A New Lease on Life

On Saturday morning, I was driving on a well-travelled road outside of Nairobi to Naivasha, a play ground for Nairobians looking to get out of town for the weekend. It’s where you go for walking safaris with giraffes, camping, and hanging out on the lake. We were four adults and four kids–all four sitting in the back, having fun and looking out the back window.

About five minutes outside of Naivasha town, on the highway, our jeep was banged into by a massive lorry (truck) that was free wheeling down the hill. As we swerved off the road to the ditch, we hit a smaller truck which rolled out of view. In a state of shock, we panicked as we noticed that another white lorry was heading directly our way. By some miracle, he missed us. My first impulse when we turned was to check on the kids. Save some glass in the face and arms, they were ok. A lesson for parents out there: Car seats matter!! The baby was fast asleep in his car seat and only opened his eyes to our screaming.

A crowd of around fifty people from town gathered to help us out of the car and attend to the screaming kids. Standing around in a state of shock, we were just trying to figure out what to do with the child who ended up with some cuts. How would we get to the hospital. As we pondered this question.. a scene out of a freak movie occurred. A blue truck lost control of his vehicle and swerved directly into the crowd, right where we were standing. Another miracle occurred, all of us ran out of the way. But we were the only lucky ones. I witnessed several people run in the wrong direction and we were soon surrounded by death and injury. By my best estimation, 5-10 must have died on the spot. My most vivid memory is of a man with his head split open, being carried away to safety.

The gentlemen who offered us a ride to the hospital were freaked out and shoved us into the car to get away from the “black spot”. We got to the hospital only to find that it was empty… no doctors, no nurses, just plenty of waiting patients. We were lucky enough to have our guardian angels drive us back to Nairobi for medical care, but there were far too many who wouldn’t get that chance.

As we drove past the scene of the accident, I was in shock. Our jeep was finished, it was truly bizarre that we all got away scott free. About forty minutes had passed and there was no sign of any police (despite the fact that the station was a mere fifteen minutes away, and the accident had been reported both in-person and by phone). I had no idea how any injured person would get to the empty hospital. By matatu (bus)? The same matatus whose reckless driving is one of the leading cause of death in Kenya?

I also wonder about all of us, my closest friends and kids who I couldn’t love more if they were my family. If any of us incurred a head injury, we’d have to drive two hours to the nearest facility with equipment to treat us. Only three hospitals in Kenya are equipped to deal with head trauma. And the whole country only has 5000 registered doctors. But you can only be treated if you can get there in time and if they are there.

I think about how I spent my entire life in the Developing World, Pakistan, China, Oman … and am so blessed I never had to experience that. Even with all my privilege, what would I do if I were caught in a similar situation, away from a hospital?

Pakistani law states that accident cases can only be taken to Jinnah Hospital.. So in a city of over 20 million people, only one hospital is authorized to treat trauma.

Driving past the scene, I was reminded of how privileged and lucky I am. The question is, what do we do with this privilege we’ve been given? I have never thought much about health issues in the developing world, that is until I took Karen Grepin’s Health Econ class. But to live out the findings of endless reports on healthcare and doctor abesenteeism felt surreal.

I am still in shock from the whole experience and also a bit loopy from the muscle relaxants for my whip lash! But I know that this experience has changed me and refocused my energies on the issues that are so important in development.

Samia

Green Revolution Event Recap

The other night i attended “Exposing the Green Revolution,” presented by NYU Wagner Health Program, World Hunger Year, Food & Water Watch, US Working Group on the Food Crisis, and IPSA.

The conversation was moderated by Brother David Andrews, recent Senior Advisor to the President of the UN General Assembly, a member of the Congregation of the Holy Cross, and a senior representative for Food and Water Watch.

Josphat Ngonyo of the Kenyan Biodiversity Network spoke in broad but convincing terms of the need to challenge the aid community’s emphasis on GMOs in Africa. He condemned the practice of instituting GMO programs that end up forcing low income farmers to buy seeds and fertilizers from multinational companies, fostering helpless dependency. GMOs, he said, clash with farmers’ lifestyles by forcing them towards monocropping, destroy the environment through overuse of land, runoff, and chemical pollution, and affect neighborhing crops through cross pollination. He also condemned food aid for making people lazy and dependent.

In order to avoid a second “green revolution,” like the one that enhanced productivity but led to destitution in India, he called for more on the ground involvement of communities, especially from AGRA, the organization in charge of bringing biotech to Africa. Furthermore, he recommended investments in commercial infrastructure; roads, warehouses, and stores, as well as increased access to credit for small farmers. Finally, he advocated work on land tenure and gender rights, as 80% of african farmers are women.

