shelters before winter. However, the trauma of the war is deeper than any structural repair can mend: “You help us rebuild our houses, but who will help us rebuild our minds?” cries one man who witnessed his wife’s killing. In response, Medair begins a psychosocial programme in 2000 which helps traumatised children in schools throughout Kosovo.

Also in 2000, Medair opens new programmes in Kenya, Uganda, Mozambique, and Sudan’s northern states. In Southern Sudan, we continue our longstanding programme, despite insecurity which limits our ability to respond. A major breakthrough occurs, however, as Jürgen Matheis succeeds in drilling our first borehole in Sudan. Villagers celebrate by giving Jürgen a cow in recognition of his team’s achievement, and the king proclaims, “Now the river is in the village!”

5January | 2010

20 years old 20 years old

In 2001, Medair becomes the first European NGO to obtain ISO 9001:2000 certification worldwide, which signifies that Medair delivers goods and services effectively, and with a focus on beneficiary needs.

Early in 2001, Medair runs food-for-work projects in Afghanistan to build vitally needed infrastructure and make quilts for shelters. In February, Medair sends trucks containing 10,000 hand-made quilts on a six-day journey from Kabul to a camp where hundreds are suffering from the cold.

However, the infamous terrorist events of 2001 lead to a new war in Afghanistan, already reeling from many years of conflict. Our team evacuates the country when the war begins, but we return in December to provide emergency winter aid to more than 5,000 displaced people.

In Sudan’s northern states, Medair provides primary health care to over 2,000 patients per month in a large displacement camp outside of Khartoum. Drought prompts our health team to expand into remote West Darfur, two years before the conflict begins, and long before most NGOs are established in this region.

Meanwhile, our D.R. Congo team persists in its remarkable mission, providing medicine for 398 health centres during 2001, and directly supporting 850,000 hard-to-reach people — some of whom have hidden for safety in remote jungle locations.

In 2002, Medair opens new programmes in Angola, Zimbabwe, and Madagascar — an island where isolated residents have very limited access to safe water, sanitation, or hygiene awareness. Our team begins training people in latrine construction and hygiene promotion, and when a cyclone strikes, Medair provides emergency assistance and helps several villages re-open the only road to the market. Today, Medair still responds to recurrent cyclones in Madagascar, but many communities now have protected water sources, more latrines, and improved hygiene awareness.

In 2003, just as peace is starting to emerge in Sudan, a conflict erupts in West Darfur and Medair quickly shifts focus to emergency relief.

In November, a truck carrying four of Medair’s national staff is attacked, and three of them are held by an armed group. Thankfully, everyone is returned unharmed, but this frightening incident underscores the vulnerability that both beneficiaries and staff face in conflict zones.

In D.R. Congo, rebel groups continue to murder and rape civilians under the euphemism of “vaccinating the population.” Medair and partner agencies initiate a real vaccination campaign — immunising 100,000 children in a week to counter a measles epidemic.

“The fact that children two months old were affected by measles, that was really the worst,” says a nurse from the Bunia health zone, “especially that it was happening in such isolation, amid such severe malnutrition. Luckily, the vaccination campaign is helping us get through such horrors. Thank you, Medair!”

War comes to Iraq in March 2003, and Medair places a team on standby in Syria, ready to assist refugees who cross the border. When the number of refugees is low, Medair moves into Iraq and supports six hospitals and improves water access for 4,000 families until security concerns compel the team to leave in October.

Uganda suffers renewed attacks by the rebel Lord’s Resistance Army in 2003, sending a million people into displacement camps. Medair manages to get emergency aid to two camps in the middle of rebel territory. “Your presence here reminds us that God has not forgotten us,” says a camp resident.

Looking back, the five-year span that began Medair’s second decade was a terribly violent period around the world. These difficult conditions proved to be a crucible for Medair. We were tested repeatedly, but each time we responded and grew, emerging as a humanitarian organisation with a strong focus on quality and accountability to our beneficiaries. By the end of 2003, Medair was providing emergency relief and rehabilitation to 2.5 million people per year across nine countries and employed almost one thousand staff worldwide.

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For more information about Medair’s ongoing programmes, visit: www.medair.org

Jüergen Matheis testing water yield during installation of a hand pump.

6 7January | 2010

Special report Special report

Too often the numbers hide the true cost to families and communities. Children growing up without mothers, husbands widowed, families torn apart. This, in a country which has been traumatised by years of fighting, and where much of the population has little or no access to safe, clean water or health care.

Medair has targeted the very poorest rural areas of the state to benefit from emergency assistance — and provide increased access to ‘Safe Motherhood’ services. These are communities where most families survive on what they can grow themselves or can collect in the bush.

In such remote areas, clinics are seeing mothers dying every month. This is particularly alarming when you understand the clinics may be serving a population of only 5,000. Most of the villages we targeted had no provision to care for pregnant women.

