Lomé September 15, 2008

I was lucky to visit some of the communities where Red Cross volunteers live and work before leaving Togo.
Villagers played music for us and prepared delicious meals consisting of African cuscus, chicken and palm wine. Their generosity made a very strong impression on me; they have so little and yet were ready to share it all with us. We ate abundantly; it would have been unacceptable for us to refuse the delicacies made by the women of the community with such care and effort.

In Koloware, central Togo, I had a wonderful time eating delicious food, singing songs, and even received an unexpected yet much honoured marriage proposal (unfortunately I had to decline).

In the community of Evou Apégamé, in the region of Plateaux, the religious leader asked me to remember him and his village, while holding my hand tightly and looking firmly into my eyes. These are moments that become unforgettable memories.

Posted for: Nathalia Guerrero

Lomé, le 15 septembre 2008

Avant de quitter le Togo, j’ai eu la chance de pouvoir me rendre au sein des collectivités où vivent et travaillent les bénévoles de la Croix-Rouge.

Les villageois ont joué de la musique en notre honneur et préparé un délicieux repas qui se composait d’un couscous africain, de poulet et de vin de palme. J’ai été très impressionnée par la générosité de ces personnes qui n’avaient que très peu de nourriture, mais qui étaient prêtes à tout partager avec nous.

À Koloware, au centre du Togo, j’ai passé un excellent moment à déguster des plats délicieux, à chanter des chansons et à recevoir une demande en mariage, qui m’a beaucoup honorée et surprise (et que j’ai malheureusement dû refuser!).

Dans la collectivité d’Evou Apégamé, dans la région des Plateaux, le chef religieux m’a demandé, en me tenant fermement la main et en me regardant fixement dans les yeux, de ne pas l’oublier, lui et son village. De tels moments deviennent des souvenirs inoubliables.

Lomé, September 12, 2008

My days in Togo are coming to an end. A few weeks from now my mission will be over and I will travel back to Canada. I have a mixture of feelings about this.

On one hand, I am glad to go back and see all the people that I love and miss. On the other hand, it is going to be sad to say goodbye to the people that I have learned to love here, such as my friend and colleague Dr Battah, the Togolese Red Cross doctor with whom I have worked throughout the last five months.

During my last visit to the field, while traveling across the regions of Togo and contemplating the beauty of its green valleys and mountains, I said farewell to all the wonderful people I have met here. In my mind and heart, I wished the Togolese a prosperous and better future.This mission has been one of the most enriching experiences of my life, both personally and professionally. I am grateful to have had the chance to know this country and live here during five months of my life. This chapter is coming to an end and a new adventure announces itself. Beginnings and ends, this is the cycle of life on earth.

Lomé, le 12 septembre 2008

Mon séjour au Togo touche à sa fin. En effet, dans quelques semaines, ma mission sera terminée et je rentrerai au Canada. J’ai des sentiments partagés à l’égard de ce départ du Togo.

D’une part, je suis contente de rentrer au Canada et de revoir toutes les personnes que j’aime et qui m’ont manqué. Mais d’autre part, je suis triste de devoir dire au revoir aux gens que j’ai appris à aimer ici, comme mon ami et collègue le Dr Battah, le docteur de la Croix-Rouge togolaise, avec qui j’ai travaillé ces cinq derniers mois.

Lors de ma dernière visite sur le terrain, alors que je me déplaçais à travers les régions du Togo et que je contemplais la beauté de ses vertes vallées et montagnes, j’ai dit au revoir à toutes les merveilleuses personnes que j’ai rencontrées lors de ma mission. De tout mon cœur, je souhaite au Togo un avenir prospère et plus radieux.

Cette mission a été l’une des expériences les plus enrichissantes de ma vie, au niveau personnel et professionnel. Je suis très reconnaissante d’avoir eu la chance de découvrir ce pays et d’y vivre cinq mois de ma vie. Ce chapitre touche à sa fin et une nouvelle aventure s’annonce. Un début et une fin, tel est le cycle de la vie sur terre.

Lomé, August 10, 2008

The power and strength of African women amaze me every day. I see them carry their babies on their backs, walk long distances to bring water or food to their homes, prepare meals for their families, take care of the children, wash their clothes, and clean the house. During the day, thousands of women sell food in the streets, under harsh sunlight, to help support their kin.

I am amazed every time I see African women carrying heavy basins of water, fruits or vegetables on their heads. Since childhood, their neck muscles have been trained to bear such heavy loads. Each one of them is a heroine to me.

They work so hard and carry such a heavy burden! But they do not complain; everything they do for their families and they do it with love. It seems to me that women hold this country and even this continent together. And with their hands they are pushing it forward, making it a better place, day by day.
Posted for: Nathalia Guerrero

Lomé, le 10 août 2008
Chaque jour, je suis éblouie par la force et la puissance des femmes africaines. Elles transportent leurs bébés sur leur dos, marchent sur de longues distances afin de ramener de l’eau ou de la nourriture chez elles, préparent des repas pour leur famille, s’occupent des enfants, lavent des vêtements et nettoient leur maison. Durant la journée, des milliers de femmes vendent de la nourriture dans les rues, sous un soleil de plomb, afin d’aider à soutenir leur famille.

Je suis éblouie chaque fois que je vois des Africaines transportant sur leurs têtes de lourds contenants d’eau, des fruits et des légumes. Depuis l’enfance, les muscles de leur cou ont été entraînés à supporter de lourdes charges. À mes yeux, elles sont toutes des héroïnes.

Elles travaillent très fort et doivent supporter de tels fardeaux! Mais elles ne se plaignent jamais. Tout ce qu’elles font, c’est par amour pour leur famille. Il me semble que ce sont les femmes qui assurent la cohésion de ce pays, voire de ce continent. Ce sont elles qui font bouger les choses afin de créer un monde meilleur, un jour à la fois.

Nathalia Guerrero

Lomé, August 6, 2008

Togo has seen really heavy rains in the last couple of days. During the rainy season, floods are a yearly ritual in Togo but this year they’ve come sooner than expected. Some of the inhabitants of Lomé consider the floods to be the result of water melting from the polar ice caps in Canada which has found its way here through the oceans and the rivers; others perceive it as a sign that the apocalypse is coming soon.

Dozens of villages are flooded and the main bridge that connects the north and the south of the country fell down a few days ago. Farmers have lost their crops and there is a general fear as the effects of higher international fuel prices are already causing price increases in the costs of basic products such as corn, bread and rice. For a population that lives with less than a dollar per day, the combination of the two phenomena could have devastating effects.

Last weekend, I visited flooded neighbourhoods in the outskirts of Lomé with my colleagues from the Togolese Red Cross. The situation here has obliged people to leave their homes and take refuge elsewhere. It is striking to see entire families making their way through the water trying to save their goods and properties.

People affected by the inundations find it hard to believe that this year’s floods might hit them as hard as they did last year; the country hasn’t yet had time to recover from the human and material losses it faced in 2007. Fortunately, they are not alone. Local and international humanitarian organizations working in Togo are mobilizing to support the people affected by the floods.

Posted for: Nathalia Guerrero

Lomé, le 6 août 2008
Des pluies torrentielles se sont abattues sur le Togo ces derniers jours. Chaque année, durant la saison des pluies, le Togo est aux prises avec des inondations. Et cette année, elles sont arrivées plus tôt que prévu. Certains des habitants de Lomé croient que les inondations sont causées par la fonte des calottes glaciaires au Canada, qui gonflent le niveau des océans et des rivières; pour d’autres, elles sont un signe de l’approche de l’apocalypse.

Des douzaines de villages sont inondés et le plus important pont reliant le nord et le sud du pays s’est effondré il y a quelques jours. Les fermiers ont perdu leurs récoltes. De plus, on redoute les effets de l’augmentation des prix du carburant à l’échelle internationale, qui a déjà entraîné la hausse des prix des produits de base, comme le maïs, le pain et le riz. Pour une population vivant avec moins d’un dollar par jour, la combinaison de ces deux phénomènes a eu des effets dévastateurs.

Le weekend dernier, des collègues de la Croix-Rouge togolaise m’ont fait visiter des quartiers inondés en banlieue de Lomé. La situation est telle, que les résidants ont dû quitter leur domicile et trouver refuge ailleurs. Il est troublant de voir des familles entières s’affairant dans l’eau à sauver leurs biens.

Les sinistrés ont de la difficulté à croire que les inondations de cette année sont aussi sévères que celles de l’année dernière. En effet, le pays ne s’est pas encore remis des pertes humaines et matérielles subies en 2007. Heureusement, ils ne sont pas laissés à eux-mêmes. Des organismes humanitaires locaux et internationaux présents au Togo se mobilisent afin de soutenir les personnes sinistrées par ces inondations.

Nathalia Guerrero

Lomé, July 14, 2008

Malaria: To have it, or not to have it…

I recently had malaria for the first time in my life. It all started with a feeling of tiredness, headaches and pains in my muscles and joints. As I had never experienced these symptoms before, I thought they were only the result of intense working hours. However, the symptoms persisted and I decided to take the malaria test. I had all the right symptoms but the result was negative. The following day, I still wasn’t feeling any better so I went to see a doctor. A second test was done and this one proved positive.

I was amazed to learn that you can actually have malaria but get a negative test result. If the concentration of malaria parasites in your blood is not high enough, the test will show a negative result, even though the parasites are present in your bloodstream. The doctor explained to me that the results also depend on the way the blood test is done, so the whole malaria issue is not a black or white matter.

