<?xml version="1.0" encoding="UTF-8"?><rss xmlns:content="http://purl.org/rss/1.0/modules/content/" version="2.0"><channel><title>IRIN - Latin America and Caribbean</title><link>http://www.irinnews.org/</link><description>Updated everyday</description><language>en-gb</language><lastBuildDate>Tue, 19 Feb 2013 11:01:44 GMT</lastBuildDate><item><title>Decades of aid manipulation</title><pubDate>Tue, 19 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201201160754460265t.jpg" />]]>DAKAR 19 February 2013 (IRIN) - Following the 9/11 attacks and the launch of the Global War on Terror, many humanitarian policy wonks spoke of a new era of heightened aid instrumentalization - that is the use of humanitarian action or rhetoric as a tool to pursue political, security, development, economic, or other non-humanitarian goals, which would muddy humanitarian principles and constrain access to those in need. </description><body><![CDATA[DAKAR 19 February 2013 (IRIN) - Following the 9/11 attacks and the launch of the Global War on Terror, many humanitarian policy wonks spoke of a new era of heightened aid instrumentalization - that is the use of humanitarian action or rhetoric as a tool to pursue political, security, development, economic, or other non-humanitarian goals, which would muddy humanitarian principles and constrain access to those in need.

But a new book, The Golden Fleece, [ http://www.amazon.com/The-Golden-Fleece-Manipulation-Independence/dp/1565494881/ref=sr_1_1?ie=UTF8&qid=1360849171&sr=8-1&keywords=the+golden+fleece%2C+donini ] argues that instrumentalization goes back centuries. The only thing that has changed is the “centrality and sheer size” of the humanitarian enterprise, says its editor Antonio Donini, senior researcher at Tufts University’s Feinstein International Center. “There never was a golden age of humanitarianism,” he says.

While aid agencies balked at Colin Powell’s description of them as “force multipliers” in the US “war on terror”, he was not far from wrong, says Lt-Gen (rtd) the Honorable Roméo Dallaire, head of the UN assistance mission in Rwanda during the genocide and author of Shake Hands with the Devil: The Failure of Humanity in Rwanda.

US aid agencies, for instance, were used as “force multipliers” in the Vietnam war and in the Central American civil wars of the 1970s and 1980s, to give but two examples.

“Humanitarians have been used… as fig leaves to veil government action and inaction in the face of war crimes and genocide. Humanitarians have been paid, manipulated, and `embedded’ with singular disregard for humanitarian principles. They have been routinely ignored, even in cases of obvious humanitarian need and enormous public outcry. They have been silent when they should have spoken out, and they have spoken out when they should have remained silent. They have called for military intervention… and on the few occasions when they got their wish, they mostly lived to regret it,” says co-author Ian Smillie, a long-time aid critic and founder of Canadian NGO Inter Pares.

The Golden Fleece explores different forms of aid manipulation starting in the 19th century, and progressing to the 20th and 21st centuries, presenting a series of case studies in Sudan, the Occupied Palestinian Territory, Pakistan, Somalia and Haiti, among others.

Instrumentalization can also be more subtle - for instance when humanitarian emergencies are largely ignored by aid agencies and governments alike - or, in the case of food aid, when it is used to dispose of surplus stocks, to create new markets and to win over governments, as opposed to more blatant manipulation involving say, the diversion of stocks by warring parties.

“Dunanist” versus not

An increase in the number and severity of crises, the vast growth of the humanitarian sector, the increased ability of governments to dictate the shape of agency programming, the more intense real-time scrutiny, and the impact this has had on funding, have made agencies more aware of aid instrumentalization.

Some agencies stick to the humanitarian principles of independence, impartiality and neutrality more strictly - notably the “Dunanist” agencies International Committee of the Red Cross and NGOs such as Médecins sans Frontières (Henri Dunant inspired the creation of the Red Cross movement at the battle of Solferino).

However, even the ICRC has struggled to uphold its principles at times: for instance, by failing to step up its protection response to victims of concentration camps in 1930s Germany; or in keeping silent about British-run concentration camps during the 1890s Boer war.

For multi-mandate agencies - both NGOs and UN - neutrality, independence and impartiality “are more guidelines than principles. For them, manipulation… has been the default position, some using and some eager to be used,” says the book.

The danger for them is that in a place like Afghanistan, “some multi-mandate agencies may find themselves in a bind,” says Donini. “They want to do humanitarian aid at one point, but having been implementing partners for the government, for military-political provincial reconstruction teams, they are realizing these chickens will come home to roost.”

Instrumenalization of aid is more obvious in some crises than others. In Somalia all local groups - from local NGOs to businessmen to warlords - have sought to manipulate assistance to project their authority or enrich themselves, say the authors.

Lessons for aid agencies

The authors refrain from being prescriptive, but some lessons do emerge. A clear one is that calling for military intervention is almost always regretted later on. “Agencies call for the cavalry at their peril,” says Smillie, “This is a cautionary tale.”

Another is that aid agencies too often compartmentalize or simplify their view of a complex emergency, perpetuating a self-referential reality in which their solutions (food, tents), define the problem. This can often lead them to ignore the real problems at hand (human rights abuses, say, in Sri Lanka, or feeding genocidal killers, say, in Rwanda).

Such a vision leads Darfur to be depicted as a relatively straightforward tale of “bad” Arabs and “good” Africans rather than a more complex power struggle over land and water.

It also blinds them to their own impact: several researchers have asserted that humanitarian aid prolonged the war in Nigeria’s Biafra in the 1960s - a conflict in which an estimated one million people died, the majority as a result of malnutrition. Of course hindsight is a wonderful thing, but Smillie, who was there at the time, says several NGOs were aware of this dynamic at the time.

Perhaps one of the most useful lessons is that, in the authors’ analysis, manipulation of assistance generally does not get the manipulators what they want. “The fact that aid can be a force multiplier may be wrong,” said Smillie. Studies have shown for instance, that humanitarian aid in Iraq and Afghanistan did little to win over hearts and minds. Perhaps its very ineffectiveness should be an incentive to loosen the hold.

As Western power wanes and crisis-affected countries begin to assert their right to control crisis response, new dynamics will arise. Donini gave Sri Lanka as an example of where its leader Mahinda Rajapakse used the Global War on Terror and respect for sovereignty rhetoric to justify overwhelming force against the Tamil uprising when he came to power in 2005, out-manoeuvering and repressing humanitarians.

Long on problems and short on solutions, the book can make for depressing reading. But Donini stressed a final point: “This book focuses on the negative - we wanted to unscramble instrumentalization. But we shouldn’t deny all the positive…. there is much about the humanitarian enterprise that is really quite good.”

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Q&A with authors of The Golden Fleece

IRIN discussed some of the book’s themes with its authors Donini (AD) and Smillie (IS).

You say aid instrumentalization is nothing new, but has it become more pronounced?

AD: There was never a golden age and there always has been instrumentalization of one kind or another. It is part of human nature to try to take advantage of assistance - be it by aid agencies, donors, warring parties or affected communities.”

IS: We [the authors] had been talking off and on over 10 years about how there was more and more instrumentalization - the sky was falling - and I wondered if it was cyclical. I thought there might have been a surge at the end of the Cold War, when there were more Western boots on the ground. But when I started to look at it I realized that was not the case - I was surprised by how similar many situations were. Instrumentalization was blatant among American NGOs in Vietnam in the 1960s and among the Atrocitarians in Bulgaria in the 1860s. The same could be said of Afghanistan and Iraq. The day before 9/11 there were hardly any Western NGOs in Afghanistan, despite great needs. The sudden outpouring of aid clearly had a lot to do with Western political and security interests. The point to show was that it was just part of an ongoing struggle between principles and the exigencies of politics and war.

Is a clearer separation needed between Dunanist and multi-mandate agencies?

AD: For me it makes sense to have a clearer separation between agencies that maintain a narrow humanitarian profile and are the only agencies that can cross lines and access fraught environments, and the rest of the aid community, which do important things but also take on human rights, peace building, state-support etc… We need a clearer definition of who is working according to these recognized principles and who is not.

IS: Should you take military protection to get a food convoy through? Some would say no. Others would say: people are hungry and if we don’t, they’ll die. There is a place for both [approaches].

How is the push for better accountability shifting the game?

AD: We are clearly improving accountability [ http://www.irinnews.org/In-depth/95731/97/Are-they-listening-Aid-and-humanitarian-accountability ] in how aid is provided, with standards (Sphere, People in Aid); access through proxies; real-time feedback; using mobile phones and video conferencing which allow agencies to check on stocks and verify if a sample of the population are receiving assistance. We have access to the Internet, to budgets, to standards, and can compare responses between different crises. When I was in Helmand Province in Afghanistan in June last year, I talked to the Afghan director of an NGO - he knows everyone there. A Taliban member summoned him to his house to discuss a water project that he had a problem with. When asked how he knew about the project, he said they were checking different NGO budgets to see where the money was coming from - whether from belligerents or independent forces…. It will become more difficult for agencies to pretend they are humanitarian when they are not. The days of arrogance characterizing the aid community - when you could fudge these issues - are gone, and that is a positive thing.

Where a lot of work is still required is working on the basis of evidence rather than hunches. Very often we come in and dump assistance without doing the proper assessments. Sometimes less is more.

Why are humanitarians not more aware of being used/using others?

AD: We’re very good at using the tools of the last crisis for the new one but are not good at adapting to new situations. That is why in places like Syria [ http://www.irinnews.org/Country/SY/Syria ] we are stuck. Should humanitarians be playing a more important role or are they just carrying the can for the failure of UN member states to find a solution?

IS: The problem among humanitarians is that they think the world began the day they arrived. They don’t know enough about the history and culture of the place, or of their business. We need to think about how lessons from the past apply in the current situation. I don’t know if there is a Biafra lesson that could be applied to Mali right now. There may be none, but it doesn’t hurt to be more literate in history of humanitarian action. Basically, this is just a lot of common sense, which is usually sorely lacking in an emergency setting.

How will dynamics shift in the future?

AD: Humanitarianism is in some ways a victim of its own success… Humanitarianism has grown in parallel with Western dominance… Now the West is in retreat, then maybe we are reaching the limits of Western modern humanitarianism?

What is emerging in parts of the world - Sri Lanka or Darfur for instance - is a more robust manifestation of sovereign nationalism… It is good that middle-income countries are more involved in defining how they will address humanitarian needs, but it is less positive that we risk a dilution or a manipulation of humanitarian agencies as a result.

India, China and other middle-income countries will start using their own soft power to advance humanitarian activities. Future crises - taking place in mega-cities, dealing with the impact of climate change - are those where the state is likely to be at the centre of the response, for better or worse. Aid agencies have traditionally been state-avoidant - this will have to change.

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]]></body><link>http://www.irinnews.org/Report/97502/Decades-of-aid-manipulation</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201201160754460265t.jpg"/></td><td valign="top">DAKAR 19 February 2013 (IRIN) - Following the 9/11 attacks and the launch of the Global War on Terror, many humanitarian policy wonks spoke of a new era of heightened aid instrumentalization - that is the use of humanitarian action or rhetoric as a tool to pursue political, security, development, economic, or other non-humanitarian goals, which would muddy humanitarian principles and constrain access to those in need. </td></tr></table>>]]></content:encoded></item><item><title>Preparing for urban disasters - challenges and recommendations</title><pubDate>Thu, 10 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201004051229450281t.jpg" />]]>BANGKOK 10 January 2013 (IRIN) - Electrical engineers and hazardous waste experts join emergency rosters. Power mapping becomes as important as hazard mapping in emergency prevention and response. #fragilecities shows up as often as #fragilestates in Twitter searches. Humanitarian science fiction? No, welcome to what demographers call the new urban millennium and the challenges, as well as changes, aid groups face responding to emergencies in urban areas.</description><body><![CDATA[BANGKOK 10 January 2013 (IRIN) - Electrical engineers and hazardous waste experts join emergency rosters. Power mapping becomes as important as hazard mapping in emergency prevention and response. #fragilecities shows up as often as #fragilestates in Twitter searches. Humanitarian science fiction? No, welcome to what demographers call the new urban millennium and the challenges, as well as changes, aid groups face responding to emergencies in urban areas.

“People are using the same recipe from a rural camp situation in cities. Aid tools and strategies have been cut and paste. This does not work,” said the director of the France-based research, training and evaluation NGO, Urgence, Réhabilitation et Développement (URD), François Grünewald, who has researched urban risks and responses for more than a decade. 

It is not enough to ask “Did we do it right?” by meeting basic humanitarian aid standards known as SPHERE [ http://www.sphereproject.org/ ], but also, “Did we do the right thing?” said Grünewald.

More often than not, the answer has been no, he concluded. 

IRIN analysed evaluations [ http://www.alnap.org/pool/files/alnap-lessons-urban-2012.pdf ] to highlight some lessons emerging from recent urban disasters. What follows are challenges and recommendations reported by groups from Manila to Mogadishu; insights from experts consulted over the past year; and an “urban” aid toolbox organizations have begun assembling but which they admit is far from complete. 

Experts generally agree: Humanitarians are still ill-prepared for urban emergencies, whether it be civil conflict in Syria [ http://www.irinnews.org/Report/97126/SYRIA-Nowhere-to-run ] or a “complex” disaster like Japan’s 2011 earthquake followed by a tsunami, resulting in fires, chemical spills and nuclear power accidents. 

Overview

Some 3.3 billion people live in urban areas, with one billion of them in slums, a number that is growing by 25 million annually, according to the UN Human Settlements Programme (UN-HABITAT). Such growth threatens to “become the tipping point for humanitarian crises,” noted the journal, Forced Migration Review (FMR) [ http://www.fmreview.org/urban-displacement ] in February 2010, which went to press soon after Haiti’s capital was hit by a 7.0-magnitude earthquake that killed more than 220,000 people, injured more than 300,000 and has left some 360,000 others still displaced [ http://www.eshelter-cccmhaiti.info/jl/index.php?option=com_content&view=article&id=11&Url= ] almost three years later. 

“Urban DRR [disaster risk reduction] and preparedness, mitigation, response and reconstruction will come to dominate humanitarian policies and programmes in the coming decades,” noted the review.

The lessons [ http://www.dec.org.uk/haiti-earthquake-appeal-evaluations ] and mea culpas [ http://www.irinnews.org/Report/88857/HAITI-US-Washington-aid-policy-may-be-shifting ] from the aid response in Haiti are still piling up: Not consulting local groups; no exit strategy; importing foreign vehicles and goods without checking locally; coordination between the military and humanitarians based on personality rather than protocol [ http://ghsm.hms.harvard.edu/uploads/pdf/haiti_case_study.pdf ]; focusing on transitional, rather than permanent, shelters.

Agencies need to learn the “new rules of the game” of urban disaster response, as the UK-based Disasters Emergency Committee (DEC), an umbrella group of some 15 humanitarian aid groups, wrote in 2011 in its compilation of lessons from Haiti [ http://www.dec.org.uk/sites/default/files/files/Evaluations/Haiti/DEC-Haiti-urban-study.pdf ].

But what exactly are those rules? What sets apart acute vulnerabilities from chronic poverty? How do you rebuild communities when there is scarce land? What are humanitarians’ responsibilities to host communities and the urban poor? And just when is a humanitarian’s job done in a chronic emergency?

Urban interventions present humanitarians with similar challenges to other chronic emergencies (Kenya, Democratic Republic of Congo, the Sahel [ http://www.irinnews.org/Theme/SAH/Sahel-Crisis ]) not tied to a specific geographic area that often lacked clear “triggers” of engagement.

Lessons aid workers have compiled from urban disasters - including Philippines’ 2009 Typhoon Ketsana [ http://www.irinnews.org/Report/90573/PHILIPPINES-One-year-after-Ketsana-challenges-remain ], Haiti’s 2010 earthquake [ http://www.irinnews.org/Report/94118/FILM-Haiti-s-Rape-Survivors ], and Japan’s 2011 twin disasters [ http://www.irinnews.org/Report/92203/HOW-TO-Trace-missing-persons ] - still leave a “huge gap”, said George Deikun, director of UN-HABITAT’s Humanitarian Affairs Office in Geneva and one of the authors in FMR’s February 2010 special urban issue.

“There is a lot of literature, but… it doesn’t bring together the critical and necessary elements in the whole cycle of humanitarian assistance to development,” he told IRIN recently. Humanitarians’ work typically has had a “shelf life [intervention period] of 90 days while governments in urban areas are looking to leverage assistance to move on beyond saving lives to re-establishing sustainable communities.”
 
Urban risks

Experts calculate that urban areas’ population growth - including residents and refugees fleeing conflict - plus unenforced or non-existing building codes can be fatal for urban residents already cut off from city services due to lack of income, security or identification [ http://www.irinnews.org/Report/88562/KENYA-Urban-refugees-need-legal-clarity-says-report ].

While experts differ on how fast the countryside is emptying into urban areas [ http://www.irinnews.org/report/95015/AFRICA-Challenging-the-urbanization-mythsAfrica ], most agree urban areas in  sub-Saharan Africa are growing more quickly than elsewhere, and that the Asia-Pacific region has the largest number of urban residents, 1.8 billion as of 2011 (43 percent of region’s population) [ http://www.unescap.org/stat/data/syb2012/index.asp ].

How the displaced manage in cities, how their needs compare to the urban poor and just what humanitarians’ responsibilities are to address chronic (rather than acute) needs is still debated, according to research on urban displacement and vulnerability [ http://www.odi.org.uk/projects/2437-sanctuary-city-urban-displacement-vulnerability#details ] by the UK-based Overseas Development Institute’s Humanitarian Practice Group, which noted that the best ways to support the urban displaced are “poorly understood”. 

Cities, the crossroads of so many legal and illegal transactions, are also becoming battlegrounds for a “`new’ kind of armed conflict [ http://www.irinnews.org/Report/97188/Analysis-Urban-violence-new-territory-for-aid-workers ]… a variation of warfare, often in densely populated slums and shanty towns [featuring] pitched battles between the state and non-state armed groups,” wrote [ http://sites.tufts.edu/jha/archives/1524 ] Kevin Savage from World Vision International and Robert Muggah, research director at Igarapé Institute, a Brazilian think tank focusing on violence prevention and reduction.

Response 

At a meeting focused on “adapting humanitarian efforts to an urban world” convened last January by the Active Learning Network for Accountability and Performance (ALNAP) [ http://www.alnap.org/pool/files/meeting-paper-2012.pdf ], a UK-headquartered network of humanitarian experts and organizations, participants concluded that even with their experience from urban disasters, “collective understanding is patchy, informal and still largely undocumented. It is still too early to say how best to respond to the challenge of urban disasters: the rules have yet to be written.” 

In 2009 the Inter-agency Standing Committee (IASC) - an umbrella group of humanitarian groups that sets policy for the aid community - formed a reference group [ http://www.humanitarianinfo.org/iasc/pageloader.aspx?page=content-subsidi-common-default&sb=74 ] on “meeting humanitarian challenges in urban areas”, setting a two-year action plan in 2010. 

