Sunday, January 27, 2013

Resilience


Lately there has been a lot of talk about resilience in international development circles.  For Niger building resilience to climate change, rising food prices, poor crop yields, and regional violence is particularly relevant.  After enduring 3 famines since 2005, millions of families across Niger are locked out of the food-production cycle.  The majority have lost animals, are unable to buy seeds for replanting, and lack cash to buy supplementary food.  These factors inevitably result in childhood stunting, impeding the development of a sustained and viable future work force.  As aptly described in this blog, Sahel Chronic Hunger Crisis Solutions, what is needed for these chronic problems are sustained solutions such as improved irrigation and protection of water sources, promotion of women's rights, teaching people about child nutrition, and utilization of resistant crop varieties and grain stores.

In September our office was given a Food for Peace monetary award from USAID.  With the title of Food Assistance to Build Resilience in Communities (FABRIC).   The purpose of this award is to provide relief and recovery through food-for-work (FFW) focusing on improved agricultural techniques, women's off-season gardening groups, land recuperation, and nutrition education with the idea that the assistance will provide assets to build resilience to future crises.  This is the largest project that our office has ever managed and has stretched and challenged us more than I think any of us ever imagined was possible.  And honestly, as I've seen the effects this large project has had on our staff I've doubted if it was a project we should have ever undertaken. It has also raised ongoing questions in my mind about my role in this kind of approach to development.  My role in the project is to be he technical advisor for the development of the nutrition education curriculum. It is very removed from being with the people and doing the education myself and seeing how they are applying the information.  

USAID food in warehouse

The majority of the 1,107 tons of food have been delivered to our warehouse and now in the process of being distributed to the 3,600 designated households.

Last week all of our staff met at the warehouse where our country director thanked us for all of our work and dedication to the project that has allowed us to stand on top of thousands of bags of beans.  During his speech he said something that resonated within me--only God know what will be the results of this project, but its possible that this food will keep a child alive who could be the next president of Niger or scientist or teacher.  Hearing those words changed my attitude about the project.  Its certainly a different approach and my involvement in it is different then I'm used to, but that doesn't mean its bad.  And I'm learning that this mantra doesn't just apply to FABRIC, buy my life and work in Niger resulting in resilience in my own heart and soul in a surprisingly odd time.

The increase of French and African forces in Mali and the subsequent killing of ex-pats in Algeria has increased the security situation here in Niger.  Security check-points and armed patrols are now a common sight in Niamey.  I can no longer visit the field, even with an armed escort.  For the first time I went to church with armed guards visibly sitting at the entrance. And last week I was told that I had to limit my running.  I wasn't told that I could no longer do it, just not as often or for as long as before.  This was a bit traumatic because I had made a deal with myself a couple of months ago that if the security situation deteriorated so much that I could not run, then that would be a sign that it is too risky for me to be here and I would leave.  But surprisingly, I don't want to leave and am willing to make the adaptations necessary to stay and keep myself safe and healthy.  The adjustment to Niger has been bumpy and I knew I hit an all-time low last December when I burst into tears when our Finance Manager offered me peanuts.  There were many days when I found myself praying, asking God to either get me out or get me through the very next minute and in His eternally faithful way, He did.  And He still is.  He's deepening a resiliency in me through new friendships, opportunities to improve our existing health and nutrition programs, and what I find extremely ironic, through dancing.  I'm a terrible dancer and always will be, but I've started taking dance lessons at the American Recreation Center and realized that it can also be a great form of exercise and I can do it indoors, which minimizes my risk of being kidnapped.  And I can listen to music while doing it. The other day I was listening to  Prayer of the Children and was particularly struck by the following words:

Can you hear the voice of the children

softly pleading for silence in their shattered world?

Angry guns preach a gospel full of hate,

blood of the innocent on their hands.

Crying Jesus, "Help me
to feel the sun again upon my face?
For when darkness clears, I know you're near,
bringing peace again."