Malaria is a much more complex disease than I had expected and it’s pretty common here during the rainy season. Every year in Togo thousands of people are diagnosed with malaria; it is part of every day life in this country. It is so common that adults rarely go to the doctor when they feel the symptoms and, instead, take the medication right away.

However, it’s a much different case for children because while malaria won’t be lethal for adults most of the time, it can be for them. A kid’s body does not have sufficient immunization and protection to fight off malaria parasites the way an adult’s does.

After being diagnosed with malaria, I took a treatment, got some rest and a few days later I was feeling much better. The symptoms slowly faded and I recovered my energy and strength. Eating well helped hasten my recovery; this is the perfect place to eat tons of fresh fish, high in proteins!

My colleagues from the Togolese Red Cross came to visit me while I was sick and took good care of me. They say that having had malaria for the first time is a very good thing because now I have developed some immunity against it.

I am very pleased to know that my presence in this country is precisely to help protect children against malaria. We are providing free mosquito nets to thousands of children that could not buy one or have access to one in other ways. Thanks to these efforts, families will gain ease from the burden of this terrible disease.
Posted for: Nathalia Guerrero

Lomé, le 14 juillet 2008

La malaria : l’avoir ou ne pas l’avoir…J’ai récemment contracté la malaria pour la première fois de ma vie. Tout a commencé par une sensation de fatigue, des maux de tête et des courbatures. Comme je n’avais jamais ressenti ces symptômes auparavant, j’ai cru qu’ils étaient causés par des heures de travail intenses. Cependant, les symptômes ont persisté ce qui m’a convaincue de faire le test de détection de la malaria. J’avais tous les symptômes, mais le résultat s’est avéré négatif. Le lendemain, je ne me sentais toujours pas mieux alors je suis allé voir le médecin. On m’a fait subir un deuxième test et celui-ci était positif.

J’ai été étonnée d’apprendre que l’on peut bel et bien souffrir de la malaria et quand même avoir un résultat de test négatif. Si la concentration dans le sang de parasites causant la maladie n’est pas assez élevée, le résultat du test sera négatif, même si les parasites sont présents dans le sang. Le médecin m’a expliqué que les résultats dépendent aussi de la façon dont le test est administré, la malaria n’est donc pas une question en noir sur blanc.

La malaria est une maladie beaucoup plus complexe que je ne le croyais et elle est très courante ici durant la saison des pluies. Chaque année, des milliers de personnes au Togo reçoivent un diagnostic de malaria, ce qui en fait donc une partie de la vie quotidienne dans ce pays. Cette maladie est tellement fréquente que les adultes vont rarement chez le médecin lorsqu’ils ressentent les symptômes, ils prennent tout de suite des antipaludiques.

Toutefois, la situation est très différente pour les enfants. Bien que la malaria n’entraine pas habituellement la mort chez les adultes, elle peut être fatale pour un enfant. Le corps d’un enfant ne possède pas une immunisation et une protection suffisante pour combattre les parasites de la malaria comme le corps d’un adulte.

À la suite de mon diagnostic de malaria, j’ai suivi un traitement, je me suis reposée et quelques jours plus tard, je me sentais déjà beaucoup mieux. Les symptômes se sont estompés lentement et j’ai retrouvé mon énergie et mes forces. Une bonne alimentation a permis d’accélérer ma période de rétablissement; c’est l’endroit parfait pour manger des tonnes de poisson frais, une excellente source de protéines!

Mes collègues de la Croix-Rouge du Togo sont venus me visiter, pendant que j’étais malade, et ont bien pris soin de moi. Ils disent que contracter la malaria pour la première fois est une bonne chose, car j’ai maintenant développé une certaine immunité contre la maladie. Je suis ravie de savoir que ma présence dans ce pays sert précisément à protéger les enfants contre la malaria.

Nous distribuons gratuitement des moustiquaires à des milliers d’enfants qui ne pourraient en acheter ou s’en procurer d’une autre façon. Grâce à ces efforts, des familles sont soulagées du fardeau de cette terrible maladie.

Nathalia Guerrero

Lomé, July 7 2008

One of the most captivating aspects of working abroad is being a witness to the world’s precious cultural diversities as well as observing the ways in which reality shapes the ways of living people have around the globe.

I am presently living in Lomé, the capital of Togo. Here, electricity cuts happen daily, sometimes for only a few hours but they can last more than 12. Often, when I come home from work I find there is no electricity in my house. After two months of being here, I have gotten used to lighting candles and now I find the light of a candle much more charming than common lights. I cook with natural gas which is helpful since I don’t need electricity to cook a nice meal.

Not knowing when there will or won’t be electricity, you must always be prepared; any minute you could lose the current for hours and hours. You need to keep everything charged: cell phone, lantern, computer, etc. Your habits change and you hardly notice yourself quickly adapting to this new reality.

The place where I live is called Cartier SousaNetimé and, like any other urban African neighbourhood, it’s pretty noisy most of the time. There’s always loud music playing during the day and late into the night, regardless of what day of the week it is. It seems like these rhythms don’t really bother anyone’s sleep. This must be part of what it means to have music running through your veins.

However, when there is no electricity, quietness fills the streets and allows me to hear the people’s voices. I live on the second floor of a building and from my balcony I see my neighbours gather together around the fire, talking and laughing. I like watching these scenes because I feel that I am observing a timeless practice that has existed as long as human kind.

I consider myself lucky because so far, we have not yet had water shortages. Nonetheless, people in Lomé advise that this is only because we are in the rainy season. I don’t want to think about it yet.

I have learned that we don’t need as much to live as we may sometimes think. Many of the things we believe are essential to us are not necessarily so. They bring comfort and are good to have but aren’t fundamental.

On the other hand, the living conditions here are so challenging and demanding for people. I wish I could do more to make things better and more equal! It really hurts to see the enormous disparities between us but that’s also why we find ourselves here. And I know that we need to remain strong to be able to contribute with our work and hearts toward the improvement of their lives, our lives.
Posted for: Nathalia Guerrero

Lomé, May 20 2008

The rainy season recently started in the southern regions of Togo. It’s been three weeks since I’ve arrived in Lomé and began to discover the ways of the Togolese people.

I’ve rarely felt as welcome as I do here and this gives a special warm feeling to my experience. Kindness and politeness are values deeply rooted in the local costumes.

The weather in Lomé is warm and extremely humid. The proximity of the ocean adds an occasional breeze that refreshes the atmosphere of a busy city, full of colors, smells, vehicles and motorbikes. Luckily, this is the mango and avocado season and I recently tried “fufu”, a local delicacy made from manioc.

In certain areas of the city, you can find beautiful and gracefully organized plantations of fruits and vegetables to be sold in the local market ‘le Grand Marché’. People in the fields work very hard every day to earn their daily bread.

The political situation of the country is more or less stable but poverty, like malaria, is endemic in this West-African country. As a consequence, criminality and banditry are common in the streets of Lomé after the sun sets down.

Tomorrow will be another day. By the end of my mission, I will have spent eight months in Togo. My colleagues say that, by that time, I will have become a Togolese, one of them. I find this to be a really sweet wish because it means we are accepted the way we are, regardless of our cultural differences. I am a Colombian citizen living in Canada and working abroad. Rather than pertaining to a particular place I feel like a citizen of the world and, aren’t we all…
Posted for: Nathalia Guerrero

Lomé, May 7, 2008

I have met the personnel of the Togolese Red Cross with whom I¹ll be working closely during the next eight months.

Dr Battah Kuami, National Health Director for the Togolese Red Cross, will be one of my closest allies for the implementation of the malaria and child survival campaign. He has been involved with the Red Cross for over 16 years and has an amazing deal of knowledge on each region of the country and its particular needs.

In the early nineties, when Dr. Battah was as student of medicine at the University of Lomé, he participated in the foundation of his faculty¹s Club of Friends of the Red Cross. He later became the president of the club, which opened a consultation post where the students provided free medical services to vulnerable populations.

An individual with a great humanitarian vocation, Dr Battah also became a Red Cross First Aid instructor and worked in the front of HIV and AIDS.

In 2005, Dr Battah was engaged by the Togolese Red Cross as National Health Director and today I have the privilege to join himself and his team in the organization of the campaign against malaria which will take place next December of 2008.

It is tremendously inspiring to work with people like Dr Battah. Through him and my Red Cross colleagues I also have the opportunity to discover the culture and traditions of Togo, its welcoming and magnificent peoples!
Posted for: Nathalia Guerrero

Maputo, April 22, 2008

Maputo, April 22, 2008

Malaria: a disease without borders.

Last night, I participated in a World Malaria Faire that took place in Maputo, the vibrant capital of Mozambique.

The event was called: Malaria, a disease without frontiers. This phrase captured my attention because I felt it was so real. Malaria doesn¹t distinguish country borders, skin color or marital status! It affects millions of children and families around the world and this is why an event to commemorate World Malaria Day is so meaningful.

There were people from many different countries at the faire, where you could find materials and presentations from international and local organizations whose efforts are focused on the fight against malaria.

Under a full moon, we had the opportunity to see a live theatrical demonstration of how mosquito nets should be used. There was music and dance and the local press covered the colorful happening.

The following day, I was happy to see that the major newspapers and TV news programs from Mozambique dedicated their time and space to cover the faire and talk about malaria, an endemic disease that kills a child every 30 seconds.

