UNICEF

Niger’s achievement in child survival.

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Time running out for solution to Yemen’s water crisis.

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Sana’a risks becoming first capital in world to run out of viable water supply as Yemen‘s streams and natural aquifers run dry

Under a staircase, clinging to a wall of Sana’a’s Grand Mosque, groups of women and children lug plastic canisters to the leaky spigots of a public fountain. Some small children struggle with canisters nearly their size as they weave slowly between the fountain and the pushcarts used to wheel the water back home.

Whether in cities or villages, this is how millions of Yemenis secure their day’s supply of water. As few can afford to pay for water to be pumped to their building, public urban fountains, which are free, remain the only option for most. Umm Husein, a resident of the capital Sana’a, said she has tap water only once or twice a week. Trips to the communal fountain – taking time out of work or studies – involve her whole family. “The women, the children, every day we go to the fountain to get water,” she said.

Water and sanitation are chronic problems in Yemen, where, on average, each Yemeni has access to only 140 cubic metres of water per year for all uses – the Middle East average is about 1,000m³ a person annually. In recent years, the government of former president Ali Abdullah Saleh had taken strides to improve water access in Yemen, but the political turbulence that arose from last year’s uprising has pushed water down the new government’s list of priorities, according to aid workers and a government employee.

Changing priorities

Two years ago, Yemen’s general rural water authority (GRWA) commissioned an assessment of existing water projects and coverage. The organisations that took part came to a collective decision to focus on rainwater harvesting in Yemen’s highlands, and on water drilling in the coastal and desert areas. Yet the ensuing political chaos halted progress in implementing solutions, according to Abdulwali el-Shami, an engineer in the government’s public works project (PWP) in Sana’a.

Beset with crises, the new president, Abd Rabbu Mansoor Hadi, has put little energy towards resolving the water crisis threatening the majority of Yemenis. Ghassan Madieh, a water specialist for UN children’s fund Unicef, said he did not “see any serious attention being given to the issue of water scarcity, or the low coverage in water and sanitation”.

Jerry Farrell, country director of Save the Children in Yemen, echoed this assessment: “[In June], the ministry of planning rolled out its plan for the next 20 months … and water was at the bottom of the list.”

Though solutions exist, the will and attention necessary to put them into practice remain absent, observers say. Farrell said that without a greater governmental commitment to water issues, international aid organisations dealing with water will not be able to work effectively in the country. The government must also provide water subsidies for the extremely poor while water infrastructure is developed, he added.

A country run dry

The spectre of a country run dry looms over Yemen’s nearly 25 million inhabitants. With its streams and natural aquifers shallower every day, Sana’a risks becoming the first capital in the world to run out of a viable water supply. The water table in the city has dropped far beyond sustainable levels, Shami said, because of an exploding population, lack of water resource management and, most of all, unregulated drilling. Where Sana’a’s water table was 30 metres below the surface in the 1970s, he said, it has now dropped to 1,200 metres in some areas.

The water supply in this largely arid country has been the source of decades-long ethnic conflicts, particularly among nomadic groups. In the northern governorate of al-Jawf, a blood feud between two prominent local groups has continued unabated for nearly three decades, largely a result of the contested placement of a well on their territorial border.

Abdulwali el-Jilani, a water specialist in Sana’a with the Community Livelihood Project, a programme to improve water access funded by the US aid agency USAid, warned that as water supply diminishes, tensions will rise: “Water is and will be the reason for powerful conflicts in the future.”

Lack of access to improved water supply has been responsible for the spread of water-borne diseases on a scale not witnessed in decades, according to Unicef’s Madieh. Dengue fever, diarrhoea and cholera have spread at alarming rates in rural areas where access to clean water is limited. Last year, more than 30,000 Yemenis were suffering from acute watery diarrhoea.

The vast majority of the water in Yemen – as much as 90% – goes to small-scale farming, at a time when agriculture contributes only 6% of GDP, according to Madieh. Though few precise statistics are available on the subject, Madieh said 50% of all agricultural water goes to the cultivation of qat, a narcotic plant chewed by most Yemenis. Almost 45% of all water in Yemen is used to cultivate a plant that feeds no one, in a country where almost half of the population is food insecure.

While the water situation in many cities is dire, it is even more distressing in rural areas. According to the latest rural water survey by GRWA, completed this year, access to improved water supply – piped water, protected springs and wells – is limited to 34% of rural areas, compared with 70% of urban areas.

Village women spend most of each day trekking many kilometres along unpaved roads to reach the few wells that have not yet run dry. Many of them also collect water from streams polluted by waste, which they attempt to eliminate with rudimentary filtering systems.

Future steps

But Yemen is by no means devoid of strategies to improve water access. Shami said the PWP is building rainwater-harvesting tanks in rural areas so that villagers don’t have to travel hours to collect water. These tanks are fitted with filtering systems, providing clean water in areas where it is hard to come by.