Can you hear the prayer of the children?
written by Kurt Bestor
Visiting a refugee camp for Malians in September 

Recently it has been estimated that over 1,500 Malians will be fleeing the fighting and crossing over to Niger, Mauritania, and Burkina Faso.  The Malian refugees who will be arriving in Niger will be predominately arriving in the area where Samaritan's Purse will be distributing food for FABRIC.  I am thankful and continue to pray for resiliency in body and soul to respond to these needs.            

You can find more information about the current influx of Malian Refugees in Niger here.

Sunday, November 18, 2012

The Other Half

The highest lifetime risk of dying in childbirth in the world is in the West Africa Country, Niger, where a girl or woman stands a 1in 7 chance of dying in childbirth.....In contrast, in the United States, the lifetime risk is 1 in 4,800...in Ireland, a woman has only 1 chance in 47,600 of dying in childbirth.

Nicolas Kristof, Half the Sky: Turning Oppression into Opportunity for Women

The Community Health Aide Training Participants
Last week I was visiting a refresher training course supported by Samaritan's Purse for community health aides about screening for acute malnutrition, exclusive breastfeeding, complementary feeding,  diarrheal diseases, and water and sanitation.  It was encouraging to see the participants and their dedication, particularly the woman who walked over 10 km to attend the training.
The training venue
The training was at a health center and while we were there we met, "Rachel" whose one-year old son, "Omar" was severely malnourished and had to be taken to the District Hospital for treatment.  After we finished discussing with our field staff and the training participants, Rachel, her husband, and Omar joined us in the land cruiser for the 70 km trek back to Niamey.  While in the car I read the discharge papers and quickly learned that our land cruiser wasn't serving as an ambulance just for Omar, but for Rachel as well.  At the age of 25 years, she was pregnant for the fifth time and HIV positive.  Her first three children had died and now her son was severely sick.  As we drove through the desert sand in the intense heat, with Rachel vomiting and Omar crying in the back seat, I contemplated the differences in Rachel's life with the lives of some girls I met in Niamey earlier the same week.


  
These girls attend a vocational school that is supported by a mission organization from Canada.  The primary objective of the school is to prevent girls from marrying before age 18.  In order for the girls to receive a free education, the families have to promise that they will not marry off their daughters.  It is  a novel concept in a country where only 31% of girls regularly attend primary school.  When I first arrived the girls were chatty and active, but soon quieted down and listened to a topic that I'm pretty sure was brand new to them--self -esteem.

"Je suis belle, precious, intelligent, unique, courageuse"

 After the lesson, each girl took five different finger paints to represent different characteristics, beautiful, precious, intelligent, and unique, and placed them on tree branches.  


I probably will never find out if Rachel will be one of the 7 women in Niger who die in childbirth and if Omar will recover to not be 2 of the 5 children who are malnourished.  But my hope and prayer is that by continuing to build the capacity of community health aides to correctly screen for acute malnourished children and for organizations that invest in the lives of girls now, these girls and their children will not.     

It is impossible to realize our goals while discriminating against half the human race.  As study after study has taught us, there is no tool for development more effective then the empowerment of women.

Kofi Annan

Tuesday, October 30, 2012

Questions

It always amazes me how 8 or so hours after riding on a plane I arrive in a world full of contrasts and opposites.  As the flight flew closer to Washington D.C last week I felt my body release the pressure and concerns of the last few months. It has been a welcome respite to be in the States with beautiful weather, good food, crisp air, healthy children, clean sidewalks, American English, safe roads.  The first day I was here I enjoyed it so much I was concerned that I wouldn't want to go back to Niger.

Appalachian Mountains, NC

St. Peter and Paul's Cathedral, San Francisco

This concern was amplified with the news of kidnappings of 5 NGO workers in Niger last week.  Due to political and religious instability of Niger's neighbors to the North, South, and East, Niger continues to find itself in a "security sandwich" as border security is quite fluid and looks like it will be for some time.  All of this has made me ponder a quote from E.B White, "I arise in the morning torn between a desire to save the world or savor the world.  This makes it hard to plan the day."