I was happy to see this because the majority of times, good media coverage helps raise people¹s awareness about major issues such as malaria, and this can also translate in increasing the support to vulnerable communities that bear this terrible burden.

As one of the humanitarian workers that are part of this global endeavor, it is quite amazing to see how many people and countries are working together to combat this mortal disease. Malaria has no frontiers, but the efforts to fight it also don¹t have borders.

Happy World Malaria Day!
Posted for: Nathalia Guerrero

Uganda to O-town to the T-dot

Thursday, June 12, 2008
Last week as I was flying to Uganda, East Africa, I sat beside a mother and her 18-month-old daughter. The woman was returning home to introduce her child who had been born in the UK. As we spoke about our plans for our respective trips, she told me about how excited she was at her family meeting her young baby and she also said she was concerned about her baby getting sick with Malaria. In silence, I glanced over at her little girl who was sitting on the ground and playing with her mother’s headphones. As it should be she was completely lost in the bliss of being a baby but the dangers of her contracting Malaria were very real.

After a quick trip to Uganda, I am now in Ottawa on my way to Toronto for World Malaria Day on Friday April 25th. In the days leading up to this first ever-global event, the Canadian Red Cross was proud to announce that along with the generous support of the Canadian government, the founders of Music World, Kroum and Eva Pindoff were going to match dollar to dollar of up to a million dollars that is donated by Canadians to the Malaria Bites campaign. It was also exciting to meet Firdaus Kharas the genius behind the HIV/AIDS PSAs, the Three Amigos. If you haven’t seen them, you can find all 5 spots on youtube.com.

Along those lines, Firdaus has created these brilliant commercials for Malaria prevention and awareness with the very funny characters of Buzz and Bite, two mosquitoes on the hunt to infect people with Malaria parasites. The 30 PSAs will be available worldwide and they have been translated into 40 languages. Buzz and Bite were produced in part with the support of the CRC and have received support from someone who is truly respected worldwide, the Most Reverend Desmond Tutu.

Firdaus produced these spots out of his own time. He volunteered to bring awareness on something he feels more people need to know about. He is passionate about the message and is active in spreading the message. And it is so inspiring to see so many people joining the Malaria Bites facebook group and to have so many supporters across the country galvanizing as a community to affect change.

I have no idea how to express how good it feels to be a part of something that is bigger than myself. As foreign as Malaria might sound, it is such a big disease, which absolutely requires all of our participation. I hope that you will join me in Toronto on Thursday and Friday as the Red Cross launches events to commemorate World Malaria Day. To borrow a phrase from U.S. Presidential Democratic nominee Barack Obama, ‘Yes We Can’.
posted by KB at 10:10 AM 0 comments
Thursday, April 10, 2008

30 Seconds and Counting
It’s been a few months since I traveled to Mali, West Africa for the launch of the Canadian Red Cross Malaria Bites campaign. Red Cross distributed over 1.8 million insecticide-treated mosquito nets, and other international partners provided vaccinations, vitamin A and deworming medicine for children under the age of 5 - a milestone many kids in Africa don’t live to celebrate.

Recently the show “American Idol” had its annual “Idol Gives Back” event. During the show, British Prime Minister Gordon Brown pledged to buy 20 million anti-malarial bed nets and oil company Exxon Mobil separately announced a $10 million donation. Although these generous donations will make a significant difference in the fight against malaria, the need is still great.

Forty per cent of the world’s population is at risk of contracting malaria. And in addition to the human toil, the disease also affects the economy and productivity of the countries that are already at risk of extreme poverty.

Since being diagnosed with the disease last summer, I’ve slowly started to feel like myself again. I used to function on four hours of sleep but while I was recovering from cerebral malaria I found myself in bed for nearly 12 hours a day. Living in one of the richest countries in the world, I’ve been able to seek treatment that the majority of those living in malaria hotspots around the world would never have access to.

Currently I’m editing the video I shot when I was in Mali. Seeing the faces of the mothers with their children as they lined up for the nets and hearing the babies crying after their vaccinations brings back a lot of memories. The love and pride that each mother showed for their child was joy at its simplest form and to think of the heartache that these same mothers are still venerable to experiencing because of the looming shadow of malaria has been extremely frustrating.

But as April 25 approaches, it’s exciting to know that the day has now been changed to World Malaria Day instead of Africa Malaria Day. I think that’s significant because the disease is a global responsibility. Since malaria is such a complex disease it will take the effort of every single one of us as global citizens to combat it and to prevent it from continuing to kill one African child every 30 seconds.

In the time that it’s taken you to read this blog, malaria has already claimed the lives of at least five more children.
Posted for Nam Kiwanuka

Bamako, December 13, 2007

Tuesday, December 18, 2007

Following many months of preparations, the largest public health event ever to take place in Mali has begun.

Early in the morning, the president of the country urged the population to attend the vaccination and distribution sites where over 2,8 million children under five will receive free health services that the majority of them cannot access on a regular bases. This is a unique opportunity for Malian families living with less than 1 dollar per day to protect their children from common diseases such as measles, polio and malaria, as well as other health conditions including intestinal worms and malnutrition.

Starting as early as 5 am, thousands of families started to line-up outside the health centres. This is one of the first signs that the campaign will be a success.Meanwhile, thousands of health workers and Mali Red Cross volunteers started setting up the sites that will deliver this massive intervention across the country.

Marking the beginning of the week-long campaign, today is a very important moment in the history of Mali.
After visiting distribution sites around Bamako, I left the capital city with a team of Red Cross workers and headed to the region of Segou. As an international delegate that is here to support the campaign and in particular the work of the Mali Red Cross, I wish to capture the immense team-effort that has made this possible with the help of my camera lenses and my pen.Segou, Niono, December 14, 2007.

We departed from Segou at 7 am and drove over an hour and a half to reach the town of Niono. As we drove, I saw vaccination and distribution centres along the road in urban, rural and isolated regions. At every community we passed by, there were lengthy line-ups of families outside the sites. The whole country is taking part in this massive effort that will improve the health of children and their mothers.

Arriving at a vaccination and distribution site is a powerful but also potentially overwhelming experience. It is a simultaneous array of faces, colors, smells, sounds and textures. Mothers chat loudly while breastfeeding their babies and waiting in line. Children run around and play. Some health workers try to control the crowd as others provide vaccines to crying children and mosquito nets to happy mothers. Families continue to arrive as others leave the sites with sobbing but healthier children.

Behind this apparent chaos, I see a display of true team-work. Everybody works together to make this happen, from donors to organizers and beneficiaries. I look at the eyes of the people present, and I feel a deep sense of humanity. We are all here for the same reasons. We care. To me, this is one of the most important messages from this campaign.
Posted for: Nathalia Guerrero

“Mobilizing the Community” – day 2

Sunday, December 9, 2007

When I first arrived to Mali, I was under the impression that this campaign was just about mosquito net distribution but since meeting with Pat Laberge the Malaria Program Manager at the Canadian Red Cross I’ve learned that it’s much more than that.

Pat has been with the CRC since 1994 and before that she was a teacher in South Africa (1990-94) towards the end of Apartheid rule. Her first mission with the CRC was in Rwanda. I can only imagine what she experienced or saw in those years. Pat said something that’s stuck with me since I met her: ‘We will always have conflict but we should work with conflict in a constructive manner’. Needless to say, I was really impressed with her.

So I’ve now learned that the campaign here in Mali isn’t just about Malaria. It’s about improving a child’s survival to any illness and their overall health. Their are 5 interventions: vaccinations for measles and polio, Vitamin A, Mebendazole for worms and the insecticide treated mosquito nets. These interventions all compliment each other in preventing illness and in aiding a child be healthier. In this way, the Red Cross is helping to build the capacity in Mali's health system.I have a two-year-old nephew and I’ve been there practically at every single doctor’s appointment since he was born. When he was a certain age, he had to be vaccinated for certain illnesses. For most countries in the developing world, most people do not have access to vaccinations. Something that is a right to us is often times unattainable elsewhere. After finding all of this out, I’m even more amazed at the power of what $7 can do.

On my second day in Mali, I was able to go door-to-door with the Malian Red Cross volunteers. It was very cool to discover that a group of volunteers weren’t flown in from Canada for this project but instead the mission represents those from the very communities who are at risk. It was impressive to see the volunteers go from each home and to speak to the families about the campaign. They explained to them that the program was for children under the age of 5 who are the most vulnerable.

They told them about the 5 interventions and about where they should go the day of the program. The Red Cross has tried to ensure that all families have access to the health centers. Depending on how far they lived from the nearest fixed site, a truck or a motorbike would transport the nets to their homes. The most important thing was to try to ensure access for all the Malian families with children under the age of 5.It was something to watch the Malian Red Cross volunteers interacting with the local community. When we walked into their family compounds we were always welcomed with smiles and curiosity. The opportunity to have their children’s health improved was something that was clearly universal.
Posted for Nam Kiwanuka

"Mali For Malaria” – day 1

Sunday, December 9, 2007
My flight into Bamako airport in Mali was filled with some really bad Franglais (what I call my French language skills), light turbulence that still left me green in the face and it seems as if from the moment that the plane hit the tarmac, I was in love with Mali.

While I muddled through my French, I somehow managed to secure an entry Visa, exchange my pounds into the local CFA currency and then I navigated my way through the manic rush hour-like atmosphere at baggage check. There were a lot of bodies, a lot of suitcases and very little space to move around. I enjoyed every second of it.