Bronx community gardener and food justice leader Karen Washington then spoke dynamically and convincingly about the disconnect between american urban food consumers and their food. she heralded the 11 community run farmers markets in New York City, and spoke of the need to educate children about where their food comes from. She also spoke of the importance of improving access and food security in low income areas of the city, changing the variety of products offered in neighborhood bodegas. Health, she said, was only one of the many reasons to create a more “enlightened” food policy. “We are sick and tired,” she said, “of being sick and tired.”

Various proposals and potential solutions were then discussed. One of the most salient was when someone asked about farmers who were comfortable, and had been for multiple generations, with enhanced crops and fertilizers and other unsustainable agricultural practices. Reprimanding farmer doesn’t make any sense, everyone agreed: Education is the key. Showing farmers how bad the products they use really are, for their health and the environment and their land, is really the key to creating change.

Though I’ve been working in the food world for the past three years, in various capacities, my experiences are almost all domestic, and since I’m at Wagner in part to throw myself into the international food world, this event was perfect for me.

In addition to learning a few new things, I ran into people I knew from the US food movement: a man who I had met at a kellogg Foundation food conference in Arizona two years ago, now an organizer for Slow Food, and a woman who I had known in New Orleans who runs community gardens.

By: Mischa Byruck

Whirlwind Tour of Midday Meals

It’s been a while since my first post and in that time a lot has happened.  As reminder, my capstone team is working for GAIN – the Global Alliance for Improved Nutrition.  We started work in Delhi on July 13, though I took my time coming to India making stops in England and Bombay to visit family and friends.  Delhi – hot, humid, and dull, Delhi - was made all the more bearable upon meeting our capstone clients finally  and realizing just how lucky wer are.  The entire GAIN-India staff is extremely generous, hospitable, and supportive.  I don’t want to jinx us, but I really think we’re a very lucky capstone team based on the stories I’ve heard from previous years.

We spent less than a week in Delhi and then hit the road to visit several locations in India where GAIN’s partner – Naandi – operates kitchens providing nutrient-fortified meals to students at government schools through India’s mandated Midday Meals Program.  (Or, “Middy Meals” as was posted on one government official’s office door.) I should mention that during our time in Delhi, one thing that made me appreciate our client all the more was their willingness to allow us to format the scope of our work with a great deal of freedom.  Most importantly, we were able to opt for only one case study, dropping the research related to universal salt iodization.  Although that topic seemed immensely interesting and one which could have had a great deal of policy impact, we didn’t feel that we could do justice to both it and the Midday Meal review.  In the end, we opted for MDM since it was a more clearly defined assignment and would allow for more field study.

Since leaving Delhi, we’ve been to Udaipur, Rajasthan, and its environs; Hyderabad, Andhra Pradesh; Visakhapatnam, Andhra Pradesh; and are now in Bhopal, Madhya Pradesh.  Having been to India, it’s been wonderful revisiting some old stomping grounds like H’bad, but also great going to new places like Bhopal and Vizag.  This amount of travel is just one more way that we’re being spoiled by our experience.

Now, don’t get me wrong, it’s not all a cake walk for us.  Our days are starting at 3:40/4am regularly so that we can arrive at the central kitchens early enough to see the lunches being prepared and the the delivery trucks heading out on their routes.  We spend some time in each kitchen speaking with the managers, route coordinators and staff (cooks, cleaners, drivers, et al, as possible).  Then we head off to see some of the schools receiving their meals with time to speak with headmasters, teachers, and students.  Before and after lunch, we go for meetings with government officials and end the day with debriefings, typing up notes, and prep for the next day.  If we’re lucky, we get two nights in one place before flying/training off to the next site.

Overall, my impression has been one of amazement.  Amazement at how much India has changed since 2003/2004 when I was here for study abroad and amazement at the work that Naandi is doing.  Everywhere I turn there are western or western-style stores.  Each city seems to have a brand new airport that puts JFK to shame (not that that is so hard to do).  Even though I spent 6 months in Hyderabad, I could hardly recognize the place given all of the new construction.  When I first came to India, it was easy to miss the US and understand why those who wanted a better chance in the world to send their children to the States for school or work.  Now, though, India has become a much more appealing place to live, at least for those who are upwardly mobile and have the option to attend school.

Naandi.  What Naandi does with a staff of five and on a shoestring budget would put any fat American NGO to shame.  Providing nutritious meals to children for whom it is often the only meal of the day, in four states, in different languages, with different tastes.  All while combatting local prejudices, political tensions and Indian bureaucracy.  I can’t help but want to drop out of Wagner and stay on full-time to help out.  I don’t think I’ll be that rash quite yet.  At least not until I take a look at my fall semester reading list.  But, honestly, Naandi, and in particular, the Naandi Midday Meal Director Leena Joseph, are inspiring.  Being here and participating in work like this is a strong confirmation that Wagner is the right place to be and that international public service is the right field to be in.

