28 posts categorized "Development"
Mukul Begum, a shasthya shebika (community health worker) for BRAC, stands in front of her home in Barisal, Bangladesh. Begum delivers basic health care, counseling, and treatment to people in her community.
Text by Molly Marsh / Photos by Laura Elizabeth Pohl
BARISAL, BANGLADESH---Mukul Begum reaches into a plastic jar for tuberculosis medicine and brings it to 70-year-old Amjed Ali Sikder, who sits on a bench outside her front door. She pours a glass of water from a clear pitcher, watching closely as he puts the pill in his mouth and swallows it. Satisfied, she gives him the water.
Begum, 37, is a shasthya shebika, one of about 80,000 health workers trained by BRAC, an international nongovernmental organization, to deliver basic health care, counseling, and treatment to people in their communities. BRAC’s social, health, and economic empowerment programs operate in each of Bangladesh’s 64 districts, reaching about 110 million people.
Shasthya shebikas such as Begum are the engines of BRAC’s work—in 2010, they treated 1,650,673 people, the vast majority in rural areas where medical information and care is limited.
For five years, Begum—a formidable but jolly woman—has made door-to-door visits to counsel people in Barisal, a district of Bangladesh, about safe sanitation, basic hygiene, and nutrition. She currently looks after 263 households; 2 percent of these receive what BRAC calls “Directly Observed Treatment Short-Course.” In other words, if Sikder hadn’t come to her house to take his medicine, she would have gone to his to make sure he took it.
People in the community also visit Begum’s house, a low concrete building that sits under a thick canopy of coconut trees, for help with a variety of ailments. Begum listens and then reaches for a shasthya shebika’s constant companion—a small blue plastic bowl that holds medicine for fever, dysentery, diarrhea, gastric ulcers, skin diseases, and allergic reactions. It also contains home pregnancy tests and pills for calcium, vitamin B, and birth control.
Begum purchases the medicine from her local BRAC office, which she can then sell to her patients at a slight profit. She also receives money when pregnant mothers deliver their babies in a hospital or when patients complete treatment—for example, she’ll receive 500 taka (about $6.50) when Sikdar finishes his 6-month treatment for tuberculosis.
Before they embark on their caregiving, shasthya shebikas receive 15 days of training at a BRAC learning center on health basics and communicable diseases. They also gather for refresher classes once a month, in which they and shasthya kormis (health supervisors) review training themes and discuss issues that have arisen in their communities. Shasthya shebikas also meet once a month with a BRAC manager to report their activities.
It’s a role Begum seems to enjoy. “In the community, people believe I’m a doctor,” she said through a translator. She stands in her front doorway; behind her a clothesline stretches down the hallway, filled with colorful clothes. To the left of her house sits a small shack with items for sale, including toilet paper, candy, bread, and snacks.
BRAC’s main health program, called Essential Health Care, targets poor people—especially women and children—with medical care using seven different components. They include programs that focus on malaria, tuberculosis, and vision problems, and on the needs of pregnant mothers, infants, and children.
Shasthya shebikas are critical to each of these efforts, in many cases receiving additional training to be able to diagnose and treat malaria, for example, or identify vision problems. Begum and others are the front line of care in their communities—not just in dispensing medicine but also referring people to clinics when ailments are beyond their expertise.
Molly Marsh is managing editor and Laura Elizabeth Pohl is multimedia manager at Bread for the World. You can follow Laura on Twitter at @lauraepohl.
Tohomina Akter washes pots and dishes in a pond near her home on the morning of Thursday, April 19, 2012, in Char Baria village, Barisal, in southern Bangladesh. Tohomina participates in a maternal and infant nutrition program called Nobo Jibon administered by Helen Keller International. The program stresses proper nutrition in young children.
Photographs by Laura Elizabeth Pohl / Text by Molly Marsh
BARISAL, BANGLADESH---The afternoon hours are Tohomino Akter’s favorite time of day. That’s when she can take a break from her household tasks, rest, and play with her 17-month-old daughter, Adia. Like any toddler, Adia much prefers movement.
Adia runs through the four rooms of their home, her pink sundress and plastic pink shoes contrasting against the gray tin walls. First is her parent’s bedroom, then the room where her father’s parents and brothers sleep. Then a small room that contains clothes and dishes, and finally the kitchen, a skinny corridor that opens to the outside on one end, where her mother prepares their food over a fire.
Adia stops suddenly at the front steps, looking out at the familiar faces of Char Baria, a village in the Barisal district of Bangladesh. In front of her lies Tohomino’s garden, a 25-foot square of spinach, amaranth, chili, and pepper plants, an important source of nutrients for Adia and her family. Spinach and red amarinthe are Adia’s favorites.