After I made my way to the parking lot, I was picked up by Nicholas who’s been living in Mali since July and by the lovely Nathalia, both Red Cross delegates and both trilingual; French, Spanish and English. How amazing is that? Did I mention that I’m still trying to master English?

As we pulled out of the airport, I took a deep breathe of Malian air and ditched my winter coat. Although it was nearing midnight, the drive into Bamako, the country’s capital, was eventful. There were scooters zipping up and down the busy highway, people walking on the side of the road and the horizon of the city was filled with lights.

The Canadian Red Cross has invited me to Mali for it’s largest net distribution to date. Along with insecticide treated mosquito nets, the Red Cross and its various partners have taken the initiative to administer measles and polio vaccinations and to provide Vitamin A supplements and deworming medicines to all of Mali’s children under the age of 5. Over the next few days I will learn about these 5 interventions and the importance of their integration.

Truth be told I didn’t know very much about Malaria until I became sick with it. Even after I was diagnosed I wasn’t as scared until I saw firsthand what it could do under such a short period of time. So imagine the damage it can do on a small child who isn’t as strong?Even though we live in Canada, this disease is closer than we think. As more of us travel, Malaria can hit closer to home through our friends and family. Being here for this campaign will be something I will never forget. I will be a part of an experience that will essentially change so many lives.

Upon checking into the hotel, I unpack my bags and power up my laptop. I sleep lightly as I am eagerly anticipating what’s to come over the next few days.
Posted for Nam Kiwanuka

Countdown to Mali

Wednesday, November 28, 2007

A year ago, I didn't really know anything about Malaria but the past few months have been an education of sorts. It's been a few days now since I found out that I will be joining the Canadian Red Cross as it distributes 1.8 million mosquitoe nets to the West African country of Mali. I'm really excited to be involved with the Red Cross in getting the word out to Canadians about this parasitic disease. Here is a recent article I wrote for the Toronto Star about what Malaria almost cost me.

"Malaria Bites"

Initially, I felt really tired and nauseous. Then I couldn’t keep my food down. Everything I ate or drank, I threw up. I knew Sierra Leone was a hotbed for Malaria but it took two visits to the doctor before I decided to get a blood test. I was shocked when the test was positive for Malaria parasites. For six weeks since my arrival in Sierra Leone, I had been taking all the recommended precautions — my daily dose of doxycycline, an anti-malarial drug, sleeping under a net, using bug spray and covering up my arms and legs in the evenings.

Soon nights had become unbearable. My temperature bounced between 38 and 39 degrees C. My mind started to play tricks on me. I was delusional. Each day I would tell my flat mates to be careful when they left for work. I felt a sense of impending doom and I felt completely at its mercy. My body ached and when everyone in the house was sleeping I quietly sobbed in my bed fearful of the outcome.

Although I was born in Africa, the idea of getting Malaria was foreign to me. It was something that I never thought I would experience or that I would be diagnosed with the most serious of the four strains of the disease. I’m sure that most of us in Canada have no idea of what exactly malaria is. I’m pleased to now be working as a spokesperson with the Canadian Red Cross in a campaign it’s launched to promote awareness of the disease. Malaria almost cost me my life and it continues to affect 40% of the world’s population, mostly young children and pregnant women, who are at risk on a daily basis of contracting this deadly illness.

Since 2003 the Canadian Red Cross, with funding from CIDA, (Canadian International Development Agency) has hand-delivered 2.5 million mosquito nets to six African nations: Sierra Leone, Mozambique, Malawi, Niger, Zambia and Togo.

Although there is no vaccine for the disease, the best weapon against Malaria is through prevention with the use of an insecticide treated mosquito bed net. These nets can last for up to 5 years and will protect a child or family from being bitten by the mosquito that carries the Malaria parasites at night.

The use of anti-malarial drugs, insect repellants and the mosquito un-friendly environments of mesh screens on windows and air-conditioning in a house are also deterrents but these are luxuries in the areas of the world where the disease is most prevalent.

I had traveled to Sierra Leone, West Africa to work as a Media Trainer with a Canadian Non Governmental Organization. Over the course of eight months, I was to train the local journalists the basics of reporting and work with them ON covering human rights stories.

The country was holding its first independent elections since the civil war ended in 2002. The brutal conflict that began in 1991, subjected hundreds of thousands of innocent civilians and children to mass amputations, rape and the abductions of kids who were forced to become soldiers. I was there to witness this.

This past summer, the people of Sierra Leone elected a new government that’s vowed to improve the lives of its people by addressing the problems of adequate housing, employment, education and health care.While I was in the hospital being treated for Malaria, I saw people lying on mats in the hallways because they couldn’t afford a bed.In Sierra Leone the patient pays his or her own medical costs. I was billed for everything including the syringes and needles that were used to test my blood. My first round of treatment consisted of 8 pills and cost 25, 000 Leones, the equivalent of $10, and approximately one third of the average monthly wage in Sierra Leone. A bag of rice is 70, 000 Leones. If someone were to get sick in that situation they would be forced to choose between their health and feeding their family.

Malaria has been called a disease of poverty and continues to affect nearly half a billion people a year, mostly in Africa. The Canadian Red Cross estimates 1 million people die from Malaria each year. The disease kills more children than AIDS, TB or any other infectious disease. Everyday, 3, 000 children, most under the age of 5, die from Malaria. That works out to a child every 30 seconds. Staggering.Shortly after I was diagnosed with malaria, the doctors told me that I also had Typhoid.

A few days later I was near death. I went into anaphylactic shock. My doctor treated me with the drug novalgin, also known as diphyrone. This extremely dangerous drug was banned in Canada during the 60s and in the United States in the 70s. This drug causes agranulocytosis and anaphylactic shock both life threatening risks. Agranulocytosis is a dangerous condition where there is a severe reduction in the body’s white blood cells and anaphylactic shock is a severe allergic reaction that kills in mere minutes if not treated.

Novalgin is still being manufactured and distributed to countries in Africa and South America. It is a painkiller that can be substituted for paracetemol or aspirin.

According to BUKO Pharma-Kampagne, an advocacy group based in Germany that monitors the activities of German pharmaceutical companies in the third world, the drug is still being manufactured because “as long as there are good profits to make there is no reason for a company to stop the production. And where drug regulation is weak and independent information is lacking even bad drugs make good business”.

What’s frightening is that when someone who can afford treatment gets infected with a common illness like Malaria, they may have to contend with a flawed system which may include banned or expired drugs.After I went into anaphylactic shock, I was so sick that I was repatriated to the UK. My fiancé had to take me to the doctor on a weekly basis. I was suffering from severe anemia and had relentless migraine headaches, something I’ve never suffered from. Just walking a few feet left me exhausted and panicked. I couldn’t sleep and I had nightmares about the day I almost died. I felt like I was missing. Like Bruce Willis’ character in the movie ‘the sixth sense’.

Following weeks of bed rest it was decided that I couldn’t return to Sierra Leone. I was devastated. I had fallen in love with the country and I had formed a strong bond with Hannah, my boss at the radio station I was working at. I felt like I could help my trainees but now I was no longer in a position to do so. I felt defeated. I had traveled to Sierra Leone with an NGO that promotes human rights only to have my fundamental right to health be violated a right that is denied from millions of people around the world on a daily basis. It is a lesson that I will never forget.

I experienced first hand what can happen when you get sick in Africa but at least I had the resources to get help. Now I’m excited that something good has come out my experience and I’m looking forward to organizing a fundraiser with the Red Cross in the New Year to bring awareness on this dangerous but preventable disease.

This past October the Canadian Red Cross launched its largest net distribution to date: 2 million nets to Madagascar and Mali. For the average cost of a magazine and a coffee, I invite all Canadians in donating a $7 net.With more and more Canadians traveling to remote areas of the world, Malaria is something more people can come in contact with. Making it a very possible reality for all of us and a $7 bed net can be the difference between life and death.
Posted for Nam Kiwanuka

Bamako, November 29, 2007

Friday, November 30, 2007

Last week, I traveled to the region of Ségou where trainings of Mali Red Cross volunteers ahead of the campaign were taking place. I traveled with Tereta, who is also a professor of sociology in Bamako. We arrived in Ségou, where the Mali Red Cross supervisors and the regional president gave us a very warm welcome. We then went to see the training of over 25 volunteers who were learning about the five interventions that will be provided during the campaign (vaccination against measles, polio, vitamin A, deworming treatments and mosquito nets).

Every volunteer had a Mali Red Cross vest and they were also learning about the history of the Red Cross. It was very special to see all these people from all age ranges wanting to help others and be part of this huge Movement. They are the best source of inspiration for me.

The next day, we drove an hour to the north of Ségou and found ourselves in the village of Niono. The volunteers at this training were not only working hard but also having lots of fun at the same time! When I arrived with Tereta, they were in the middle of a role-play activity where a group of five volunteers pretended to be the health and Red Cross workers at the vaccination and distribution sites. Another group of volunteers represented the mothers and their children, and the remaining were the audience, which couldn¹t stop laughing and making fun of the nervous actors.

There was laughter, joy and at the same time serious commitment to the work that will be done during the campaign. It was a beautiful experience to be there.

