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RecognizingChild Traf cking

Warning Signs in the Field

Changes in USAIDsEmergency

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The Legacy of

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Supporting Staff in

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Monday Developments Magazine provides in-depth news and commentary on global trends that affect relief,

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DepArtmeNtS

4 efe t ons romthe res dent

5 in obytes

29 vents

31 jo pportun t es

FeAtureS

8 hree r n ples oe t ve ta care

Creating durable and far-reachingstaff care.By Siddharth Ashvin Shah

11 row ng a nsStaff considerations forexpanding community-basedorganizations.By Stephanie Tholand

13 upport ng ta nH gh- sk os t onsPractical steps for providing yourstaff with the care they need.By Leah Tioxon

15 ak ng care otudent interns

A blueprint for incorporating staff care into overseas internships.By Judith Fox and Janet Shriberg

16 car ng or ta Whoare lso urv vorsNGOs in Haiti form ongoingworking group to share experienceand pool resources.By Amber Elizabeth Gray

17 me to rans ormlo al Health

Incorporating noncommunicablediseases into global public healthefforts.By Nathan Grey and Rennie Sloan

8

De e e 2010 Vol. 28 No. 12THIS ISSUE

M D D L M M zi

3DEcEmbEr 2010M

ONDAY DEVELOPMENTS

18 he ower orevent on

Incorporating child protection whileworking in trafficking hot spots.By Cathy Herholdt

21 he lo al e ess on:ea h ng very corner

Community-based organizations indeveloping nations take the hit, butalso show their resilience.By Victoria Dunning and SarahModica

23 ak ng to k olo al Hunger

Newly released Global HungerIndex shows uneven progress.By Sarah Immenschuh

25 ew Flex l ty nU iD mergen y Food

ss stan eEmergency Food Security Programexpands funding for local foodpurchase, cash and voucherprograms.By Jonathan Dworken

27 Lets eally nd theWar n etnamTackling the legacy of Agent Orange.By Charles Bailey and David Devlin-Foltz

21

18

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4/32 MONDAY DEVELOPMENTS DEcEmbEr 20104

Managing Editor/Art DirectoChad Brobst

Advertising/SubscriptionsKatherine Delaney

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refle tions f o the P esident

Like most years, the lastyear has been filled withobstacles for the internationaldevelopment community, butas the New Year approachesthere are reasons to be hopeful. We now have theopportunity to make our own communal resolutionsand evaluate the work we have done over the pastyear. Four major changes will still be with us in 2011:

The Economic Crisis. Since February 2007, theglobal economic crisis has exacerbated the daily hardships of the poor abroad, increased the needsof many Americans, and lowered the resourcesavailable to philanthropic foundations, non-profitorganizations and developing governments. Whilethe economy has improved since the height of therecession, the impacts of the crisis are still visiblein the U.S. NGO community as non-profits slowly regain the capacity they lost to deliver programs.

Haiti. Eighty percent of Haitis people already lived in abject poverty when the January earth-quake hit. Eighty-two InterAction members haveeither responded directly or supported the relief activities of others. Working with the UN and donorcountries, U.S.-based NGOs have contributed toproviding access to safe water, emergency shelter,short-term labor and the necessary seeds and toolsfor the planting season. There was a greater degreeof coordination among NGOs, the UN, U.S. agenciesand the U.S. military in response to the Haiti earth-quake than there was following the 2004 South Asiatsunami. Of course, the response has not been per-fect. The complexity of the disaster, the magnitudeof problem and the diversity of actors on groundcreate a massive ongoing challenge. This large urbancrisis has reconfirmed the need to coordinate andfind sustainable solutions with local government

leadership and civil society.The Presidential Policy Directive (PPD). During the September UN MDG Review Summit,President Obama announced a Global Develop-ment Policy to shape the way the U.S. governmentwill advance development. The announcement of the PPD during the summit reinforces PresidentObamas earlier promise to have the MDGs becomeAmericas Goals. After years of advocacy by U.S.civil society, the PPD also provides for a more robustUSAID with more professional staff, including apolicy unit. The U.S. NGO community has largely

heralded these changes forwhat they area majorstep forwarddespite thefact that many questionsremain unanswered.

Pakistan. As the yeardraws to a close, Paki-stan is still facing massivefloods that have been ongo-ing since the beginning of

August. Current estimates are that over 20 millionpeople have been directly affected and one-fifthof the country was at one point underwater. Morethan 46 InterAction members have been active inPakistan. As the largest humanitarian disaster inUN history, the flooding will impact the ability toharvest and plant crops and the fears of increasingrates of water borne illnesses remain. These floodscome at a time when fighting in the Swat Valley hasdisplaced over 1 million people, which complicatesthe humanitarian assistance needs of the country and could led to the targeting of U.S. NGOs basedon allegations that they are agents of the U.S. gov-ernment.

Looking at these four major events in 2010, weshould not only focus on the challenges, but alsocelebrate the successes. While obstacles have inhib-ited the NGO communitys ability to respond andchanged the context in which we operate, they alsoshow through hard work, collaboration and ongo-ing professionalism just what U.S. NGOs can accom-plish. Ending the year with a new direction by theObama administration through the PresidentialPolicy Directive for a Global Development Strategy and the newest Quadrennial Diplomacy and Devel-opment Review (QDDR) has revitalized the way the United States government does developmentand our own opportunities to advise and collaborateto advance effective development. We should spendthe holidays rejoicing about our collective successes

and impactlarge or smallover the last year.Afterwards we should examine what we can do bet-ter and how we can work with the Obama admin-istrations new policies to make achieving the MDGsand foreign assistance reform, mitigating climatechange and our other pressing goals a reality MD

Sam WorthingtonP esident and cEO

Inte A tion

2010: The Year in Review


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Infobytes

Full participation of women andgirls with disabilities is vital to effec-tive development policy and prac-tice. With these words, SAIDAdministratora v hah sent hismessage of support to kick off theGender, Disability and Develop-ment Institute (GDDI) as part of the

fth International Womens Insti-tute on Leadership and Disability(WILD).Mo l ty internat onalU ( I SA) hosted a vibrant,

ve-day institute convening 53disabled women activists from 42

countries and 20 professionalsfrom international development anddonor agencies to strategize waysto improve the lives of disabledwomen and girls worldwide. artici-pants had the opportunity to dis-cuss challenges and opportunitiesfor inclusive development; interna-

tional legislative frameworks; dopolicies; and ways to access thewealth of knowledge in disabledpeoples organizations.

he event received recognitionfrom high-level disability rightsand womens rights advocatesincluding .S. Secretary of StateH llary cl nton , who noted inher letter to the disabled womenactivists, You are playing a critirole in combating discriminationpromoting inclusion, and defending human rights the world over.

Senator om Hark n (D-IA), along-time disability rights advocand Ambassador-At-Large forGlobal Womens Issues,Melanne

erveer , also sent video mes-sages emphasizing the critical rothat disabled women have in intenational development.

IT Internships for Haitian Studentshe o l Foundat on recently announced a $50,000 contribution to

support NetHope Academys IC Internship program in Haiti to create fulltime job opportunities for unemployed Haitian computer science studentsand provide the NGO community with much needed I specialists to as-sist in their post earthquake rebuilding efforts. he six-month paid intern-ship program aims to place over 60 students in full-time employment atits conclusion. In addition to the Voil Foundation (a subsidiary of rilogyInternational artners), NetHope has received funding and support fromM roso t, c s oand enture .

he program is already underway, initially employing 36 interns whospent the rst two weeks participating in intensive boot camp-style class-room trainings at SIH before being deployed to receive on the job trainingwith the I departments of 14 international NGOs, including InterActionmemberscathol el e erv es, cHF internat onal, World s on,internat onal es ue comm ttee, Ha tat or Human ty, Mer y

corps, el e internat onal, con ern and ave the ch ldren .he humanitarian sector is facing a critical shortage of I professionalsin Haiti. NGO staf ng has risen from 3,500 to 10,000 in-country employ-ees, however the number of I support staff has not been able to increasequickly enough to respond to their needs. he already shallow resourcepool of skilled I staff was further depleted following the earthquake andseverely limits relief and development efforts.

ore information can be found at www.nethope.org/academy.

Expanding Development to Include EveryoneBy Susan Dunn, Project Specialist, Mobility International USA



Infobytes

Grow justice.

Plant knowledge.