Tohomino planted the garden after receiving training in “Nobo Jibon,” a program administered by Helen Keller International, a nongovernmental organization that works in several Bangladesh districts. The vegetables she harvests have increased the nutrients available to her family, especially her daughter. What’s more, the extra money the family earns selling the surplus vegetables goes toward buying additional food for Adia.
In the program, Tohomino learned why a diverse, healthy diet is important, and also about the importance of breast-feeding her daughter. Tohomino attended classes for almost two months, hearing from health workers the benefits of giving Adia only breast milk during her first six months of life.
Tohomino has stuck to that schedule, introducing supplementary foods only after the initial six-month period, and she’ll continue to breast-feed Adia until she is 2.
“I did not do many things [before taking the class],” Tohomino said through a translator. “But after learning, I am keeping things clean and hygienic to prevent diseases, and cooking nutritious foods to keep me and my family healthy.”
Tohomina Akter feeds her 17-month-old daughter Adia. The nutrition programTohomina participates in stresses exclusive breast-feeding until six months and breast-feeding plus supplementary feeding from six months until 24 months.
Molly Marsh is managing editor and Laura Elizabeth Pohl is multimedia manager at Bread for the World. You can follow Laura on Twitter at @lauraepohl.
Photo by Flickr user likeablerodent
Feed the Future has the potential to be a major step forward in U.S. foreign assistance, but it is not the first effort to adopt a country-led development approach. The Millennium Challenge Corporation (MCC), a U.S. government agency, uses a country-led approach in its work with developing countries. The MCC is widely regarded as one of the more innovative examples of U.S. foreign assistance, and it provides a compelling model for establishing a country-led development approach for Feed the Future.
MCC’s approach to country-led development puts participating governments in the lead on both program development and program implementation. To secure U.S. funding, or in MCC parlance to sign an aid “compact,” developing country governments are invited to propose projects that reflect their own development priorities. Partner governments are required to consult with key stakeholders in their country, including civil society groups, the private sector, and communities slated to benefit directly from the assistance. MCC is a partner in the process of developing the compact; its role includes ensuring that proposed investments have good potential to spur growth and reduce poverty, and that the government consults with stakeholders who will benefit from the compact and who can help make the program successful. Just developing and signing the compact can take one to two years.
Before governments submit a project proposal, they must conduct rigorous analysis to identify their country’s key barriers to economic growth and poverty reduction. Based on the analysis, they propose programs to help overcome these barriers, and MCC helps them select and design investments that show greatest promise for increasing incomes among beneficiaries. It’s rare for MCC not to help countries sharpen their proposals. MCC’s objective is not economic growth by any means that works—nor is it to support just any project that will help poor people. The agency will only fund investments that do double duty: stimulating growth and lifting people out of poverty.
An example of how MCC tries to make projects both country-led and successful comes from the Philippines. Water shortages in one district led the government to propose using MCC funding to build a system of reservoirs. Farmers in the district blamed their low productivity on a lack of year-round access to water. When MCC technical specialists analyzed the situation, they determined that the water shortages were caused by inadequate delivery mechanisms rather than storage capacity (which would have required the reservoirs). Thus, MCC did not change the problem identified by the community as a priority, but the solution was adapted based on MCC’s analysis of its causes. MCC’s strengths include its access to such technical expertise. Is this inconsistent with a country-led approach? MCC doesn’t see it that way. Rather, the process works as a partnership, with both parties working to identify the investments with the greatest potential for poverty reduction.
Got any questions about poverty-focused foreign assistance? You're not alone. To help answer your most frequently asked questions, we've put together a nice little questions and answers sheet. Here's an excerpt, but visit our Offering of Letters website for the full document.
I keep hearing that poverty-focused foreign assistance programs address the root causes of poverty. What does that mean?
Addressing the root causes of poverty involves more than simply building a road so farmers can transport their goods to market. It involves teaching a community how to build and maintain that road so it can provide transportation for the harvest of future generations. Building sustainable development takes time, but by investing in programs that serve and partner with communities, we begin to win the battle against hunger and poverty.
Times are tough in the United States. Is now the time to keep investing in poverty-focused foreign assistance?
U.S. investments in developing countries are an important component of our national security and foreign policy. U.S. poverty-focused foreign assistance supports political stability in developing countries and fights the hopelessness that can lead to instability and conflict.
Research shows that economically stable countries are less likely to pose a threat to their neighbors or to the United States. For example, for every 5 percent drop in income growth in a developing country, the likelihood of violent conflict or war within the next year increases by 10 percent.2 In addition, investments in poverty-focused foreign assistance save us from costly interventions later on.
What’s the difference between international food aid and poverty-focused foreign assistance?