On the way back to Ségou, we stopped at a small town called Marakala. There, we met the chief doctor who is receiving all the mosquito nets sent from the Canadian Red Cross warehouse in Bamako. The level of organization at this health centre was incredible. We also met the Red Cross supervisors who were preparing for the training of volunteers.

Madame Mah N¹Diaye, the Mali Red Cross supervisor in Marakala, is a woman that works in a female mutilation prevention program. The backyard of her house is the office and training centre of the Mali Red Cross in Markala. At this same location, a group of women sew baby clothes, tablecloths and bed covers to sell. This is how they raise funds to support the female mutilation prevention program. I felt a deep respect for their work and commitment and felt tremendously proud to be part of a Movement that counts with people such as this group of women.

We left Marakala before the end of the day and returned to Ségou. As the sun went down, purple, yellow and orange colors spread across the sky and shone over the river Niger. It was a perfect way to say goodbye to the unforgettable and colorful experiences we shared on this day.
Posted for Nathalia Guerrero

Bamako, November 26, 2007

Friday, November 30, 2007

Mali is preparing for the largest public health campaign ever held in its territory! During the last few weeks, the Ministry of Health and its national and international partners have trained over 10,000 health workers across the country that will provide vaccination services during the campaign.

The Mali Red Cross has also trained over 2,500 volunteers who will be working alongside the health personnel at the vaccination and distribution sites.

The mosquito nets, vaccines, vitamin A, and all the supplies needed for the campaign have travelled during weeks and they have now reached their finaldestinations: basic health-care centres all over the map.
Religious and community leaders, members of civil society, the media, the public and private sectors, have all been engaged in the campaign.

Information sessions in key regional hubs have been held to discuss each actor¹s role and the ways in which they can best contribute to the success of this massive public health initiative.I had never seen anything like this in my life! The whole country has mobilized to make this happen; to protect the lives of over two million children and their mothers, to improve their health and give them more chances to grow, develop and lead lasting and fulfilling lives.
Posted for Nathalia Guerrero

Malaria Really Does Bite!

Monday, November 26, 2007
A lot has happened in the past week. Although the malaria bed net distribution campaign here in Madagascar is over and has been for a couple of weeks, it seems, my experience with the illness most certainly isn’t. Apparently a mosquito carrying the P. Falciparum strain of malaria, at some point within my two and a half months here, bit me, presumably on one of my two field trips to Morondava. Subsequently I no longer have to wonder what its like to be affected by malaria. I can say with greater authority now that it’s uncomfortable, painful and downright scary.

I discovered I had malaria this weekend while on another fieldtrip, this time I went to the beautiful town of Fulpoint to observe a cyclone response exercise. I had been feeling generally ill for quite some time with bouts of dizziness and headache sending me to the doctor frequently, but, never really revealing the true source of the problem. Finally, after a dizzy and slightly feverish night in Fulpoint followed by a hot and even dizzier morning there I went to the local health center where I did a “rapid test” for malaria. It came out positive, but, I was lucky, I had access to drugs, a comfortable bed and most importantly more support and help than I could ever ask for.

(I would like to use a little of this space to thank all of the amazing people who took time away from their demanding jobs to so kindly help me this week. It will not be forgotten!)

I was unable to observe much of the exercise due to my condition, but, saw a little of the tent camp that had been put up for the “beneficiaries” (local residents who would pretend to be affected by the make believe cyclone). It was quite interesting to see what might be done if a cyclone were actually to hit. The meetings between the partners who would be responding to this make believe cyclone were even more illuminating.

Watching the combined efforts of such a diverse group provided a fascinating lesson about emergency response and the necessity for consummate coordination and communication in such a scenario. The exercise was generally successful, as I was informed by my bedside, but, not without the expected hitches. Those hitches, though, are the very reasons why we conduct such an exercise, I now understand.

Although I could do very little to participate it and was confined to my bed most of the time, I am happy to say the exercise demonstrated once again the resolve and commitment of the Red Cross and the humanitarian community as a whole here. This was confirmed on an even more personal level when my illness was revealed to me and the others attending. I have never experienced more kindness and selflessness than that exhibited by those who came to care for and visit me even despite the great challenges they were facing in the exercise.

Upon return to Tana on Wednesday I was taken to the “hospital militaire” where I was once again tested—this time I was given a more thorough “smear test”. The test revealed I was afflicted by the particularly grave strain of malaria common in Madagascar. I was then prescribed a new medicine and put on immediate bed rest and have since become a Tom Cruise movie connoisseur (mostly because the “Tom Cruise Selection” seems to be the only English language DVD we can find here).

This whole experience has indeed made the necessity of the Red Cross’ work and the bed net program even more apparent. Malaria, as the website says, really does bite. It’s painful and if not treated can and often does kill. It troubles me to think about those thousands of children infected by malaria who do not have the same access to the comforts and medicines that were afforded to me. As I lay here in my cozy bed I know if something should get worse treatment is only minutes away, but, it’s not that easy for every one. This is why prevention is so vitally important here. I had previously seen how excited mothers and children had been to receive their bed nets and now I truly know why: Malaria bites!
Posted for: Mandy LaRiche

The campaign “Semaine de la santé maternelle et infantile”...

Wednesday, November 14, 2007
The “Semaine de la santé maternelle et infantile” or SSME has finally come to a close, the visitors have returned home to Canada and we find ourselves once again back in Tana.

We spent a great deal of the past week of the campaign back in the coastal town of Morondava. This time we were able to survey several the distribution sites and watch volunteers from the Croix-Rouge Malagasy in the midst of their work distributing nets and supporting the campaign. A distribution site is, in fact, quite an interesting sensory experience. Upon first approach the sight of an apparent mass of people either sitting, standing, or leaning, but all waiting with several small children in tow, paired with the desperate cries of some of the children being poked with painful but necessary immunizations, in concert with the pervasive searing midday Morondava heat can be quite overwhelming.

Yet, as the initial shock dissipates it is easy to see that most of the sites were working as well oiled machines, or as it was put by another “organized chaos”. Generally the sites would function as follows: a parent or guardian called by number, the accompanying children would be immunized and given a vitamin supplement, and then they would be handed an insecticide-treated net or ITN. Most children would leave the site wiping leftover tears from their eyes while proudly balancing their new net on their heads. It was a gratifying thing to see.

During one of the site visits we also had the opportunity to go with a mother to her home to observe a net being hung. On the way the mother explained that she had four kids, a boy, a girl and a pair of twins, she then revealed that she was 24 years old, only a year older than I. I wondered what I would do in her situation, being so young, with so many children, so few resources, and the constant looming fear of malaria. I then thought of my own mother, of how much she sometimes worries for her children, which led me to ponder how one could ever possibly deal with such a preventable illness affecting their daily lives and loved ones so pervasively.

When I returned to the site a little distressed by my personal discovery but in awe of that woman’s resilience it was explained to me that malaria, like many other illnesses affects not only the family, but, the community as a whole. Indeed the loss of someone close is horrific, but, malaria often also threatens the economic viability of an entire region. Those affected by malaria understandably cannot partake in wage earning activities, and are subsequently unable to provide for themselves or any dependants. A region filled with people suffering from malaria can, as a consequence, become completely debilitated.

Of course, when I first joined the campaign understood that ITNs were essential, but, the experience of the past week has truly personified the campaign and emphasized the great value of the nets to many Malagasy people. Overall it’s been a greatly enriching time that I will not soon forget. I am hopeful that the nets will serve their purpose and will protect vulnerable families and communities in the approaching rainy season, when, due to a great resurgence of mosquitoes, they are needed the most.

Posted for Mandy LaRiche

Morondava, October 27, 2007

Monday, October 29, 2007

Our campaign against malaria started five days ago. During that time, I have had the privilege and the honour of working side by side with volunteers from the Malagasy Red Cross involved in the life-saving initiative.

I have followed them to urban areas and remote villages where distribution sites of mosquito nets were set up. One of the sites that struck me most is located five hundred meters away from the ocean shore, under the shade of an enormous palm tree, in the village of Ndrina.

Benajmin Randriamparany, the Malagasy Red Cross volunteer in charge of this community, knows almost every single family living in the village. He spent his days assisting with the operations of the site, and went back and forth to the community several times a day to bring mothers and children that had not yet come to receive their net. His commitment to the success of the campaign was remarkable and showed how critical it was for him to ensure that every child under five received a mosquito net. During these field visits, I have talked with many of the mothers coming to the distribution sites and the nurses working there. They know better than anybody else the importance of sleeping under a net and evading the bite of the lethal malaria-carrying anopheles.

I also had the opportunity to set off in a small boat and visit the coastal community of Betonia. Bernard Rakoto, the head of this village and father of eight children, asked me to bring back a message to the people that have supported this effort in Canada and especially to the members of the Canadian Red Cross. “In the name of my village, I thank you for your generous support. Thank you for helping us fight malaria!” Rakoto’s offspring and thousands of other children have already received free mosquito nets, vaccination against measles, vitamin A and deworming treatments, measures which immediately improved their quality of life.

The vaccinations and distribution of mosquito nets will continue until next week. Subsequently, follow up activities will start on the 31st October and will go on for another week, to ensure that the impact of their efforts is optimal. My colleagues from the Malagasy Red Cross have a long way to go before the malaria campaign comes to a close. However, they know what a difference their efforts are making and this, as they themselves put it, will be their best reward.

