THE PILLARS
In this section:
Orthopedic Clinic Aids Injured Afghans
Guatemalan Weavers Find New Markets
Committee Provides Youth Perspectives
Training Saves Lives in Asia
GLOBAL HEALTH
Orthopedic Clinic Aids Injured Afghans
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Malik, 17, lost his legs when he stepped on a mine
in the outskirts of Kabul earlier this year. Now he
is learning to pull himself up on the stumps of his
legs and uses a wheel chair from the Kabul Orthopedic
Organization.
Emily Phillips, Management Sciences for Health |
KABUL, Afghanistan—Malik, 17, was cutting across
a field after leaving his job at a bakery on this city’s
outskirts earlier this year when he stepped on something hidden
in the grass, and an explosion tore off both of his legs.
As he crawled toward help, a second landmine blasted his arms
and torso.
Today, Malik is learning how to pull himself up on the stumps
of his legs at the Kabul Orthopedic Organization. When he’s
ready, he will be fitted with prosthetic legs crafted at the
USAID-funded Kabul Orthopedic.
Kabul Orthopedic opened in 1996 with equipment and support
from former Reuters and ITN war correspondent Sandy Gall,
who chairs Sandy Gall’s Afghanistan Appeal. USAID has
funded the organization since 2004.
Focused largely on Afghans who have been maimed by land
mines, Kabul Orthopedic is sectioned into three units: prosthetics,
orthotics, and physiotherapy. The clinic provides rehabilitation
therapy, massage, mental health treatment, and other services,
all free of charge, to more than 10,000 disabled patients
a year.
Afghanistan is one of the world’s most heavily mined
countries, and some 250,000 Afghans live with disabilities
as a result. Mines maim close to 500 people per year. Demining
efforts are underway, but more than 1,000 square kilometres
of land are still believed to be mined.
Most of the patients at Kabul Orthopedic, like Malik, are
young amputees. Some are disabled by cerebral palsy or polio.
Others are women receiving physiotherapy for injuries suffered
during childbirth due to lack of antenatal care or trained
midwives. USAID-funded training and health education programs
are working to address those issues.
“Many Afghan women have babies too soon and too close
together,” said Dr. Gul Maky Siawash, director of Kabul
Orthopedic. “When they come here, we also try to educate
them about these things.”
Kabul Orthopedic employs half a dozen amputees to help design
and construct the artificial limbs fitted on patients. Among
them is Mahpeky, an 18-year-old caught in a landmine explosion
with her father 10 years ago. The accident cost Mahpeky her
legs and her father his life.
“I first came here as a patient,” she said. “When
my father died, for a long time I was scared about what we
would do. Now I am the only one earning a salary in my family.”
Kabul Orthopedic also distributes devices to assist the
disabled and give them greater mobility, including crutches,
wheelchairs, and walking sticks.
Until now, health services for the disabled have been largely
concentrated in Kabul, but this is changing later this year,
as the Afghan Ministry of Public Health adds services for
the disabled at health facilities throughout the country.
In preparation, USAID this fall sponsored a training course
in Kabul for 62 doctors, nurses, and midwives from four USAID-funded
nongovernmental organizations that collaborate in clinical
training.
Trainees were instructed in detection, screening, and assessment
of disabilities. Course participants also visited Kabul Orthopedic
and other rehabilitation centers. The master trainers are
now working with some 700 medical staff from USAID-funded
health facilities in 14 Afghan provinces.
Judie Schiffbauer from Management Sciences for Health
contributed to this article.
GLOBAL DEVELOPMENT ALLIANCE
Guatemalan Weavers Find New Markets
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Chorti women weave bottle sleeves for Zacapa Centenario
rum.
Hugo Cabrera, USAID/AGEXPRONT |
GUATEMALA CITY—To help some of the thousands
of farmers who went broke after coffee prices collapsed between
2001 and 2004, about 400 women are earning income by hand-weaving
bottle sleeves for this country’s finest rum.
They are part of a project of the Guatemalan Non-Traditional
Products Exporters’ Association (AGEXPRONT), a U.S.-funded
group that has been helping farmers recover from the coffee
price plunge. AGEXPRONT has been introducing farmers to alternative
revenue sources—be it planting crops other than coffee
or looking at creating products from resources unique to their
area.