The group pledged to prepare the industry better to respond to crises in urban areas, by, among other things, launching a database of urban-specific aid tools [ http://www.urban-response.org/ ] that aimed to be the clearinghouse for all information on aid in urban emergencies (done); strengthening technical surge capacity for urban emergency response (partially done); developing or adapting humanitarian tools for urban areas (partially done); promoting protection of vulnerable urban populations (done). Developing guidance on supporting food security in post-crisis areas and building preparedness and community resilience into humanitarian policymaking are still incomplete as of early January 2013.

The UN Office for the Coordination of Humanitarian Affairs (OCHA), UN-HABITAT, the Kenyan government and NGOs are trying to pilot a “Multi-Hazard Response Plan” created in Kenya that brought together local and national governments and almost 100 groups working in urban areas to prepare for future urban emergencies. Kenya’s election violence in December 2007 killed an estimated 1,200 persons and displaced more than 660,000 [ http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/7289.pdf ], many of whom sought refuge in cities and have yet to return home. 

But even bringing together urban actors can be complicated, if not impossible, noted URD.

According to a report [ http://www.alnap.org/pool/files/rapport-echo-urba-alnap-vfinale-aout.pdf ] the group published in December 2011, new “players” in urban settings include: gangs controlling the population, churches exploiting their distress, social networks linked to the diaspora, community-based organizations trying to attract aid for their constituency, and private companies looking for clients in the aid industry. 

The group is finalizing a “concept note” to call attention to the impact on urban areas of Syria’s ongoing fighting, which the UN estimates has killed 60,000 people since protests turned violent in 2010. According to the Syrian Network for Human Rights, in 2012 some 8,200 people died in areas surrounding the country’s capital, Damascus.

On the housing front, Shelter Project [ http://www.shelterproject.org/ ], led by the Norwegian Refugee Council’s Internal Displacement Monitoring Centre and the Geneva-based NGO Shelter Centre, working with other humanitarian groups and agencies, is developing guidelines for moving people out of emergency shelters into permanent housing. A draft is expected by mid-2013.

The World Food Programme (WFP) is reviewing food-targeting practices and with Food and Agriculture Organization (FAO) is developing global guidelines to strengthen urban food security and nutrition in emergencies. 

Challenges

For all the recommendations proffered following recent urban disasters (see sidebar), five key challenges remain:

Urban access. “International agencies are king in rural areas versus cities where they play a supporting role,” said one aid worker. The challenge of working with leaders from neighbourhoods and communities (which researchers note are not necessarily the same), as well as civil society staff and officials from multiple levels of government - all necessary partners - becomes more complicated when the government is a combatant in conflict, as in Syria [ http://www.irinnews.org/report/95606/Analysis-Principles-or-pragmatism-Negotiating-access-in-Syria ].

Cluster chaos. According to URD, “multi-sector geographical coordination” makes more sense in urban areas - where all aid is delivered by a single level of authority - rather than the current “cluster” model of crisis coordination [ http://www.humanitarianresponse.info/ ] in place since mid-2006, which divides aid by issues, such as food, shelter or education.

In Haiti, leadership posts of many sectors were vacant. Once in place, the system was “too heavily bureaucratic” and not able to carry out quick needs assessments; the health sector alone had more than 400 groups participating at one point. Theme-specific groupings were unable to meet multi-sector challenges. Cluster meetings were primarily conducted in English to accommodate the large number of Anglophone emergency responders, which was often too fast-past paced for local Francophone or Creole-speaking groups [ http://www.unglobalcompact.org/docs/issues_doc/un_business_partnerships/2010_haiti_earthquake/Response%20to%20the%20Humanitarian%20Crisis%20in%20Haiti.pdf ].

Targeting vulnerable communities. In cities the most vulnerable tend to be highly mobile, untraceable and scattered. Refugees and internally displaced persons may seek out sprawling urban areas for anonymity due to fears of harassment, detention or eviction, making it difficult to track, profile, register or document them. In turn, the task of measuring the impact of satisfying humanitarian versus economic needs is hard because conventional needs assessments do not distinguish acute needs (such as war-inflicted health trauma) from chronic ones (cholera borne of slum living and urban poverty).

Identifying and targeting assistance in cities is a “huge challenge” said UN-HABITAT’s Deikun. “The problem with emergency response is that it has to be done quickly and be done by yesterday. It relies on existing data that is not always correct, and may be politically distorted. Mapping vulnerable urban populations in high-risk environments before the emergency strikes is rarely done.”

Seeking urban experts: Emergencies in urban areas require expertise often in short supply: adapting water and sanitation projects [ http://www.irinnews.org/Report/97161/SANITATION-Urban-water-woes ] to complex, dense and underserviced urban environments; conducting urban vulnerability and community resilience analyses and plans; developing land use management plans and tenure guidelines; removing debris [ http://www.irinnews.org/Report/33933/PAKISTAN-IOM-starts-debris-removal-in-quake-area ]; reconstruction of urban housing; resettlement of affected populations from emergency shelter and trauma surgery - to name a few.

Following Haiti’s earthquake, the lack of trauma specialists and surgeons led to inappropriate treatment, excessive unnecessary amputations and health complications, according to multiple evaluations. The IASC reference group on humanitarian challenges in urban areas has created and is disseminating generic terms of reference for a number of these specialists capable of responding to urban disasters. 

Exit strategy. Humanitarians are the “last ones” to develop an exit strategy, said URD’s Grünewald. “The humanitarian is focused on saving lives. We only think of it at the end.” The problem is when there is no strong governance to take over and “the principal activities of many agencies seem to be stuck in an extended relief mode,” DEC noted [ http://www.dec.org.uk/sites/default/files/files/Evaluations/Haiti/DEC-Haiti-urban-study.pdf ]. Bring along an urban adviser or development specialist as early as the damage assessment, Grünewald counselled, to  decide when to exit.

He concluded humanitarians can only do so much. 

“[Humanitarian] NGOs want to become engaged in slums. But all the money from all the donors would only be a drop in the bucket - and there would still not be an exit strategy… The Band-Aid system is messy and can only be a Band-Aid.”

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Aid in an urbanizing world

A series of articles on challenges and changes humanitarian workers are confronting in urban emergencies
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]]></body><link>http://www.irinnews.org/Report/97199/Preparing-for-urban-disasters-challenges-and-recommendations</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201004051229450281t.jpg"/></td><td valign="top">BANGKOK 10 January 2013 (IRIN) - Electrical engineers and hazardous waste experts join emergency rosters. Power mapping becomes as important as hazard mapping in emergency prevention and response. #fragilecities shows up as often as #fragilestates in Twitter searches. Humanitarian science fiction? No, welcome to what demographers call the new urban millennium and the challenges, as well as changes, aid groups face responding to emergencies in urban areas.</td></tr></table>>]]></content:encoded></item><item><title>Urban violence - new territory for aid workers</title><pubDate>Tue, 08 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201211010757450280t.jpg" />]]>DAKAR 08 January 2013 (IRIN) - The gradual expansion by a small number of humanitarian agencies beyond their traditional remits of war and natural disaster towards tackling the consequences of large-scale criminal violence in urban settings raises questions about the legal framework and working methods of such interventions.</description><body><![CDATA[DAKAR 08 January 2013 (IRIN) - The gradual expansion by a small number of humanitarian agencies beyond their traditional remits of war and natural disaster towards tackling the consequences of large-scale criminal violence in urban settings raises questions about the legal framework and working methods of such interventions.

The tricky question for humanitarian NGOs is whether or how to intervene - for how long, on what legal basis and under what strategy. While drug cartels and other criminals often claim lives, the theatres of violence they generate are not covered by the Geneva Conventions [ http://www.icrc.org/eng/war-and-law/treaties-customary-law/geneva-conventions/index.jsp ], which have for more than 60 years guided humanitarian interventions in wars.

“If there is no declared conflict but there are all the hallmarks of warfare in terms of the intensity of violence and the organization of armed groups, there are questions about what norms and rules apply,” said Robert Muggah, professor at the Institute of International Relations at the Catholic University of Rio de Janeiro and research director at Igarapé Institute, a Brazilian think tank focusing on violence prevention and reduction.

“What laws apply when an international organization negotiates access to civilian populations with the dons of drug cartels or illegal self-defence units? What kinds of immunity are personnel granted? What are the expected procedures for dealing with militaries and police? In most cases, humanitarian agencies simply get on with the difficult work of providing assistance and minimizing harm with little time to reflect on these and other tricky questions,” he told IRIN.

Negotiating access

In 2008 the International Committee of the Red Cross (ICRC) launched a five-year pilot project [ http://www.icrc.org/eng/resources/documents/publication/p4009.htm ] to negotiate access for humanitarians in some of Brazil’s Rio de Janeiro slums, while MSF has sent mobile clinics throughout some of the most violent neighbourhoods in the Honduran capital of Tegucigalpa, where drug and gang-related violence have rendered emergency medical care almost non-existent.

“Organizations such as ICRC and MSF have made clear policy statements about their intention to engage [in] urban centres that are in conflict or so-called `other situations of violence’. They are only relatively recently starting to reckon with what this might mean in practical terms,” said Muggah, who is also coordinating HASOW, Humanitarian Action in Situations Other Than War [ http://www.hasow.org ].

Created in 2011 as a two-year international initiative, HASOW probes the legal implications of humanitarian action in such settings, the changes they are spurring in international agencies, and the impact of intervention.

He and other analysts say dealing with violence in urban centres is forcing humanitarians to re-examine their “in-and-out” modus operandi, given the intricacies - and time - demanded by conflict meditation and prevention.

So-called “grey zone” conflicts pitting the state against, for example, urban drug gangs exacts a growing humanitarian cost. The death toll since 2006 in Mexico’s war against the cartels is estimated to stand at between 50,000 to 110,000 [ http://www.phoenixnewtimes.com/2012-07-26/news/mexicans-pay-in-blood-for-america-s-war-on-drugs/ ] - many of them ordinary people, unrelated to the gangs or the security forces.

While cities are not necessarily more deadly than the countryside, noted the World Bank in 2010 [ http://siteresources.worldbank.org/EXTSOCIALDEVELOPMENT/Resources/244362-1164107274725/Violence_in_the_City.pdf ], “many of today’s cities - especially those that are growing very quickly - experience a convergence of factors that increase the risk for destabilizing levels of violence if they are not appropriately addressed.”

“It shouldn’t matter whether an IHL [international humanitarian law] framework is applicable or not; it’s the consequences of this violence that aid groups are responding to, regardless of the nature of violence,” said Elena Lucchi, humanitarian consultant and a former Médecins Sans Frontières (MSF) operational adviser on urban issues. “Decisions should not derive from dilemmas over legal frameworks.”

The risk is that governments may spurn humanitarians’ involvement in order to protect their reputation and sovereignty in these so called “situations other than war”, Lucchi added.

“Situations other than war”

There are different sources of urban violence (chronic or short-term) - political violence, organized crime, drug wars - and only some scenarios lend themselves easily to humanitarian intervention, said François Grünewald, executive director of the France-based research, training and evaluation group, Urgence, Réhabilitation et Développement (Groupe URD).

In gang violence driven by organized crime, humanitarian agencies are quite limited, Grünewald told IRIN. For one, humanitarian principles (neutrality, doing no harm, etc.) - even if they applied - do not cut much ice with gangs.

“The actors in that kind of urban violence don’t care at all about humanitarian issues,” he said. “In most war settings groups have a goal - to control territory or to gain political recognition and political power. And if you have that goal you can’t do just anything. Those actors have political motivation, they look for recognition; they might be inclined to enter into a dialogue with humanitarian actors. The drug cartels in Mexico - they just don’t care. They just kill.”

The few organizations with an “entry point” into the second scenario, Grünewald said, include MSF with its medical mandate and ICRC because of its special engagement with authorities and “non-state” actors, like gangs.

In addition, Doctors of the World (Médecins du Monde) has sent exploratory missions to Bolivia and Mexico to examine the impact of urban violence on health.

Violence is just one aspect of a broader challenge - how to operate effectively in urban settings - said Nicolas Moyer, executive director of the Canada-based Humanitarian Coalition [ http://humanitariancoalition.ca/ ]. Aid experts say humanitarians’ response to the 2010 earthquake in Haiti, which killed more than 220,000 and left more than 350,000 people still displaced three years later, exposed the aid community’s shortcomings in urban areas.

Seeking new tools

Largely missing from the aid workers’ toolbox is how to measure progress and needs in urban areas.

MSF recently conducted assessments of health care access and availability in parts of Guatemala, Honduras, and Mexico, and found that violence in some urban areas has disrupted essential services to the point that for much of the population acute needs go unmet.

“In the most violent areas - such as on the outskirts of big cities in Mexico and Honduras - health professionals are not keen to work there because they fear for their own security,” said Gustavo Fernandez, MSF programme manager for Guatemala, Honduras, Iraq, Lebanon, Sudan, and South Sudan. “This creates a vacuum; the existing health structures just cannot absorb the demand.”

In addition to running mobile clinics in Honduras, MSF partnered with the Health Ministry to work alongside health centre staff - at times very few of them - providing medical care, medicines and staff training. “We are always working with [Health Ministry] staff so when MSF leaves, they can continue primary care at the health centres,” said MSF’s head of mission in Honduras, Laurence Gaubert.

MSF also works closely with local firefighters as they are the ones capable of responding to medical emergencies in urban conflict zones.

Humanitarian agencies must adjust how they measure progress in such settings, said consultant Lucchi.

“For medical aid organizations, which commonly have worked in closed environments like refugee settings, one of the indicators of success would be a reduction of mortality,” she said. “In protracted situations in [sprawling urban] settings… this sort of emergency threshold is not really appropriate. So it’s essential to look for alternative ways of measuring and monitoring.”

Needs assessments capable of separating acute needs from chronic ones in urban areas where there is extreme poverty, weak health systems and poor governance are still rudimentary [ http://www.irinnews.org/pdf/IASC_tools_assessment.pdf ], making it difficult for humanitarians to measure impact in a context of widespread, longstanding need.

Development disconnect

Aid experts say urban violence exposes the gradually narrowing disconnect between humanitarian and development operations.

While in “traditional” conflict settings, the two are starting to coordinate better, Muggah said, urban violence poses new dilemmas.

In an urban environment, a humanitarian agency cannot use the same modus operandi as during, for example, inter-communal fighting, said MSF’s programme coordinator, Fernandez. “In [urban] settings, the [existing local infrastructure] - though disrupted and though unable to address some critical needs - still exists; the actors are still there. For the sake of continuity and a comprehensive approach, humanitarian agencies must coordinate with all other actors.”

In rural refugee camps aid groups contend with few authorities or agencies; in cities their legitimacy depends largely on being able to work long-term with multiple levels of authority (city, municipal, district, local) as well as NGOs and public workers, said Muggah.

“For some development agencies reinforcing community structures comes naturally. But for many humanitarian organizations this is rather more difficult - there tends to be inclination towards substitution as opposed to reinforcing and capacity-building, and the latter is a real need in these urban settings.”

Humanitarian Coalition’s Moyer said urban interventions have sparked, and will continue to spark, debate over fundamental principles. “A pure humanitarian mandate is in-and-out lifesaving, while responding to urban violence requires more integrated approaches, longer-term approaches… I don’t think there’s resistance to it; I think there’s curiosity about what’s involved and what the possible outcomes might be.”

np/pt/am/oa/cb

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Aid in an urbanizing world

A series of articles on challenges and changes humanitarian workers are confronting in urban emergencies
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]]></body><link>http://www.irinnews.org/Report/97188/Urban-violence-new-territory-for-aid-workers</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201211010757450280t.jpg"/></td><td valign="top">DAKAR 08 January 2013 (IRIN) - The gradual expansion by a small number of humanitarian agencies beyond their traditional remits of war and natural disaster towards tackling the consequences of large-scale criminal violence in urban settings raises questions about the legal framework and working methods of such interventions.</td></tr></table>>]]></content:encoded></item><item><title>Urban water woes</title><pubDate>Wed, 02 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201009290735590125t.jpg" />]]>NEW YORK 02 January 2013 (IRIN) - In Zimbabwe’s capital, Harare (population 3,000,000), a man relieves himself in the dirt next to his tin shack, holding his nose to ward off the stench of a nearby overflowing latrine. In Ramallah (population 300,000) in the occupied Palestinian territory a 14-year-old girl wakes with menstrual cramps - and skips class because her school lacks a washroom where she can clean herself in private. In Bangladesh’s mega-capital (population 12 million), a monsoon-season flash flood leaves thousands with cholera.</description><body><![CDATA[NEW YORK 02 January 2013 (IRIN) - In Zimbabwe’s capital, Harare (population 3,000,000), a man relieves himself in the dirt next to his tin shack, holding his nose to ward off the stench of a nearby overflowing latrine. In Ramallah (population 300,000) in the occupied Palestinian territory a 14-year-old girl wakes with menstrual cramps - and skips class because her school lacks a washroom where she can clean herself in private. In Bangladesh’s mega-capital (population 12 million), a monsoon-season flash flood leaves thousands with cholera.

Different continents, same problem: City populations continue to grow above ground while water resources shrink underfoot, leaving emptying aquifers to sate growing needs, and compounding existing problems with wastewater collection.

With water use growing at more than twice the rate of overall population increase (according to the Food and Agriculture Organization), how can authorities ensure that every urban dweller gets 20-50 litres of clean water daily for drinking, cooking and cleaning? How can governments create sanitation systems that do not sicken city dwellers?

Background

Some 3.3 billion people (more than half of the world’s population) live in urban areas, a figure which is expected to rise to five billion by 2030. Ninety-five percent of this growth is taking place in countries least able to afford the cost of expansion.

In East Asia alone - in one of the most disaster-stricken areas worldwide [ http://www.irinnews.org/report/97021/DISASTERS-Asia-s-2012-figures-and-trends ] - the UN Office for Disaster Risk Reduction (UNISDR) estimates the number of people living in urban flood plains may reach 67 million by 2060.

A Megacity Task Force of the Germany-based International Geographic Union has called the world’s 40 or so megacities (concentrations of at least 10 million people) “major global risk areas” prone to natural disaster and supply crises.

"The dimensions of these urban disaster problems are huge,” said Robert Piper, UN resident coordinator in Nepal, whose capital, Kathmandu, is consistently ranked as one of the world’s most earthquake-prone [ http://www.irinnews.org/report/96639/NEPAL-Radio-stations-ill-prepared-for-earthquakes ] cities. “And doing something about it on the scale necessary is expensive.”

Cities of less than one million residents, such as Ramallah, are now growing at a faster rate than larger urban areas, noted Graham Alabaster, manager of the UN Human Settlements Programme (UN-HABITAT), in Geneva. Like megacities, he said, smaller cities share the same pressing problems:  infrastructure too weak to handle ever-more densely packed populations, and understaffing so severe it can put water, sanitation and hygiene (WASH, in aid industry lingo) under the management of less than half as many administrators as is necessary.