MA in

Sustainable

International

Development

MS

in

International

Health

Policy

and

Management

MA

in

Coexistence

and

Conflict

GRADUATE PROGRAMS

IN

SUSTAINABLE INTERNATIONAL

DEVELOPMENT

http://heller.brandeis.edu

Boston

Brandeis University

PhD

in

Global

Health

and

Development

For many of the developmentprofessionals who attended, it wasan opportunity to identify concrete

ways of removing barriers and ex-panding their programs to includewomen with disabilities.

Although I have been awareof the importance of disabilityinclusion, I dont think I ever reallyengaged with these issues intel-lectually or emotionally, shared

nna M mran , rogram Associatefor Africa, rickle p. ngagingwith these issues in such a uniquesetting had an impact that will staywith me through my personal lifeand shape the way I do my work from now on.

judy Heumann , Special Ad-visor for International Disability

ights, .S. Department of Stateand ue tel of the SAID Dis-ability eam, also presented toover 100 attendees emphasizingthe importance of understanding

the SAID Disability olicy, fromanti-discrimination and accessibilityperspectives as well as developing

relationships with international de-velopment actors. hey also reiter-ated how vital it is for developmentactors to consult with people withdisabilities in all parts of the projectcycle on the ground.

Other strategies included in-creasing outreach to women withdisabilities in the eld; developinginclusive organizational and humanresources policies; hiring peoplewith disabilities as staff membersand interns in order to access keyexpertise; using internal and exter-nal communications to highlight theimportance of inclusive develop-ment; and forming partnershipswith organization led by womenwith disabilities.

he intensive ve-day institutelaid the groundwork for new rela-tionships, strengthening of existing

networks, and a renewed com-mitment to broad-based inclusivedevelopment for all. InterActionmembers who attended GDDIincluded mer an jew shWorld erv e, cbM, Hand apinternat onal, Mer y corps,

r kle Up, World s on inter-

nat onal and inter t on staff.I SA looks forward to continu

ing to engage with the InterActiocommunity on this important crocutting issue.

For more information on I SAefforts to promote inclusive develment, visitwww.miusa.org/idd.

Dorothy Mapulanga (left), a 1997 WILD alumna from Zimbabwe, mentorsFlorence Mukasa, a 2010 WILD delegate from Uganda.
http://www.miusa.org/iddhttp://www.miusa.org/idd


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How an o ganizationsette dis e n the spe-ifi diffi ulties fa ed ythei staff? How ight we fine tune staff a e p og a s sothat p evention and inte vention oth hit the ulls-eye fodive se needs and indsets? How ight staff a e p og a sfo a su se tion of staff indu e enefits in ultiple levels ofou o ganizations and the o unities with who we wo k?

An o ganization that an onfidently answe these ques-tions will expe ien e self-assu an e in pla e of dou t whenit o es to staff a e. And dou t exists in the inds of

any when staff a e is entioned. Leade ship and oa dsof di e to s a e unsu e a out how to allo ate esou es.So e staff have high expe tations, ut dou t thei expe -tations will e et. So e staff g u le a out eing takenaway f o p og a i ple entation. The o unities withwho we wo k a e entitled to wonde if staff a e enhan esp og a delive y o e ely puts fo us on the sa ifi es thathu anita ian wo ke s ake.

Applying what has een lea ned f o the fields of ehav-io al edi ine, pu li ental health and glo al health ang eatly influen e ou staff a e out o es. Staff a e p og a sshould have the following o ponents:

Right-sized prevention to p ovide edu ation/ esil-ien y fa to s efo e diffi ulties a ise and to p event thewo sening of existing diffi ulties;

Accurate assessments to dete ine the natu e andextent of diffi ulties; and

Smart interventions to itigate and heal diffi ultiesthat do o u .

These o ponents ay e ele enta y, ut the hallenge ishow to i ple ent the in ways that esolve the dou ts andquestions entioned a ove. Th ee p in iples an fa ilitate

i ple entation, y inspi ing onfiden e and p o oting effe -tive, fa - ea hing staff a e: (1) diffe entiation in assess ent;(2) dive sity of inte ventions; and (3) diffusion of lea ning.

Differentiation in assessmentFigu e 1 illust ates the fi st p in iple: diffe entiation. Like

diffe ential diagnosis in edi ine, the fi st step is gene atinga list of possi le diffi ulties f o whi h staff ay suffe giventhe assess ent. The next step is a syste ati o pa ison

of findings that suppo t the p esen e and extent of diffe entdiffi ulties. Diffe entiation is a logi al tou th ough possi ili-ties; and ideally, othe assesso s a e a le to ag ee with thelogi e ause othe o peting diffi ulties a e eithe uledin o uled out y eviden e.

Staff a e assess ent is not edi al diagnosis. No ispathologizing ostly well people going to ake staff a ep ovide s ve y popula . Howeve , the failu e to take i po -tant possi ilities into a ount eans that a diffi ulty ay eove looked and the oppo tunity to e uled in issed.If diffi ulties a e dete ined in o e tly o pa tially, thesele tion of staff a e inte ventions is likely to e flawedo in o plete.

Diffe entiation, the efo e, egins y unde stand-ing and app e iating all the diffe ent possi ilitiesthat an ause staff and ope ations to suffe .This does not ean eve y possi ility ust e

he ked in eve y assess ent. One na owsdown possi ilities given the data: staff p o-files (e.g., past expe ien e), diffe ent expo-su es sustained (e.g., seve e t au ain the o unity they a e wo kingwith) and wo k ontext (e.g., an-age ent/leade ship/ ento ship,in- ount y onditions). The diffi-

ulties (X, Y) ay then ange

Principles of 3 Effective StaStaff care

By Siddharth Ashvin Shah ,medi al Di e to , G eenleaf

Integ ative St ategies


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Staff care

f Care

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Benefits canbe realized by both staff andleadership.



from individuals feeling burned out, to individuals sustaining trau-matic stress injury (from a critical event or vicariously), to leadershipdysfunction, poor team dynamics, communication breakdowns andmany other possibilities.

The importance of competent differentiation is illustrated in thecontradictory next steps when determining whether someone hasburnout or traumatic stress injury. For burnout, giving time for R&R(i.e., rest, relaxation, recreation, recuperation) tends to be an effectiveintervention. Individuals do well with self-directed activities when they take a break from circumstances that engender burnout. However,giving R&R to someone with traumatic stress injuries can lead torecurrence or worsening of symptoms because individuals with traumafrequently suffer an inability to relax and may indeed be triggered by many of the otherwise enjoyable R&R activities. The nervous systemof a traumatized person requires more targeted interventions.

Quite often, staff members suffer from more than one difficulty.There are so-called co-morbid (meaning suffered together) difficul-ties, a most common combination being that poor team dynamics andburnout that occur simultaneously and can perpetuate each other.Being alert for such co-morbid difficulties will excel in applying thesecond principle: diversity of interventions.

D vers ty o ntervent onsGiven any difficulty or set of difficulties, an appropriate set of preven-

tion activities and interventions needs to be selected for staff care toactually be experienced as care. Diversity refers to taking into accountthe various realities in which staff care interventions will be employed.Three prongs of diversity must be considered in the intervention selec-tion process: culture, cognitive style and capacity (see Figure 2).

The cultural background of staff membersbe that nation of origin,religious traditions, or other measures of cultureconfigures thesuitability of any particular intervention. Individuals with a connec-tion to specific cultural traditions may benefit greatly from familiar

traditions (e.g., rituals) that are re-tooled to soothe specific stressesor heal specific experiences of trauma.The organizations culture should also be considered when selecting

and presenting interventions. Stigma can be significantly attenuated if interventions are explained (along with the assessments findings andconclusions) in a way that reflects a deep understanding of organizationalculture. When staff care difficulties and interventions create a sharedvocabulary that works with an organizations culture, stigma begins tocome out of the closet and get aired out. A shared vocabulary helps indi-viduals collectively acknowledge that staff stress and staff difficulties arethe groups responsibility and that anyone can be vulnerable at times.

The second intervention prong within diversity is cognitive style.

Taking culture into account means that inter-group variety has beenconsidered. However, there is also significant diversity within every cul-tural group. Because learning styles and sensibilities are varied, the way interventions are presented should satisfy the cognitive styles of diversestaff. For example, some learn best with an evidence-based, scientificapproach; others respond to a warm, personable approach. While blendedapproaches may successfully satisfy a diverse group, the attempt to satisfy all cognitive styles with one experience may also alienate individuals at theextremes. However it is achieved, matching cognitive style is importantsince a good fit can add to the durability of any intervention over time.Individuals will stick to interventions they agree with.