It’s a desperate situation that requires immediate action to save lives.

Please give a gift today to support this vital work. You can use the reply form provided with this newsletter or cut out the reply form on the back page and send to our Freepost address. Thank you.

Sudan (Northern States): Helping bring Safe Motherhood to South Kordofan

Women in South Kordofan risk some of the most dangerous conditions on earth. Complications related to pregnancy and childbirth are a leading cause of death among those of reproductive age. The statistics are shocking — for every 10,000 live births, 552 mothers die, up to a quarter of the women in South Kordofan have no access to antenatal care, and just 450 trained midwives serve a population of over 2.7 million.

Just off the main road leading south we enter the small village of Mamnoa. My first impression is of a village struggling with poverty. The village consists of some tukuls (mud huts) and old grass fences. There is no water point. We see many children, most of them very thin and poorly nourished. Most of the younger women we meet are pregnant.

We are here to meet Kadija, a midwife in the village. Kadija recently graduated from the midwifery school in El Fulla and she proudly shows us her graduation certificate. We are warmly greeted and invited into the best tukul of Kadija’s family — normally the bedroom of the parents. We sit down and before long the tukul is filled with adults and children who are all eager to see the two kawajas (white people). It is the first time for an international NGO to work in their village and there is an atmosphere of excitement. We are offered water and locally made lemon juice, after which we introduce Medair and our project.

Kadija’s husband joins us and shares with us the desperate needs of the village. He estimates that during the last 12 months they’ve lost six women in childbirth and about 200 children have died in the last three years, victim to infectious diseases.

Population: 37.8 million

Capital: Khartoum

Infant mortality rate (per 1,000 live births): 62

Maternal mortality rate (per 100,000 live births): 590

Number of internally displaced people:6,000,000

Field Report: Visiting Mamnoa

We want to help Kadija tackle the extremely high maternity and infant mortality rates in her community — through health promotion, antenatal clinics and early identification of danger signs. We share our plans to support Kadija’s work as much as possible and agree to finance the construction of a tukul which will be used as an antenatal clinic. We will also supply Kadija with the drugs and equipment needed to run the clinic and visit her regularly for supervision and training. We brought the first supplies with us, so begin to explain their correct use through our translator, while half the village eavesdrops. By now, almost four hours have passed and we indicate that we need to leave soon to reach our accommodation for the night before it gets dark. We manage to postpone an invitation for a meal until our next visit and make our way to the car surrounded by excited villagers. One woman approaches us with an enlarged goiter, another woman needs help with a dental problem. We try our best to explain that we don’t have a solution for all the health problems in the village but that we really want to improve the situation of the pregnant women. They show their appreciation by promising to name their next babies after us.

Much later than planned, we reach our car, happy and exhausted about our visit in Mamnoa. We are currently working with 11 more midwives in the locality.

Name: Rebekka Frick Job Title: Reproductive Health Manager Country: Sudan (Northern States)

Programme Title: Reproductive Health Care Support, Public Health Promotion, and Water & Sanitation Improvements in South Kordofan

Fact File

Field staff interview

Can you tell us a bit about your role? I manage the work of our field engineers and foremen, community mobilisers and hygiene education team. This involves field trips to the villages to monitor the progress and quality of the construction of the spring protections, water pipe networks and wells.

Tell us about the team you lead.They’re a good bunch! It’s been a challenge to lead such a big team, around 15 people. But I think everyone gets on well together and enjoys working with each other, which is definitely a plus.

What’s a typical day for you?Mmmm…not sure I’ve had two the same yet! A day’s work ranges from being in the office sorting data received from the engineers, planning the next trip, ordering materials — to travelling for hours in a Land Cruiser on bumpy roads and switching to horseback as conditions require.

Bringing Safe, Clean Water to Mountain Communities

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What programmes do you have running right now?We’re constructing spring protections, water pipe networks and wells, as well as providing house-to-house and community-wide hygiene education. This is happening in four districts across Badakhshan: Raghistan, Yawan, Khwahan and Kohistan. We hope to extend this to other areas of Badakhshan next year.

What for you sums up the difference Medair is making in Afghanistan?On a recent visit to a village called Salamdeh, I was struck by its remoteness and precarious location — literally clinging to the mountainside — and the difficulties faced by the people living there. I saw a little girl trying to collect water from a frozen stream. The stream was along a narrow, windy, icy path which had a nasty drop to one side. In another village, I saw a young girl collecting water from a dirty pool that was also used by the animals.

I hope that by next spring I’ll see those same children drawing safe, clean water from a Medair protected spring!

Tim Pegg is Medair’s Water and Sanitation Project Manager for Badakhshan province, northern Afghanistan. Tim talked to us about living and working in this remote and mountainous region.

To read more of the interview with Tim, please visit www.medair.org/interview