Poverty-focused foreign assistance includes a variety of programs that address hunger and poverty, including international food aid programs. International food aid is often an emergency or humanitarian response, while poverty-focused foreign assistance programs seek to address the long-term causes of hunger and poverty.
Photo by Flickr user alexanderdrachmann
Last month, news reports indicated that the food crisis in West Africa’s Sahel region was worsening — at about the same time the United Nations declared the famine over in the Horn of Africa.
The countries in the Sahel, which is just below the Sahara and extends from the Atlantic Coast to the Red Sea, are among the world’s poorest. According to the U.N., nearly 23 million people in Niger, Chad, Mali, Burkina Faso, Mauritania, Senegal, Nigeria and Cameroon — including 1 million children — could face food shortages this spring. This isn’t a new phenomenon. For years the region has been challenged by droughts, poor harvests, climate change and the impact of overpopulation.
While we can’t control Mother Nature, we can help the people of this region and others who rely on U.S. food assistance by urging Congress to protect food aid funding and to pass a farm bill that improves the nutritional quality of food aid and reduces costs and inefficiencies. Members of Congress will debate and authorize a new farm bill this year.
Congress should consider a bolder approach to how U.S. food and farm policies can meet our global and domestic challenges. Bread for the World Institute’s 2012 Hunger Report recommends that food aid programs should follow the lead of Feed the Future — a new U.S. Global Hunger and Food Security Initiative — by focusing more on improving nutrition for the most vulnerable people, especially pregnant and lactating women and children under the age of 2. This will help achieve the strongest possible nutrition and development outcomes with the limited resources available.
The most critical period in human development is the 1,000 days starting at pregnancy and lasting through a child’s second year. Healthy development, particularly in the brain, depends on getting the right foods during this critical time. Even short bouts of hunger can be catastrophic, because the resulting physical and cognitive damage is lifelong and irreversible. Early hunger and malnutrition is associated with problems later in life, such as chronic illness and poor school attendance and learning.
According to UNICEF (the U.N. children’s fund) more than 1 million children in the Sahel region could experience “severe and life-threatening malnutrition” this year, and more than 300,000 children under the age of 5 in Niger are at risk of severe and acute malnutrition.
The United States should strengthen its leading role as the world’s largest provider of food aid, and also move quickly to improve its nutritional quality. Current regulations should also be restructured and improved to include cash, vouchers and local procurement of food.
New mothers, young children and other vulnerable people — such as those living with HIV/AIDS — can benefit from highly nutritious forms of food aid now available. These cost more than the foods normally included in U.S. food aid, but it is possible to reduce costs by purchasing in or near the countries where the food is needed. By buying food from smallholder farmers in and around the region, we would help reduce poverty, build self-reliant communities and get aid to where it is most needed — more quickly and cheaply.
The longer-term solution to these recurrent food crises is to improve the productivity of farmers in the region, improve the process of getting food from farm to table, and improve access to markets through programs such as Feed the Future.
In crisis situations, food aid is critical. The farm bill gives the United States an opportunity to improve this essential tool and to more effectively help the poorest people in the poorest places, such as West Africa’s Sahel region. Food aid is a crucial tool in combating global malnutrition, and Congress should act before the next famine is declared.
David Beckmann is president of Bread for the World.
These women are part of a sewing/tailoring workshop at a family center run by MRDS.org in Sulaymaniyah, northern Iraq. (Copyrighted photo courtesy of Heber Vega)
If people remember a photograph, they are more likely to remember the issue or event that goes along with it. As a photographer, I try to take memorable and striking photos that will help our members remember the issues of hunger and poverty.
But when it comes to photographing hunger and poverty-related issues, there's the added responsibility of maintaining the dignity of the people being photographed. It's what I aim for in my photography for Bread for the World, and it's what these photographers do well on their blogs.
Here are my top five humanitarian photo blogs, in no particular order:
- Esther Havens is an American photographer whose work I first stumbled upon on the Charity:Water blog. Her vibrant pictures capture people's strength, dignity, and unique personalities. Some of her pictures are even funny -- which is rare in humanitarian photography -- as you can see in this blog post about Rwandan boys participating in an education and food program. Don't miss her post about the reality of working as a humanitarian photographer.
- Ikuru Kuwajima is based in Kazhakstan and works around Central Asia, an area that I hadn't seen many pictures of before following Ikuru's blog. From people rebuilding their lives in Kyrgyzstan to Armenians still coping with the aftermath of a 1988 earthquake, Ikuru's pictures reflect his journalism background, but with an artist's sensibilities. He also spent time last year in Japan -- his home country -- documenting the aftermath of the earthquake and nuclear plant emergency.