Interventions that match cognitive styles also engage people moredeeply with the cause of staff care. One-size-fits-all interventions runthe risk of missing significant individual needs while providing a goodfit to only a fraction of individuals. The following one-size-fits-allinterventions can miss individual needs:

Lets all debrief what you are going through. For anybody who wishes to use our employee assistance program,

here is the number. We think it is only smart to maintain yourwellness while doing this work.

Yoga is proven to help you relax. Well have weekly classes at 9am. Here are breathing techniques to calm your mind when you

feel stress.

In an ideal world there would be a custom designed interventionfor each individual. Staff would make informed decisions amongempirically tested interventions. Some individuals gravitate towardsmind-body therapies; others use techniques from their religious tra-ditions. Others see a psychotherapist. Some seek self-care techniquesin order to be totally self-reliant in their healing process, while othersprefer to heal in relationships and groups.

But the ideal isnt practical. Nor is the other extreme, in which every-one must use the same one-size-fits all intervention. The middle way

is a menu of options that fit diverse cognitive styles. Information andtraining is provided on this menu of options so staff members canmake an educated choice. A well-chosen menu of options providesvariety and allows individuals to gravitate towards interventions thatwill be durable in challenging circumstances.

A note on matching both culture and cognitive style: When interven-tions agree with a persons culture and sensibilities, shame decreases.The shame-reduction stems from individuals feeling aligned with howdifficulties are being conceptualized and handled. Non-alignmentleaves people feeling blamed or misunderstood.

The third prong of intervention diversity is capacitythe resources

Staff care

continued on page 30

Staff Assessment

Di f f er ent i at i on

Burnout(Difficulty Y)

Figure 1

Capacity

Culture

Cognitive Style

Di ver si t y

PreventionA

PreventionB

InterventionT

InterventionS

InterventionR

Figure 2


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cBO rO th

ICAN WO ND H S L S! I can no longer follow these policies. No onewants to see a member of their organization

stand up and proclaim those words at a staff meeting. Yet workers on the ground often feelthis way when they attempt to adhere to paper-work and new procedures that go against thegrain of their working style, even if they are thelogical next steps for the organizations growth.

Increasingly, the international donor andaid communities are turning to community-based organizations (CBOs) in developingnations to play a central role in developmentefforts: looking to these groups to help defineneeds and carry out programming with lessor no involvement from traditional interna-tional NGOs. And in taking on the latter role,there is often pressure for these local CBOsto transform into entities that operate morelike their international NGO counterparts.

So how does one introduce systems froma bureaucratic culture of structure into theCBO culture of struggle without negatively upsetting the community-level mode of opera-tions? Attempting to merge these two culturespresents a distinct set of challenges to thoseworking in both camps. It is essential that staff members are genuinely ready to step out of thehustler mentality, and that they understandwhy those changes are necessary. Leadersplanning for this organizational shift often feelunsure about how to include staff care com-ponents, which leaves psychological impactsunaddressed. The Antares Foundation, whichspecializes in staff management and supportfor humanitarian and development organi-zations, warns that excessive bureaucraticdemands or unclear work roles may be potentsources of distress. The same is true in theCBO context. Without a carefully directedapproach and implementation, even agreed-upon changes can end up feeling like a cage.

The people who work at the grassroots levelare a distinct group in the development sector,

a community with their own culture and life-style. And they are very attached to the back-and heart-breaking work to which they com-mit themselves every day. A lot of pride comeswith knowing how things work in the neigh-borhood or in the village. With that pridecomes an inevitable distrust of people who keepthemselves removed from that level of personalengagement and wariness of the rules they bringwith them. This culminates in a face-off betweenuncertain realities on the ground and the clear-cut systems and policies of bureaucracy.

This clash can be brought to the fore when

CBOs grow larger. They decide to take on moreNGO-like systems and apply stronger account-ability standards, but dont necessarily considerhow the changes will impact staff mentalitiesand commitments. This push is to be expectedthough because CBOs see themselves as grass-roots efforts, too small and too busy for bureau-cracy. In order for the underprivileged to gain astronger foothold in life, small businesses needto grow, children need education and CBOsneed to expand their impacts. Sustainableempowerment initiatives are finally becom-

ing the expectationafter years of dumping

aid dollars and UN workers into the globalSouth to fix it. Microfinance, the developmentdarling, is not just a solution for Bangladesh;it is a service for people struggling anywhere,as Muhammad Yunus of Grameen Bank hasproven by opening branches in Queens, NewYork and Omaha, Nebraska.

Empowerment is so hot right now. Every-one wants to do it and to be seen doing it. Butan organization pushing too hard and too fastto take on new knowledge tools and to growlarger will result in workers feeling restricted,

O O C B

O

N N GG OO

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row ng a nsStaff considerations for expandingcommunity-based organizations.By Stephanie Tholand , P o co ps Voluntee ,Foundation fo Sustaina le Develop ent



cBO rO th

not empowered. An extra step must be inserted for small organizationsstriving to introduce new standards to their community-oriented staff.Professor of Management Michael A. Roberto, the author of two books

on leadership and decision-making, recommends that leaders get outof the room when making major decisions, in order to get multipleviews and activate open debate. This creates a lessening of the salienceof the hierarchy and status differences among team members, allowingfor more candid staff discussions and contribution of ideas. Every staff member will feel the effects of new policies differently. Giving themspace to fully explore and voice their concerns during planning willhelp prevent sudden outbursts of discontent months later.

In order to make clear the benefits of new systems, and to makedecisions that staff feel connected to, it is important to take a pagefrom monitoring and evaluation (M&E) principles as well. Link every suggestion and resulting decision to the organizations intended out-comes and larger goals. Staff on every level of the organization willthen understand how the new processes will directly enhance theirdaily efforts to improve lives in the community. By making the deci-sion process inclusive and locally driven, stress and uneasiness dueto change will be minimized.

The work that small organizations are able to do alongside theirconstituents, and how well they understand their communitys needsand concerns, is envied by many NGO, non-profit and governmentworkers who have chosen the cubicle route. As they strive to reach morepeople in need, CBOs often take on unfamiliar and complex systems

of management, borrowing from their NGO siblings. These growingCBOs might be your grantee, your partner or your employer, and asthey try to increase their structure and reliability, leaders must consider

how these changes will impact morale. Organizations have consider-able ability to create working environments that mitigate impact onindividuals and even enhance thriving in challenging environments,says John Fawcett, a staff care consultant for international NGOs.

When discussing staff care we often focus on addressing the psycho-logical needs of Western NGO workers transitioning into impoverishedareas, working in the midst of humanitarian crises. Yet community workers around the globe also face traumas and challenges on a daily basis, working in near-permanent crisis mode, hustling for every dol-lar and for every child. Surely their psychological health is in need of maintenance as well.

People in Aid has begun researching staff care methods in non-emergency development work. It would greatly benefit global develop-ment efforts to expand that research. Maneuvering through the psy-chological territory between office-based management proceduresand local community fieldwork is a delicate, complex process. Elementsof staff care must be incorporated into this type of transition experi-ence. Small organizations striving to gain credibility by adopting moreaccountable processes and long-term proactive planning should begiven as much holistic support as possible. MD

The author can be reached at [email protected].

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hi h-riSk care

opportunity to debrief helpful.Additionally, you can providestaff with resources such as bro-

chures that discuss the stages of re-entry, typical stress responsesafter a difficult assignment, jobsearch tips and the warning signsof traumatic stress. Check withyour employee benefits teamto see whether access to theEmployee Assistance Programextends beyond the terminationdate and make employees awareof any additional resources theirbenefits plan provides.

Address both acute and chronic stressors. While staff in high-risk positions are more likely to experience acute, traumatic stressors, thecommon stressors of workload, workplace tension, poor managementand unclear policies are also present. And it is these seemingly lesssevere stressors that can lead to burnout. Acknowledge these every-day stressors and include high-risk staff in the process of addressingorganizational issues. Suggestions include: flexible, results-focusedwork arrangements to give staff control of their time and allow themmore realistically to manage the demands of work, life and self-care;provide ongoing training for managers in communication skills, goalsetting, leadership and strategic planning; and offer resources to staff such as regular webinars on relaxation techniques, workshops on timemanagement, and coaching on how to deal with conflict.

While it is easy to come up with ideas for improving staff support,securing resources to put these ideas into action is the real challenge.How can you get the staff, time and money resources you need tomake meaningful improvements in staff care?

Make a business case for staff support. Rapid turnover, absentee-ism and illness: these are all linked to high levels of stress and they have significant impact on the organization financially and in termsof morale and program effectiveness. Research your organizationsnumbers and do the math. Find out what it is really costing you tokeep doing business as is.