Throughout my journey across the region of Morondava, I was invited inside people’s homes and even helped them out in putting up their new mosquito nets. These experiences account for a myriad of images, interactions and moments that have taken a unique space in my heart, memories I will cherish for a long time.

Posted for: Nathalia Guerrero

Morondava, October 24th 2007

Monday, October 29, 2007
I arrived in Morondava two nights ago. A small town in the western coast of Madagascar, Morondava is one of the regions targeted by the Canadian Red Cross’s malaria campaign in this East-African country.

From the beginning of the campaign on October 22nd, I have visited rural and urban distribution sites of mosquito nets in Morondava and its surrounding areas. I am very impressed to see such a mass mobilization of mothers; hundreds of them arrive in the early morning to these sites and wait patiently until their children are vaccinated against measles and provided with a mosquito net, vitamin A and deworming treatments. Breastfeeding and gossiping are the main occupation here, while waiting for their child’s name to be called out loud by the medical personnel.

An orchestra of crying children plays at each distribution site from morning to evening. Mothers leave the sites with a bright smile on their face, while their little ones shed tears and moan.

Marlyn, a mother of four children, two of them baby twins, took our team to visit her home. After a long walk under the strong Malagasy sun at midday, we arrived to her house. She put up the new mosquito net and tenderly laid her babies on the bed to sleep under it. Afterwards, she invited us to drink coconut water.

The coconut water was a relief, and so it was to see that families were attending the distribution sites. This is a sign that the campaign is a success. It also shows that the door-to-door visits carried out by the Red Cross volunteers ahead of the campaign were tremendously effective.

As the campaign continues to move forward, I keep on following Malagasy Red Cross volunteers in their daily activities. As a communications delegate, I am a privileged witness of their efforts. I see their hearts in action.
Posted for: Nathalia Guerrero

Antananarivo, October 14, 2007

Monday, October 22, 2007
just came back from my first field trip in Madagascar. Our team drove over 700 kilometres from Antananarivo to Morondava, a small city located in the west coast ofthe island. The journey was a great opportunity to get to know our colleagues from the Malagasy Red Cross and share unique moments that will stay with us forever. It has also allowed me to discover the stunning landscapes and variety that this country has to offer.

The purpose of my visit to Morondava was to attend a Red Cross training to over thirty volunteers coming from different regions of the country. The participants were first introduced to the history and principles of the Red Cross. They were then taught social mobilization techniques and explained the roles that they will undertake during the week of the campaign against malaria.

In a country where this disease is the first cause of child mortality, such a campaign is taken very seriously by all involved. As I was talking to one of the local Red Cross coordinators, she said: "the fight against malaria is a fight against poverty". I will never forget these words and the expression in her deep black eyes when she said them.

I didn't understand much of what was being said during the training as it was given in Malagasy. But it was special just to be there and see how keen these volunteers are about helping their communities in the fight against malaria. Some of them are very young and passionate about humanitarian work. I think they are true youthful leaders that will make enormous contributions to their people. The hardships they have faced did not break their resolve but rather infused them with a force that now motivates them to help others.

For me, one of the best parts of my work is the opportunity to meet people such as them. It is a privilege to live these experiences alongside them and to learn from their strengths and experiences.

Antananarivo, October 1st 2007

Monday, October 22, 2007
Following a brief meeting with the President of the Malagasy Red Cross, I feel that now I have a better understanding of what the Red Cross principle of voluntary service really means. He told me a story that happened a few years ago in an isolated region of the country.

He was a volunteer with the Malagasy Red Cross when a wave of forest fires caused the displacement of hundreds of families. The local Red Cross didn’t have the funds to undertake a disaster prevention program, but there was an urgent need to educate families and protect them from natural calamities. His small group of fellow volunteers formed a community committee and started recruiting and mobilizing other Red Cross volunteers to implement a disaster preparedness program “without a cent,” as he himself put it.

Regardless of the program’s economical constraints, the volunteers were trained and went door to door to educate families on what to do to prevent and respond to major forest fires. They didn’t receive a per diem or a financial recognition to their work. But they did it because vulnerable populations needed their help.

I have seen similar efforts take place in different parts of the world and these examples give me the sense that the Red Cross is indeed an immense family. I don’t speak Malagasy, but at our office we all speak the same language. We all believe in the importance of protecting and providing assistance to vulnerable communities wherever they are, wherever we are.
Posted for: Nathalia Guerrero

Antananarivo, September 29th 2007

Monday, October 22, 2007
The days go by quickly in this part of the world where the sun goes always down at the same time of the day (around 6:30 pm). After my first two weeks in Antananarivo, my body has finally adapted to the new time zone and the different foods, which include a lot of red meat, vanilla and coconut.

I am sharing a small apartment with Mandy, a junior delegate who is here to develop her skills in humanitarian assistance from the malaria campaign experience and prepare for future missions with the Red Cross.

Every day, when I leave what I consider “my home” in Madagascar, a long line of people at their age d’or, greet us with a big smile on their face as we leave to the office of the Malagasy Red Cross.

They walk several kilometres a day to reach the place right under our home. It is an initiative that provides one meal a day to elders who don’t have the means to buy it. Their smiles are like a ray of sunshine that lightens my mornings.

Once I arrive at the office, I meet Mboula, my counterpart, and we start working on all the preparations ahead of the week of the campaign against malaria.
Posted for: Nathalia Guerrero

Malaria Campaign launch - getting ready...

Tuesday, October 2, 2007
Antananarivo is a vibrant city. Being here feels like being in the 1960s or 70s. Old structures and almost antique French cars fill this city situated in the highlands of the island. Poverty here is endemic but the laughter of playful children can be heard throughout the city. The kindness and hospitality of the Malagasy people towards visitors is known internationally.

It has been quite moving to see the pride the malgache take on their culture, history and geography. They are also very much aware of their history as a colonized country and their recent independence in the 1960s.

I am part of a team of four people from the Canadian Red Cross that is currently preparing for the launch of the Malaria Campaign - an immense effort to prevent this disease from killing more children under five years of age and their families.

When I participated in the post-tsunami operations, I was a witness of human generosity as the response to the disaster was almost as comparable as the destruction it caused.

Millions of people from all over the world gathered funds and supported the tsunami survivors. Today, I am again a witness of this universal human generosity by being part of this effort.How is it possible that so many children die of a preventable disease such malaria each year? I ask myself this question, especially when I see children playing in the streets. This is happily starting to change in Madagascar. In October 2007, over one and a half million families will receive a free insecticide-treated mosquito net, one of the simplest methods of combating malaria.

I enjoy very much working with the logisticians that make all this happen! They are at the heart of the operation, always alert and on call, anything can happen, but the nets HAVE to reach their final destination. It’s their job and they feel responsible for helping to protect the lives of those kids.

If you imagine the thousands of kilometres that a bed net crosses from its point of departure to its final destination: the bed of a child… it really makes you wonder!

I was amazed when I first realized that thousands of these mosquito nets travel by air, water and land. A logistician will do all it takes to reach the most isolated communities, and this means that sometimes bed nets can arrive by ox carts, pyrogue, unimog, or carried on human shoulders. This one is the most adventurous parts of the campaign…

Posted for: Nathalia Guerrero

Fighting Malaria in Africa

Tuesday, October 2, 2007
It has been over a week since I arrived in Antananarivo, capital of Madagascar. I am here to support the efforts of the Canadian Red Cross in the fight against malaria in the African continent.

Part of my work is supporting the Malagasy Red Cross in the launch of this massive malaria campaign that aims at distributing over a million bed nets to families with children under five.

Mboula, my counterpart in the MRC is a former journalist, like myself, with over four years of media experience. She joined the Red Cross only two months ago and is preparing for the October 2007 malaria campaign.

This is my first time in the African continent and, to my surprise, Madagascar is a nation that resembles some south-east Asian countries. During my last mission with the Canadian Red Cross, I spent one year in Indonesia working in the post-tsunami operations.

Today, I find it quite astonishing that the Malagasy people are descendants of not only Africans but also of Indonesian travellers that came to the island about 2,000 years ago. Being familiar with the Indonesian culture, I feel very comfortable in Madagascar. This the fourth biggest island of the world and one of its poorest countries.

Posted for: Nathalia Guerrero

Settling into the rhythm of the place...

Sunday, October 14, 2007
I have been here in Madagascar a little over a month now and I can most assuredly say I will not return home the same person. Although I will forever be an outsider here (a “vazaha” in Malagasy) I am beginning to settle into the rhythm of the place.

Until our field visit last week, I had only seen the capital and therefore my experience of the project and of Madagascar itself had been somewhat limited. This recent visit, though, I feel gave me little more insight. Even in Antananarivo one cannot help but notice the jarring beauty of the surrounding mountains, yet, as we traveled a few hours outside the city I was rendered speechless by the amazing geography of this great island.

Mountains were followed by grasslands, which were then followed by deserts. We drove though bitter cold and searing heat, through green forests and fields of giant ant hills, most often over roads that were impassably rough and remarkably dusty. It is true I was astounded by almost everything on this visit, but, it is fair to say I was most moved by the people I met. From my jovial but devoted traveling companions (from the Croix-Rouge Malagasy and the Canadian Red Cross delegation), to the helpful and courteous members of the local Red Cross societies, to the people on the roadside happily waving to us “vazahas” as we stirred up dirt clouds with our lumbering land rovers. I have come to greatly appreciate the people here.