South Africa — Community Health

We arrived in Cape Town on July 7th for a month-long study on community health in South Africa. After a few days of classes and site visits to various health and treatment centers in the surrounding townships, I began observing at Sonke, an organization which works to strengthen government, civil society, and citizen capacity to support men and boys to take action to promote gender equality, prevent domestic and sexual violence and reduce the spread of impact of HIV/AIDS. Sonke uses a broad range of social change strategies including working with government to promote the development of new policies, advocacy, activism, and community mobilization to ensure deliverance from government, strengthening organization capacity among partner organizations, using communications and digital stories, community education, and research. Main sponsors include USAID, PEPFAR, UNICEF, and University of California. This is particularly relevant as South Africa has the highest incidence of rap
e in the world, domestic abuse is rampant, and women have little value associated with them; behaviors which developed from a variety of historical, cultural, and economic circumstances.

In the township of Khayelitsha, which is the second largest township in South Africa (nearly 1 million residents), I observed Sonke’s One Man Can Campaign, which focuses on community education including workshops, community events, murals, door-to-door campaigns, street soccer festivals etc. I attended several community hospitals, where Sonke’s representative (who was a local man of about 30 years old) used the waiting room filled with approx. 75 patients, as a platform for disseminating sexual health information and gender sensitivity, talking about current events (such as an ongoing rape trial), providing information on health resources, and then attempting to create a dialogue within the waiting room. They partnered with another NGO, Treatment Action Campaign, who informed those waiting on HIV and treatment options. This was important because the link between sexual violence and HIV is not well understood. Although women were more vocal then men, both used the time to sha
re opinions and fears, ask definitional questions of rape, and voice anger/concerns; since forums like this are not often available, the participants were happy to have this opportunity and thanked “Sonke” as we left. The hospital has become more than a place of treatment, but a place to become educated and participate in dialogue; a town hall meeting feeling. We also attended a men’s clinic, which was housed in a trailer about fifty feet away from the hospital, which gives information on men’s health, trains on gender sensitivity, testing, treatment, and counseling. The room was filled with men of all ages, actively asking questions and engaging in discussion. The counselors and nurses were from surrounding townships and were excellent and passionate teachers. The greatest part of the experience so far is understanding that people really want information, particularly on health, and are seeking it out wherever they can; unfortunately the places to find these resources are often far from their homes and expensive to reach.

More on Sonke and other orgs soon to come!

Jennifer Ilekis

The Whirlwind and Work

I arived in Zimbabwe a few days ago. Shep met me at the airport and I was wisked to the SHAPE International Offices. After quick introductions to the staff, I headed to my host’s home. Bleary eyed from a long flight to Harare, it was all really a blur.

Over the weekend, SHAPE had some student musicians in the recording studio for an upcoming album release. Brilliant! Their voices were great. If I had a cord to download the video from my camera, I would upload it to YouTube and post the link here. In the meantime, text will need to suffice.

On Sunday, I rested! Thankfully. I met some of my host’s friends on Saturday evening. We played a game of 30 Seconds until 3am. I still can’t think of what the game is called in English, but you have things you want to get people to say, like garfield or To Kill a Mockingbird, and you can use any clues you like except sounds like and saying the answer. People guess. And, you guessed it, you have a maximum of 30 seconds per card to guess all five. Needless to say, at 3am after a long day, long flight, and little sleep, I was knackered.

Now it’s Wednesday and I’ve had my first few discussions with folks about work in the office. Looks like fund raising, information & communications technology, and some basics in management are the main areas to help with. The next step is to set them up with a few, free Internet-based resources to start organizing their contacts, their volunteers, and their donors. I also have a few management tools in mind. Ever since I was introduced to Salesforce.com, I’ve been a big fan. I set up the resource for HOGC, for myself, and am now in the process of setting it up for Hands on Zimbabwe (aka, SHAPE Int’l).

I have talked with a number of the staff about their individual project areas. There is a real need for project management training, information technology training, and some old-fashioned computer networking. Anyone have old routers or two and a server they’d like to donate and ship to Zimbabwe?

Everyone is quite appreciative of the advice I’ve provided and I hope they feel the same way when I leave.

Zimbabwe Bound

On July 9th, I’ll be heading to Zimbabwe for about 5 weeks to lend a hand to an organization called SHAPE International, based at the University of Zimbabwe in Harare.  The organization’s goal is to reduce the number of HIV infections in the university student population through masculinity training and women’s assertiveness training.  They do a number of other activities to promote awareness and understanding of HIV/AIDS.  What’s interesting about this organization, though, is that they organize and train university students to be peer counselors.  It’s the university students who come up with ideas for activities; it’s the university students who lead first-year orientations; it’s university students trying to educate and change the risky behavior that could lead to HIV infections.