Find cheap labor. Cant afford to hire additional staff? Need someoneelse to create your business case? Look to your nearest university. Stu-dents from fields such as social work, human resources, nonprofit man-

agement, and public health are all skilled candidates for an internshipin staff support. Most graduate programs require students to completea practicum: This means that in exchange for a few hours a week of supervision, you could have 16 to 30 hours/week of unpaid assistance.

Include staff support costs in grant proposals. Keeping the lightson is a regular part of doing business. Preparing and supporting staff in high-risk assignments should also be a regular part of doing busi-nessnot a luxury. Make staff support part of the operating costs of working in volatile areas and include these costs in grant proposals.Make sure your organization has a staff support policy in place to back up the request for support funds. MD

Wh le t s easy tcome up w th deafor mprov ng stafsupport, secur ngresources to putthese deas ntoact on s the realchallenge.

Today... A Staff Care Resource

he following is based on research conducted as part of astaff care pilot program for humanitarian workers in contextsof chronic violence and injustice, and on extensive dialoguewith local partners. his resource was developed by the LatinAmerica and the Caribbean region ofchur h World erv e and is being used in a variety of ways, including reading it outloud before starting a staff meeting, hanging it up in the of ceand as a gift to colleagues. It is available in nglish and Spanishand soon will be available in Creole and ortuguese. For adigital version and/or more information please contact [email protected].

Today

1. I am thankful for being able to contribute, along withmany others in Latin America and around the globe, tobuilding a world with more peace and justice and free ofhunger and poverty.

2. I remind myself I wont be able to resolve every problemtoday, so I will try to prioritize well.

3. With respect and affection, I will say No or I cant dothat now when necessary. When I need it, I will ask forhelp from my colleagues, without hesitation.

4. I will take care of my body while working. I will take a

break when I need one, eat healthily and try to exercise.5. If I am preparing for a trip, I will plan, delegate, ask for

help and coordinate tasks, so I may leave and comeback peacefully.

6. If I am travelling, I will try to concentrate on my job andappreciate the gift of visiting colleagues, organizationsand communities.

7. I will try to be kind to the members of my team andacknowledge their work and effort.

8. Ill try to save time, strength and willingness for doingsomething after work that I like or have been postponingfor a long time, such as contacting a loved one or takinga walk in a special place.

9. As I plan, budget or revise a new or ongoing program, Iwill be aware of the safety and physical, emotional andspiritual well-being of humanitarian workers, and of theirrights.

10. I will celebrate I am a human being who is unique,important and, today, has a wonderful job that makes adifference in the world.



ONDAY DEVELOPMENTS

i ter care

ANY OF S CALL A I IN our careers when we served as interns

for organizations. During this period,we might have put financial advancement onhold and dedicated our energies to unpaidwork in the hope of furthering our trainingand eventually securing a job in our chosenprofession. Graduate student interns, how-ever, enter organizations with a variety of backgrounds, field experiences and levels of awareness of their personal and professionalreadiness to work in contexts affected by disas-ter. They may experience a variety of problemsrelated to the stress of adjusting to interna-

tional settings, including feelings of isolationfrom their support systems and emotional

reactions of depression and/or anxiety. Fur-ther, working in contexts affected by disasterand trauma may be associated with symptomsof vicarious trauma: an important staff-careissue that can equally affect student interns.

While the past decade has seen a risingnumber of conferences, published papersand working groups dedicated to awarenessof and response to the needs of humanitar-ian and development staff, little attention hasbeen given to how universities and organiza-tions can model self-care and staff support

as elements of their academic and internshipexperiences. To address this gap, we havedeveloped recommendations for graduate

programs that offer their students interna-tional field placements. In line with researchand practical frameworks that address staff care issues for humanitarian workers by con-sidering timing and context, these suggestionsare organized in terms of three phases: intern-ship preparation, internship participation andre-entry. For each phase, the recommenda-tions offer suggestions for individual andorganizational programming elements thatmay provide students with practical and aca-demic experiences relevant to self-care before,during, and after international internships.

reparat on phase1. The university faculty internship facilita-

tor meets with students individually to exploretheir specific interests for professional devel-opment while on internship.

2. The university faculty facilitator andthe NGO develop a partnership and collabo-rate to develop relevant work. Information isthen provided to interns about the contextand work activities in order to assist studentinterns as they prepare for their internshipexperiences.

3. Student interns enroll in academiccoursework at the university that focuses onparticular work contexts as well as issues of self-care generally and within the context of their anticipated field placement.

4. Email or phone contact is established

between the intern and NGO before the interndeparts for the internship site; this ongoingcommunication serves to increase connection

and provide further information about thecontext and work.5. A meeting is held between the univer-

sity faculty facilitator and individual internsto explore the challenges of the internshipenvironments and to develop personal cop-ing strategies.

6. Intern cohorts (those going to the sameinternational site) work together to identify challenges and ways they may cope in prepa-ration for their fieldwork in the international

ak ng care o

tudent internsA blueprint for incorporating staff careinto overseas internships.By Judith Fox , Assistant P ofesso , Di e to , maste s P og a in Inte nationalDisaste Psy hology, G aduate S hool of P ofessional Psy hology, and JanetShriberg , Assistant P ofesso , maste s P og a in Inte national DisastePsy hology, G aduate S hool of P ofessional Psy hology, Unive sity of Denve

University of Denver students interningin India this past summer pose in front of abanner advertising a radio show in which they participated.

continued on page 28



haiti Staff care

IN H AS 20 Y A S, H HAS been growing attention to the psychosocialimpact on humanitarian workers of workingin post-disaster and post-conflict environ-ments. I have spent much of the last 12 yearsworking in Haiti. In the first month after theearthquake that devastated Port-au-Prince, Ireceived 21 requests for staff support andcounselling for our local staff from localand international NGOs already operatingthere. I ended up spending most of the first sixmonths following the earthquake in country,

working directly on the issue of staff supportand providing psychological first aid to Hai-tian nationals.

I worked mostly with one large interna-tional NGO, while also assisting many otherlocal organizations in developing or imple-menting staff support programs or services.While this article is not a personal account,it merits mentioning that balancing my ownlosses while supporting others elevated theissue of staff support for those of us involvedin complex emergency response from one of

necessity to one of imperative. The impact of the destruction in Haiti has been describedas unbearable and unimaginable by almosteveryone I have worked with, and this is howI experienced it as well.

The earthquakes destruction has beenmagnified by the convergence of human loss,shoddy construction in a major urban area, acomplete absence of urban planning, and totalchaos in the initial days after the earthquake.For almost everyone, the lossloss of family,home, national symbols and major systems

is perhaps the most significant dynamic of thisdisaster. In a country with a long history of violence, poverty and disaster, loss and deathare familiar. Despite this, many people I spokewith described the sense of loss as paralyz-ing. As the first few months passed, more andmore programs contacted me about their staff care or staff support needs.

Unable to meet the demands for staff care,and with the blessing of an effective, visionary and Haiti-centric country director, we invitedall organizations who had expressed interest

in some form of staff support, as well as all theother NGOs in our database, to our office foran NGO staff support working group. Almost

40 people attended. Within two weeks, theNGO Staff Support Working Group wasformed and has met monthly since January 25.

The initial goal was to share ideas andresources for staff support. In the first twomeetings, each participant/organizationshared their support strategies and/or needs,and we talked about how many of us hadimprovised to continue our programs, assistour tragically affected beneficiaries, and pro-vide support to staff. Arising from this poolingof ideas, we began to actively share resourcesand promoted several initiatives:

community psychosocial informationshared via radio, the most universalmedia in Haiti;

education campaigns providing basicscientific information on earthquakes tocounter the rumors that this was Arma-geddon;

a three-day Introduction to Staff SupportPrograms training initially planned forone international NGO was extended toall members of the working group inter-ested in developing or implementing sim-ilar programs (almost 30 attended); and

a series of trainings that began in July with a session entitled Tending the Help-ers Fire: Practical Self-Care Skills, pro-vided for local psychologists and humanresources managers.

Working group interest has also led to someorganizations providing staff care retreats.Participants in the three-day sessions haveused what they have learned in many ways:from developing a strategic plan for wellnessand staff support, to initiatives that educatesenior management about staff care issuesand create buy-in for similar programs. Theworking group meetings also cover simple

staff care techniques. They continue to operateas a shared community meeting, with respon-sibility for venues, facilitation and planningshared by all participating national and inter-national NGOs.