- Glenna Gordon, an American photojournalist, shuttles between West Africa and New York, but used to live in Liberia, where she photographed for newspapers and NGOs. If you're looking for news and music from Africa, plus fresh photographs and introspective commentary about life in Africa, then you'll enjoy Glenna's blog, Scarlett Lion. Her photo story on Harper, Liberia, a decaying coastal town, is a must-see.
- Heber Vega is a humanitarian aid worker-turned-photographer who has been based in Iraq since 2003. His blog is a mix of his own photography -- like this post on photographing women in a Muslim Country; interviews with other photographers; and advice on photographic techniques. One thing that impresses me about Heber, who's from Chile, has nothing to do with his pictures: he founded The ONE-SHOT Project, a nonprofit that teaches photography and multimedia skills to Iraqi children.
- Photo Philanthropy is well-known in photography circles for promoting photography for social change. Every year since 2009, the organization has granted awards for the best humanitarian photo stories from professional and amateur photographers (full disclosure: I entered the contest in its first year and didn't win). The blog features pictures, interviews with Photo Philanthropy award winners and grantees, and opportunities for photographers to work with nonprofits.
If you know any other humanitarian photo blogs that you like to visit, please share them with us in the comments. And don't forget to check out Bread for the World's Flickr stream and the Bread Blog for beautiful photos and compelling stories.
(Copyrighted photo courtesy of Esther Havens)
In this next installment of hunger resources, I've gathered a collection of articles on how U.S. farming is changing, and several updates on development campaigns such as the Half-in-Ten campaign and the Millennium Development Goals. Got any hunger resources of your own? Share them in the comments section below.
- The Changing Organization of U.S. Farming. (Donoghue, Erik…et al. USDA/ERS, Dec. 2011): "Future innovations will be necessary to maintain, or boost, current productivity gains in order to meet the growing global demands that will be placed upon U.S. agriculture."
- Achieving the Right to Food: From Global Governance to National Implementation. (deSchutter, Olivier. UN Committee on World Food Security, Oct. 2011): "What he meant is that unless we take seriously our duties towards the most vulnerable, and the essential role of legal entitlements in ensuring that the poor have either the resources required to produce enough food for themselves or a purchasing power sufficient to procure food from the market, our efforts at increasing production shall change little to their situation."
- Cutting Poverty in Half in 10 Years: Tools for Action. (Half in Ten, Nov. 2011): "The Half in Ten campaign’s goal of cutting the U.S. poverty rate in half over the next decade goes beyond a simple examination of the number of people who fall below the official poverty level. The campaign recognizes that well-being is multidimensional and that moving above the official poverty line does not necessarily signal an end to deprivation."
- The Big Handout: How Government Subsidies and Corporate Welfare Corrupt the World We Live In and Wreak Havoc On Our Food Bills, by Kostigen, Thomas M. (Rodale, 2011).
- FWD: Famine, War, and Drought. (USAID): "Famine, war, and drought are threatening millions of lives in the Horn of Africa and the world should be talking about it. Do more than donate. FWD the facts."
- More Money or More Development: What Have the MDGs Achieved? (Kenny, Charles and Andy Sumner, Center for Global Development): "What have the MDGs achieved? And what might their achievements mean for any second generation of MDGs or MDGs 2.0? We argue that the MDGs may have played a role in increasing aid and that development policies beyond aid quantity have seen some limited improvement in rich countries (the evidence on policy change in poor countries is weaker)."
What would you do this Christmas if you had two little children to feed and all you had in your house was one banana? This was life for Heather Rude-Turner, a single mom working full-time. Even with her job, there just wasn’t enough to support her two kids, Naomi, 5, and Isaac, 3.
“I don’t eat a lot of times because I feel bad taking the food away from my kids. I have one banana in the house. If I cut it in half, they can each have half of the banana. I don’t need vitamins.”
Unfortunately, one in five families with children in America are struggling to put food on the table this Christmas season. They need your help.
Can you make a special Christmas gift today for hungry families? Your gift will enable Bread for the World to fight for programs that help parents feed their children.
The government programs that Bread advocated for over the years allowed Heather to get the help she needed so she could feed Naomi and Isaac. Heather recently completed her college degree, and in a few months she’ll be marrying her sweetheart, Mark.
But many families are experiencing a different story this Christmas. The economy has pushed more people into poverty. At the same time, all programs that are focused on helping hungry and poor people are under attack in Congress. If these programs are slashed, the cuts are going to cost lives. Children across America will be hungry.
Will you make a gift now to help us protect funding for programs that benefit hungry people?
We need your support to fight hunger. Please give a special Christmas gift today, and help families like Heather, Naomi, and Isaac.
Get updates on issues and actions to take on behalf of hungry people.