Weather extremes

Climate change has not made things any easier. World temperatures will rise by 4 degrees Celsius by the end of the century, predict a joint team of researchers from Germany’s Potsdam Institute for Climate Impact and the NGO, also in Germany, Climate Analytics [ http://www.climateanalytics.org/news/new-report-examines-risks-4-degree-hotter-world-end-century ].

“In developing countries, the already-stressed, existing systems were built without climatic change in mind,” said Robert Bos, the WASH coordinator for the World Health Organization (WHO) in Geneva.

Water may be delivered in decades-old leaking iron pipes instead of flexible PVC ones that expand and contract in response to temperature fluctuations. Sewage systems may be too small to remove waste, which can ferment and release toxic methane gas created when temperatures reach record highs.

To brace against increasingly volatile weather, cities in arid regions (such as Johannesburg and Dakar) must stockpile water for annual droughts, while those in flood-prone areas (such as Shanghai and Calcutta) must stockpile medicines and recruit additional health staff to prevent and treat water-borne diseases.

The countries at the highest risk of weather-related disasters worldwide, identified in a November 2012 report [ http://germanwatch.org/en/5696 ], are Thailand followed by Cambodia, Pakistan, El Salvador and the Philippines.

As of March 2012, three years ahead of schedule, the world achieved one of its Millennium Development Goals: providing safe drinking water to half of the 2.6 million people who struggled without it in 2000.
Even so, 2.5 billion people in the developing world lack adequate sanitation and 780 million of them lack clean water [ http://www.unicef.org/wash ].

In addition to large-scale efforts organized by national governments, here are five experiments WASH experts are testing to manage water sources in an urbanizing - and increasingly warmer - world.

1) DE-SLUDGING TECHNOLOGY

Latrine pits into which sewage systems drain are the most common way to collect waste in slums in the developing world. But cleaning these pits, which are often uncovered, can pose persistent challenges. Shacks may be so densely packed that vacuum tankers cannot be deployed.

Individual workers may have to clamber into pits and manually clean them, putting themselves - and their families - at risk of disease. Absentee landlords may have little interest in dealing with sewage pits, leaving them neglected to the point where they overflow.

With a US$100,000 grant from the US-based Bill & Melinda Gates Foundation, researchers in Belo Horizonte (the third-largest city in Brazil) are creating biodegradable building blocks that replace conventional cement or brick and allow latrine pits to decompose naturally once they are filled. Another Gates grant of $4.8 million to the London School of Hygiene and Tropical Medicine is funding the design of latrine pits that have an active “bio-filter” of tiger worms and other organisms to break down waste. This technology creates environmentally-friendly sewage that poses few human health risks.

2) UPGRADING SCHOOL SANITATION

Where school toilets and latrines do exist (they are available in only an estimated 37 percent of countries where the UN Children’s Fund, UNICEF, is active), long queues snake around school buildings during breaks and after class. “We need to upgrade sanitary facilities for all children, but especially for menstruating girls [ http://www.irinnews.org/report/97080/AID-POLICY-Integrating-menstrual-hygiene-management-into-aid-programming ] so they can continue to attend school and meet their needs for privacy, dignity and cleanliness,” said Ania Grobicki, executive secretary of the Stockholm-based Global Water Partnership.

In China, UNICEF and its partners built school hand-washing stations. In Malawi and Kenya, they introduced a new design of urinals for girls. And in Bangladesh and India, they have launched “menstrual hygiene projects” so girls can continue their studies without interruption.

3) PRE-IDENTIFIED WASTE DISPOSAL SITES

When natural disasters strike, they can generate millions of tons of solid and liquid waste that threaten public health and hinder reconstruction. The earthquake that hit Haiti’s capital of Port-au-Prince in January 2010 - killing more than 220,000 people, leaving more than 350,000 displaced almost three years later and causing the capital’s already-shaky municipal waste collection system to collapse - highlighted the need to select waste-disposal sites pre-disaster.

Garbage towered along remaining roadsides; construction materials were piled up in ravines, drains and other open spaces. Before aid agencies and the government focused on hazardous waste disposal, surgeons tossed body parts into fetid, decaying piles. After the disaster, the Haitian government assigned one municipal landfill to dispose of medical waste. In 2011, the UN released disaster-waste guidelines [ http://www.unocha.org/about-us/publications/disaster-waste-management-guidelines ] that outlined dangers of different waste types.

4) TURNING WASTE INTO WATER

In some urban areas in the developing world, more water is lost through leakage and other infrastructure problems than is delivered. “But wastewater collection, recycling, and retreatment can multiply supplies,” said Grobicki from Global Water Partnership.

Cities that are already making wastewater potable include Singapore (where 3 percent of drinking water is recycled) and Perth, Australia (where officials hope 10 percent will soon be so). This microfiltration and chemical treatment technology has also been used in Windhoek, Namibia, (population 300,000) which has been recycling wastewater since 1968, and is holding a meeting in 2013 to evaluate its experience [ http://www.iwahq.org/1tk/events/iwa-events/2013/water-reuse-2013.html ].

5) LOW-COST, HIGH-IMPACT SOLUTIONS

WASH systems do not have to be pricey to be effective, as proven by the shallow, gravity-driven sewers that have long served the `favela’ slums of Rio de Janeiro, Brazil’s second largest city of some six million people.

“Increasingly, municipal authorities are establishing `low-income customer service units’ or LICSUs,” said Timeyin Uwejamomere with the London-based NGO WaterAid. “One such programme recently brought sanitation to 150,000 people and clean water to 400,000 in Lilongwe, Malawi.”

At King’s College London, researchers are examining how to deliver water with segmented flexible rubber hoses. In India, Bangladesh, Kenya, and Uganda, WaterCredit, a programme of the US-based Water.Org, helps households buy drinking water and toilets through micro-financing.

mmg/pt/cb

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Aid in an urbanizing world

A series of articles on challenges and changes humanitarian workers are confronting in urban emergencies
-----------------------------------------------------------------------------------------------------------

]]></body><link>http://www.irinnews.org/Report/97161/Urban-water-woes</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201009290735590125t.jpg"/></td><td valign="top">NEW YORK 02 January 2013 (IRIN) - In Zimbabwe’s capital, Harare (population 3,000,000), a man relieves himself in the dirt next to his tin shack, holding his nose to ward off the stench of a nearby overflowing latrine. In Ramallah (population 300,000) in the occupied Palestinian territory a 14-year-old girl wakes with menstrual cramps - and skips class because her school lacks a washroom where she can clean herself in private. In Bangladesh’s mega-capital (population 12 million), a monsoon-season flash flood leaves thousands with cholera.</td></tr></table>>]]></content:encoded></item><item><title>Analysis: The militarization of hospital beds</title><pubDate>Thu, 20 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2008/200804029t.jpg" />]]>NEW YORK 20 December 2012 (IRIN) - Delivering health aid to hotspots including Haiti and Afghanistan has brought together - and at times pitted against one another - humanitarians and militaries in an uneasy but increasingly necessary union.</description><body><![CDATA[NEW YORK 20 December 2012 (IRIN) - Delivering health aid to hotspots including Haiti and Afghanistan has brought together - and at times pitted against one another - humanitarians and militaries in an uneasy but increasingly necessary union.

As the military’s role in health aid is likely to grow - since the 2004 Indian Ocean tsunami, the US military has deployed 40 times to natural disasters worldwide - delineating the rules and responsibilities of each side in the field has become all the more necessary.

Even after some two decades of working more closely with militaries to deliver aid, researchers and humanitarians are still divided about such cooperation in health care.

“It is not just a case of one-off costs, but the long-term impact of a hospital not being seen as a safe or neutral space, or of it being associated with an opponent’s strategy,” said Simone Haysom, a researcher with the London-based Overseas Development Institute’s Humanitarian Practice Group, who co-authored a study [ http://www.odi.org.uk/publications/6584-civilian-military-humanitarian-response ] on trends in coordination between humanitarian organizations and militaries.

“To have any type of weapon near a health structure makes them the target in conflict. That is why a no-weapon strategy is the best way to guarantee patients’ security,” Michiel Hofman, a UK-based operations adviser for health NGO Médecins sans Frontières (MSF), told IRIN in early 2012.

Somalia [ http://www.irinnews.org/Report/96362/SOMALIA-Principles-and-pragmatism ], where two of MSF’s workers were kidnapped and another two killed in late 2011 [ http://www.irinnews.org/Report/95504/HEALTH-Healthcare-in-the-crossfire ], is the only country where the NGO uses armed guards (private) near its clinics. Only in Afghanistan in the 1980s and the Russian Republic of Chechnya in the 1990s has MSF been forced to use government or opposition forces for security. Notwithstanding, the no-weapons-in-clinics rule is absolute.

Haiti

The Oslo Guidelines [ http://www.unhcr.org/refworld/docid/47da87822.html ], written in 1994 and revised in 2007, give recommendations on ways humanitarians should work with armed forces, and the International Committee of the Red Cross (ICRC) has its own rules [ http://www.icrc.org/eng/resources/documents/misc/66ddf7.htm ]. But Haiti’s earthquake in January 2010, which killed more than 220,000 and has left more than 350,000 still displaced years later, highlighted the need for more specific guidelines, even in times of peace, say experts.

Coordinating with the military - often a last resort - largely depends on the context of the country and its disaster, such as: Is the emergency man-made, or a natural disaster? Is there a conflict? Is the government stable? While the earthquake in 2010 and ensuing cholera epidemic happened at a time of peace in Haiti, the country’s history of instability complicated the humanitarian response, said Viviana De Annuntiis, civil-military coordination officer for the UN Office for the Coordination of Humanitarian Affairs (OCHA) in Haiti’s capital, Port-au-Prince.

De Annuntiis said because Haiti’s crisis was a natural disaster, the strategy continues to be one of cooperation between the two sides, but if the political situation deteriorates, the strategy turns into one of “coexistence” in which humanitarians and militaries work separately to “minimize competition and conflict” by staying out of each other’s way.

The Oslo Guidelines and the ICRC’s rules distinguish between what is called for during peace time and conflict, with the understanding that the biggest risk, for humanitarians, to work with militaries is becoming a target. Regulations that fail to identify what to do in countries deemed fragile - like Haiti - fall short, experts say.

In Haiti coordination between the humanitarian and security community post-earthquake was largely based on “personal relationships and friendships among leaders of response entities", according to a recently published study [ http://ghsm.hms.harvard.edu/uploads/pdf/haiti_case_study.pdf ] of Haiti’s health system by Harvard Medical School and NATO.

The study is the first in a series analysing multinational military forces’ participation in health system strengthening in crisis-affected fragile states. In Haiti, this “complex web” of coordination was ultimately "underdeveloped and inefficient" to handle such a large disaster, the study concluded.

In September 2011, the UN Stabilization Mission in Haiti (MINUSTAH) published rules of engagement [ http://www.un.org/en/peacekeeping/missions/minustah/ ] for aid workers and armed forces working in Haiti, with the expectation that other aid agencies and NGOs working there will draft their own rules. A first revision is scheduled for early 2013.

The Geneva-based Inter-Agency Standing Committee (IASC), which issues recommendations to improve humanitarian aid delivery [ http://www.who.int/hac/global_health_cluster/about/policy_strategy/ghc_position_paper_civil_military_coord_2_feb2011.pdf ], has emphasized the importance of focusing on populations in need and not allowing political agendas to influence health aid delivery.

Pros and cons

But the problem is military aid almost always has an agenda, leading to suspicion when an army provides health care. The army’s biggest motivator is self-protection, said a former officer with the UK army and now OCHA’s regional civil-military coordination officer for the Asia-Pacific region, Sebastian Rhodes Stampa.

“I don't think [military health aid] is particularly altruistic - it meets a specific need to influence potentially problematic populations at the operational level and is often linked to the military concept of `force protection' - a number of strategies to ensure the local populace don't target you,” he told IRIN.

While militaries are known for their strong, highly mobile field-based capabilities and experience in treating war-time trauma, said Rhodes Stampa, the flipside is they work independently and unilaterally, “undermining government attempts to provide health services,” added Haysom from ODI.

Setting up health care facilities in order to further political aims complicates - and compromises - their humanitarian partners, said Sandrine Tiller, MSF’s programme adviser for humanitarian issues.

Afghanistan

“Quite a few of the armed actors in Afghanistan have set up health facilities for political objectives. It is not just the Western military forces but also other countries looking for influence,” Tiller said. “Few of these health facilities are really responding to health needs.”

Not only are these “politico-health” facilities ineffective, they may also be dangerous for patients and providers, added MSF’s Hofman. “When you link hospitals to military interventions, then hospitals become targets. If [the army] builds a hospital in the morning and fights the opposition in the afternoon, then the army is participating in the war. Then the health facility becomes a target.”

He cited a German-funded hospital the army built in Afghanistan in 2009 that was repeatedly targeted by international and opposition forces.

Five MSF workers were killed in Afghanistan in 2004. MSF blamed its compromised security on the NATO-led security coalition, which did not observe the Geneva Conventions [ http://www.icrc.org/eng/war-and-law/treaties-customary-law/geneva-conventions/index.jsp ] - the core of humanitarian law that regulates armed conflict and treatment of war victims - which was, until then, a major tool MSF used to negotiate with governments security for its projects.  

“That decision [to not apply the conventions] has given free rein to states to start disregarding the Geneva Conventions and to decide which part of them to abide by… It is harder to negotiate [access] agreements with states now,” said Hofman, the MSF adviser. The conventions also apply to rebel groups, known as “non-state actors”.

But the situation was not that simple, said Stuart Gordon, professor in the department of International Development at the London School of Economics. “There was a blindness on the part of the NGO community. They saw Afghanistan as being in a post-conflict phase, which led them to cooperate with NATO authorities and the Afghan government to an extent that perhaps they should not have.”

Wherever possible, using civilians to deliver aid is most often the best idea, he concluded. “Unless there is an overwhelming need, the concern is that they [military] are used before they are necessary.”

MSF withdrew from the country soon after the killings, but since 2009, has resumed healthcare services and maintains talks with the many military actors in Afghanistan, including the Afghan army and the NATO-led International Security Assistance Force (ISAF) [ http://www.isaf.nato.int/ ], to which the US is the number one contributor.

History

The need for humanitarians to cooperate with armed forces originated in the late 1980s as states began sending their militaries to help after natural disasters and manmade conflicts [ http://www.irinnews.org/InDepthMain.aspx?InDepthId=6&ReportId=59215 ].

Such coordination was then novel and the presence of UN peacekeeping troops alongside combat forces in Afghanistan positioned humanitarians alongside a supposed “Western” agenda, according to some onlookers, including locals, experts say.

Though two decades have passed since humanitarians and militaries were first forced to work together in Iraq, details on how to coexist are still being sorted out. Despite the existence of some guidelines [ http://www.unocha.org/what-we-do/coordination-tools/UN-CMCoord/publications ], aid groups are still struggling to carry them out in crises.

“Is it a lack of clarity, lack of awareness or lack of will?” asked ODI in a recent paper [ http://ochanet.unocha.org/p/Documents/05-12%20Literature%20Review%20-%20Trends%20and%20challenges%20in%20humanitarian%20civil-military%20coordination.pdf ].

The institute has research under way in Afghanistan, Pakistan, South Sudan, Haiti and Timor-Leste to learn why.

nb/pt/cb

]]></body><link>http://www.irinnews.org/Report/97088/Analysis-The-militarization-of-hospital-beds</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2008/200804029t.jpg"/></td><td valign="top">NEW YORK 20 December 2012 (IRIN) - Delivering health aid to hotspots including Haiti and Afghanistan has brought together - and at times pitted against one another - humanitarians and militaries in an uneasy but increasingly necessary union.</td></tr></table>>]]></content:encoded></item><item><title>DISASTERS: Slow-onset disasters take toll</title><pubDate>Fri, 07 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2008/20080904t.jpg" />]]>DHAKA/BANGKOK 07 December 2012 (IRIN) - In southwestern Bangladesh, recent large-scale water-logging - stagnant flood water that fails to recede - threatens agriculture and public health for years to come. It is a crisis in the making, highlighting the risks slow-onset natural disasters pose to poor countries, and how ill-prepared officials are to respond - even with ample early warning.</description><body><![CDATA[DHAKA/BANGKOK 07 December 2012 (IRIN) - In southwestern Bangladesh, recent large-scale water-logging - stagnant flood water that fails to recede - threatens agriculture and public health for years to come. It is a crisis in the making, highlighting the risks slow-onset natural disasters pose to poor countries, and how ill-prepared officials are to respond - even with ample early warning. 

“At first glance, one would expect that, the slower the onset of a disaster, the better prepared we should be to mitigate its impacts,” UN Special Representative of the Secretary-General for Disaster Risk Reduction Margareta Wahlström told IRIN. “What we often find, instead, is that we [are] far too late to react.” 

Last year, residents in Thailand had months of flood warnings [ http://www.irinnews.org/Report/94109/GLOBAL-The-risk-of-warning-fatigue-in-disaster-preparedness ], beginning in July 2011, as flooding upcountry triggered by a tropical storm slowly wound its way south. Flooding persisted in some areas until mid-January 2012. But even with ample warning, the disaster killed at least 628 people, affected more than 13 million people and damaged 20,000sqkm of farmland [ http://reliefweb.int/sites/reliefweb.int/files/resources/Full_Report_3858.pdf ]. 

Warnings not heeded 

Khurshid Alam, former head of livelihoods and disaster reduction at ActionAid’s office in Bangladesh, said slow-onset disasters receive less media attention and are less dramatic than flash floods or cyclones. “The persistent water-logging of the Satkhira region in the country’s southwest is currently the most significant slow-onset disaster plaguing the country.” 

Unlike a flash flood, whose effects can be fatal immediately, it can take years of warnings before slow-onset disasters - such as droughts, riverine erosion, coral bleaching and increasing soil and water salination - turn deadly [ http://www.who.int/hac/about/definitions/en/index.html ].

The problem is that warnings are not always heeded, said Wahlström. “Given the collective experience of responding to drought emergencies over the last 50 years, it is surprising that, once again last year, the world was caught short in its response to a drought-fuelled famine in the Horn of Africa [ http://www.irinnews.org/Region/HOA/Horn-of-Africa ] and in the western Sahel [ http://www.irinnews.org/Theme/SAH/Sahel-Crisis ], which was predicted well in advance. The lives and livelihoods of millions were at stake, but the warnings were not acted on.” 

Governments, donors and aid groups, conditioned to responding to rapid-onset disasters, need to become more flexible in responding to early warnings, advised Wahlström. This is especially true in Asia, one of the most natural-disaster prone areas [ http://www.irinnews.org/Report/96983/Analysis-Assessing-Southeast-Asia-s-aid-coordination-during-crises ] in the world, with more fatalities attributed to natural hazards between 1975 and 2011 than anywhere else in the world [ http://www.adrc.asia/publications/databook/ORG/databook_2011/pdf/DataBook2011_e.pdf ].