With its ongoing sessions and the programsit has helped organizations undertake, theworking group is a practical example of howsmall steps can make a big difference: makingthe most of staff care resources in the midstof a major disaster so that staff can better carefor themselves and the people they serve. MD

NGOs in Haiti form ongoing working groupto share experience and pool resources.

car ng or ta Who re lso urv vors

By Amber Elizabeth Gray , Staff Suppo t consultant, resto ativeresou es T aining & consulting



ONDAY DEVELOPMENTS

O cO u icaB e iSeaSeS

H WO LD HAS CHANG D, B the global health community has not yetcaught up. Great strides have been made

against many traditional global health issues,including HIV/AIDS, tuberculosis, malaria,infant and child mortality, and malnutrition.Today, more people are living longer than atany time in history. Of course, there is stillmuch work to be done, but at least, we aremaking progress.

In contrast, relatively few resources havebeen mobilized to address the growing bur-den of noncommunicable diseases (NCDs),including cancer, cardiovascular disease, dia-betes and respiratory diseases. Although thesediseases account for more than 60 percent of all deaths globally and have a disproportionateimpact on low- and middle-income countries,they have yet to elicit a sense of urgency or aunified call to action.

Today, cancer, heart disease and stroke dwarf all other causes of death in most major regionsof the world. Even in sub-Saharan Africa, thesediseases now constitute a major portion of alldisability and death. NCDs also impede eco-nomic development. From a 2010 report pro-duced by the American Cancer Society andLivestrong, we know that just two NCDscancer and heart diseaseaccount for more

than $1.6 trillion in lost productivity every year.Despite these facts, NCDs are absent frommost global health and development agen-das, including the Millennium DevelopmentGoals, which drive a substantial portion of global health and development efforts andfunding. NCDs have never been addressedin meetings of the G8 or G20. They are notamong the funding priorities of major govern-ments and are missing from major programssuch as the United States Global Health Ini-tiative. The Center for Global Development

estimates that NCDs receive less than 3 per-cent of all public and private developmentalfunding for health.

In 2001, the HIV/AIDS crisis was beginningto attract heightened attention at senior levels,but it took a UN General Assembly summit totruly mobilize the global community around

this issue. Following the summit, the GlobalFund to Fight HIV/AIDS, Tuberculosis andMalaria was established, which brought criticalattention and resources to address HIV/AIDSand the other two diseases. HIV/AIDS wassubsequently incorporated into the Millen-nium Development Goals and became a major,if not the primary, focus of U.S. global healthefforts with the creation of the PresidentsEmergency Plan for AIDS Relief (PEPFAR).

These advances began with awareness cam-paigns that created public, public health, pri-

vate sector, NGO and governmental demandfor the control of HIV/AIDS. We are now inthe early stages of another paradigm shift in the

global health community, one that recognizesthe growing burden of NCDs and demands amore balanced global health agenda.

Thanks to the efforts of vocal advocateswithin the UN community and the supportof the NGOs committee to health and devel-opment, the UN General Assembly passed aresolution in May to hold a high-level meet-ing on NCDs in September 2011. The truesuccess of the September 2011 meeting willbe largely determined in the months leadingup to it. Heads of state, including the UnitedStates, must be convinced right nowthat thisis a health, economic and development issueof epic proportions and that their participa-tion at senior-levels will be critical to avertinga public health and economic catastrophe.

In addition to a high-level commitmentfrom member states, the global health anddevelopment community must join togethernow to ensure that the meeting agenda andoutcomes document will include meaningfulindicators and measurements to combat thehuman and economic costs of these diseases.NCDs must be included in future iterationsof the global health and development agenda,including the MDG successor goals, if we areto maintain and expand the significant prog-ress we have made in public health globally.

Dr. Serigne Gueye, president of the AfricanOrganisation for Research and Training inCancer (AORTIC), hopes that the world willmobilize around the noncommunicable dis-ease threat in Africa with the same urgency it has responded to infectious disease. Now,more than ever, we must take steps to balanceour global response to both communicableand noncommunicable diseases, especially inregions like Africa, said Dr. Gueye.

It is time to rebalance the global healthagenda so that all major causes of death and

disability are appropriately addressed throughintegrated and synergistic interventionsfounded on a robust primary-care infrastruc-ture and overall health systems strengthening. Studies have shown that a more balancedhealth agenda that includes NCDs will accel-erate and improve efforts to combat otherthreats to health and development. If donecorrectly, the integration of NCDs into theglobal health agenda will strengthen healthsystems, bolster economies, and transitionlower-income regions out of poverty. MD

Incorporating noncommunicable diseasesinto global public health efforts.

me to rans orm lo al Health

By Nathan Grey , National Vi e P esident fo Glo al Health, and RennieSloan , Di e to , Glo al Health co uni ations, A e i an can e So iety

lthough these d seasesaccount for more than60 percent of all deathsglo ally ... they haveyet to el c t a sense ofurgency or a un ed callto act on.



BO HA* HAD O HAN H strikes against her by the time she was14. The oldest child of five siblings and

divorced parents, Bophas father was a drugaddict, her step-father an alcoholic and hermother unemployed. The family lives in Poipet,Cambodia, a town along the Thailand borderknown for its casinos, beggars and dark reputa-tion as a hub for human trafficking.

Last year, Bophas mother sold her to a sol-dier in exchange for a piece of land. At first shewas forced to do household work; then the manbegan raping her.

I cried out loud to ask for help, but no one

could help me, said Bopha. I wanted to runaway from the house the next day, but I couldnot because there were a lot of soldiers watch-ing and surrounding the house. The man didthis to me again and again my body andmy heart were painful.

Bopha eventually escaped her enslavement by pretending she was sick and getting permissionto leave the house to get medicine. She waited forthe right moment and asked someone for help.She was directed to Cambodian Hope Organiza-tion (CHO), a small NGO that operates a safe

haven in Poipet for victims of trafficking.I asked a motor-taxi driver to drive me

as fast as he could to meet with CHO staff because I was very afraid that they wouldchase me, recalled Bopha. CHO staff mem-bers took her to the safe haven where the longhealing process began.

The threat of child trafficking is very real,particularly in border areas where the migra-tion rate is high and there are significant pock-ets of poverty. The Greater Mekong Subregionof Southeast Asia has many characteristics of a high-risk area, including access to Thailand,where people migrate from all over the world

in search of economic opportunities and abetter life.According to the U.S. State Departments

2010 Trafficking in Persons (TIP) Report, theprevalence of trafficking victims in the world is1.8 per 1,000 inhabitants. In Asia, that figure is 3per 1,000. Statistics show a 59 percent increase invictims identified worldwide since the last reportjust two years ago. Unfortunately, that figurerepresents only 49,105 of the estimated 12.3 mil-lion adults and children enduring forced laborand prostitution around the world.Trafficking

is not just toward the sex industry, said Rich-ard Johannessen, World Concerns Asia AreaDirector, who is based in Bangkok. People are

bought and sold for slavery in sweatshops, aschild brides, for circuses, sacrificial worship,forced begging, hard labor, domestic servitudeand for the sale of human organs.

The shocking statistics around child traf-ficking have only recently reached living roomconversations in the developed world, butawareness of the problem is growing. The 2010TIP Report marks the tenth year in the fightagainst modern slavery, which began with theUnited Nations Palermo Protocol in 2000. Theprotocol encourages governmental responses toincorporate prevention, criminal prosecutionand victim protection. While progress is beingmade in understanding the web of destructioncaused by human trafficking, a summary of theTIP report notes, 10 years of focused effort tocombat trafficking only represents the infancy of this modern movement.

Southeast Asia is seeing increasing implemen-tation of prevention programs and networkingamong agencies involved in child protection.Many NGOs are focusing on prevention inhopes of protecting larger numbers of children,and are leaving the rescue and rehabilitation of victims to organizations that specialize in thesetactics, such as International Justice Mission.

This is not just a Southeast Asia problem,warns Johannessen, noting that massage par-lors and other businesses in any large U.S. city can be staffed with women and young girlswho have been trafficked. Keep in mind thatits on your doorstep as well.

ident y ng r sk a torsPoverty and migration top the list of issues

that put people at risk for trafficking, says AnaMaria Clamor, who heads World ConcernsChild Protection Program. When people aredesperate, theyre willing to do anything. Thatdesperation makes them vulnerable, explained

Clamor. People who are poor typically lack information about the danger of trafficking.Families that migrate to urban centers in

search of work are vulnerable to offers formoney that could lead to danger. Children areoften left unsupervised while parents work,notes Johannessen, and consequently becomeeasy targets for traffickers.