Nigerien Military
When I've told people familiar with Niger, that I've been working there for the last few months, the typical response is, "Oh Niger, that is...an interesting place."  And indeed it is for multiple reasons--political, religious, developmental, nutritional.  Recently Niger has been in the spotlight as it continues to make strides in child malnutrition at a time when the international aid community has increased its awareness of the importance of reducing childhood stunting as shown in this video.  During the American Public Health Association I attended a session on maternal and neonatal mortality and one of the speakers happened to highlight the trends in the large population growth potential in Niger.  He remarked that if business continues there as usual, it has the potential to undue years of global health work simply because the environment cannot support the projected population numbers.  He encouraged public health practitioners to not just go to the "safari countries",  but to the places where mother's and children's lives are most at risk.

Women at Guineobangou Health Center
This encouragement coupled with prayer and realization that I still have many unanswered questions about life in the desert.  Many questions that perhaps will never fully be answered, but at least have the potential of resolving by returning.

Answers to desert questions often depend upon what one brings in coming, how one my be accustomed to moving through anything.  Embracing desert and mountain spirituality requires assuming the hazards of a rugged land, remaining open to the threat it poses.  There may be no substitute for the instructive power of place. 
Belden Lane  

Sunday, September 23, 2012

Oasis

There has been some encouraging news about Niger this past week.  On Wednesday the Medical Journal, The Lancet published a case study about Niger reporting that there have been significant reductions in the mortality rate of children under the age of 5 between 1993-2009 based on analyzing household surveys.  The authors of the study attributed it to increases in child survival interventions such as the use of insecticide treated bed nets, improvements in nutritional status, vitamin A supplementation, usage of oral rehydration salts and zinc, care-seeking for fever, malaria, and childhood pneumonia, and vaccinations.  The increases in the child survival interventions have been possible because of collaborations between the government and international NGOs to increase universal access of health care for pregnant women and children by building rural health centers throughout the country, reducing the cost for maternal and child primary health care, and increasing or building the capacity of the health care work force.  In relationship to it's neighbors, Benin, Burkina Faso, Chad, Mali, and Nigeria, Niger is the only country on track to achieve the Millennium Development Goal #4 (reduce by two-third the under-five child mortality rate).  This is no small feat for a land-locked, resource-poor desert country that is often at the mercy of extreme crises such as famine and floods.  Which is why this report from Reuters on the same day was also encouraging.  The Ministry of Agriculture reported on state-owned radio that this year's harvest for millet, sorghum, and maize should be better this year, reducing the rates of food insecurity that plagued the country last year and increasing the rates of malnutrition.

When I was in the desert a month and half ago I experienced my first oasis.  We would be driving along through the sand, struggling to find our way and then out of nowhere, grass would appear with a little water and a camel or two grazing.  In a similar way I find this news about the positive changes in Niger to be an oasis.  For months I have heard, and lately seen, the ravages of the 2011 drought  resulting in emergency-levels of malnutrition, the arrival of the Malian refugees straining the resources of Nigerien rural health centers and staff, and the spillover of Muslim-Christian tension resulting in the burning of churches in the Zinder region of Niger.  This news is an oasis in the midst of a food, political, and religious desert.


As I've been thinking about oasis this past week, I've been thinking about other sources of oasis.  This past week it has often rained in the early part of the morning.  Perhaps nothing is more refreshing in the desert than seeing the sun rise after a nightly rainfall, as I did during my morning run this past Tuesday.  And, I've been attending a small church each week.  Christians are by far the minority in this Muslim country and last week, despite increased threats of security, our small group gathered and found oasis in Romans 8, particularly 31, "If God is for us, who can be against us?"  All of this is a reminder that God has not forgotten to provide oasis for the people of Niger.  He has not forgotten the small child at the mother's breast, He has not forgotten the mother searching for food for her child, He has not forgotten the farmer struggling to harvest his millet, and He has not forgotten me and my continual search for desert oasis.