I was connected to the organization through my old employer, Hands On Network.  Hands On Network is national, coordinating agency for a number of domestic and international nonprofits who engage and challenge volunteers to actively participate in improving their communities.  Because SHAPE Int’l puts student volunteers to work, they were able to join the network.

SHAPE wanted someone from the Network to help them tighten up their strategic plan, to help them with some fundraising strategies, as well as thinking about their programming.  Although my work with Hands On Gulf Coast in Biloxi, Mississippi give me a pretty good flavor for the volunteer business, I don’t think it prepared me for the conditions in Zimbabwe.  So, rather than spending an inordinate amount of time planning solutions to problems described via email, I figure it’s best to wait until I see the operation and the conditions they work through before I provide my thoughts and ideas for improvement.

So, we’ll see how it all goes.  More to come.

Life in Meheba Refugee Settlement

June 21, 2009

Originally home to over 200,000 refugees, Meheba now houses approximately 14,000 people hailing from Angola, DRC, Rwanda, Burundi, and Sudan. Those that are left have hopes of being offered resettlement in the U.S. or Europe (in actuality only about 1% of refugees world-wide are able to utilize this option), or being absorbed into the Zambian population. Some, such as one of FORGE’s employees, were born here in Zambia but are still considered refugees and unable to obtain citizenship.

In theory, refugees are supposed to have the right to travel and work within the country of acceptance, but that is not the case in Zambia. In Meheba, FORGE is one of only three employers and the 50 or so jobs that we offer to refugees is by far the largest number. The UN and Zambian government occasionally hire refugees, but most of their positions are held by Zambians.

In many ways Meheba is not a traditional refugee camp. Each family has land for cultivation and the main center of the settlement houses a fairly large market with fresh vegetables, rice, beans, and bread. Many of the miners based near Solwezi will visit Meheba for produce as it is better quality and cheaper than in town. One of FORGE’s employees has an extensive garden and he supplies us with fresh greens, tomatoes, and onions on a regular basis. Cooking them is more problematic as our stove/oven consists of a charcoal brazier that is “slightly” difficult to light in the mornings. I’m getting the hang of it though.

FORGE operates multiple different programs in the settlement. I am here to help with the pre-schools of which there are three spread out throughout the camp. There are also multiple libraries, two health programs, a Women’s Center, an agricultural loan program, and a high school sponsorship program.

This past Saturday (June 20) was World Refugee Day and the UN sponsored a huge celebration on the grounds of one of the schools in the settlement. There was native dancing and skits based on sexual & gender based violence and the flight of refugees during war. It was slightly disturbing to watch the cheering whenever women’s rights were mentioned or anti-violence speeches were given knowing that only two days earlier a two-year-old had been raped in the settlement. We’re hopeful that things will improve though.

-Caitlin

IPSA Summer Book Club-Mountains Beyond Mountains

On Thursday, 6/18, an eclectic group of current and future NYU students met to discuss the book Mountains Beyond Mountains by Tracy Kidder. MBM chronicles the life and work of Paul Farmer, an American doctor has worked tirelessly since the mid-1980′s to bring high quality medical care and social equity to various underdeveloped regions, but most notably Haiti. Much of this work occurs through the organization he co-founded, Partners in Health, but his work in these regions began long before the founding of PIH.

Discussion began with general reactions, all positive, to the book. Some identified with Farmer and his quest (also noting the frequent mentions of Lord of the Rings, a favorite of Farmer’s, in MBM); others admired Farmer for his work but felt that they didn’t share his tireless devotion. The book prompted a great deal of discussion around the methodologies, advantages, pitfalls, and other issues surrounding international development.

Farmer was criticized for not working to improve poverty more holistically. Although much of his work has reported and analyzed the associations between poverty, disease, and poor health outcomes, Farmer himself has refrained from working directly in alleviating poverty. His life’s work has centered around multi drug tuberculosis health care, and he himself has become directly involved in administering that care. Farmer cites this as crucial to improving health and quality of life, but some would criticize that he could be more effective by working less with patients.

Farmer, however, treasures his time with patients, especially those of Haiti. Furthermore, by working in Haiti so often, Farmer rejects many of the rewards and advantages of the American medical system, and some thought he was particularly unique in his refusal of material rewards.

Farmer himself would most likely sternly rebuke any such criticisms of himself, as he does in the book, and there can be no doubt that he has improved the lives of thousands, if not millions, by working in his unique methods.

Andrew Quinn