My visions of the malaria project in Madagascar were also encouraging. In the metropolis of Tana it had sometimes been hard to envision how the weeklong campaign would unfold in some of the more remote towns and villages. This field visit allowed me to observe volunteer trainings and talk to the on site volunteers. This gave me a great deal more insight into what will be happening in the upcoming weeks.

My recent travels to Morondava have been both enlightening and alarming. I was, indeed, refreshed by the voyage into the field, but, was also shaken by some of the visions and stories surrounding the campaign. I discovered that Madagascar’s beauty is unquestionable, but, also that there is a pressing need for something to be done to improve the lives of many of the people here. I have realized the distressing truth that death, disease and loss are not foreign concepts to many Malagasy people. It is sad to see that something as preventable as malaria can ravage a people as resilient and affable as those that inhabit this place.

Almost everyone seems to have been affected by or have had an experience with malaria and as I discovered, on my arm, my first mosquito bite of the trip (despite layers of insect repellant and a bed net) I began to ponder just how it must feel to be afflicted by such an illness without the comfort of and assurance that is provided by easy access to drugs and treatment.We now preparing for the upcoming intensive week of the Campaign Integree, which will hopefully contribute to the eradication of this devastating and endemic problem. During the week of the campaign we will once again venture into the field for to observe the activities of the Croix Rouge Malagasy and its partners here and I will assuredly learn a great deal more about this important work.

Posted for: Many LeRiche

Getting grounded...

Friday, October 5, 2007
At times it’s hard to believe that I’ve only been here a little over two weeks, and at times it feels like I’ve only just arrived. I’ve spent my time here trying to develop a familiarity with my new surroundings. Antananarivo, while still foreign and (aside from a few streets around the office) tremendously hard to navigate, has become quite a comfortable home to me. I am slowly acclimatizing to the city’s noises, sights and smells.

I have also been finding my way in my new job as junior delegate, I’ve developed a clearer understanding of just what it is a delegate does and have subsequently become more familiar with the project itself. I’ve learned the Canadian Red Cross purchased nets are, in fact, a portion of a larger campaign— the Semaine Sante des Meres et Enfants, a week focused on women and children’s health, something I believe to be essential and empowering.

The nets will be distributed along with vaccinations and family planning advice during a one week campaign that endeavors to reach a vast segment of the population here. This campaign seems a huge undertaking at times, especially considering the difficulty of overland transportation, the dispersed communities, and the substantial amount of material and training necessary. In fact, a great deal of time here at the Croix-Rouge is spent devoted to organizing the movement of people and things around the country.

Of late we have been organizing our own travel as our small Canadian Red Cross delegation is set to venture out tomorrow. We plan to travel overland to the coast. This trip is something I think will be both informative and refreshing. We hope to have the opportunity to observe a future distribution site (in the process of preparing for the SSME) and we will also hopefully meet some Croix-Rouge volunteers.

I am looking forward to seeing another side of Madagascar, something I managed to get a brief peek at when on Sunday, Nathalia (the Canadian Red Cross communications delegate) and I took a ride just a few kilometers out of Tana. The quiet and seemingly relaxed pace of the countryside provided quite a contrast to the busy, often crowded streets of Tana. The shape of the mountains, to my surprise, reminded me of those on the west coast of Ireland where I had worked for some time.

I spent the afternoon contemplating the apparent sameness of all the places I’ve been. I realized my experience here to date has reinforced my belief that despite our differences we all share the experience of being human. Inherent in this shared humanity, I feel, everyone deserves the things that the Red Cross and its partners here are attempting to provide; health, knowledge and hope
Posted for: Mandy LeRiche

Welcome to Madagascar!

Tuesday, September 25, 2007
When I landed in Madagascar two days ago, I was not sure what to expect. It felt as though I had walked off the plane and into another world. I had hoped to get a view of the island from the air but the sun had long set and I had an aisle seat. That seat, though, was invaluable to me, as this was how I would get to my new home for the next five months in Antananarivo, Madagascar.

Only a month ago I had received the phone call from the Canadian Red Cross International office informing me that I was to become the new junior delegate. I was thrilled.

I then set about on a series of medical visits where I was poked and prodded with a host of vaccines and prescribed with five months worth of anti-malarial medicines. With sore arms and two full bags I then traveled to Maniwaki, Quebec (a few hours outside of Ottawa) where I attended the Canadian Red Cross overseas personnel basic training course. After seven intensive days of learning and one final night in Canada, I boarded my flight.

Upon arrival I was met Madagascar Malaria Program Manager and former junior delegate Adam Johnston. My next days in Madagascar were spent learning how a malaria bed net campaign is organized and implemented. Thus far my experience has been enlightening.

Since my arrival here I have been met with such warmth and generosity on behalf of the Malagasy people. I'm excited to see how the program unfolds and expect to learn a great deal.
Posted for: Mandy LeRiche

Community Efforts by Community Members

Friday, March 23, 2007

Even for someone from the west coast of Canada the recent rhythm of the rain has seemed an almost foreign sound after months of straight sunshine. It signals the beginning of the rainy season, and with it, an increase in mosquitoes harboring the malaria parasite. In preparation, the Kenya Red Cross has mobilized its volunteers for an intensive ‘Hang Up’ campaign to encourage the use of mosquito nets.

When properly hung over sleeping spaces, insecticide treated nets prevent malaria by providing an effective barrier to mosquitoes. In July and September 2006, the Kenya Red Cross - in partnership with the Kenya Ministry of Health, distributed approximately 3.5 million long-lasting insecticide treated nets free of charge, but now they must promote proper usage by those most at risk – children and pregnant women. Over the longer term, a ‘Keep Up’ program will be conducted through periodic house to house visits by volunteers to continue to promote net use as well as communicate other health messages such as prompt treatment of fever and completion of immunizations.

The Kenya Red Cross, like other national societies, is a volunteer based organization rooted at the community level. This enables Red Cross to be effective in social mobilization - a process to reach, influence, and involve all relevant segments of society to affect positive behavior and social change. However, organizational capacity does not guarantee program success and it is therefore critical to gauge and evaluate programs in order to adapt approaches and strategies and become more effective. The Kenya Red Cross and the International Federation of Red Cross and Red Crescent Societies, with technical support from the American Red Cross, will be conducting an evaluation of the “Keep Up” program to assess its effectiveness, and I have been working to support Dr. Patricia David - Senior Health Advisor with the American Red Cross prepare the initial survey.

In order to prevent inaccurate results, a great deal of thought and attention must be put into the careful wording of every question asked in a survey of this nature. It is critical to rely not only on the advice of professionals who specialize in the field of data collection and analysis, but also on people with local knowledge who understand the cultural context. Questions must be easily understood, even by those with little or no education, but must not be overly leading, or they risk encouraging false responses.

This baseline survey will provide information about current net ownership and use as well as gauge the level of general malaria knowledge. When compared against the final survey, the results will reveal the impact and effectiveness of the program and will provide information that can be used to develop guidelines and training materials for future Red Cross programs and for other civil society organizations wishing to implement similar initiatives.

Outside of work, and through a strange twist of fate, I have had the opportunity to link up with a grassroots women’s group from Kibera – one of Nairobi’s slums, and one of the largest in the world. There are nearly a million people living in Kibera, approximately one quarter of the population of Nairobi. Though they pay rent, they have no legal entitlement to the land on which they live. They are forced to seek protection from forced displacement through political or tribal patronage, or they risk having their homes dismantled or burnt down. With each wave of migration towards the urban center and away from the problems of rural underdevelopment faced throughout the country and the region, Kibera has become home to residents from all the major tribal and ethnic groups. This multi-ethnic make up combined with the system of political and tribal patronage has been the source of many violent and volatile conflicts over the years.

The group I met was formed spontaneously by women representing all of Kibera’s tribes and major religions who came together despite that their differences were often the source of conflict, with a common desire to provide protection and support to women being targeted for rape and abuse during the tribal warring of 2000. Since then, they have grown to nearly 200 members and evolved into a branch of a broader movement called the Vision Sisters. Today, the Kibera Branch meet regularly and are involved in everything from support and care to people living with HIV/Aids to pooling funds to acquire legal entitlement to land.

As the lack of land ownership is one of the main reasons for the marginalization of those living in Kibera, the primary goal of the Vision Sisters is to raise funds to purchase legal land and shelter outside of the slum for all of its members. However, in recognition that this will take time, they have also turned their attention to meeting the immediate needs of the most vulnerable among them, and within the broader community. To support their initiatives, they run a catering service for local weddings and celebrations that provides a source of revenue they use to rent a meeting room and fund their activities and land purchases.

Until now, the group has been entirely self-funded and independent, but through meetings with local contacts and introductions to other contacts, the group is beginning to tap into some of the resources and support structures that they can access through partnerships and collaborations. As a result of their networking, several members were invited to participate in last summer’s World Urban Forum held in Vancouver. When Mama Hamza, the group’s Chairlady, shared with me her thoughts on the conference, I could see the pride and confidence the experience had instilled in her. At the World Urban Forum, they were able to meet with other grassroot groups as well as major organizations from all over the world to share ideas and learn from each other. These women, most of whom are of a generation that didn’t have the opportunity to attend school beyond primary level, now speak the language of development; talking about organizational capacity, income generation activities, and good governance. With the support of a local contact with the United Nations Development Programme, occasional access to a public computer for email and typing, and a small budget for printing, they are now preparing to write a proposal for funding to build a women’s shelter and have interest from a major international donor.