Sunday, September 9, 2012

Indifference

In my ongoing contemplation of how the geography of desert shapes people's lives physically and spiritually, I had a new realization this past week.  It brings about indifference. Since I arrived in Niamey I've been searching for a word to describe the interactions I've had so far with the Nigeriens I meet in the street and in the market.  I think indifferent is probably the best.  Part of this is because I live in the capital city and I am just one of many expatriates that descend and ascend on the city on a regular basis.  Some stay for years, some for just a few months.  We come and go and interact with other expatriates in our own contrasting universe of  air-conditioned homes, SUVs, supermarkets, and guarded offices.  We have little "need" and time to form relationships with the people we are serving.  Part of this is also due to the Muslim/Christian divide.  I have never lived in a Muslim country before and still learning how to greet properly.  And some of this is due to the nature of the land that is Niger.

This past week I went to visit five Health Centers that Samaritan's Purse supports.  We left early in the morning and within minutes of leaving the city limits it is easy to see the barrennes that makes up the majority of the country.  


Every once in awhile we would drive pass a village composed of a few mud huts, a mosque, and perhaps a health center.  Each village rose out of the sand, like a mirage, indifferent to non-arable land desert heat and sun, and proclaiming an insistance to survive.  


I needed to go on this trip for multiple reasons.  Right now I'm in the process of deciding the direction for our health and nutrition program--what projects should be continued and what new ones could feasibly be added.  For practical purposes, I needed to go and see the distance between the health centers, see their infrastructure, review their registration books.  But really, I needed to go and meet the people.  I needed to find connection.


I needed to meet the community health workers we support.


I needed to see mothers with their children and learn how we can better help them keep their children alive and healthy.



And I did.  One of the last stops was at a health center where the community aids were weighing children and giving out supplementary food (unfortunately not plumpy'sup because we don't have any new supplies since the last order was declared contaminated by the World Food Program).  As soon as I arrived as I was swarmed by many women with their young children eager to greet me, displaying gratefulness, not indifference.


And in my heart, I think my indifference to this place is beginning to ebb away. I've had difficult days wondering why God has brought me here when I often feel so useless and disconnected to the world around me.  But I'm learning that God's silence is not the same as indifference. Slowly I'm beginning to see how I can apply here what I learned in school and elsewhere.   And although I would prefer to be living in the community, with opportunities to form deep relationships with the people, by being in the capital city I have the prospects of helping a wider away of people. I guess in this case its quantity, not so much quality.  Thank you for your continued prayers as I continue to discern how to connect and help well.

We long for silence, realizing that our only way out of the desert is to go deeper into it, beyond the breakdown of language to the "still point" where God meets us in emptiness.

The Solace of Fierce Landscapes: Exploring Desert and Mountain Spirituality
Belden Lane

Sunday, August 26, 2012

Security

In the last three weeks I've been in Niger one of the words that I've heard the most often is security.  We talk often about personal security, political security, and food security.  Although Niger itself is stable as a country, some of our neighbors, Mali and Nigeria, are not.  And as Niger experiences the brunt of the Sahel famine, it is quite food insecure.  I've been calling Niger "ground zero" for malnutrition as it also has one of the worst rates of malnutrition in the world right now.  In the last two weeks I've seen more children who are malnourished then in the four years I was in Cameroon.  This past Thursday I went to village where Samaritan's Purse was distributing millet, rice, and oil to the most food insecure households.

Distribution of millet
    
After I saw the food distribution, I went with the president of the local women's group to visit her farm, where she planted moringa trees with seeds given by Samaritan's Purse.  She was using the leaves to supplement her family's diet and this was very encouraging as the leaves are very rich in vitamin A, C, iron, and calcium.

Daughter of the women's group president holding a moringa leaf

Because Niger is one of the "hot spots" for international aid right now, its been quite interesting to see and learn about which international NGOs are here and what they are doing.  We stopped at a health center for me to see it and learn about their needs.  At the same time Doctors Without Borders (MSF) was at the health center doing a immunization clinic and measuring mid-upper arm circumference (MUAC) to because there had been a measles outbreak in the area.

A MSF worker measuring MUAC to determine nutritional status
Next we visited a women's group and asked them questions about the health of their children, the common foods, their breastfeeding practices.  Shortly after I asked about breastfeeding a grandmother told me about her grandson who was born 4 weeks ago, yet only weighs 2 kilograms.  She brought me this boy to examine.