Nattakarn Noree, coordinator of the San JaiNetwork, a consortium of 96 Christian NGOs inThailand that fight trafficking, tells the story of a 17-year-old Burmese boy who was trafficked

Incorporating child protection whileworking in trafficking hot spots.

revent onBy Cathy Herholdt , Staff W ite , Wo ld con e n

chi trafficki

Unsupervised children wandering the streetsof Poipet near the Cambodia/Thailand border are easy targets for traf ckers.

he ower o

*Childrens names in this article have been change


19/32



to Thailand after being offered a job by a taxidriver. He followed the man to a pier where hewas knocked unconscious. The boy woke upon a fishing boat in Malaysia. Young people,desperate for income, are lured by traffickerswith similar ploys every day around the world.

Poverty encompasses numerous risk fac-tors, including children not attending schooland parents relying on them to help earnincome to support the family. Lack of citizen-ship in rural areas also puts children at risk asthey lack legal rights and are unable to accesssocial services, education and healthcare.

NGOs also support programs in Battambang,Cambodia, a town along the path of migrationto Thailand, where large numbers of childrenspend their days searching for recyclables in thecity dump to sell. They are unsupervised by their parents or other adults while they are at thegarbage dump or on the streets, said Clamor.

Human traffickers prey on children like these.Disasters also create a risk for childrenbeing trafficked. The Haiti earthquake is acase in point. In its aftermath an increasednumber of children were trafficked across theborder to the Dominican Republic and fromthere, around the world.

During the emergency, the border wasopenednicely openedbecause it was use-ful for humanitarian reasons, said UNICEFRepresentative in Haiti Franoise Gruloons-Ackermans in an October 15, 2010 article on

the agencys website. But we heard about a lotof movement of children. And among themwere probably children who were trafficked.

UNICEF also fears that worsened economicpressures faced by families after the disastercould allow traffickers to convince parentsto give up their children for what they think might be a better life.

The TIP Report suggests aid and relief orga-nizations work to reduce the gaps after a disasterthat traffickers could later exploit. Working toidentify vulnerable children and reunite themwith family members should be a priority.

Long-term solut onsBreaking the cycle of poverty is a frontline

approach in child protection. Enabling parentsto earn an income through vocational train-ing, microlending and small business supportreduces the need for families to migrate andmeans their children are less likely to haveto work.

We raise people out of poverty so that they wont migrate, and parents wont be tricked intogiving away their children, said Johannessen.In Southern Laos, on the border of Thailand,where it was traditional for 16-year-old girls togo across the Mekong River and become pros-titutes by virtue of development programs,those families are now raising coffee as a cashcrop, and are able to make enough money tosend their children to school.

Informing children and adults aboutthe risk of trafficking is another primary approach. Child protection can be as simpleas warning potential victims about traffick-ing scams, and warning people who educatechildren about the issue of child trafficking.

Much of the work NGOs are doing inimpoverished countries is already helpingprotect children. Educational and vocationaltraining programs are by nature anti-traffick-ing opportunities, keeping children off thestreets and preparing them for future work.

Integrating curricula about child abuse andchild rights can be powerful, as was the casewith 10-year-old Nong Ae who attended a childabuse awareness workshop in Thailand. Hermother, a former sex worker, had been takingher to visit an American man at a guesthousenear their home in Chiang Mai. The man gainedthe young girls trust by giving her expensivegiftsa bicycle, cell phone and laptop. Thenhe began sexually molesting her and payingher mother 1,500 Baht ($47) in return. If thegirl refused to go, her mother would beat her.

At the child abuse training, this young girlrealized she was a victim of abuse and, after-ward, called a government hotline to report her

perpetrator. The 72-year-old man was arrestedon June 18, 2010. The story made national news.Helping families migrate safely is another

way NGOs can help. This includes providinginformation on the danger of trafficking, HIV/AIDS awareness and knowledge of sexual andreproductive health.

trengthen ng apa ty and work ngn partnersh pPreparation and properly trained staff are

critical before stepping into the issue of childprotection.

Sometimes an NGO can do more harmthan good, said Clamor. First you have tounderstand what child protection is, then howyou can integrate this into what youre doing.Dont do it alone. You really have to coordi-nate with the government and other NGOs,because it is a huge problem.

CHO found themselves in this situationwith Bopha, who began displaying severe psy-chological problems after entering their safehaven. There were also legal issues to tackle,as her perpetrator was a soldier with influence.

The case became very complicated. CHOhad to refer her to another organization (Inter-national Justice Mission) that could help herwith her legal issues, said Carmen AuroraGarcia, a program off icer with World Con-cerns Child Protection Program. There isrisk to being involved with very powerfulcriminals, even the risk of being killed. Rescueis very dangerous. Have a referral system inplace if you are or might be dealing directly with child protection issues.

CHO Director Chomno In stresses theimportance of networking, sharing resourcesand information, building good relationshipswith local authorities and working withchurch leaders as vital components of effec-

tive prevention and rescue work.Garcia calls these locals championsthosewho will advocate for people in their commu-nity. Local partners know the context and they know the problems, she said. As an organiza-tion, prioritize what you do best and work inpartnership with other agencies or institutionsin a collaborative way. Traffickers are well orga-nized and they work very well with other inter-national dealers. It is a business and an industry and we have to think like them, or even betterthan the ones leading and organizing it. MD

chi trafficki

Do Something!NGOs can begin by examining World

Concerns framework to address thecomplex nature of child traf cking:

Safe in Community Ai s to keephild en safe in thei o unity th ough oth

fo al and non-fo al edu ation, in ludingwo kshops on hild a use awa eness and

hild ights. Safe Migration Gives hild en andfa ilies info ation they need if they a e

onside ing ig ation, in luding info ationon the dange s of t af king, HIV/AIDSawa eness, and knowledge of sexual and

ep odu tive health. Safe Haven P ovides a ho e to

eha ilitate hild en who have een t af kedo a used. Strength in Network Suppo ts the SanJai Netwo k to ena le e e s to helpone anothe , sha e lea ning and developjoint st ategies fo g eate i pa t elatedto p ote tion issues affe ting hild en andwo en.



ONDAY DEVELOPMENTS

WHIL GLOBAL BAN S AND multinational businesses watchedstocks tumble and homeownerswatched mortgages crumble, the non-profitsector waited to see how funding and programswould be affected. Indeed, many non-profitorganizations experienced a drop in philan-thropic giving that would affect their programsand staffing; and there were widespread reportsof increased demand for direct services for thepoor. But did the troubles on Wall Street andMain Street reach as far as the community schoolin Uttar Pradesh, India, or the health promoterprogram in Kisumu, Kenya? The Global Fundfor Childrens (GFC) research found that it didthe shocks of the economic downturn reverber-ated from the global markets to the grassroots.

Dedicated to the vision that all childrenshould have the chance to grow up to beproductive, caring citizens of a global soci-ety, GFC makes small grants to innovativecommunity-based organizations that servechildren and young people who are amongthe worlds poorest. To date, it has supportedmore than 450 organizations in 75 countries.Its complementary media ventures program

harnesses the power of books, films, and pho-tography to promote global understanding.To better understand the grassroots perspec-

tive on the economic crisis, GFC conducted asnapshot survey at the height of the economiccrisis, with a follow-up survey six months later,of over 200 active grantee partners within itsnetwork of over 450 community-based orga-nizations (CBOs) providing direct services tovulnerable children and youth. These CBOstypically operate on a shoestring budget to pro-vide their programs and services; the median

annual budget of anew GFC grantee partneris $55,000. The two surveysfocused on resource managementand financial and programmatic impactin the wake of the economic downturn.Responses to both surveys provide uniqueinsight into the effects of the global recessionon grassroots organizations.

The initial survey administered in April 2009to 234 CBOs achieved a 73 percent completionrate, representing CBOs in six regions (Africa,Central and Eastern Europe and the Common-wealth of Independent States, East and SoutheastAsia, Latin America and the Caribbean, SouthAsia, and the United States). The follow-upsurvey of 259 organizations in November 2009achieved a 60 percent completion rate, again insix regions, with 74 percent of these respondentshaving also completed the original survey. In

both surveys, nearly 70 percent of respondentsreported that the economic crisis had moder-ately or severely impacted their organization.

in t al mpa tResponses to the survey in early 2009

demonstrated that the global recession hadcreated a downward trend in the amountof funding available to the CBOs surveyed.One in India noted: We have been informedby two donors that we should expect 2025percent reduction in funding unless there is

some change in the business situation in thecountry.