“We are trying as much as possible to go the natural way,” Shami said, referring to efforts not to drill or truck in water, common methods of obtaining water in areas particularly tight on the resource. “We don’t want villagers to spend so much effort just to collect water.”

Jilani, the water specialist, said Yemeni activists are trying to create local awareness of the country’s water emergency. Organising regional workshops on water conservation techniques is one method activists hope will build local engagement on the issue. “There’s a role to be played by citizens too,” he said, “in adopting a path to rebuild and improve water administration in their areas.”

Yet experts agree that if Yemen’s leadership doesn’t take meaningful action soon, the consequences will be devastating. “In 10 years’ time, we will have only surgical solutions left,” Madieh said. “It will be very painful to the Yemeni people. They will have to make choices about survival, because water is life and water is survival.”

Source: Guardian.UK

Fragile newborns survive against the odds.

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TAMALE, Ghana, 7 August 2012 – Awintirim Atubisa spent the first two months of his life tied to his mother’s chest in a cloth ‘pouch’, just like a baby kangaroo.  When he was born, six weeks premature, he weighed 1.3kg and was at risk of hospital-acquired infection, severe illness and respiratory tract disease.

But he survived, thanks to the UNICEF-supported Kangaroo Mother Care program.  The program encourages mothers to wrap their premature and underweight newborns to their chests using a ‘pouch.’  Snuggled against their mother’s skin, the babies’ body temperatures stabilise, their heart rates steady and they begin to breathe more easily.

Kangaroo Mother Care has been particularly successful in the Upper East and Central regions of Ghana, where babies who might have once died for want of an expensive incubator are now surviving.

Skin-to-skin care

Awintirim’s mother, Lydia Atubisa, says skin-to-skin contact, which is the cornerstone of Kangaroo Mother Care, calmed her baby son.

“When he was alone, he would start to shake and cry. But he becomes still as soon as I tie him to me and hold him. The heat of my body makes him feel like he is still in the womb,” she said.

Margaret Kugre, the nurse in charge of the program at the Upper East Regional Hospital, said that constant skin contact between mother and baby saves the lives of fragile babies in a region where incubators are scarce and unreliable. Before Kangaroo Mother Care was introduced in 2008, up to four tiny babies would have to share the maternity ward’s only incubator, which was often broken for months at a time.

Exclusive breast feeding is another key aspect of the program.  Babies are fed nothing but breast milk for the first six months of life, avoiding illnesses from contaminated water or breast milk substitutes.

The program encourages mother and baby to go home as soon as possible, to reduce the risk of hospital-acquired infection.  Lydia and her son were in the hospital for one month after the birth, but as soon as he was stable and gaining weight and she could confidently tie her cloth pouch and breastfeed, they moved back home to Sandema.  Awintirim and Lydia only return to the hospital for monthly weigh-ins.  At his latest check-up, six weeks after delivery, he weighed nearly 2kg.

In the first six months of 2011, 99 underweight babies were born in the Bolgatanga Municipal area in Ghana’s Upper East Region.  All were introduced to the Kangaroo Mother Care program and all survived.

Lydia is confident her son will become strong and she has big dreams for his future: “I want him to be a doctor so he can save lives, like the doctor who saved him.”

Culture adapts to new approach

The kangaroo program has been quickly adapted into Ghanaian culture. Ms. Kugre said mothers were happy to carry their newborns on their chests but nurses also involve a woman’s husband and mother-in-law.  “Carrying the baby on the back is preferred in Africa,” she said. “We work with the whole family so it is not so strange to them. In the ward, we wrap the babies onto the mother-in-law so she can feel what it’s like.”

Derek Bonsu, the Medical Superintendent at Saltpond Hospital in Central Region, said Kangaroo Mother Care empowers mothers. “They get to play an active role in the saving of their child. And no one monitors a vulnerable baby better than a desperate mother.”

Central Region also enjoys success

The program has saved hundreds of lives since it was introduced to the Central Region in 2008. Mr. Bonsu said premature and underweight babies were common and often died before Kangaroo Mother Care was introduced.

“We are in the middle of an area with social and economic problems. There is a lot of illiteracy and poverty, an early age of sexual initiation, a tradition of harmful practices, malnutrition… Mothers have had anaemia, malaria and other parasites and infections, all having an effect on the pregnancy, delivery, and health of the unborn baby. Many of the babies are born preterm or with too low a birth weight.  This should not be deadly, but we did not have a functioning incubator in the hospital and were losing the babies.”

The success of the program is clear. Before June 2008, 9 out of the 16 underweight babies born at the hospital died.  After the program started in June, all 12 babies born underweight lived.

Source: UNICEF

 

 

Adolescents map HIV risks, part of a holistic approach to treating HIV/AIDS in Haiti.

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From 22 to 27 July, experts are gathering in Washington, D.C., for the International AIDS Society’s biennial conference on rolling back the HIV and AIDS epidemic. UNICEF has hosted a leadership forum stressing the need for innovation in eliminating new HIV infections in children. This story is part of a series illustrating UNICEF’s efforts on behalf of children and women affected by HIV.