Our next stop was the refugee camp for the people who escaped from Mali.  MSF was also there providing medical care for all of the people there.  During the tour I saw a mother who had just given birth to a boy a few hours earlier.  I wondered what was going through her mind--if she hoped to be able to return home and raise her son in her own land.
The MSF clinic

One of the tents for the Malian people

As I learn and see more about the harsh realities Nigeriens face living in an insecure place I find it quite overwhelming at times.  A week ago I was talking with the country director about malnutrition here and why it is the way it is.  He told me that instead of asking why, the question is what.  What do I do?  What can I do?  Watching a mother watch her child struggle for breath because he is so malnourished breaks my heart.  No mother should EVER have to bury her child for something that is completely preventable.   How to best treat AND prevent is the ongoing question in this insecure place.

In particular, the way of the desert teaches us how to pray: how to stand before God, how to speak to God, and above all how to keep silent before God.  It reminds us that God is born in barrenness, where there is an absence of pride, of masks, of illusions and of false images.  Paradoxically, God fulfills in emptiness.  God appears when we are not filled with other attachments and distractions, when we are not full of ourselves.

John Chryssanvgis, In the Heart of the Desert

Sunday, August 19, 2012

Desert Nomad

This past week some colleagues and I went to the Northern part of Niger, close to Algeria, to assess the possibility of expanding our work in that part of the country.  Because there are no domestic flights to that part of the country and it would've taken days to drive there, we flew on a humanitarian aid plan operated by the U.S Air Force.

Our plane to Arlit

Inside the plane

That part of Niger is predominately desert and most of the people that live there are Tuaregs, who have for centuries lived as nomads wandering from oasis to oasis, constantly in search of water for themselves and their livestock.

Tuaregs at an oasis

 In the mid-1960s a French multinational mining company discovered that underneath all of that sand was huge supply of uranium.  The company came and created a town, Arlit, for the sole purpose of catering to the needs of the Nigeriens working at the mining company.  The mining company designed the town and built the houses, the hospital, the grocery stores, and the restaurant.

Mining for Uranium

In 2006 the little mining town in the desert became well known after a few expatriates were kidnapped and held for ransom.  Because of that and the political situation in Niger and neighboring Libya, almost all of the NGOs left the area.  Recently the area has become more stabilized, however we had to be accompanied by both Nigerien and American armed forces everywhere we went.

Our Nigerien escorts
 
The first day we were there we wanted to do an assessment of a local village.  We, and a Civilian Affairs team from the US military, first stopped at the Prefet's (regional authority) office to announce our presence and explain our plans.  While we were meeting with the Prefet and his officials, another well-dressed man came in and announced that he would lead us to where we wanted to go.  So he, and his two car entourage, and us in our four car entourage went tromping through the desert in search of women and men we could talk to about their life and do a water assessment.


After about two hours of wandering through the desert we finally found some people huddled under the shade of one of the few trees around.  Myself and a colleague asked the women questions about their access to education, health services, food, and their livelihoods.
One of the women and her son we interviewed

They explained to us their life as nomads, staying in one place as long as there was water, but never long enough to send their children to school for any length of time.  Their diet consists of millet and rice with the occasional camel and goat milk.  When we asked about if the women breastfeed their children and for how long, they explained that they first give their children sugar water and typically breastfeed their sons for two year and their daughters for one year.  They explained to us that they breastfeed their son longer so that he will be more intelligent.  After they were finished telling us about their life, I saw one women give a baby a bowl of brown water to drink.  The nomadic life is a isolating, difficult one demanding fortitude and perseverance in both mind and body.  The women explained to us their many needs and discerning if and how to help well is challenging.  How do you provide health and nutrition education for a group of people when you do not know where they will be in the next month?  Follow them on a camel through the desert?


And if the best way to start working with a community is to learn from them, what does it mean to live a life of moving from spring to spring in the desert?  

To survive at all, the desert dweller--Tuareg or Aboriginal--must forever be naming, sifting, comparing, a thousand different "signs"--the tracks of a dung beetle, or the ripple of a dune--to tell him where he is; where the others are; where rain has fallen; where the next meal is coming from. 
Chatwin, The Songlines