For example, the Chorti Mayan communities of Jocotán,
a remote and undeveloped district far from Guatemala’s
capital, were particularly hard hit by the coffee crisis.
Most rural workers were laid off after the price of coffee
on international markets plunged. Some plantations were abandoned,
leaving entire villages out of work.
The Bethania Health Clinic in Jocotán reported 25
deaths by starvation in 2001.
But in 2002, the Chorti community forged an alliance with
a project called Kiej de los Bosques or Protectors of the
Forests, which searched for market outlets for the region’s
primary assets—abundant native palm trees. When woven
together by hand, the leaves of the palm trees proved a durable
fabric for items like bed rolls and stool covers.
Kiej de los Bosques helped the community link with Licorera
Nacional, distiller of the world famous Zacapa Centenario
rum. The result was a deal for the Chorti women to hand-weave
2,000 bottle covers per month.
With this deal in place, Kiej de los Bosques turned to AGEXPRONT
and USAID to expand assistance to other Chorti communities
in Jocotán.
Recently, Kiej de los Bosques struck a deal with a producer
of traditional cookies called champurradas. The cooperative
now produces decorative carrying cases for cookie cans, which
are sold in airports to travelers as an easy way to transport
cookies and also serve as keepsakes.
Today, following the Global Development Alliance (GDA) approach
of linking traditional craft suppliers into the supply chains
of national and international buyers, more than 400 Chorti
women produce 25,000 palm-frond sleeves each month for Zacapa
Centenario rum, 40 percent of the total demand.
The AGEXPRONT Supply Chain Alliance has placed various other
products in department stores in Guatemala City.
The greater Chorti community in Jocotán has benefited
from USAID’s assistance. Whereas a typical income for
Chorti women may be $6 per month, many now make as much as
$150 and send their children to school. Credit systems are
also developing in local markets, driven by the guaranteed
income from local crafts.
Countrywide, USAID’s Rural Market Diversification initiative
has assisted over 18 businesses, generated $48 million in
increased sales, and created 48,000 jobs. In addition to linking
local crafts producers with final buyers, technical assistance
focuses on certification of export requirements, strategic
planning, and market analysis.
“With targeted assistance from USAID and AGEXPRONT,
Chorti communities that were once marginalized are now a vital
part of the local economy,” said Kim Kim Yee, a program
officer in the GDA Secretariat. “And through the involvement
of private sector partners such as Licorera Nacional, USAID
is able to render assistance that will be sustained beyond
direct donor support.”
AGEXPRONT was founded in 1982 and includes more than 1,000
innovative export companies, generating more than $2 billion
in export sales and half a million new jobs.
ECONOMIC GROWTH, AGRICULTURE, AND TRADE
Committee Provides Youth Perspectives
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These Haitian youth are part of a mapping program where
young people collect data, conduct interviews, and coordinate
focus groups to investigate issues affecting their communities.
IDEJEN—USAID/Haiti |
Ten years ago, Emmanuel Lagedo Ochora slipped away from school
to visit relatives in Gulu, Uganda, and was abducted by rebel
forces. He had little or no hope of rescue—or surviving—what
became a 21-day ordeal. Today, at 23, he is working for social
change in his community and advising USAID and its partners
on their worldwide youth initiatives.
Ochora is one of eight young community leaders selected
from different world regions to serve on the Youth Advisory
Committee, set up under the USAID Office of Education’s
EQUIP3/Youth Trust, a consortium of 12 organizations aiming
to prepare out-of-school youth for the work world, civil society,
and family life. The advisory group helps engage young people
as development partners, rather than as individual beneficiaries.
Youth up to age 24 account for about 40 percent of the world’s
population. Nearly 85 percent of young people live in developing
countries, according to the 2003 World Youth Report. They
also are most likely to be illiterate, out of school, victims
of conflict, and at risk for HIV/AIDS.
Ochora and other members of the advisory committee—coming
from Bolivia, Guinea, Haiti, Pakistan, the West Bank/Gaza,
the Philippines, and Ukraine—are providing USAID with
insight on how to address the needs of youth.