Urban risk 

Urban areas require particular attention. The UN Office for Disaster Risk Reduction estimates the number of people in East Asia living in the flood plains of urban areas may reach 67 million by 2060.

More than two-thirds of the world’s urban population now live in low- and middle-income countries, and nearly one billion of them - mostly in Asia - reside in slums [ http://www.irinnews.org/report/96176/How-to-Measure-urban-poverty ]. 

Slum dwellers worldwide - a population growing by 25 million annually, according to UN Human Settlements Programme (UN-HABITAT) - are more likely to encounter chronic disasters than other urban areas. 

“The unpredictability of these events - for example, water-logging in flood-prone areas - makes it difficult to set triggers for response,” said Gerson Brandao, humanitarian affairs advisor for the UN Resident Coordinator’s office in Bangladesh. 

Water-logging causes increased salination in croplands, and affects not only rural farms but also the peri-urban and urban areas where agriculture is increasingly practiced. It also increases the risk of waterborne disease. “Water-logging isn’t simply a bad flooding but a continuous hazard,” Brandao continued. 

In Bangladesh shrinking wetlands, which have traditionally helped drain flood water, have worsened water-logging in recent years [ http://www.irinnews.org/report/95671/BANGLADESH-Dhaka-s-shrinking-wetlands-raise-disaster-risks ].

A 2011 study commissioned by the UN Office for the Coordination of Humanitarian Affairs (OCHA) on slow-onset disasters warned, “If livelihoods are not restored or strengthened between events [caused by a chronic hazard]… then smaller and smaller hazards can push households over the edge, resulting in a vicious cycle.” 

Erratic weather 

Bangladesh’s yearly drought, and the resulting food shortage, known locally as ‘monga’, is another slow-onset disaster, said Alam. The country’s annual droughts affect up to 2.3 million [ http://www.bracresearch.org/publications/ja.pdf ] of the country’s 8.4 million cultivable hectares, hitting farmers mostly in the northwest, according to the government, which says increasingly erratic weather is affecting crop cycles. 

In 2010, Bangladesh had 47,447mm of total rainfall. In 2011, rainfall levels increased by 40 percent. In southwestern Bangladesh, 2011 flood water did not recede as usual, compromising shelter, medical care, and access to food and income for more than one million people [ http://www.lcgbangladesh.org/derweb/minutes/2012/Slow_Onset_Disaster_Consultation_Report_07May2012.pdf ].

But even without increased rainfall, this area - where three major river systems meet - is already at high risk of flooding, Shahadat Hossain Mahmud, the government’s rural risk reduction specialist at the Ministry of Disaster Management and Relief, told IRIN. 

“These [river] systems all bring in a large amount of silt…so the river banks flood even with a little rainfall.” 

The government’s Tidal River Management (TRM) project aims to divert water to shallow lakes [ http://www.ijstr.org/final-print/june2012/Tidal-River-Management-(Trm)-of-Selected-Coastal-Area-of-Bangladesh-For-Mitigation-of-Drainage-Congestion.pdf ], repair a number of flood embankments [ http://www.irinnews.org/Report/75735/BANGLADESH-Cyclone-damaged-embankments-urgently-need-repair ] and earth dykes, and dredge river beds, said Abdul Latif Khan, of the disaster management ministry. 

The government is also working with coastal farmers to help them build homes on stilts [ http://www.irinnews.org/Report/94168/BANGLADESH-Disaster-resilient-settlement-points-way-forward ], test new farming techniques [ http://teca.fao.org/es/read/6846 ], and explore fish and crab farming to recoup income lost as cropland disappears. 

As a natural-disaster prone country that is extremely vulnerable to climate change effects [ http://reliefweb.int/sites/reliefweb.int/files/resources/WRR_2012_en_online150.pdf ], Bangladesh’s best hope is to cope, said Hossain. 

ao/fm/pt/rz 

]]></body><link>http://www.irinnews.org/Report/96989/DISASTERS-Slow-onset-disasters-take-toll</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2008/20080904t.jpg"/></td><td valign="top">DHAKA/BANGKOK 07 December 2012 (IRIN) - In southwestern Bangladesh, recent large-scale water-logging - stagnant flood water that fails to recede - threatens agriculture and public health for years to come. It is a crisis in the making, highlighting the risks slow-onset natural disasters pose to poor countries, and how ill-prepared officials are to respond - even with ample early warning.</td></tr></table>>]]></content:encoded></item><item><title>Analysis: When lack of early warning becomes manslaughter</title><pubDate>Tue, 04 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201002280931290129t.jpg" />]]>BANGKOK 04 December 2012 (IRIN) - The recent conviction in Italy of seismologists on manslaughter charges, based on their failure to warn residents about a 2009 earthquake, could have serious repercussions for earthquake preparedness, experts say.</description><body><![CDATA[BANGKOK 04 December 2012 (IRIN) - The recent conviction in Italy of seismologists on manslaughter charges, based on their failure to warn residents about a 2009 earthquake, could have serious repercussions for earthquake preparedness, experts say. 

“This trial and the verdict represent an extremely worrisome precedent that must be considered by scientists when offering their services in the interests of public safety,” Warner Marzocchi, chief scientist at Italy’s Istituto Nazionale di Geofisica e Vulcanologia (National Institute of Geophysics and Volcanology), told IRIN. 

In a regional Italian court on 22 October, six scientists and a government official were convicted of negligence for underestimating the magnitude of what turned out to be a fatal earthquake. The judgement said the scientists knew the real risk but failed to adequately warn the public. 

Found guilty of multiple manslaughter - the first job-related charge of this kind for anyone working in early warning worldwide - they were sentenced to six years imprisonment. 

The 6.3-magnitude earthquake on 6 April 2009 killed more than 300 people, displaced another 25,000 and destroyed 10,000 buildings in the university town of L’Aquila, about 85km northeast of Rome. 

The defendants gave a “falsely reassuring” statement to the public before the earthquake hit, according to the court decision. The defence maintained there was no way to predict when a major earthquake will happen. 

Science’s limits

According to the US Geological Survey (USGS) [ http://www.usgs.gov/faq/index.php?action=artikel&cat=120&id=800&artlang=en ], scientists have only been measuring earthquakes for 100 years. 

While meteorologists can effectively predict the path and strength of a storm, the same is not yet possible with earthquakes, said Peeranan Towashiraporn, head of the disaster assessment and monitoring department at the Asian Disaster Preparedness Centre (APDC) in Bangkok. 

“We follow proven methodologies and quality data, but this science is still immature and… not advanced enough to understand everything occurring underground,” Towashiraporn continued. “We talk about earthquake risks as a probability and chance - it’s a projection.” 

The L’Aquila quake was preceded by small tremors; following such minor seismic events, the probability of a large, fatal aftershock is mathematically unlikely - a probability of less than 1 percent, according to seismic research.

Early warning for a disastrous earthquake is “nearly impossible to do,” said Surono, head of Indonesia’s Volcanology and Geological Hazard Mitigation Centre. (Like many Indonesians, he goes by only one name.)

Since 2000, Indonesia has had 45 earthquakes that have killed nearly 176,000 people, making it one of the world’s most deadly places to be in an earthquake, according to the Belgium-based Centre for Research on Epidemiology of Disasters (CRED). 

It is possible to forecast whether an earthquake is likely to hit, but the specifics are still unknown. “We cannot tell the time. We would know earthquake hazard zones based on the historical eruptions, but we won’t know when the earthquake will occur,” Surono said.

“What we have are probabilistic forecasts - hazard models based on a long-term, daily possibility of a large event which is very low, say once in 100 or 1,000 years,” said Ian Main, professor of seismology at the UK’s University of Edinburgh. 

Risk communication

Italy’s manslaughter convictions may dissuade disaster experts from speaking openly about natural hazards, warned ADPC’s Towashiraporn. “Scientists may be very reluctant to share predictions if they will be legally bound to the information.”

Italian scientist Marzocchi said seismic scientists will want amnesty before issuing public statements. They might also exercise excessive caution in their warnings, which could lead to false alarms. These, in turn, could lead to the long-term risk of scientists losing credibility with the communities they are trying to keep out of harm’s way, he said. 

“There is a pressure from society and policy makers on scientists to be accurate. Society wants to know accurate answers, but scientists… do not predict. Scientists only forecast and analyze,” said Fouad Bendimerad, chairman of the board of Earthquakes and Megacities Initiative (EMI), a disaster-preparedness NGO in the Philippines [ http://www.emi-megacities.org/home/ ].

Complicating matters is the poor, sometimes non-existent, communication among scientists, policy-makers and decision-makers, Bendimerad added, calling for more interdisciplinary research on the best ways to communicate seismic risks. 

According to the California-based Earthquake Engineering Research Institute (EERI), earthquake specialists need more training on how to communicate their scientific findings, and the public needs help interpreting them. Accurately communicating the risk of an earthquake based on still-evolving science and technology is one of the biggest challenges s eismologists face, according to the Japan-based International Association for Earthquake Engineering [ http://www.iaee.or.jp/ ]. 

The scientists in L’Aquila experienced this challenge first-hand, according to Main. At a government press conference preceding the quake, “the message [that the possibility of an imminent earthquake, while small, could not be ruled out] was mistranslated by an official under severe pressure,” he said.

Preparedness

Considering the imprecision of earthquake early warnings, preparedness is critical, Towashiraporn said. 

A 2004 EERI report [ https://www.eeri.org/lfe/pdf/Report_LFE_Contributions.pdf ] highlighted recent major earthquakes - in Kobe, Japan, in 1995; in Armenia, Colombia, in 1999; and in Northridge, California, in 1994 - as proof of the need for emergency planning in seismic hazard areas. 

“[The L’Aquila case] could be used to heighten awareness, or take some preparatory action at an appropriate level,” Main said. 

According to CRED, earthquakes have killed more people [ http://www.irinnews.org/Report/87908/DISASTERS-Earthquakes-the-decade-s-deadliest-killer ] in the last 10 years than any other natural hazard in the world.

Preparation is particularly needed in Asia, where there were three times as many deaths from earthquakes and tsunamis [ http://reliefweb.int/report/world/asia-pacific-disaster-report-2012-reducing-vulnerability-and-exposure-disasters ] than elsewhere in the world. A 2010 World Bank report [ http://www.gfdrr.org/gfdrr/sites/gfdrr.org/files/publication/Preparing_for_Asia's_Next_Big_Earthquake_0.pdf ] predicts it is “only a matter of a few years before the next major earthquake strikes East Asia and the Pacific. It is only a few decades, at most, before a major earthquake occurs near a metropolitan area.” 

For years, experts have predicted a large-scale earthquake in Nepal’s Kathmandu Valley, where some 2.5 million people live, many of them in the major metropolis of Kathmandu.

Amod Dixit, executive director of the non-profit National Society for Earthquake Technology-Nepal in Kathmandu, says forecasts are only one part of saving lives. “Whose job is it to make buildings safer? The job of scientists is to analyze and present the possibility. Implementation is the job of government.”

Engineers estimate an earthquake comparable to the area’s 1934 earthquake, which killed some 8,000 people, would kill more than 100,000 today, injuring another 300,000 and damaging six out of 10 structures. There is little search-and-rescue capacity in the city, where only 15 fire engines serve the entire Kathmandu Valley population - and 12 of them were not even operating earlier this year.

What next?

In 2011, after the L’Aquila disaster, the Italian government set up an International Commission on Earthquake Forecasting for Civil Protection [ http://www.geos.ed.ac.uk/homes/imain/igmpapers/LAquila.pdf ]; both Main and Marzocchi are members.

The panel recommended developing protocols to handle “low-probability” events. No government in the world has yet established protocols on how to translate scientific information to communities at risk of an earthquake - no matter the probability. 

The commission also advised that scientific findings be preserved to ensure nothing is lost in translation by government intermediaries when earthquake risks are communicated to the public. 

But the panellists remained humbled by the field’s uncertainty. “Most of seismology is forensic. We learn something new after each event,” said Main. 

“If this basic concept is not accepted, scientists, decision-makers and indeed anybody involved in public safety may always be prosecuted after the occurrence of an unlikely event,” added Marzocchi. 

rg/pt/rz

]]></body><link>http://www.irinnews.org/Report/96965/Analysis-When-lack-of-early-warning-becomes-manslaughter</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201002280931290129t.jpg"/></td><td valign="top">BANGKOK 04 December 2012 (IRIN) - The recent conviction in Italy of seismologists on manslaughter charges, based on their failure to warn residents about a 2009 earthquake, could have serious repercussions for earthquake preparedness, experts say.</td></tr></table>>]]></content:encoded></item><item><title>Analysis: Why dead body management matters</title><pubDate>Wed, 31 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201104211256170786t.jpg" />]]>BANGKOK 31 October 2012 (IRIN) - Dead body management is a key element of disaster response: How corpses are dealt with can have a profound impact and long-lasting effect on the mental health of survivors and communities, say experts.</description><body><![CDATA[BANGKOK 31 October 2012 (IRIN) - Dead body management is a key element of disaster response: How corpses are dealt with can have a profound impact and long-lasting effect on the mental health of survivors and communities, say experts.

“Their proper management is a core component of disaster response, together with the rescue and care of survivors and the provision of essential services,” Morris Tidball-Binz, a forensic adviser at the International Committee of the Red Cross (ICRC) [ http://www.icrc.org/eng/assets/files/other/icrc-002-0880.pdf ] in Geneva, told IRIN.

Large-scale natural disasters may result in many tens of thousands of fatalities which can overwhelm local systems, and the absence of mass fatality planning can result in the mismanagement of dead bodies.

In the aftermath of the 2010 earthquake in Haiti, which killed more than 200,000 people [ http://www.irinnews.org/Report/93460/HAITI-Political-stalemate-adds-to-reconstruction-woes ], lack of coordination resulted in corpses being piled up outside morgues and hospitals, while thousands were buried unidentified in mass graves.

But there are also misconceptions about the management of dead bodies. Despite popular belief, cadavers resulting from a disaster do not spread disease.

According to the latest guidelines [ http://new.paho.org/disasters/index.php?option=com_content&task=view&id=719&Itemid=931 ] by the Pan American Health Organization and World Health Organization (PAHO/WHO), there is no evidence that corpses result in epidemics, as victims of natural disasters generally die from trauma, drowning or fire - not infectious diseases such as cholera, typhoid, malaria or plague.

Certain infectious diseases like tuberculosis, hepatitis B and C, and diarrhoeal diseases last for up to two days in a dead body. HIV may survive for up to six days. All these infections pose only a slight risk of contamination, say the guidelines.

“There is no existing evidence that dead bodies pose a significant public health risk for diseases outbreaks,” said Kouadio Koffi Isidore, a researcher on infectious diseases and public health risk management in disasters at the UN University International Institute for Global Health (UNU-IIGH) in Kuala Lumpur. “Any source of disease transmission will merely be among the affected disaster survivors,” he added.

While there is a potential risk of diarrhoea from drinking water contaminated by faecal material from dead bodies, routine disinfection of drinking water is sufficient to prevent waterborne diseases, experts say.

Nevertheless, death as a result of infectious diseases like cholera, typhus or plague may represent a health risk requiring appropriate disposal of corpses, said Isidore. “Certain precautions should be taken when disposing [of] corpses immediately after death, especially in a context of infectious diseases outbreak.”

PAHO/WHO guidelines recommend disinfection with chlorine solution, rather than lime powder which is commonly used but which has a limited effect on pathogens.

Awareness and training

There is also a need to raise awareness among communities on the risk of infection from practices such as the washing and shrouding of a dead body (an obligatory duty for Muslims), as well as large gatherings during funerals.

According to the PAHO/WHO guidelines, the empowerment and training of local communities is a major part of the management of cadavers, as local residents are typically the first to arrive to help rescue people.

The psychological aspect is also extremely important. Proper and dignified management of the dead can help ease the trauma of losing loved ones. Rapid retrieval of corpses should be a priority: It aids identification and reduces the stress on survivors. Another challenge is that the sight and smell of dead bodies can often distress survivors.

An important element is adequate training of body recovery teams to mitigate stress among team members.

According to the Asian Disaster Preparedeness Centre (ADPC) [ http://www.adpc.net/v2007/Programs/PHE/INFORMATION/Public%20Health%20Fact%20Sheets/Downloads/Dsposal%20of%20Dead%20Bodies.pdf ], in the aftermath of a disaster, this is key in addressing the psychological trauma of losing a loved one and witnessing death on a large scale.

“Priority should be placed on helping people recreate social networks to avoid isolation, and to give people an appropriate opportunity to mourn,” International Medical Corps [ http://internationalmedicalcorps.org/ ] child psychiatrist Lynne Jones told IRIN in an earlier interview [ http://www.irinnews.org/Report/88091/HAITI-Wounds-beneath-surface ].

Religion and customs

Religious and community leaders can play a major role in helping relatives to better understand and accept the recovery and management of dead bodies, ADPC guidelines say.

Local communities should be encouraged to carry out traditional ceremonies and grieving processes and observe whatever cultural and religious events they normally practice.

“If deaths are not dignified - that is, lacking proper burials or mourning ceremonies - this denies people the means to accept and come to terms with their loss,” Jones told IRIN after the Haiti earthquake [ http://www.irinnews.org/Report/88091/HAITI-Wounds-beneath-surface ].

Body disposal

Under international best practice Sphere standards [ http://www.sphereproject.org/ ], corpses should be disposed of in a manner that is dignified, culturally appropriate, and based on good public health practices.

Rapid cremations, the use of bulldozers to gather dead bodies, or the lack of a place in which to bury a corpse, can cause a lot of stress.

Sphere standards require graveyards to be at least 30 metres from groundwater sources used for drinking water, with the bottom of any grave at least 1.5m above the groundwater table; surface water from graveyards must not enter inhabited areas.

ICRC advises that the cremation of unidentified bodies should be avoided since there are no health advantages: Burials are preferred in emergencies unless there are religious or cultural reasons for another course of action.

Moreover, cremation can destroy evidence needed for future identification, requires large amounts of fuel that can result in smoke pollution, and can cause logistical problems for recovery teams having to deal with a large number of corpses.

fm/ds/cb/oa

]]></body><link>http://www.irinnews.org/Report/96673/Analysis-Why-dead-body-management-matters</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201104211256170786t.jpg"/></td><td valign="top">BANGKOK 31 October 2012 (IRIN) - Dead body management is a key element of disaster response: How corpses are dealt with can have a profound impact and long-lasting effect on the mental health of survivors and communities, say experts.</td></tr></table>>]]></content:encoded></item><item><title>FILM: Heroes of HIV: The Prison Educator</title><pubDate>Thu, 01 Dec 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201112011434460766t.jpg" />]]>NAIROBI 01 December 2011 (IRIN) - The latest chapter in our Heroes of HIV film series follows former prisoner Jean Julux Alusma as he works to increase awareness and understanding of HIV/AIDS among inmates of Haiti’s jails. </description><body><![CDATA[NAIROBI 01 December 2011 (IRIN) - The latest chapter in our Heroes of HIV film series follows former prisoner Jean Julux Alusma as he works to increase awareness and understanding of HIV/AIDS among inmates of Haiti’s jails. 
 