With a grim forecast for available resources,many CBOs took proactive organizational andprogramming measures to mitigate the effectsof the crisis. Approximately two-thirds (65percent) made downward budget revisions;half (51 percent) reallocated funding to covernew or increased costs; and others opted tomake staff changes by merging roles, reducingsalaries, or eliminating positions altogether.Grassroots organizations often do not have afunding cushion for economic downturns. For

those few that had more stable organizationalstructural support, nearly 40 percent reportedhaving to access reserve funding, depletingavailable resources, to provide continuity inprogram services. Even after using reservefunding, an organization in Mexico empha-sized that their next step was program reduc-tion. Our reserves have practically emptiedthemselves. We have already had to confrontimmediate expenses and now we have had tocarry out substantial cutbacks.

Despite these reported revisions and cuts,

receSSiO effectS

Community-based organizations indeveloping nations take the hit, but alsoshow their resilience.

he lo al e ess on:ea h ng very corner

By Victoria Dunning , Vi e P esident of P og a s, andSarah Modica , Knowledge manage ent and G antOpe ations Of e , Glo al Fund fo child en

PhooVcorSoaresFooacom


22/32



ONDAY DEVELOPMENTS

H 2010 GLOBAL H NG IND (GHI) L AS D for the fifth year by the International Food Policy ResearchInstitute, Welthungerhilfe and Concern Worldwidedocu-

ments impressive progress against hunger in the past two decades,but warns that advances have been uneven. The Index singles outchildhood undernutrition as a major obstacle and urges that interven-tions be targeted where they will do the most good: among pregnantand breastfeeding women and children in their first two years of life.

The report scores countries based on three equally weighted indica-tors: the proportion of people who are undernourished, the proportionof children under five who are underweight and the child mortality rate.

The Index is calculated for 122 developing and transition countries forwhich data on the three components of hunger are available. It ranksthem on a 100-point scale, with 0 being the best score (no hunger)and 100 being the worst, although neither of these extremes is reachedin practice. A decrease in the score indicates an improvement in thecountrys hunger situation.

Uneven progress

Global hunger remains serious despite significant progress. Since1990, the first year for which the Index was calculated, the GHIdecreased by nearly 25 percent worldwide. In the past two decades,GHI scores have fallen by 14 percent in sub-Saharan Africa, 25 per-

cent in South Asia, and 33 percent in the Near East and North Africa.Progress in Southeast Asia and Latin America and the Caribbean wasespecially great, with GHI scores decreasing by 40 percent and more.

Some countries achieved significant absolute progress in improvingtheir scores. Between the 1990 GHI and the 2010 GHI, the greatestimprovements were seen in Angola, Ethiopia, Ghana, Kuwait, Malay-sia, Mexico, Mozambique, Nicaragua, Tunisia, Turkey and Vietnam.

South Asia and sub-Saharan Africa continue to suffer from thehighest levels of hunger, with regional scores of 22.9 and 21.7 respec-tively. Among individual countries, the Democratic Republic of theCongo (DRC) has experienced the greatest increase in hunger, largely because of conflict and political instability. The DRC also has thehighest proportion of undernourished peoplethree-quarters of thepopulationand one of the highest child mortality rates in the world.

potl ght on h ld undernutr t onMalnutrition among children under two years of age is one of the

leading challenges to reducing global hunger; and it can cause life-long harm to health, productivity and earning potential. Consider-

able research shows that the window of opportunity for improvingchild nutrition spans from conception to agetwothe critical, first 1,000 days. After agetwo, the effects of undernutrition are largely irreversible.

In South Asia, the low nutritional, educa-tional and social status of women is among the main contributors tothe high prevalence of underweight in early childhood. In sub-SaharanAfrica, low government effectiveness, conflict, political instability andhigh rates of HIV and AIDS are among the major factors that lead tohigh levels of child undernutrition.

Child undernutrition is concentrated in a few countries and regions.

Newly released Global HungerIndex shows uneven progress.By Sarah Immenschuh , co uni ations Asso iate,

Inte national Food Poli y resea h Institute (IFPrI)

Fm

W

A ove: Mali,nutrition consultationfor pregnant and breastfeeding women.

lo al HungerakingStock of

hu er i ex



hu er i ex

Stunting is a good overall indi-cator of undernutrition becauseit reflects the cumulative effects

of a chronic lack of propernutrition. More than 90 percentof the worlds stunted children(children whose height is lowfor their age) live in Africa andAsia, where rates of stuntingare 40 percent and 36 percentrespectively. In Burundi, Mada-gascar and Malawi, 53 percentof children are stunted. InEthiopia and Rwanda, the fig-ure stands at 51 percent. And inNiger, 47 percent of children arestunted. Stunting also afflictsmore than half of under-fivechildren in Afghanistan, Guate-mala, Timor-Leste and Yemen.

Research also demonstratesthat it is more effective to pre-vent child undernutrition thanit is to treat it. For that reason,it is crucial to focus interven-tions on pregnant mothers andinfants and children up to 24 months of age. The well-being of mothersis a critical element because poorly nourished girls tend to give birthto underweight babies, perpetuating the cycle of malnutrition.

e t ve ntervent onsSome countries have made notable achievements by instituting

national policies that benefit mothers and young children. Between1990 and 2002, China reduced child malnutrition from 25 percent to8 percent through: a successful poverty alleviation strategy; effectivelarge-scale health, nutrition, and family-planning interventions; andincreased spending on water, sanitation and education. In Malaysiabetween 1990 and 2005, rapid economic growth, as well as interventionstargeted to women and young children, led to a decrease in the propor-tion of children who were underweight from 22 percent to 7 percent.

Social protection programs, such as conditional cash transfer pro-grams, have been particularly successful in alleviating poverty. TheBolsa Familia program in Brazil has provided financial assistance toover 12 million families and has had a great impact on the health and

education of children in Brazil. The program offers grants to mothersin exchange for commitments to invest in their childrens health andeducation. It has brought about a marked increase in school attendance,the timely vaccination of infants, and pre-natal care.

In order to improve child nutrition, countries need to target inter-ventions to pregnant and lactating women and to children during theirfirst two years of life. In addition, they have to address the underly-ing causes of undernutrition, including poverty, gender inequality and conflict. The GHI report urges efforts to engage, empower andsupport those working to improve nutrition at the local level. Andnutrition, especially for women and young children, needs to be atop political priority. MD

it s cruc al to focuntervent ons on

pregnant mothersand nfants andch ldren up to 24months of age.

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ONDAY DEVELOPMENTS

uSai fu i

H NI D S A S IS IGH -fully proud of its long commitment toemergency food assistance. In 2009

alone, USAIDs Office of Food for Peace sup-ported NGOs and the United Nations WorldFood Program (WFP) by providing 2.4 mil-lion tons of food aid under the Title II foodaid program. This food, which was part of over $2 billion in grants, benefited over 60million people around the world.

To complement the Title II food aid pro-gram, which makes available commoditiesproduced in the United States, USAID hasnow launched a major new initiative entitledthe Emergency Food Security Program. Thisprogram provides substantial additional fund-ing for the purchase of food nearer to wherean emergency occurs. It also provides cashand food vouchers directly to those personsaffected by a disaster.

he mergen y Food e ur ty rogramThe Emergency Food Security Program was

established early in 2010 by USAIDs Office

of Food for Peace. It uses funds provided by Congress under the International DisasterAssistance Account for the purpose of localand regional procurement (buying commodi-ties in or close to the country where the foodaid is to be distributed), cash transfers andfood vouchers.

This program builds on the experienceof USAIDs Office of U.S. Foreign DisasterAssistance. It is closely aligned with the TitleII food aid program, which remains the U.S.governments primary source of emergency

food assistance. Each time the new programis used, therefore, a sound justification mustspecify why it is more appropriate than TitleII food aid. Such circumstances include when:

Title II food aid cannot arrive in a suffi-ciently timely manner through the regularordering process or prepositioned stocks;

cash or voucher programs are moreappropriate than in-kind food aid toaddress specific emergency food security

needs due to market conditions; or in certain cases, significantly morebeneficiaries can be served through theuse of local regional procurement, cashor vouchers.

The program is focused only on emergen-cies because the funding is from the Interna-tional Disaster Assistance account. To ensureconsistency with the Title II food aid program,it uses the same approach to emergencies: thegoal is to save lives and reduce suffering of people affected by an emergency, defined asa specific shock that has an impact on foodsecurity. This shock may be a natural disasteror a complex emergency.