“Youth are a vital element in U.S. efforts to encourage
economic growth, reduce poverty, and promote moderate democratic
practices around the world,” said John Grayzel, director
of the Office of Education. “Their participation is needed
at all stages of development, from program conceptualization
to implementation and replication.”
To engage youth in development, the Office of Education
funds dozens of programs providing education and job training
to dropouts in 100 countries.
Advisory committee members shared their experiences at an
education workshop recently. They also met with USAID staff
from the offices of education and democracy and governance
to develop Agency-sponsored education and civic programs.
Oleksandr Yakubovskyy, 20, a journalist in Ukraine, works
with the Interactive Gender Theater, which draws its audience
into shows created and performed by young people. The shows
promote problem-solving strategies and education about HIV/AIDS,
child slavery, alcohol abuse, drugs, and violence.
“Since the revolution,” Yakubovskyy said, “people
are beginning to believe they can make a difference and that
their voices are being heard.” But, he added, those changes
are not always reflected in the formal school curriculum.
Catherine Kamping, 24, chair of the Youth Employment Network
in the Philippines, said economic restraints prevent many
youths from volunteering for civic projects. “The reality
is they cannot afford to work for no pay,” she said.
In the years since his abduction, Ochora cofounded Gulu
Youth for Action, the first nongovernmental youth organization
in his city, and has organized blood drives and raised scholarships
to keep young people in school.
“When you want to work with young people, send another
young person,” he said.
DEMOCRACY, CONFLICT, AND HUMANITARIAN ASSISTANCE
Training Saves Lives in Asia
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Women participate in training for medical first responders
in Indonesia.
Rebecca Scheurer, USAID/Nepal |
SAVAR, Bangladesh—When a building collapsed here
last April, trapping 100 people, fire service and civil defense
workers reacted quickly to save 84 lives.
The officials had just trained through an Office of U.S.
Foreign Disaster Assistance (OFDA) program, which taught them
new skills and introduced them to new equipment, such as jackhammers
and sledgehammers.
The Bangladeshi government allocated its own resources for
search-and-rescue equipment after seeing the results from
the initial trainings of first responders through OFDA’s
Program for Enhancement of Emergency Response (PEER).
PEER is an Asia regional disaster preparedness program that
USAID has funded since 1998. The program runs in Bangladesh,
India, Indonesia, Nepal, and the Philippines.
PEER aims to provide participating countries with the capacity
to train local organizations’ members as experts in the
areas of medical first response, collapsed structure search
and rescue, and hospital preparedness. Graduates of the program
are expected to share their skills with respective local and
national institutions.
In each country, the approach varies, and includes such
institutions as fire departments, hospitals, ambulance services,
and police forces.
PEER’s impact was evident during tsunami relief efforts
in Indonesia, when more than 20 PEER-trained hospital preparedness
professionals and emergency medical doctors reached the disaster
site within 24 hours.
In India, more than 100 PEER-trained first responders led
relief efforts in the Andaman Islands, while others were deployed
to conduct operations along India’s southern coast. More
than 2,000 people have been trained beyond the first tier
of PEER graduates as a part of a national plan to train 8,000
people.
In Nepal, the Institute of Medicine has incorporated hospital-preparedness
training into its curriculum, and the National Police Academy
continues to pursue PEER training for all its cadets.
In the Philippines, PEER-trained rescuers have been deployed
following building collapses, avalanches, mudslides, and train
accidents.
“PEER training continues to be a valuable investment,
one that’s really paying off here in South and Southeast
Asia, where communities are so susceptible to earthquakes,
floods, and other natural disasters,” said Rebecca Scheurer,
regional advisor for OFDA based in Kathmandu. “It has
allowed us to build cadres of skilled disaster management
professionals while working towards longer-term, sustainable
disaster preparedness and response systems at the national
and local levels of government throughout the region.”
The lynchpin in the PEER program is hospital preparedness.
Johns Hopkins University worked with Asian regional medical
providers to create a curriculum on how to operate in disaster
situations for doctors, nurses, and senior administrative
personnel.
“The Indian Ocean tsunami and its devastating effects
on Indonesia and Sri Lanka were a rude awakening that disasters
of all degrees of severity can occur at any time,” Scheurer
said. “OFDA will judiciously program its remaining resources
for PEER training to maximize impact on countries that have
shown their commitment to prepare for disasters.”
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