 “In Haiti, 120,000 people are living with AIDS, of which 67,000 are women, who are always more at risk,” says Alusma. Today, Haiti has the highest HIV/AIDS rate in the Caribbean, with 2.2 percent of adults estimated to be HIV positive. Young women are more than twice as likely to be infected as young men.  
 
 In Haiti’s only women’s prison, Alusma trains a select group of peer educators, who in turn pass on the information to other prisoners.
 
 “When prisoners are exposed to other prisoners teaching them about HIV, they are much more willing to accept an HIV test, more willing to access medical care and more eager to take their medications and enter into treatment,” says John May of Health Through Walls, an NGO.
 In Haiti, stigma, discrimination, a weak health care system and extreme poverty greatly increase the impact of HIV/AIDS.
 
 According to one of Alusma’s trainees, “in Haiti, most women don’t have jobs and depend on men for clothes and food… to keep that relationship they have to have sex with them. I've learnt a lot here and when I get out, I'm going to be passing on the information to my son and daughter.”
 
 ]]></body><link>http://www.irinnews.org/Report/94362/FILM-Heroes-of-HIV-The-Prison-Educator</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201112011434460766t.jpg"/></td><td valign="top">NAIROBI 01 December 2011 (IRIN) - The latest chapter in our Heroes of HIV film series follows former prisoner Jean Julux Alusma as he works to increase awareness and understanding of HIV/AIDS among inmates of Haiti’s jails. </td></tr></table>>]]></content:encoded></item><item><title>FILM: Haiti&apos;s Rape Survivors</title><pubDate>Wed, 02 Nov 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201111041227140188t.jpg" />]]>NAIROBI 02 November 2011 (IRIN) - More than 18 months since the earthquake struck Haiti in January 2010, women and girls living in makeshift camps remain vulnerable to sexual violence. </description><body><![CDATA[NAIROBI 02 November 2011 (IRIN) - More than 18 months since the earthquake struck Haiti in January 2010, women and girls living in makeshift camps remain vulnerable to sexual violence. 
 
 IRIN's latest film follows a survivor of rape, Shirley Christoff, as she attempts to rebuild her life in a rundown informal settlement in Port-au-Prince. Christoff, together with thousands of other women, lives in constant fear for her safety. 

View the film: Haiti's Rape Survivors [ http://www.irinnews.org/film/?id=4832 ]
 
 According to human rights organizations, continued lack of security is one of the main factors contributing to high levels of rape in and around the internal displacement camps. More than 250 cases of rape were reported in several camps in the first 150 days after the earthquake, according to Amnesty International. 
 
 Sexual violence and other forms of gender-based violence were widespread in Haiti even before the earthquake. In the 1990s, Human Rights Watch (HRW) documented the use of rape as a form of oppression during the regime of Raoul Cédras. From 2004 to 2006, the UN Security Council estimated that 35,000 women and girls were subjected to rape and sexual violence. 
 
 "After you have been raped, you have nowhere to go, you have to return to the camp and face the person who raped you," says Christoff. As police stations and courts were reduced to rubble during the earthquake, the few protection mechanisms that did exist were destroyed. 
 
 According to Amnesty and HRW, the post-earthquake humanitarian and government response to gender-based violence has been wholly inadequate. While effort was being invested to ensure basic needs were met, little to no attention has been paid to the rights of women and girls to be protected from sexual violence. Survivors of sexual violence have taken matters into their own hands, with two grassroots organizations providing support to thousands of women. The first emergency response system dedicated to sexual violence was set up in October and a call centre has already recorded 400 cases of rape. 
 
 This film is the 10th in a series of films about displacement, Forced to Flee. Others in the series include Bolivia’s Changing Climate [ http://www.irinnews.org/film/?id=4263 ], Israel’s African Migrants [ http://www.irinnews.org/film/?id=4262 ] and Haiti’s Homeless Hotel [ http://www.irinnews.org/film/?id=4100 ].
 
 ]]></body><link>http://www.irinnews.org/Report/94118/FILM-Haiti-apos-s-Rape-Survivors</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201111041227140188t.jpg"/></td><td valign="top">NAIROBI 02 November 2011 (IRIN) - More than 18 months since the earthquake struck Haiti in January 2010, women and girls living in makeshift camps remain vulnerable to sexual violence. </td></tr></table>>]]></content:encoded></item><item><title>DISASTERS: New risk index helps identify vulnerability</title><pubDate>Mon, 05 Sep 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201106190631010812t.jpg" />]]>JOHANNESBURG 05 September 2011 (IRIN) - A new disaster risk index launched by the UN University Institute for Environment and Human Security in Bonn could help donors and aid organizations better understand why some countries are more at risk of calamity than others, and shape their responses when disaster strikes.</description><body><![CDATA[JOHANNESBURG 05 September 2011 (IRIN) - With the media spotlight on the drought and famine in the Horn of Africa, governments and aid organizations have come under fire for their lack of a developmental approach, but a new tool launched by the UN University Institute for Environment and Human Security in Bonn could help them better understand vulnerability in the longer term. 
 
 The World Risk Index (WRI), explained Jörn Birkmann, scientific head of the WRI project at the UN institute, is unique in defining risk as the interaction between a natural hazard and the vulnerability of a particular community. 
 
 WRI takes into account social, political, economic and ecological factors to determine the capacity of an affected community to respond. It looks at four main components, which in turn take into account at least 28 variables. 
 
 1. Exposure to a natural hazard (sudden as well as slow-onset natural disasters like droughts). 
 
 2. Susceptibility, which is understood as the likelihood of society and ecosystems to be damaged should a natural hazard occur. Existing economic, infrastructure, nutrition and housing conditions are taken into account. 
 
 3. The capacity to cope, which looks at the state of governance, disaster preparedness and early warning systems, medical services, and social and material security levels. "Governance is a critical issue as it is politically sensitive which is why it is overlooked by many similar indices, but the fact is you need a stable government that has the capacity to deliver to help people become resilient," said Birkmann. He illustrated his point by contrasting the impact of the recent earthquakes in Haiti and Japan. "Owing to higher coping and adaptive capacities, such as building laws, there were significantly fewer victims in Japan." 
 
 4. Adaptation strategies - implying the capacities and strategies which help communities address the expected negative consequences of natural hazards and climate change. 
 
 “Information on coping capacities is relevant for short-term responses, but where long-term programmes and planning is concerned, it is useful for NGOs to know about the area’s adaptation capacity,” said Peter Mucke, managing director of Bündnis Entwicklung Hilft (Alliance Development Works), a consortium of five German NGOs which worked with the UN University on the study. "So while we come to know which countries need short-term responses like food, at the same time we need know where we have to provide food-for-work programmes or strategies to provide water in the long term." 
 
 Afghan example 
 
 Afghanistan, which according to the WRI has the world’s poorest adaptive capacity and the second lowest coping capacity, tops the list of countries most vulnerable to disasters. 
 
 The tool is uncomplicated. “The index gives you all that information at a glance - showing the strength of a particular area’s capacity to adapt or cope in percentages, which is useful to communicate the strengths and weakness of a particular area when you are seeking funding from donors,” said Birkmann. 
 
 For instance, Afghanistan's lack of capacity to cope is shown at 93.4 percent; its adaptation capacity 73.55 percent; and vulnerability 76.19 percent. WRI uses the various percentages, and also factors in sea-level rise predictions, to calculate an overall risk figure: The Pacific island of Vanuatu comes out as the country most at risk of a disaster. 
 
 No risk index can be flawless: In the case of Vanuatu, people will only be at risk of a metre-rise in sea level in 100 years - by which time the country’s population may have changed considerably from the 2005 figures used by WRI. 
 
 WRI is dependent on the availability and quality of the data it uses. It covers 173 out of 192 countries. Somalia is not included. 
 
 WRI’s methodology could be used to focus in on any community of any size in the world. 
 
 jk/cb 

]]></body><link>http://www.irinnews.org/Report/93658/DISASTERS-New-risk-index-helps-identify-vulnerability</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201106190631010812t.jpg"/></td><td valign="top">JOHANNESBURG 05 September 2011 (IRIN) - A new disaster risk index launched by the UN University Institute for Environment and Human Security in Bonn could help donors and aid organizations better understand why some countries are more at risk of calamity than others, and shape their responses when disaster strikes.</td></tr></table>>]]></content:encoded></item><item><title>GLOBAL-HAITI: Search and rescue standards turn 20</title><pubDate>Mon, 10 Jan 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201001191314230870t.jpg" />]]>GENEVA 10 January 2011 (IRIN) - When Mexico City was hit by a magnitude 8.1 earthquake in 1985, disaster response teams searched the same buildings over and over again. During search and rescue efforts for the 1986 El Salvador earthquake, two European rescue teams clashed over the appropriate approach. Twenty years ago, international search and rescue was &quot;very chaotic indeed&quot;, said Joe Bishop, an emergency management consultant. &quot;It was a free-for-all, there was no commonality at all... the tools were totally inappropriate for the job, all to the detriment of the affected people.&quot;</description><body><![CDATA[GENEVA 10 January 2011 (IRIN) - When Mexico City was hit by a magnitude 8.1 earthquake in 1985, disaster response teams searched the same buildings over and over again. During search and rescue efforts for the 1986 El Salvador earthquake, two European rescue teams clashed over the appropriate approach. 
 
 Twenty years ago, international search and rescue was "very chaotic indeed", said Joe Bishop, an emergency management consultant. "It was a free-for-all, there was no commonality at all... the tools were totally inappropriate for the job, all to the detriment of the affected people." 
 
 That changed with the development of the International Search and Rescue Advisory Group (INSARAG) 20 years ago in December. "I think there's still a lot to be done, but we've made major inroads since the earthquake in Mexico in 1985," said Bishop. 
 
 Jens Kristensen, a UN official who was rescued from the rubble five days after the 12 January 2010 earthquake in Haiti, agreed: "INSARAG has come a long way in 20 years." 
 
 The international response to the Haiti earthquake was the largest ever. "The best outcome," observed Kjell Larsson, a senior adviser to the Swedish government, "was that the USAR [urban search and rescue] teams saved more lives than any other earthquake response in the past 10, 20 years." 
 
 Nihan Erdogan, a humanitarian affairs officer with the UN Office for the Coordination of Humanitarian Affairs (OCHA) and Haiti United Nations Disaster Assessment and Coordination (UNDAC) team member, said the search and rescue operation in Haiti "allowed INSARAG to learn significant lessons". 
 
 INSARAG held its first global meeting in Kobe, Japan, in September, linking up 200 participants, 79 countries and eight international organizations. Co-organized by OCHA, the meeting launched celebrations for INSARAG's 20th anniversary and commemorated the 15th anniversary of the Great Hanshin earthquake in Kobe. 
 
 Erdogan believes the main achievement of the meeting was the INSARAG Hyogo Declaration, which was adopted by all participating member states. 
 
 The next step, said Erdogan, will be the implementation of "a common understanding and common strategy [which] will make a big difference at the operational level". 
 
 Lessons learned 
 
 Erdogan suggested the biggest lesson for INSARAG over the years has been to have minimum international standards. Referring to her experiences in Haiti, she said: "It was challenging to coordinate the USAR operations while teams had completely different opinions and approaches to security measures." 
 
 On 16 December 2002, General Assembly Resolution 57/150 endorsed the establishment of international standards and USAR capacity-building with the aim of improving the efficiency and effectiveness of international search and rescue operations, but a remaining challenge has been the certification of qualified international USAR teams. 
 
 One measure that has already been introduced to address this gap is the INSARAG External Classification (IEC) process, established in 2005 to identify competent USAR teams. 
 
 "Haiti was the first big disaster using the classified teams," said Erdogan. In light of Haiti, "now we know very well that IEC worked very well". 
 
 Yet out of the 60 international USAR teams that responded to the Haiti earthquake, only eight were IEC-classified. Larsson noted that "it's a fairly costly process ... and it's a fairly slow process". 
 
 It can take years for an international USAR team to complete the classification process, Erdogan said, and the queue to qualify for IEC classification extends to 2014. 
 
 Once a team has been classified, "we speak the same language and do the same thing", Erdogan said. 
 
 Mariusz Feltynowski, leader of a USAR Poland classified team, said in a review of the Haiti response that "cooperation with other certified teams was almost faultless. This happened because teams worked with the same standards, similar equipment and mainly because they knew each other." 
 
 Capacity-building 
 
 Another lesson that has emerged is the need to strengthen capacity at local, national and international levels. Because of time and distance issues, at least 48 hours can pass before an international rescue team arrives at an emergency. 
 
 "If we can spread out the methodology through all levels and layers of response, we can save more lives," said Larsson. "If the national teams are trained, they can come together and work better with the international teams in a rescue operation." 
 
 INSARAG now aims to classify national teams. 
 
 Toni Frisch, INSARAG chairman, noted that "[w]hile the benefits of the INSARAG External Classification process in ensuring minimum international operational standards and matching needs to capacity were amply demonstrated in Haiti, the importance of introducing similar minimum standards and methodology at the national level became abundantly clear as a key to better preparedness for earthquake response". 
 
 "Beyond the rubble" 
 
 Yet another lesson addressed at the global meeting in Kobe was the "beyond the rubble" concept. 
 
 Using the analogy of a local fire and the response carried out by a local fire department, Larsson noted that the firefighters do not simply show up, put out the fire and then leave. There are procedures in place for after the fire, such as relocating victims, dealing with trauma, and so on. He said there was room for improvement in this post-disaster phase. 
 
 During this period in Haiti, the expanding role of the USAR teams was seen to add value to overall humanitarian assistance. They assessed the safety of vital public buildings, recovery of damaged equipment and collection of the deceased. 
 
 The recognition of this reconstruction "beyond the rubble" has become an important aspect of how USAR teams will think about future responses to disasters. 
 
 International USAR 
 
 A typical international USAR team includes search, rescue and medical components as well as administrative and logistical support and can be deployed within eight hours of notification of an emergency. A medium team consists of 20-60 people and a large international deployment can comprise 80 to 100-plus. 
 
 "Dogs spearhead most of the search operations," said Bishop, but structural engineers, vets and medics are also needed. 
 
 A team can remain in operation for 10 to 14 days before being resupplied, but the operational effectiveness for life-saving has a limited window of about four days. "The survival rate dramatically drops after four days," he said. 
 
 "Ninety percent of the rescues are done by locals, [while] international teams deal with deep penetration protracted rescues." 
 
 Political feedback 
 
 A senior humanitarian official said it was "crystal clear" that nations gained positive visibility in the media from their USAR teams. In addition, it was a good way to hone skills and develop the "real-life" experience for use at home. 
 
 Yet as Bishop pointed out, "These teams deploy gratis. It doesn't cost the affected country a single cent. The prime mover is that they are doing humanitarian relief. 
 
 "The investment that they are making in vulnerable countries is the right investment," said Bishop. "Equipment, training and maintenance costs would be unsustainable in many countries." 
 
 And while there is "nothing stopping a do-gooder or a nice john from showing up with a dog and a shovel... the INSARAG family is working toward filtering [out 'disaster tourism']," added Bishop. 
 
 kz/bp/mw 

]]></body><link>http://www.irinnews.org/Report/91584/GLOBAL-HAITI-Search-and-rescue-standards-turn-20</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201001191314230870t.jpg"/></td><td valign="top">GENEVA 10 January 2011 (IRIN) - When Mexico City was hit by a magnitude 8.1 earthquake in 1985, disaster response teams searched the same buildings over and over again. During search and rescue efforts for the 1986 El Salvador earthquake, two European rescue teams clashed over the appropriate approach. Twenty years ago, international search and rescue was &quot;very chaotic indeed&quot;, said Joe Bishop, an emergency management consultant. &quot;It was a free-for-all, there was no commonality at all... the tools were totally inappropriate for the job, all to the detriment of the affected people.&quot;</td></tr></table>>]]></content:encoded></item><item><title>HIV/AIDS: MSM groups hail pill to prevent HIV</title><pubDate>Wed, 24 Nov 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201011241354350201t.jpg" />]]>NAIROBI 24 November 2010 (IRIN) - Gay rights groups have hailed the results of the first study to show that an antiretroviral (ARV) drug can prevent HIV as an important step in the fight against HIV, but say that in countries that criminalize homosexuality, the breakthrough is unlikely to have a significant impact.</description><body><![CDATA[NAIROBI 24 November 2010 (IRIN) - Gay rights groups have hailed the results of the first study to show that an antiretroviral (ARV) drug can prevent HIV as an important step in the fight against HIV, but say that in countries that criminalize homosexuality, the breakthrough is unlikely to have a significant impact. 
 
 The Iniciativa Profilaxis Preexposicion or Prexposure Prophylaxis Initiative (iPrEx) study [ http://www.iprexnews.com/english.html ] found that daily oral pre-exposure prophylaxis (PrEP) - the use of ARVs to prevent HIV in high-risk groups - reduced HIV infection risk among participants who took the ARV Truvada by an average 43.8 percent. The clinical trial of 2,499 men who have sex with men (MSM) and transgender people was conducted at 11 sites in Brazil, Ecuador, Peru, South Africa, Thailand and the United States. 
 
 "We are as happy as anyone out there about the findings from this study, but fear that unless our countries reconsider their laws, many MSM will not benefit from its results," said David Kuria, chairman of the Gay and Lesbian Coalition of Kenya [ http://galck.org ]. 
 
 He noted that the frequent arrests of gay men in countries like Kenya already made it difficult for those who were HIV-positive to strictly adhere to their ARV regimen and would certainly create challenges in rolling out any pre-exposure prophylaxis policy. 
 
 The study found that PrEP was more effective in people at higher risk for HIV - based on reports of unprotected receptive anal intercourse - and among those who took the pill more consistently; for instance, those who reported using PrEP on 90 percent or more of the days saw 72.8 percent efficacy. 
 
 Implementation challenges 
 
 "Implementation of PrEP is highly unlikely in countries where access to ARVs is already seriously limited. Even in places where access to ARVs is more stable, PrEP will likely be targeted to groups most at risk for HIV, including MSM," said a statement from the Global Forum on MSM and HIV [ http://www.msmgf.org ]. "This would in turn require disclosure of same-sex behaviour, which could prove difficult or even dangerous in countries where violence, stigma and discrimination against MSM persists." 
 
 According to the AIDS Vaccine Advocacy Coalition [ http://www.eurekalert.org/pub_releases/2010-11/avac-faq112310.php ], the UN World Health Organization (WHO) and UNAIDS must "move without delay to issue a statement clarifying the implications of the results” for MSM. 
 
 Globally, around 80 countries criminalize same-sex relationships, creating obstacles to HIV prevention. 
 
 Right to health services 
 
 A senior government official in Kenya says while homosexual activity remains illegal in the country, government HIV agencies are working to understand and better serve the MSM community with health services. 
 