Food commodities provided under the pro-gram should be purchased in the developingworld. To ensure the safety and quality of thecommodities, independent contracts must beused for inspection services prior to shipmentand distribution of food aid to ensure commodi-ties meet national and international standards.

To promote a do not harm approach, arapid market impact analysis must be under-taken to determine whether there exists a risk of a discernible negative market impact. Sucha negative impact would include an increasein prices facing low-income consumers livingwhere the food is purchased (for local andregional procurement) or in the program loca-tion (for food aid distribution activities andcash or voucher programs).

Why these hanges?For several years, WFP and NGOs have

been using funds from other donors and pri-vate sources for local and regional procure-ment. This practice has gained adherentsas the food can arrive more quickly and beless expensive than purchasing and sendingthe food from the United States. A report by

the U.S. Government Accountability Officereviewing WFPs local and regional procure-ments from 2001 to 2008 found that localprocurement in sub-Saharan Africa costsapproximately a third of similar in-kind foodaid purchased and shipped from the UnitedStates. This report also found that the foodprocured locally and in the region took anaverage of 35 to 41 days, respectively, to arrivewhereas U.S. in-kind food aid took an averageof 147 days. Further, local procurement cansometimes have a positive impact helping to

Emergency Food Security Program expandsfunding for local food purchase, cash andvoucher programs.

ew Flex l ty n U iD mergen yFood ss stan e

By Jonathan Dworken , Deputy Di e to , Of e of Food fo Pea e,U.S. Agen y fo Inte national Develop ent

by the end of scalyear 2010, U iD hadprov ded a total of 17grants worth over $244m ll on for programs nHa t , Kenya, Kyrgyzstan,Mozam que, ger,

ak stan, r Lanka andudan.Pho

oMercyCorps



uSai fu i

stimulate local markets and production.At the same time, NGOs have been using

cash and food vouchers in emergencies as a

way to save lives and protect and promote live-lihoods. Cash and vouchers can be especially appropriate when food is available on localmarkets, but due to the nature of the emer-gency, some people do not have sufficientresources to purchase it. This situation wastrue in the response to the 2005 Asian tsunamiwhere several NGOs deployed this approach, aswell as the 2003 food security crisis in Ethiopia.A three-year study undertaken by the Over-seas Development Institutewhich includedreviews of NGO programs in Africa, Asia andAfghanistanconcluded that, It is possibleto target and distribute cash safely, and peoplespend money sensibly, on basic essentials andon rebuilding livelihoods. What is more, cashtransfers can provide a stimulus to local econo-mies and in some contexts can be more cost-effective than commodity-based alternatives.

In the past, USAID has supported limitedlocal and regional procurement, as well as cashand voucher programs, through the Office of

U.S. Foreign Disaster Assistance using fundsfrom the International Disaster AssistanceAccount. The Emergency Food Security Pro-

gram aims to build on and expand this typeof programming.

pply ng or grantsUSAID published an annual program

statement (APS) for the new program severalmonths ago. This APS outlines the purposesfor which funding would be provided and theprocess for submitting grant proposals. NGOsand WFP follow the same process to apply forgrants under this program.

To save potential applicants the investmentof drafting full proposals, applicants must firstsubmit a 1-2 page concept paper that is quickly reviewed to determine whether a proposedintervention would be responsive to severalcriteria, including whether the applicationmeets the definition of emergencies used inthe program and provides a strong justifica-tion for using the program instead of TitleII funding. If the concept paper is approved,applicants are invited to submit a short, 5-10

page proposal that would be reviewed by aformal technical evaluation committee.

USAID has now provided over $200 million

in funding under the program. The first twogrants were for approximately $5 million eachto address drought in Niger. One grant wentto Mercy Corps for local procurement of foodfrom areas of Niger where a surplus exists.The other grant was to Catholic Relief Servicesto distribute vouchers to beneficiaries thatthey can use to purchase grains and pulsesavailable on local markets in that region of the country. By the end of fiscal year 2010,USAID had provided a total of 17 grantsworth over $244 million for programs in Haiti,Kenya, Kyrgyzstan, Mozambique, Niger,Pakistan, Sri Lanka and Sudan. MD

More information on the program andtechnical resources for these programs cabe obtained on the Food for Peace Web sitwww.usaid.gov/our_work/humanitarian_assis-tance/ffp/. You may also contact John Brookthe Emergency Food Security Program TeaLeader, at [email protected].

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ONDAY DEVELOPMENTS

a e t Ora e

DING H WA IN VI NA ,

Trinh Thi Nam was a volunteer cook for Vietnamese troops hidden below

the jungle canopy. There she was sprayed sev-eral times with what she later learned was theherbicide Agent Orange, for she soon devel-oped severe chloracne, a skin condition of large lumps and lesions that she still has allover her body. Now 56, she lives in a centralVietnam village with her son Luc, 18, whois totally disabled with mental deficiencies,violent tremors and muscle degeneration. Hecannot talk or get out of bed.

I have sleepless nights thinking about hisfuture, she said recently, because when I

die, whos going to take care of him? If sheis lucky, Vietnamese and U.S. NGOs will bea big part of the answer.

We now know that much of the 20 mil-lion gallons of Agent Orange and other her-bicides that U.S. troops sprayed for a decadeover Vietnam was contaminated with dioxin,an extremely toxic byproduct of acceleratedproduction. Chloracne and some birth defectslike Lucs are among more than a dozen healthconditions that the U.S. government has, aftera long struggle, recognized as being linked to

direct and indirect dioxin exposure, at leastamong U.S. Vietnam veterans and their off-spring. Others include various forms of cancer,diabetes, heart disorders, Parkinsons diseaseand hypertension.

Last year, the U.S. Department of VeteransAffairs (the VA) paid billions in benefits toVietnam-era veterans suffering from theseconditions. In Vietnam, however, the VietnamRed Cross estimates some 3 million peoplesuffer health effects of the kind linked todioxin exposure, including more than 150,000children like Luc; and far too little has beendone for them. Moreover, much of the 5 mil-lion acres of trees and cropland that were

sprayed remain degraded or barren.Just as alarming, hot spots of dioxin stillcontaminate the soil at former U.S. military installations where Agent Orange was storedand handled. Some of it spilled and soakedinto the ground, where it is still entering thefood chain to sicken people. Researchers havefound 28 such sites, often by their smell, whichis similar to common garden weed-killers.Some of the sites, like the Da Nang airfield,are so contaminated that visitors are asked tothrow away their shoes afterward.

This is a humanitarian concern that we cando something about. The issue was tangled fordecades in a web of geopolitical and scientificconflict, but recent progress in U.S.-Vietnamrelations has created a window of opportunity for a greater U.S. effort. It is time for a sharedpublic-private commitment to close this lastremaining wound and end the war in Vietnamonce and for all.

About 500 foreign NGOs are registered withthe Vietnam Union of Friendship Organiza-tions, an umbrella for groups like the Vietnam-U.S. Friendship Society. Since 1997, the FordFoundation has supported U.S. and Vietnam-ese NGOs providing basic health care, rehabili-tation and therapy for families like the Trinhs.The War Legacies Project, a NGO based inVermont, for example, funded the backyardwell that now saves Ms. Trinh the 1.5 kilometerwalk she used to make daily to fetch water.

In Da Nang, the East Meets West Founda-tion provided a back brace and a scholarshipof $8 per month to pay school fees for 8-year-old Ngo Thi Ha Phong, whose spina bifida isone of the conditions the VA recognizes asdioxin-related. Her mother gathers and sortstrash to make a living, but often gets to thedump too late for the best choices becauseshe must care for Phuong and her 17-year-oldbrother, whose legs are twisted and useless.

I have asked [the East Meets West Founda-tion] to help me get a motorbike so I can getthere faster and make more money, she said.

In 2000, Ford began grantmaking to stimu-late forward movement on the Agent Orangelegacy. Several years later, the Joint Advisory Committee on Agent Orange, comprised of officials from both governments, began meet-ing to discuss cleanup and remedial actions.In 2006, President George W. Bush and Viet-namese President Nguyen Minh Triet met in

Tackling the legacy of Agent Orange.

Lets eally nd the War n etnam

By Charles Bailey , fo e Fo d Foundation rep esentative fo Vietna andThailand, and David Devlin-Foltz , Vi e-P esident, Poli y and P og a s, theAspen Institute

Much of the 5 m ll onacres of trees andcropland that

md dec 10 small

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