By Jean Panel Fanfan

PORT-AU-PRINCE, Haiti, 25 July 2012 – Before an earthquake devastated Haiti in 2010, the country’s HIV and AIDS response focused largely on treatment, care and support – with much less attention given to preventing the spread of the virus.

Today, however, even as Haiti still struggles to recover from the quake, there is agreement that HIV and AIDS must be addressed through a holistic approach that includes prevention. Services for people affected by the epidemic are growing both more reliable and more widely available, but programmes responding to the special vulnerability of young people to infection – particularly adolescents – must be scaled up.

Haiti’s HIV prevalence rate is 1.9 per cent among adults aged 15 to 49. The population is young, with 33 per cent of Haitians between 10 and 24 years old, and vulnerabilities to HIV for young people abound, particularly in the slums and camps of Port-au-Prince.

Putting risk on the map

In partnership with two local organizations, GHESKIO and the National Office against Violence (ONAVC), UNICEF is taking on the challenge of identifying places where adolescents and young people are at increased risk of contracting HIV. Together, they are engaged in a mapping initiative in two communities in Port-au-Prince that is intended to reveal the obstacles that keep vulnerable adolescents – particularly girls – from gaining access to HIV prevention services.

The project’s results will be used to increase adolescents’ and young people’s use of HIV, sexual and reproductive health-related services. By engaging these groups with mapping technology, the initiative empowers youth to effectively advocate for addressing issues in their communities.

 

In July, 24 adolescents from the low-income communities of Cité Plus and Village de Dieu took part in a four-day training. They learned about HIV risks, modes of transmission and prevention methods, and received instruction in the UNICEF-GIS innovative digital mapping platform developed by UNICEF, the Massachusetts Institute of Technology (MIT) and the Innovative Support to Emergencies, Diseases and Disasters (INSTEDD). During the workshop, the adolescents collected preliminary data using mobile phones to map geographic locations for each identified risk related to HIV and AIDS.

Twelve facilitators were also trained to assist the mapping team. The data collection process is expected to take three months, culminating in the production of a digital map for distribution to local authorities. Officials will use that information to improve access to, and uptake and quality of, HIV and sexual and reproductive health services for adolescents.

‘We still have a lot to do’

Haiti’s Secretary of State for Youth and Civic Action, Francener Thélusma, was present during the launch of the initiative and expressed his support. “Our role is to support our partners in this initiative to strengthen it,” he said. “The statistics on HIV/AIDS show that we still have a lot to do. It is our responsibility to develop strategies to facilitate positive efforts like the present undertaken by UNICEF.”  He also asked the adolescent mappers to take measures to protect themselves against HIV.

Rhazi Koné, a member of UNICEF’s social and civic media team, directed the training sessions. “UNICEF has, in recent years, introduced an equity-focused use of digital tools to communicate, engage and build the capacity of vulnerable youth in several countries. This is indeed a new and exciting approach to youth communication, advocacy and community development,” he said. “It promotes dialogue between communities as well as governments and organizations to create a more child-friendly environment.”

One 16-year old participant, Dominique Billy Costacurta, could not hide his excitement about the prospect of learning and sharing knowledge about HIV prevention. “I will take advantage of this opportunity to inform other young people in my neighborhood about the risk of getting HIV and AIDS,” he said.

Source: UNICEF.

Make breastfeeding easier for mothers, says UNICEF.

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On the 20th anniversary of World Breastfeeding Week, UNICEF says strong national policies supporting breastfeeding could prevent the deaths of around 1 million children under five in the developing world each year.

Despite compelling evidence that exclusive breastfeeding prevents diseases like diarrhoea and pneumonia that kill millions of children every year, global rates of breastfeeding have remained relatively stagnant in the developing world, growing from 32 per cent in 1995 to 39 per cent in 2010.

“If breastfeeding were promoted more effectively and women were protected from aggressive marketing of breast milk substitutes, we would see more children survive and thrive, with lower rates of disease and lower rates of malnutrition and stunting,” said UNICEF Executive Director Anthony Lake.

Some of the roadblocks to improving breastfeeding rates are widespread and unethical marketing by makers of breast milk substitutes, poor national policies that do not support maternity leave, and a lack of understanding of the risks of not breastfeeding.

In June, world leaders meeting in Washington, D.C., pledged as part of the “Committing to Child Survival: A Promise Renewed” movement to work toward ending preventable child deaths. World Breastfeeding Week provides an opportunity to restate the critical role of breastfeeding in reducing child mortality.

The 2008 Lancet Nutrition Series highlighted the remarkable fact that a non-breastfed child is 14 times more likely to die in the first six months than an exclusively breastfed child. Breast milk meets a baby’s complete nutritional requirements and is one of the best values among investments in child survival as the primary cost is the mother’s nutrition.

“Breastfeeding needs to be valued as a benefit which is not only good for babies, mothers, and families, but also as a saving for governments in the long run,” said Mr. Lake.

Source: UNICEF.