 "Access to health is a right enshrined in the constitution, and this right does not discriminate between gay and straight," said Nicholas Muraguri, head of the National AIDS and Sexually transmitted infections Control Programme, NASCOP. 
 
 "We know gay people have a hard time accessing health services; many health workers are ignorant or stigmatize MSM - we are starting to train them on these issues," he added. "We are also conducting a study on the health needs of MSM, and will use their own networks to ensure they have access to services." 
 
 The study's authors urged WHO, UNAIDS and other global and national HIV policymaking bodies to develop clear recommendations for next steps in the study of PrEP. 
 
 According to the Gay Men's Health Crisis (GMHC) [ http://www.gmhc.org ], an NGO providing HIV services in New York, while the study's results are welcome, it is important to keep using other prevention methods. 
 
 "We know that by far the most effective prevention technologies remain condoms and lubricant, and clean needles," said Marjorie J Hill, chief executive officer of GMHC. "We support further research to develop effective biomedical prevention interventions, even as we spread the word about what works best now." 
 
 kr/mw

]]></body><link>http://www.irinnews.org/Report/91180/HIV-AIDS-MSM-groups-hail-pill-to-prevent-HIV</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201011241354350201t.jpg"/></td><td valign="top">NAIROBI 24 November 2010 (IRIN) - Gay rights groups have hailed the results of the first study to show that an antiretroviral (ARV) drug can prevent HIV as an important step in the fight against HIV, but say that in countries that criminalize homosexuality, the breakthrough is unlikely to have a significant impact.</td></tr></table>>]]></content:encoded></item><item><title>HAITI: HIV-positive people especially vulnerable to cholera</title><pubDate>Mon, 22 Nov 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201011040952360035t.jpg" />]]>PORT-AU-PRINCE 22 November 2010 (IRIN) - As the death toll from the cholera epidemic sweeping through Haiti surpasses 1,000, with more than 19,000 confirmed cases, officials say people living with HIV are especially vulnerable.</description><body><![CDATA[PORT-AU-PRINCE 22 November 2010 (IRIN) - As the death toll from the cholera epidemic sweeping through Haiti surpasses 1,000, with more than 19,000 confirmed cases, health officials say people living with HIV are especially vulnerable. 
 
 Only about 25 percent of people infected with cholera develop symptoms - mainly watery diarrhoea and vomiting - but people already weakened by illness, malnutrition or pregnancy are particularly at risk. 
 
 "[People living with HIV] are very much at risk because they already have a weakened immune system," explained Hanz Legagneur, director of the Ministry of Public Health in the country's West Department. 
 
 Cholera can be easily treated with oral rehydration salts that replenish the body's water and electrolytes, but can be deadly for people who fall ill quickly and lose too much water before obtaining assistance. 
 
 People living with HIV are often too poor to pay for transport to health facilities, which can prove deadly when time is short. 
 
 "Anyone can die within four hours without treatment or oral rehydration salts; [for] someone infected with HIV it will be even less - it can be two or three hours," said Reginald Dupont of SeroVIE, an NGO for lesbian, gay, bisexual and transgendered Haitians living with HIV. 
 
 Haiti - with an HIV prevalence of 2.2 percent - has approximately 120,000 HIV-positive people. Like much of the population, many are living in tents following January's earthquake, with little access to potable water or clean toilets. 
 
 Health workers have been overwhelmed by the cholera epidemic and have not yet released numbers of HIV-positive people who have contracted the water-borne disease. But according to Dupont, people infected with HIV often lack adequate access to healthcare and due to stigma, may not receive appropriate medical attention. 
 
 The UN Population Fund (UNFPA) [ http://www.unfpa.org/public/home/news/pid/6897 ] has distributed nearly 7,000 hygiene-cholera kits since 1 November to pregnant women and people living with HIV. The kits contain soap, a toothbrush and a bucket, as well as chlorine to prevent infection. 
 
 National and international organizations are also working to raise awareness about cholera prevention measures. According to Marie Jose Salomon, the HIV focal point for the UNFPA in Haiti, radio spots explaining the risks of cholera to people with HIV are set to be released soon. 
 
 Although cholera treatment centres have been set up nationwide, the UN Office for the Coordination of Humanitarian Affairs [ http://www.reliefweb.int/rw/rwb.nsf/db900sid/MCOI-8BECGJ?OpenDocument&RSS20&RSS20=FS ] has estimated that only 10 percent of the money, supplies and skills needed to adequately address the epidemic have so far been made available. 
 
 ag/kr/ks/mw

]]></body><link>http://www.irinnews.org/Report/91152/HAITI-HIV-positive-people-especially-vulnerable-to-cholera</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201011040952360035t.jpg"/></td><td valign="top">PORT-AU-PRINCE 22 November 2010 (IRIN) - As the death toll from the cholera epidemic sweeping through Haiti surpasses 1,000, with more than 19,000 confirmed cases, officials say people living with HIV are especially vulnerable.</td></tr></table>>]]></content:encoded></item><item><title>HAITI: Combating TB in Port-au-Prince&apos;s tent cities</title><pubDate>Wed, 17 Nov 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201003221118410900t.jpg" />]]>PORT-AU-PRINCE 17 November 2010 (IRIN) - Health workers in Haiti are concerned about the spread of tuberculosis (TB) in the tent cities that have housed more than one million people since the massive earthquake in January.</description><body><![CDATA[PORT-AU-PRINCE 17 November 2010 (IRIN) - Health workers in Haiti are concerned about the spread of tuberculosis (TB) in the tent cities that have housed more than one million people since the massive earthquake in January.
 
 "With the quake this became an emergency," said Macarthur Charles, a doctor with Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), [ http://www.gheskio.org ] one of the largest HIV- and TB-focused NGOs in Haiti.
 
 "The main TB hospital, the sanatorium here in Port-au-Prince, collapsed and [the GHESKIO] hospital in Leogane [about 29km west of Port-au-Prince] for treating multi-drug resistant TB [MDR-TB] also collapsed."
 
 GHESKIO suffered losses to its health infrastructure worth an estimated US$10 million, and the two government TB sanatoriums were also destroyed by the quake.
 
 "TB is an extremely important situation because transmission is facilitated by the situation of people living under tents," said Jean William Pape, director and founder of GHESKIO.
 
Across the capital, people are crammed into tiny tents, with 6-10 people sharing a single tent made for two people, while others live in six-by-six or ten-by-ten metre tents.
 
 "There is a delay in care. There is the issue of malnutrition or of having untreated HIV that allows you to have more TB, and then there's the question of you being in small areas with other people," said Megan Coffee, a US infectious diseases specialist who has been running an expanded TB ward at Port-au-Prince's General Hospital since January.
 
 The spread of MDR-TB is also a concern. The condition often develops as a result of patients on first-line TB drugs not completing the initial course of treatment. Treating MDR-TB can cost 50-200 times more than first-line treatment. An estimated 2 percent of newly diagnosed TB patients and 12 percent of previously treated TB patients in Haiti have MDR-TB, according to the UN World Health Organization (WHO). 
 
 After the earthquake, GHESKIO was able to trace all its MDR-TB patients and continue their medication; some are being treated as outpatients while others are being housed in isolation tents in the capital. GHESKIO is building a new 30-bed centre for patients with MDR-TB, and is strengthening its laboratory capacity to improve TB surveillance.
 
 Shortly after the quake, health workers saw a spike in TB cases, but some think this could have been as a result of increased screening by volunteer organizations. "A lot of the foreigners who came to Haiti to help, they had TB on their mind, they were screening for it... I think that drove the referrals we saw early on, and now I think we've gone down because there is less active screening," said Charles. 
 
 A pre-existing epidemic 
 
 While the earthquake has destroyed TB infrastructure, stretched limited health resources and worsened living conditions, the disease is not new to Haiti. According to a new WHO report on TB, [ http://www.who.int/tb/publications/global_report/2010/en/index.html ] the current prevalence in Haiti is 312 cases per 100,000 people, by far the highest in the western hemisphere. Like much of the developing world, it is closely linked to HIV; Haiti's HIV rate is 2.2 percent. With 30 percent of the global HIV positive population likely to contract TB in their lifetime, the joint TB and HIV burden in Haiti is heavy. 
 
 "Living conditions for those in tents are visible now, but they existed long before the earthquake. I would say 60 percent of people now living in tents lived in the same conditions before," said Anany Gretchko Prosper, head of medical operations for Partners in Health, another long-standing health NGO. 
 
 "The patients I've been seeing in the aftermath of the earthquake had nothing to do with the earthquake - there's no way that TB developed in two weeks," said Coffee. 
 
 Ahead of Hurricane Tomas in October, the expanded TB ward Coffee runs was transferred from tents to a room in the hospital, with 27 beds for in-patient care; hundreds of outpatients also frequent the clinic. About 25 percent of Coffee's patients are HIV-positive and some 40 percent of in-patients are HIV-positive. 
 
 However, GHESKIO's Charles acknowledged that these new centres could quickly reach capacity, and providing adequate treatment and care would remain "a challenge". 
 
 Following the quake, UNAIDS released a situation assessment [ http://data.unaids.org/pub/FactSheet/2010/20100226_haiti_aidsresponse_en.pdf ] which named some of the priority areas for action in Haiti as: rebuilding the health system, restoring networks for people living with HIV, and protecting internally displaced people from HIV. It noted that a new national strategic plan for HIV would be needed, taking into account the country's new realities. 
 
 ag/kr/cb

]]></body><link>http://www.irinnews.org/Report/91113/HAITI-Combating-TB-in-Port-au-Prince-apos-s-tent-cities</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201003221118410900t.jpg"/></td><td valign="top">PORT-AU-PRINCE 17 November 2010 (IRIN) - Health workers in Haiti are concerned about the spread of tuberculosis (TB) in the tent cities that have housed more than one million people since the massive earthquake in January.</td></tr></table>>]]></content:encoded></item><item><title>HAITI: Unarmed in the fight against cholera </title><pubDate>Thu, 04 Nov 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201011040950060019t.jpg" />]]>ARTIBONITE 04 November 2010 (IRIN) - A colourful cholera prevention poster in Haiti has images of smiling people getting water from a tap, a man using a sturdy latrine and people walking a sick boy to a health centre. But these vital tools for fighting the infectious bacterial disease are absent in most communities.</description><body><![CDATA[ARTIBONITE 04 November 2010 (IRIN) - A colourful cholera prevention poster in Haiti has images of smiling people getting water from a tap, a man using a sturdy latrine and people walking a sick boy to a health centre. [ http://new.paho.org/disasters/index.php?option=com_docman&task=doc_download&gid=1380&Itemid ]

But these vital tools for fighting the infectious bacterial disease - which by 3 November had killed at least 442 people in Haiti and infected more than 6,742 - are absent in most communities, such as the village of Deslandes in the Petite Rivière d’Artibonite District. 

Here, there is one well for 600 people that rarely functions, the village has no toilets and reaching the nearest health centre requires crossing a river. Most people use the River Artibonite - thought to be the source of the epidemic - as their primary source of drinking, bathing and laundry water. 

“Everyone uses the river,” resident Melinda Sineas told IRIN. “But the river is dangerous now.” 

It has been decades since Haiti last saw cholera, but with the country’s abysmal water and sanitation conditions diarrhoeal disease is common. 

“The lack of water and sanitation infrastructure in Haiti made it very difficult to imagine we would not have a major diarrhoea outbreak as a consequence of the earthquake,” said Joia Mukherjee, chief medical officer with Partners in Health (PIH), a Boston-based NGO which has worked in Haiti for over 20 years. 

Haiti is one of the few countries in the world where sanitation coverage for urban dwellers decreased between 1990 and 2006, according to the UN Children’s Fund (UNICEF) and World Health Organization.
[ http://www.who.int/water_sanitation_health/monitoring/jmpfinal.pdf ]

Open defecation 

Rural areas like Deslandes are badly off as well. Open defecation is the rule - a practice that is all the more dangerous when cholera is present. Less than 40 percent of Haitians have access to toilets, according to UNICEF-Haiti. 

“When people get sick they relieve themselves in the woods like all of us,” Deslandes resident Ovid Floville, 50, told IRIN. “[Once they are too weak] and cannot stand any more, they stay at home and their whole body gets covered in diarrhoea.” 

He said people scrub their homes with river water. NGOs have brought bleach and other supplies to nearby villages but Deslandes is isolated and access difficult, noted local pastor Solomon Tomas. 

“People talk a lot about prevention,” PIH’s Mukherjee told IRIN. “But you have prevention [messages] against a backdrop of extreme privation. It is tough for people to avail themselves of the tools to prevent infection.” 

Still, even in the absence of a sound water and sanitation system, some interim measures make a significant difference, she said. “There are things you can do in the absence of proper infrastructure [that will be effective] - for example, handing out soap, handing out water purification tablets. It does not completely prevent the problem but it is still worth doing these things.” 

Medical care a boat ride away 

If prevention is difficult in places like Deslandes, so is treatment. While some 80 percent of cholera cases can be successfully treated with oral rehydration salts, if they are not on hand one must get to a health post.

"There is a health centre in [the town of] La Chapelle but it can't deal with the number of people who are sick," the pastor said. "It can take two or three hours to get to the hospital."

When Smith Lorine, 47, came down with vomiting and diarrhoea, family and friends worried, having seen many Deslandes residents with similar symptoms dying in the days before. 

It was midnight and Lorine and his son first had to wake the man who transports people across the river. After the canoe journey, Lorine - still vomiting - got a ride on a motorcycle to the hospital in the nearest city, Mirebalais. 

“I couldn’t handle it but I had to go on,” he told IRIN. 

After treatment Lorine was sent home from hospital with two gallons of purified water. When he runs out he plans to go back for more. If the hospital stops giving out water, the small-scale farmer is committed to finding it himself. 

“I don’t have the means to buy water, but I will have to find a way. I never want to drink river water again.” 

In cholera-endemic areas, such as in Asia and sub-Saharan Africa, people can be carriers and not fall ill, Mukherjee said. “Here in Haiti [where diarrhoeal disease is common], you’re adding a new strain amid an already weak - I won’t even say ‘system’ - a complete lack of infrastructure.” 

PIH and three other institutions in 2008 published a report about the widespread lack of access to clean water in Haiti. This lack, the report said, “ranks as one of Haiti’s most significant obstacles when it comes to meeting basic human rights standards. Historical legacies of inequality, disempowered or corrupt governance, and persistent levels of extreme poverty have all contributed to the Haitian government’s systemic inability to deliver clean water to its people.” [ http://parthealth.3cdn.net/0badc680352663967e_v6m6b1ayx.pdf ]

Mukherjee said developing a water and sanitation system must be the job of government. Since the January 2010 earthquake PIH has been wary about how little funding the government has received, she said. “The infrastructure cannot be done by an NGO. It’s important to assist the government in getting some of the resources coming in - that’s critical.” 

ag/np/cb

]]></body><link>http://www.irinnews.org/Report/90979/HAITI-Unarmed-in-the-fight-against-cholera</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201011040950060019t.jpg"/></td><td valign="top">ARTIBONITE 04 November 2010 (IRIN) - A colourful cholera prevention poster in Haiti has images of smiling people getting water from a tap, a man using a sturdy latrine and people walking a sick boy to a health centre. But these vital tools for fighting the infectious bacterial disease are absent in most communities.</td></tr></table>>]]></content:encoded></item><item><title>Analysis: Are humanitarians learning the lessons from Haiti?</title><pubDate>Thu, 28 Oct 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201004051229450281t.jpg" />]]>LONDON 28 October 2010 (IRIN) - Listen to locals, tap into existing capacity, coordinate needs assessments, find strong leaders and provide transitional shelter - not just tents. These are some of the lessons to have emerged from the 2007 tsunami evaluation, numerous earthquake responses and the latest Haiti real-time evaluation, begging the question: when will the humanitarian community start applying these lessons learned.</description><body><![CDATA[LONDON 28 October 2010 (IRIN) - Listen to locals, tap into existing capacity, coordinate needs assessments, find strong leaders and provide transitional shelter - not just tents. These are some of the lessons to have emerged from the 2007 tsunami evaluation, numerous earthquake responses and the latest Haiti real-time evaluation, begging the question: when will the humanitarian community start applying these lessons learned. [ http://www.alnap.org/resource/5536.aspx; http://www.urd.org/spip.php?article458; http://www.irinnews.org/Report.aspx?ReportID=87825 ]

“There is still a tendency not only to reinvent the wheel, but also to turn it the wrong way,” notes the Haiti Real Time Evaluation (RTE), written in August 2010 but just published in October.

What worked

Some things did go right in Haiti, say both the RTE and Sir John Holmes, former under-secretary general for humanitarian response at the UN, and currently director of the Ditchley Foundation. [ http://www.ditchley.co.uk/ ]

At a Haiti applying lessons-learned forum hosted by the Overseas Development Institute (ODI) on 26 October, Holmes outlined some relative successes. Search and rescue teams worked efficiently; medical care, with a major contribution from Médecins Sans Frontières, was strong, as were the World Health Organization’s disease control efforts; water distributions were prioritized, with thousands of cubic litres distributed by May 2010; organization of food assistance, after initial hiccups, meant food aid reached 3.5 million people; and emergency education efforts were good. Further, some 57 percent of the US$1.5 billion revised humanitarian flash appeal was funded. 

It is easy to criticize, said Holmes and important to remember the extreme challenges such large-scale crises pose. “There is a glib narrative that the humanitarian community doesn’t apply the lessons it learns, but it is important to remember there are some things that are just hard to get right,” he said.

Flaws

But at the operational level repeat problems emerged. Needs assessments were incomplete and duplicative; transitional - as in medium-term - shelter was not provided at scale; [ http://www.reliefweb.int/rw/lib.nsf/db900sid/EGUA-86NQ3X/$file/alnap-innovationcasestudyno5-shelter-jun2010.pdf?openelement ] sanitation solutions were inadequate; and the overall protection response- particularly to sexual and gender based violence - was weak. 

Process-wise, few agencies informed local communities of what they were doing or why they were there; and while they coordinated closely at first with what was left of the national authorities, this coordination dwindled over time, according to the RTE. 

Most coordination meetings for each sector, or “cluster”, took place in English, marginalizing locals who spoke only French or Creole; and many national staff were barred due to too-tight security measures, says the RTE.

Perhaps most frustrating, after the stress laid on improving leadership in the humanitarian sector over recent years, was the poor leadership exhibited at the top of the UN system, but also among cluster heads. It took several weeks for the UN to decide whether to appoint a humanitarian and recovery head or to merge it all under one leader; and to appoint the right person for the post.

The UN humanitarian country team was only convened a full three weeks after the disaster hit, notes the RTE.

“Mega-disaster” constraints

However, observers must not overlook the major challenges unique to the Haiti context, pointed out all three speakers at the ODI forum. The scale of destruction made Haiti a “mega-disaster” said Linda Poteat, director of disaster response at US NGO network Interaction, with government officials killed, rubble-strewn streets and few suitable buildings to hold meetings in. Thirteen out of 16 ministries were destroyed.

This was a disaster in which the responders were also the victims, she pointed out - “National staff had lost their homes and lost family members - they had to make sure they were okay while being called on to work 16-hour days; many skilled ministry staff were dead - including the chief, government-NGO liaison.”

Rather than being put to work, some staff should have been sent away immediately, given the levels of trauma they were experiencing, Holmes told IRIN.

The urban locus of the Haiti disaster posed a huge challenge to the humanitarian community, which is still geared up primarily for rural response, and is only now beginning to address urbanization challenges, said Ross Mountain, director of independent group, Development Assistance Research Associates (DARA). [ http://www.irinnews.org/report.aspx?ReportId=90825 ]

“You can’t dig a latrine in the middle of a city,” said Poteat. “Camps are hard to secure in urban spaces. Populations kept on moving around - from camps to villages and back, so it was hard to keep track of them.”

Urban crisis response is the focus of the latest World Disasters Report. [ http://www.ifrc.org/publicat/wdr2010/index.asp ]

Further, widespread media attention brought hundreds of small NGOs to Haiti to try to help out, many with little emergency experience; in addition to the hundreds of reporters seeking instant stories and a strong US military presence, said Holmes. “There were even more actors there than usual... This can further hamper coordination efforts... We didn’t get leadership quite right, but it was not as wrong as some think,” he said.

Amid this chaos, and amid reports that the already-weak government was struggling to respond amid heavy staff losses, many aid agencies bypassed local structures, said Holmes. “Yes, we should involve local actors more, but at the same time - it is hard to get that right,” he said. 

Improving leadership

Agencies need to be more “ruthless” when it comes to appointing the right people to leadership roles, said Holmes. “It doesn’t always matter if someone has the right local knowledge - if they are not used to large-scale disaster response, then they must be replaced,” he told IRIN.

Mountain agrees humanitarian leaders need to be tougher. “You have to sometimes be unpopular and take risks - you cannot be guaranteed success,” he told IRIN. “There is no robust-enough system in the UN to address this dimension of leadership.”

Appointing and training the right leaders has been at the forefront of humanitarian reform over the past few years, but the wide-scale impact is yet to be felt, implies the RTE. Stronger surge capacity rosters - which NGOs and UN agencies are getting better at setting up in advance - should be developed at a wider scale, said Mountain.

On the coordination front, clusters need to shift from simply sharing information, to setting strategy, said Poteat. This has long-time been a recommendation in humanitarian response, yet is still not practised across the board. One sector to do this well was shelter, she said.  

And while coordinating with military actors may be difficult for humanitarians, they have to face up to the challenge, said Holmes. In Haiti, the US military was looking for a strong humanitarian-led coordination structure, yet this was slow to emerge. “We need more policies and scenario-planning done ahead of time when it comes to CIMIC [civil-military-coordination],” he told aid workers at the ODI. 

Recommendations

The RTE recommends aid agencies hone their approach to large-scale natural disasters in urban settings. “We will see more of these disasters - the Haitis, the Pakistans, linked to climate change - in the future,” said Mountain, “and we do not have the tools we need to deal with them. This is a warning that we need to prepare,” he said.

Other recommendations include vastly improving protection and water and sanitation responses in crises; to use new technology more effectively - for instance using SMS applications to distribute cash, or satellite imagery in needs-assessments. As Mountain told IRIN: “Everyone talks about satellite imagery being available to map needs, but where is it? Whenever I’m on the ground, I can’t access it.” 

Holmes posed the question that in scenarios where thousands of aid agencies are turning up, “maybe the NGO community needs to put more effort into certification [of quality players] and even amalgamation in some cases.”

And in terms of approach, agencies should finally try to grasp the lesson that taking an inclusive, participatory approach does not necessarily slow down response, but can indeed make it quicker, said the RTE.

These lessons are not necessarily new - the challenge is how to apply them. Holmes suggested an independently-run follow-up matrix outlining actions aid agencies must adopt in the next disaster, so they can be held to account. Poteat suggests more future-oriented scenario planning - for instance for a large-scale megalopolis-centred disaster. “Rather than always looking backwards, we need to prepare for the future,” she said.

Following the discussion, UN humanitarian sector heads and aid agency representatives in Geneva met in Geneva to discuss how to turn the evaluation’s findings into actions.

aj/cb

]]></body><link>http://www.irinnews.org/Report/90910/Analysis-Are-humanitarians-learning-the-lessons-from-Haiti</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201004051229450281t.jpg"/></td><td valign="top">LONDON 28 October 2010 (IRIN) - Listen to locals, tap into existing capacity, coordinate needs assessments, find strong leaders and provide transitional shelter - not just tents. These are some of the lessons to have emerged from the 2007 tsunami evaluation, numerous earthquake responses and the latest Haiti real-time evaluation, begging the question: when will the humanitarian community start applying these lessons learned.</td></tr></table>>]]></content:encoded></item><item><title>FUNDING: Unravelling the conundrum of US aid to Haiti</title><pubDate>Thu, 21 Oct 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200908051332480217t.jpg" />]]>NEW YORK 21 October 2010 (IRIN) - In reporting that “not a cent” of the US$1.15 billion the US promised for Haiti reconstruction at the UN donors’ conference in March had reached the stricken nation, the Associated Press largely cast the blame on a single senator - Tom Coburn, a conservative Republican from Oklahoma who had objected to a minor provision in the legislation that authorized the spending.</description><body><![CDATA[NEW YORK 21 October 2010 (IRIN) - In reporting that “not a cent” of the US$1.15 billion the US promised for Haiti reconstruction at the UN donors’ conference in March had reached the stricken nation, the Associated Press largely cast the blame on a single senator - Tom Coburn, a conservative Republican from Oklahoma who had objected to a minor provision in the legislation that authorized the spending.
 
 Coburn had “anonymously pulled” the legislation until his concerns could be addressed, the wire service reported on 28 September, [ http://www.google.com/hostednews/ap/article/ALeqM5idZiVQhHcyG1gpBjzXaAmmk4_OtAD9IHE5BO1?docId=D9IHE5BO1 ] and the senator was swiftly vilified by prominent liberals for sacrificing the poor of Haiti on the altar of his ongoing campaign for fiscal prudence. Comedian Jon Stewart called him an “international a**hole of mystery”, for placing a “secret hold” on the bill. MSNBC broadcaster Keith Olbermann said Coburn was “committing an atrocity against the people of Haiti and doing so in the name of ‘We the People’ of the United States.”
 
 It is true that Coburn has placed a hold on much-needed funds for Haiti - $500 million in fact - but he is not holding up the $1.15 billion that Secretary of State Hillary Clinton promised to a round of applause at the UN donors’ conference.
 
 That money was included in a supplemental spending bill that passed both houses of congress, after months of bureaucratic back and forth, and was signed by President Barack Obama on 29 July 2010. The Obama administration had asked congress for a total of $2.8 billion for Haiti assistance, but the final version of the legislation (H.R. 4899, P.L. 111-212) included a total of $2.93 billion for Haiti. The money was divided into three categories: $1.642 billion was earmarked for relief; $1.140 billion for recovery and reconstruction (the money Clinton promised); and $147 million for diplomatic operations, according to a Congressional Research Service report on 6 August 2010. [ http://www.nationalaglawcenter.org/assets/crs/R41232.pdf ]
 
 As of September, the US Agency for International Development (USAID) reported [ http://www.usaid.gov/our_work/humanitarian_assistance/disaster_assistance/countries/haiti/template/fs_sr/fy2010/haiti_eq_fs70_09-03-2010.pdf ] that more than $1.1 billion of the $1.642 billion for Haiti relief had been spent since the earthquake. But the $1.140 billion for recovery and reconstruction has remained in the US treasury because the vast proportion of this assistance cannot be disbursed until the secretary of state reports to various congressional committees on exactly how the money will be spent and how its oversight will be managed. Senator Coburn has nothing to do with the obstruction of this money.
 
 According to a state department spokesman, Clinton has just begun the process of meeting the requirements set by the legislation. The administration “is still working with the appropriate committees on these issues,” he said. “We have been conducting numerous briefings on the Hill to ensure coordination and consultation.” In the meantime, the US government has reprogrammed “approximately $300 million for Haiti’s initial recovery phase… to lay the foundation for long-term sustainable development.”
 
 He added: “We expect to start obligating our reconstruction assistance soon.”
 
 In responding to the outcry that his hold generated, Coburn pointed out that it was the Obama administration that was responsible for the delay in reconstruction funds, pointing to the tangle of “executive branch bureaucracy” for the hold-up. “Despite the fact that more than 10 weeks have passed since this bill was passed into law, the secretary of state appears to have fulfilled that condition only this week,” he wrote on 7 October.
 
 Two objections
 
 But this does not change the fact that Coburn is holding up $500 million intended for Haiti, part of a different piece of legislation, the Haiti Empowerment, Assistance, and Rebuilding Act, which passed the Senate Foreign Relations Committee on 25 May. The Oklahoma senator had two objections to the bill. He believes that the creation of a senior policy coordinator to advise and coordinate US policy would duplicate tasks already undertaken by the US ambassador to Haiti. He also says the $500 million in the legislation “must be paid for with cuts to lower priority programmes elsewhere within the federal government’s bloated $3.7 trillion annual budget.” [ http://coburn.senate.gov/public/index.cfm/rightnow?ContentRecord_id=32b1abcc-55bb-47b4-b775-52c57f91dd33 ]
 
 “It is irresponsible to authorize any new spending that is not paid for because the end result will be a lower standard of living for the United States and an inability for our nation to assist others when disasters and other crises occur in the future,” he wrote.
 
 A staffer on the Senate Foreign Relations Committee told IRIN that negotiations were under way with Coburn to achieve a resolution. “We have confidence that we will be able to find a way forward,” he said.
 
 In the meantime, Haiti continues to struggle. Other countries have also delayed sending reconstruction assistance. Less than 15 percent of the money promised at the donors’ conference for 2010-11 has been received. “US procrastination in delivering assistance… sets a negative precedent,” said Dan Beeton of the Center for Economic and Policy Research in Washington D.C. “It could discourage other countries - some of which certainly have far less money available, but which might otherwise be inclined to share more anyway - from supporting Haiti in its hour of greatest need.”
 
 pd/cb
 
 ]]></body><link>http://www.irinnews.org/Report/90835/FUNDING-Unravelling-the-conundrum-of-US-aid-to-Haiti</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200908051332480217t.jpg"/></td><td valign="top">NEW YORK 21 October 2010 (IRIN) - In reporting that “not a cent” of the US$1.15 billion the US promised for Haiti reconstruction at the UN donors’ conference in March had reached the stricken nation, the Associated Press largely cast the blame on a single senator - Tom Coburn, a conservative Republican from Oklahoma who had objected to a minor provision in the legislation that authorized the spending.</td></tr></table>>]]></content:encoded></item><item><title>HIV/AIDS: Global Fund looks to private sector to fill funding gap</title><pubDate>Thu, 14 Oct 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2007/2007082136t.jpg" />]]>JOHANNESBURG 14 October 2010 (IRIN) - With its coffers running at least US$1 billion short, the Global Fund to Fight AIDS, Tuberculosis and Malaria is looking to the private sector to fill the funding gap. </description><body><![CDATA[JOHANNESBURG 14 October 2010 (IRIN) - With its coffers running at least US$1 billion short, the Global Fund to Fight AIDS, Tuberculosis and Malaria is looking to the private sector to fill the funding gap. 
 
 At a 12 October conference [www.gbcimpact.org/itcs_node/2/0/event/2323] on the role of buisness in health in Johannesburg, South Africa, members of the Fund’s board and secretariat said private sector contributions had become increasingly important as its historic donors – governments – were shying away from fully funding the global health financing mechanism. 
 
 “In the new context that we’re in, where we’ve gotten [funding] increases from governments but we know that these governments are under pressure, this is exactly where the private sector has to step up,” said the Global Fund’s private sector team manager, David Hayward Evans. ”We need more funds... and we believe, we hope, that the private sector can contribute.” 
 
 At the 5 October replenishment meeting in New York, donors pledged $11.7 billion to the Global Fund over the next three years, but the Fund projected it would need at least $13 billion over the same period to maintain current programming. [http://www.plusnews.org/Report.aspx?ReportId=90689] Private sector contributions, led by petroleum producer, Chevron, only accounted for about 3 percent of all pledged contributions at the meeting. 
 
 Brian Brink, chief medical officer for international mining corporation Anglo American, who represents the private sector on the Fund’s board, told IRIN/PlusNews he would like to see business become one of the Global Fund’s top 10 donors. He plans to push the idea at a special business summit ahead of this year’s G20 meeting in South Korea on 11 November. 
 
 Uneasy bedfellows 
 
 At present, business can support the Global Fund in several ways, including through in-kind donations, such as the provision of country support staff; by supporting the implementation of Global Fund financed programmes through skills training; or by acting as a service provider. [http://www.theglobalfund.org/documents/replenishment/2010/Partnering%20for%20Global%20Health_The%20Global%20Fun%20and%20The%20Private%20Sector.pdf]
 
 Brink highlighted successful examples of such partnerships, including the training in financial management of Global Fund grantees by Standard Bank and the distribution of bed nets by South African-based fast-food chain, Nando’s, but there are indications that the private sector is less keen to make financial contributions. 
 
 The Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC), an independent NGO that serves as a focal point for public-private partnership within the Fund, conducted a survey of 30 of the companies invited to take part in the Johannesburg conference. The survey found companies were most interested in contributing to the Fund through in-kind donations.
 
 Among the companies’ main concerns in partnering with the Global Fund were that they would be seen as money pots, the potential for conflicts of interest, and that the Global Fund did not align with their corporate social responsibility strategies. 
 
 According to Evans, some businesses also remained wary of joining forces with the Fund's governmental partners, regarded as overly bureaucratic compared with the corporate world. 
 
 llg/ks/mw]]></body><link>http://www.irinnews.org/Report/90765/HIV-AIDS-Global-Fund-looks-to-private-sector-to-fill-funding-gap</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2007/2007082136t.jpg"/></td><td valign="top">JOHANNESBURG 14 October 2010 (IRIN) - With its coffers running at least US$1 billion short, the Global Fund to Fight AIDS, Tuberculosis and Malaria is looking to the private sector to fill the funding gap. </td></tr></table>>]]></content:encoded></item><item><title>HEALTH: New global plan aims to wipe out TB</title><pubDate>Thu, 14 Oct 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201010111231470645t.jpg" />]]>JOHANNESBURG 14 October 2010 (IRIN) - A new roadmap for curbing the global epidemic of tuberculosis aims to save five million lives between 2011 and 2015 and eliminate TB as a public health problem by 2050 but comes with a price tag of US$47 billion, nearly half of which must still be found.</description><body><![CDATA[JOHANNESBURG 14 October 2010 (IRIN) - A new roadmap for curbing the global epidemic of tuberculosis aims to save five million lives between 2011 and 2015 and eliminate TB as a public health problem by 2050 but comes with a price tag of US$47 billion, nearly half of which must still be found. 
 
 The Global Plan to Stop TB 2011-2015 developed by the World Health Organization’s (WHO) Stop TB Partnership builds on progress towards goals laid out in a 2006 plan to halve TB prevalence and death rates by 2015 and scale up TB diagnosis, treatment and care, but adds essential research targets including the development of faster methods to test and treat TB and to prevent it through an effective vaccine. 
 
 After peaking in 2004, the global incidence of TB is declining, but “far too slowly”, noted Mario Raviglione, director of WHO’s Stop TB Department, at the launch of the plan in Alexandra, a Johannesburg township. The curable disease still affects some nine million people a year and claims nearly two million lives annually. 
 
 In southern Africa the death toll from TB is particularly severe, largely as a result of a twin epidemic in HIV - people infected with HIV are between 20 and 37 times more likely to develop TB. 
 
 The choice of a primary school in an impoverished South African township to host the launch was significant: South Africa has the world’s third highest burden of TB, a disease that spreads easily in overcrowded, poorly ventilated dwellings like the ones that cram the streets of Alexandra. 
 
 The South African government’s Kick TB Campaign, which started in June 2010 during the country’s hosting of the FIFA World Cup, targets school children in high TB-burden areas like Alexandra with information about TB that it is hoped they will pass on to their families and communities. At the launch on 13 October, hundreds of children gathered in a playing field attached to Pholosho primary school to kick around soccer balls emblazoned with illustrations of TB symptoms. 
 
 One of the learners pleaded with the international experts, activists and journalists gathered for the event to “stop TB in my lifetime”. Rifat Atun, chair of the Stop TB Partnership Board, responded that this is exactly what the plan aims to do and that, providing funding is made available, it is a realistic goal. 
 
 Guidance on TB control 
 
 Specifically, the plan provides countries with guidance on how to improve TB control through scaling up existing interventions for its diagnosis and treatment and by making use of new diagnostic tests and drugs that will become available over the next five years. A new test that uses molecular line probe assays to detect multi-drug resistant (MDR-)TB in a few days instead of the weeks needed using older testing methods has already been introduced in some countries. Other tests that will soon be available can detect TB in a matter of hours. 
 
 Current TB drug regimens take six months to be effective for drug-susceptible TB and much longer for drug-resistant strains, during which time many patients are lost to follow-up. The pipeline of new TB drugs promises shorter treatment times. Meanwhile, nine TB vaccine candidates are in clinical trials and a new generation of TB vaccines is expected to be available by 2020. 
 
 Other major elements of the plan focus on efforts to combat drug-resistant TB and TB in people living with HIV. It calls for a scale-up in access to tests that can detect resistance to first- and second-line TB drugs, identifying limited laboratory capacity as the main reason why only 5 percent of the estimated 440,000 people who had MDR-TB in 2008 were diagnosed. It also recommends testing all TB patients for HIV (by 2008, only about 22 percent of TB patients knew their HIV status) and providing antiretroviral treatment to all those who test positive. 
 
 The plan estimates that $10 billion alone is needed to fund further research and development over the next five years, about $7 billion of which still needs to be raised. Out of the estimated $37 billion needed to implement the Global Plan’s TB diagnosis, treatment and care targets, a funding gap of about $14 billion remains. 
 
 Atun of the Stop TB campaign said he was encouraged by the record levels of support for the Global Fund to Fight AIDS, Tuberculosis and Malaria at the Fund’s replenishment meeting in New York last week at which donors pledged a total of $11.7 billion over the next three years. He added, however, that part of the shortfall for funding TB programmes and research will need to come from domestic budgets. 
 
 ks/cb 

]]></body><link>http://www.irinnews.org/Report/90767/HEALTH-New-global-plan-aims-to-wipe-out-TB</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201010111231470645t.jpg"/></td><td valign="top">JOHANNESBURG 14 October 2010 (IRIN) - A new roadmap for curbing the global epidemic of tuberculosis aims to save five million lives between 2011 and 2015 and eliminate TB as a public health problem by 2050 but comes with a price tag of US$47 billion, nearly half of which must still be found.</td></tr></table>>]]></content:encoded></item><item><title>DISASTERS: Reducing the risk in slums</title><pubDate>Tue, 21 Sep 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201009201401370390t.jpg" />]]>NAIROBI 21 September 2010 (IRIN) - The disproportionately high risk of disaster faced by a billion slum-dwellers across the world could be significantly reduced with prudent investment, states a new report.</description><body><![CDATA[NAIROBI 21 September 2010 (IRIN) - The disproportionately high risk of disaster faced by a billion slum-dwellers across the world could be significantly reduced with prudent investment, states a new report. 
 
 "We cannot stop urbanization but we shouldn't be naïve; a trend does not mean destiny, disasters can be prevented," Matthias Schmale, the Under-Secretary-General of the International Federation of Red Cross and Red Crescent Societies (IFRC), said in Nairobi at the global launch of the 2010 edition of the World Disasters Report. 
 
 Schmale said solutions for disaster risk reduction and preparedness "need to be found in dialogue with the affected people; moving from the bottom upwards". 
 
 The World Disasters Report 2010 [ http://www.ifrc.org/publicat/wdr2010/index.asp?navid=09_03 ] focuses on urban risk, with the IFRC warning that 2.57 billion urban dwellers living in low- and middle-income nations are vulnerable to unacceptable levels of risk fuelled by rapid urbanization, poor local governance, population growth, poor health services and a rising tide of urban violence. 
 
 The estimated one billion urban dwellers now living in crowded slums will rise to 1.4 billion by 2020, the report says, adding that Africa, which is often considered predominantly rural, "now has an urban population (412 million) larger than North America (286 million)". 
 
 "Urban is the new rural," Schmale said. "We know that it is better to give seeds than food... we should invest more in preparedness as shown by the recent disasters in Haiti and Chile where the magnitude was worse in Chile but the impact was worse in Haiti." 
 
 According to IFRC, urban poverty and disaster risk are often closely intertwined and the links between them will be increased by climate change. 
 
 "In any given year, more than 50,000 people can die as a result of earthquakes and 100 million can be affected by floods and the worst-affected are most often vulnerable city dwellers," IFRC said. 
 
 Leadership 
 
 James Kisia, deputy secretary-general of the Kenya Red Cross Society (KRCS), said there was a need to rethink the definition of social development. 
 
 "The average African man in a rural area will not live in a single room with his children but this is increasingly becoming the norm in informal settlements in urban areas; we seem to have left such social issues at the mercy of economic development," he said. "Leadership cannot be left to the government alone, we must partner together to create an enabling environment for social development." 
 
 Good urban governance is a recurring theme in the World Disasters Report 2010, with the IFRC stressing that it is essential to ensure that people are empowered and engaged in the development of their urban environment and are "not marginalized or left exposed to disasters, climate change, violence and ill health". 
 
 IFRC quoted David Satterthwaite, lead writer of the report and senior fellow at the International Institute of Environment and Development (IIED), as saying: "The crisis of urban poverty, rapidly growing informal settlements and growing numbers of urban disasters arises from the failure of governments to adapt their institutions to urbanization. 
 
 "It stems also in part from the failure of aid agencies to help them [governments] to do so - most aid agencies have inadequate or no urban policies and have long been reluctant to support urban development at a sufficient scale." 
 
 js/am/mw 

]]></body><link>http://www.irinnews.org/Report/90542/DISASTERS-Reducing-the-risk-in-slums</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201009201401370390t.jpg"/></td><td valign="top">NAIROBI 21 September 2010 (IRIN) - The disproportionately high risk of disaster faced by a billion slum-dwellers across the world could be significantly reduced with prudent investment, states a new report.</td></tr></table>>]]></content:encoded></item><item><title>HAITI: Emergency sheds light on needs of pre-quake disabled</title><pubDate>Wed, 15 Sep 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201003311653310230t.jpg" />]]>PORT-AU-PRINCE 15 September 2010 (IRIN) - A man who had a leg amputated after being shot during political unrest in 2004 recently came to an emergency clinic for earthquake victims in Haiti’s capital Port-au-Prince, hoping to get help.</description><body><![CDATA[PORT-AU-PRINCE 15 September 2010 (IRIN) - A man who had a leg amputated after being shot during political unrest in 2004 recently came to an emergency clinic for earthquake victims in Haiti’s capital Port-au-Prince, hoping to get help. 

Many people with physical disabilities pre-dating the 12 January 2010 earthquake are identifying themselves as direct quake victims so they can access services, according to Kate Gerry, physical therapist with Handicap International (HI). 

“He is on a waiting list,” Gerry said of the gunshot-wound amputee. “He is someone who would benefit a lot from prosthesis; we can’t just turn him away.” HI’s current official remit, however, is to help quake victims only. 

Assistance to Haitians wounded and disabled by the quake has underscored the challenges of carrying out an aid response in a country where pressing socio-economic problems existed long before the quake. 

Some 60 percent of Haitians lack access to basic healthcare services, according to the UN Children’s Fund (UNICEF). But most aid funding is strictly for quake response. 

“You need to keep the priorities as [the donors are setting out],” Faiz Rahman, HI prosthetics and orthotics project manager, told IRIN. He acknowledged there is “frustration” among people who are disabled but were not directly affected by the earthquake. 

It is a delicate balance, Gerry said. “There are [funding constraints] and then there’s also the ethics - that there are people who really need [help]. Who cares how they lost their limbs?” 

Local NGO J’aime Haiti estimates that just 5 percent of disabled Haitians had access to health and social services pre-earthquake. Haiti ranks 149 out of 182 countries in the UN’s latest Human Development Index. 

A paper by Active Learning Network for Accountability and Performance in Humanitarian Action (ALNAP) sets out the context of the quake response, noting that most Haitians survive in the informal sector, with no guarantee of income or access to capital. [ http://www.alnap.org/pool/files/haiti-context-analysis-final.pdf ] 

“In a place like Haiti, where poverty was extreme even before the earthquake, aid agencies are unable to meet all the needs of the population,” Sarah Wilson with Christian Aid’s Haiti emergency assessment team told IRIN. “But our development work does not stop because of the earthquake; the emergency relief continues alongside the development work.” 

New amputees 

The earthquake added 3,000 to 4,000 amputees to Haiti’s disabled population of about 800,000 (out of a population of 10 million), according to the Haitian secretariat for the integration of disabled people. It also destroyed most facilities dedicated to services for the disabled community. 

HI has its main clinic in Port-au-Prince where earthquake survivors can be fitted with prostheses and orthoses, and can get physical therapy and psychosocial support. HI also has people stationed in camps for displaced people - in Port-au-Prince, Petit-Goave and Gonaives - to facilitate access to services. Given the level of destruction, mobile clinics and accessible services are essential, HI says. 

“The thing we can’t simulate here [at the clinic] is that when you go into the community… some people are living in tents on steep hills with rubble all around,” said HI’s Gerry, adding that disabled people not only have to adjust to a new prosthetic limb, but also have to learn to navigate Port-au-Prince’s chaotic traffic and rubble-strewn streets. 

Hopes for the future 

The disaster worsened conditions for the disabled but at the same time brought international attention to the disabled community’s situation, said Gerard Oriol, founder of J’aime Haiti. 

The attention on Haiti is a chance to highlight how stigma attached to physical disability has long hampered disabled people’s development, he said. 

“Generally one thinks of a handicap as a medical problem, but in fact it’s more of a social problem. If we could eliminate the social and cultural barriers, there’s no reason a handicapped person couldn’t integrate into society.” 

Oriol sees the earthquake as opening a door to better services, which he said had already begun to improve in recent years with the 2006 creation of the secretariat for the integration of disabled people, and laws affirming the rights of people with disabilities. 

ag/np/cb

]]></body><link>http://www.irinnews.org/Report/90484/HAITI-Emergency-sheds-light-on-needs-of-pre-quake-disabled</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201003311653310230t.jpg"/></td><td valign="top">PORT-AU-PRINCE 15 September 2010 (IRIN) - A man who had a leg amputated after being shot during political unrest in 2004 recently came to an emergency clinic for earthquake victims in Haiti’s capital Port-au-Prince, hoping to get help.</td></tr></table>>]]></content:encoded></item><item><title>HAITI: SMS-ing preparedness </title><pubDate>Sat, 28 Aug 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201008272203360573t.jpg" />]]>DAKAR 28 August 2010 (IRIN) - “Are the canals and trenches around your home clean and free of rubbish?” Hundreds of thousands Haitians are receiving this message by SMS in the morning, followed in the afternoon by advice about clearing out debris, as part of a project this week by the International Federation of Red Cross and Red Crescent Societies (IFRC).</description><body><![CDATA[DAKAR 28 August 2010 (IRIN) - “Are the canals and trenches around your home clean and free of rubbish?” 

Hundreds of thousands Haitians are receiving this message by SMS in the morning, followed in the afternoon by advice about clearing out debris, as part of a project by the International Federation of Red Cross and Red Crescent Societies (IFRC). 

Now common in disaster response, SMS was widely used in Haiti just after the 12 January 2010 earthquake to locate trapped people and save lives. Later, aid agencies began sending out messages about distributions of food and relief supplies. 

“Now we are using it for preparedness,” Sharon Reader of IFRC in Haiti told IRIN. 

Haiti, prone to catastrophic storms and flooding, is approaching the peak of the hurricane season. 

Other question in IFRC’s week-long preparedness series - sent in the local Creole language - include: “Have you noticed what areas of your neighbourhood flood?” and “Where can you get information before, during and after emergencies?” “Do you know what causes landslides?” Each is followed a few hours later by advice, which takes into account people still living in tents: "If you live in a tent, secure ropes, tarpaulins and areas exposed to wind and rain." 

Landslides remain a huge risk for some 1.3 million still living in tents and other temporary housing in the capital. People living in camps are extremely vulnerable to floods and landslides, the UN Office for the Coordination of Humanitarian Affairs (OCHA) in Haiti says in its latest bulletin, 17 August. 
[http://oneresponse.info/Disasters/Haiti/Coordination/publicdocuments/OCHA%20Haiti%20Humanitarian%20Bulletin%20No%209.pdf]

The preparedness messages - which began on 24 August - are sent out to all Voila mobile phone subscribers through a platform that has been developed specifically for the Red Cross, according to IFRC. Voila is one of Haiti’s largest telecommunications providers and has developed a web-based platform that allows the Red Cross to send SMS through their country-wide network. 

The International Organization for Migration, which leads camp management, and the Haiti Department of Civil Protection are planning to extend the SMS preparedness campaign, according to OCHA. 

In March IFRC sent SMS messages to millions of people to announce a measles, diphtheria and tetanus vaccination campaign. One upgrade IFRC and the mobile provider are working on will enable IFRC to pinpoint a spot on a map and reach people within a certain distance, Reader said. 

“This is really important, using this means to reach people,” Reginald Barbier, a student in the capital Port-au-Prince, told IRIN. 

“Generally we’ve gotten information like this on TV and radio, but some people do not always have access to that. But just about every Haitian has a mobile phone.” 

In the final message in the week-long preparedness series, IFRC provides a free line - *733 - "for more information on how you and your family can prepare for emergencies". The line gives recorded messages, changed periodically, about preparedness, health, hygiene and other subjects, Reader said. She said currently the line receives about 500 calls per day. 

Other NGOs, including Oxfam, have set up phone lines for questions and feedback. Oxfam received over 1,400 calls between March and May on a line it has set up for Haitians go give feedback on relief efforts, according to the NGO's Julie Schindall. 

“It is open to everyone... Anybody can call it, and remain anonymous if need be,” she told IRIN. “We put up signs in camps where we work, publicizing the number and encouraging people to call with feedback or questions.” 

Land searches 

IFRC is also using SMS to help tackle what aid workers say is one of the greatest challenges in Haiti’s clean-up and recovery: land shortages. 

“The biggest challenge for agencies [providing shelter] continues to be the lack of available land on which to build, either because land is blocked by debris or because of land ownership issues,” OCHA said. 

IFRC is doing the first-ever SMS assessment for shelter, Reader said. A series of questions and answers via SMS will identify people who own land and who have space for a shelter. 

“This project will not only help decongest a camp but alleviate tensions by directing those without land to a free Red Cross information line which will provide information about shelter plans within the camp.” 

She said the two-way SMS assessments will yield a list of people and contacts for carrying out a more detailed investigation. 

“It does not remove the need to eventually meet with people and see the land and ownership documents,” Reader said. “But it speeds things up - rather than going tent to tent with a clipboard.” 

Reader said while high-tech is great, for effective communications it’s about finding the best approach for the situation. “If that’s a town meeting or a bulletin board, that’s great too.” 

np/cb

]]></body><link>http://www.irinnews.org/Report/90319/HAITI-SMS-ing-preparedness</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201008272203360573t.jpg"/></td><td valign="top">DAKAR 28 August 2010 (IRIN) - “Are the canals and trenches around your home clean and free of rubbish?” Hundreds of thousands Haitians are receiving this message by SMS in the morning, followed in the afternoon by advice about clearing out debris, as part of a project this week by the International Federation of Red Cross and Red Crescent Societies (IFRC).</td></tr></table>>]]></content:encoded></item><item><title>In Brief: Fish nets join mosquito nets against malaria </title><pubDate>Fri, 02 Jul 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201004270928560748t.jpg" />]]>JOHANNESBURG 02 July 2010 (IRIN) - New drugs to fight malaria may well lie at the bottom of the ocean, according to researchers studying over 2,500 samples from marine organisms collected at depths of over 900 metres. They have already found 300 that contain substances that can kill the parasite. </description><body><![CDATA[JOHANNESBURG 02 July 2010 (IRIN) - New drugs to fight malaria may well lie at the bottom of the ocean, according to researchers studying over 2,500 samples from marine organisms collected at depths of over 900 metres. They have already found 300 that contain substances that can kill the parasite. 
 
 "Healing powers for one of the world's deadliest diseases may lie within sponges, sea worms and other underwater creatures," said an internal publication by the University of Central Florida (UCF) after a study of samples collected off the Florida coast in the United States with the help of the Harbor Branch Oceanographic Institute in Fort Pierce, Florida. 
 
 "So far we have a hit rate of over 10 percent," said Debopam Chakrabarti, Professor of Molecular Biology and Microbiology at UCF, who is leading the research. He was "quite enthused by the promise of the project", but warned that "early promise does not always materialize" into a usable drug. 
 
 Chakrabarti has spent over 20 years researching treatments for the mosquito-borne illness, and turned to the largely unexplored biological potential of the ocean because "[current] drugs are becoming increasingly less effective and [malaria] is still killing," he told IRIN. 
 
 The UN World Health Organization has noted that about 3.3 billion people - half of the world's population - are at risk of malaria, and around 1 million people worldwide are killed by it every year. 
 
 tdm/he
]]></body><link>http://www.irinnews.org/Report/89701/In-Brief-Fish-nets-join-mosquito-nets-against-malaria</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201004270928560748t.jpg"/></td><td valign="top">JOHANNESBURG 02 July 2010 (IRIN) - New drugs to fight malaria may well lie at the bottom of the ocean, according to researchers studying over 2,500 samples from marine organisms collected at depths of over 900 metres. They have already found 300 that contain substances that can kill the parasite. </td></tr></table>>]]></content:encoded></item><item><title>HAITI: &quot;We are again exposed to catastrophe&quot; </title><pubDate>Fri, 04 Jun 2010 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201004051229450281t.jpg" />]]>DAKAR 04 June 2010 (IRIN) - The rain and winds signalling the start of Haiti’s storm season are already taking a toll on the makeshift shelters housing people displaced by the January earthquake, and aid agencies warn that there could be worse to come.</description><body><![CDATA[DAKAR 04 June 2010 (IRIN) - The rain and winds signalling the start of Haiti’s storm season are already taking a toll on the makeshift shelters housing people displaced by the January earthquake, and aid agencies warn that there could be worse to come. 

"Tarpaulins are generally holding up better than tents, but even the best tarpaulin or best tent is not a good place to live during the rainy or hurricane season," Timo Lüge, communications officer of the interagency group overseeing shelter, told IRIN. "Many camps get flooded each time it rains, and living conditions are dire." 

Some 1.5 million displaced people are living in camps. 

Aid agencies are working to build sturdier, portable housing with raised floors as quickly as possible; 1,873 of a planned 120,000 transitional shelters have been built – enough to house 9,365 people – but completing 120,000 could take about one year, Lüge said. 

Funding and materials are on hand, but land tenure issues and rubble removal are hampering the process. "It will take many months to secure land, buy the required materials, transport them and finish construction," he said. 

"With building materials for over 7,000 transitional shelters in country, the biggest challenge for shelter cluster [the interagency group handling shelter] members is a lack of available land on which to build," the UN Office for the Coordination of Humanitarian Affairs (OCHA) in Haiti said in its 24 May bulletin. 

In the meantime aid agencies are distributing wood, nails, rope and other materials and disseminating guidance, including in a poster in Creole, on how to reinforce and waterproof existing shelters, Lüge said. 

In a recent survey of 28 sites international relief agency Oxfam found that "extreme overcrowding" and poor drainage raised the risk of flooding and disease. The OCHA bulletin said there was not enough water for washing, which compromised hygiene. Cases of diarrhoeal disease were low, but skin diseases from lack of water were frequent. 

Catastrophe 

The US National Oceanic and Atmospheric Administration has predicted an "active to extremely active" hurricane season in the Atlantic Basin. OCHA said in a 1 June communiqué: "With so many people still so vulnerable after the recent earthquake, a serious hurricane this year could be devastating." Haiti's Department of Civil Defence has been identifying buildings, such as schools, that could serve as communal hurricane shelters. 

Jean-Ferdinand Jean-Jacques, who lives with his wife and children in Caremaga camp, in the Maïs-Gaté 2 area of the capital, Port-au-Prince, said damage from early storms had been considerable. "Most tents are flooded as we speak; they are rotting from the bottom up. People are working on putting sandbags at the base of their tents." 

Harold Desaugustes, a member of the Caremaga camp committee, told IRIN: "Already, the winds and rain have destroyed temporary shelters of people who do not have proper tents. With the storms starting, we are again exposed to catastrophe." 

He said many people, including his family, live in rudimentary shelters of plastic sheeting and poles. "Sometimes, in the middle of the night, the structure crashes in from the rain and winds." He recently bought a second piece of plastic sheeting after the first was blown away by the wind. 

Desaugustes's household consists of 16 people, including five children under the age of six. "We generally ask other camp residents who have tents to allow our children to sleep there – a couple of the kids here, a couple there." 

np/he]]></body><link>http://www.irinnews.org/Report/89376/HAITI-quot-We-are-again-exposed-to-catastrophe-quot</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201004051229450281t.jpg"/></td><td valign="top">DAKAR 04 June 2010 (IRIN) - The rain and winds signalling the start of Haiti’s storm season are already taking a toll on the makeshift shelters housing people displaced by the January earthquake, and aid agencies warn that there could be worse to come.</td></tr></table>>]]></content:encoded></item></channel></rss>