Knowing the language and systems of organizations may seem insignificant, but that knowledge is the key to accessing outside support. With this support, a local group like the Vision Sisters can develop programs that are based on their understanding of the needs and capacities of their community that those on the outside would likely never be able to. While I was not there in an official Red Cross capacity, I helped to brainstorm ways that they could tap into the services and training provided by the Red Cross, such as First Aid training and the HIV/Aids home based care program. In its essence, this is how the Red Cross can best serve the most vulnerable - by tapping into the potential within vulnerable communities and empowering community members to actively improve their circumstances.

Walking through Kibera, the vibrancy of life is evident throughout; its narrow dirt pathways - arteries of activity - wind between the jumble of tin shelters. A butcher hacks at hind quarters along side a barber who cuts hair, and nearby a rough piece of blackboard advertised in chalk a ‘movie theatre’ - a cramped dark room playing pirated dvd’s on a small television. Evident also is the tragic realities of utter poverty; garbage and feces line the paths - evidence of the ‘flying toilet’ - a practice of disposing of human waste by simply tossing away the bag used as there is nowhere to properly dispose of it - and flows into streams used for drinking, contributing to the spread of disease. Substance abuse is rampant, as is physical abuse. Children are especially vulnerable as many have been orphaned by mother’s succumbing to HIV/Aids, a growing problem with one fifth those infected with HIV in Kenya, living in its slums.

It was humbling to see the strength and resilience of those who live there; to see that people find ways to support their families, ways to have their children go to school, ways to feel joy and happiness even when surrounded by hardship. However, it is also discouraging knowing the immense challenges they face, and I can’t help but feel that the slum phenomenon will be one of the biggest challenges the world will face in the next hundred years if globalization continues to further marginalize people through gross disparities of wealth.

…As I looked out over the ever expanding horizon of tin roof tops, feeling overwhelmed and somewhat dejected, Mama Hamza tapped me on the arm knowingly as a close relative would and spoke in almost reassuring tones about the future of Kiberia. She remains optimistic that things can improve, and she has taught me that if women like her, who have seen and experienced so much hardship, can find reason for optimism then all of us should.

Lamu

Saturday, February 24, 2007

Beaming in the mid-day sun like bright white beacons, the clusters of ancient stone buildings and the starbursts of green palms were all that broke the otherwise endless blue of sea and sky as we crossed the narrow ribbon of Indian Ocean from nearby Manda Island.

We were headed to Lamu; an island ringed by a collar of white sand and renown for its fascinating cultural history and fantastic Swahili cuisine. Nestled tranquilly in an archipelago of the same name that stretches Kenya’s northern coast to Somalia, Lamu and its surrounding islands are dotted with isolated rural villages where the distance, difficulty, and cost of travel make access to health care extremely limited. We had come to conduct an assessment of the malaria health situation and to meet with the local Red Cross branch and Ministry of Health district to discuss a proposed community based integrated malaria prevention, diagnostic, and treatment project.

Lamu is a captivating place where you cannot help but feel transported back through time and absorbed by cultural richness. It is recognized as one of the oldest and best preserved Swahili settlements in East Africa with most of its architecture dating back to the 14th century when it was one of the main ports of the Arab trade routes. Unlike most of the rest of Kenya, the region is almost entirely Muslim, but centuries of Arab, African and European cultural influences are reflected in the diversity of today’s Swahili culture and evidenced in Swahili cuisine’s blend of Indian and Arabic spices with local seafood tropical fruit. Palm thatched roves cap the white stone buildings of the island’s towns that are themselves intricately woven mazes of narrow lane ways where the only traffic is the occasional donkey, a group of giggling children, or a woman gliding past gracefully; her black flowing bui bui garment alluding that she was perhaps just a shadow.

After several weeks of gridlock traffic during my daily commute to the Red Cross office in Nairobi, it was a pleasant change of pace to have only to negotiate the odd donkey-jam during my ‘commute’ along the shoreline from Shella - where we were staying, to Lamu town - where the Red Cross office is located. We met the local Red Cross staff in a small bungalow restaurant over looking the ocean the morning before we were to set out for some of the other islands to carry out our assessment. They were gracious in sharing with us information about the programs they are running and the challenges they face.

As the region is susceptible to both severe drought and flooding, the resulting serious issues over access to clean drinking water, food security, and overall basic health have been their priorities. The Kenyan Red Cross has had an active branch in the region for a number of years and today has over 200 volunteers who have been involved in a variety of disaster response and health programs; including a recent integrated measles/malaria campaign that saw the distribution of Long Lasting Insecticide-treated Nets to all children under five. They noted that having volunteers in almost every village gave them unique access for providing community based health strategies. They also noted that there were virtually no other organizations working in most of the villages. Unfortunately, though they have the capacity, in a region made up of islands, the enormous geographic and logistical challenges mean they do not always have the necessary resources or support.

Following our meeting with Red Cross, the members from the branch arranged for a meeting with the Ministry of Health regional representatives, and after gathering our things, we re-entered the traffic along the break water – men carrying large sacks of dried goods or pushing carts, and of course, more donkeys. We met with both the Public Health Officer and the District Medical Officer who were able to describe to us the overall health picture of the region based on data collected over the years. Malaria has been, and continues to be, the number one cause of out patient visits – meaning it is the leading cause of sickness, and it is the number one killer of children under five. Though the region has a number of health facilities, they have been difficult to staff and keep properly supplied. Furthermore, access to these few health facilities usually requires transportation by boat and often tides, weather and cost are preventative. By their estimates, a full 40% of the regions population has no access to medical facilities and the other 60% may have limited or infrequent access.

The following day we went out to see for ourselves some of the challenges to health facility access and to assess the overall health situation at the village level. There is a near ever-present wind in Lamu that creates a decent swell and even traveling by speed boat there were a number of considerations that had to be given to tidal, and weather conditions. It gave me reason to pause and consider how challenging travel must be given that most boats used in the region are dhows – traditional Arab sailing vessel carried by lateen sails that are as stunning in their simplistic beauty as they are awe-inspiring for their long history of travel between Africa and India.

We first visited the Bargoni area; one of the only areas accessible by road and only thirty kilometers from Somalia. Due to its proximity to the border, there is a large military camp in the area, attached to which is a Health Center. The Health Center was established to serve the military personnel but has also been serving the surrounding villages. This meant that those living here had comparatively better access to health services than most other areas in the Lamu district. However, in meeting with the community based health volunteer who worked at the center, it was clear that they were often under staffed, under stocked, and ill-equipped to provide proper care. Furthermore, serious cases required referral to Lamu town and transport - first by road, then by boat - was not always available.

Nearby we visited the small rural village of Msukani where we were met by curious but nervous children and gracious village elders. We were ushered into a meeting hut where, we were informed, all important village meeting take place – and where they on occasion watch soccer. We were soon joined by all the village elders who came in and took a seat while the children of the village peeked quietly from around the corner of the door. Through our local Red Cross translator we were able to ask them about what they felt to be their biggest health problems, what they did when they were sick, and when and how they were able to get treatment. It was clear in talking to them that there were a number of serious health problems, with malaria and respiratory tract infections being the two most prominent.

While the village was only 12 kilometers away from the health center – as opposed to the 44 kilometer average throughout Lamu – and even with the road, often if someone became ill they would not immediately go to the centre as there is no transport and walking is often to difficult for the seriously ill. Normally when someone in the village becomes sick, they are first treated at home using traditional remedies. If conditions worsen than arrangements are made to get the person to the health center, transporting the person by wheelbarrow if necessary. In serious cases where a person is referred to Lamu town hospital, transportation is an even greater challenge as they rely almost entirely on the good will of the military to drive a sick or injured person to Mokowe where they then have to pay to be transported by a boat, if one is available. It was easy to understand how limited access to proper health services was even here where there was a health center nearby and a road to the nearest port, to say nothing of the more isolates and remote island villages.

When it comes to malaria, access to medical facilities is vital because even with the successful reduction in cases of malaria through preventative intervention strategies like bed-net use, none are 100% effective and once someone has fallen ill with fever, the first 24 hours are critical for acquiring proper diagnostic testing and, if necessary, drug treatment. New drugs such as artemisinin-based combination therapies (ACTs) have proven to be very effective in treating malaria but for those living in remote areas, such as in Lamu, it is necessary for them to be made accessible at the community level without contributing to their misuse that could lead to new drug-resistant strains of malaria developing. New technologies such as Rapid Diagnostic Tests (RDTs) have now made it possible for malaria testing to be done outside of a laboratory and by those who require only basic training. The possibility now exists for RDTs and ACTs to be brought from house to house and administered by a local community based volunteer to those who would otherwise be too sick, too poor, or otherwise unable to make it to a health facility. With the enough commitment from the Ministry of Health, the Red Cross, and other partners, this type of a program could be successfully undertaken by local Red Cross volunteers in regions where there is a clear need; such as here in Lamu.

Catching one final glimpse of the overlapping belts of white sand and azul water from the window of the plane as we began our return to Nairobi, I couldn’t help but feel that the beauty of the region masked a much more complex picture; one that included serious challenges to the health and well being of the people who lived there. It can be overwhelming at times when you begin to consider all the challenges and implications related to developing and implementing basic health programs. I took comfort in an image that will stay with me from our visit to Msukuni village; that of a village elder, physically frail but strong in spirit and full of pride, who spoke with conviction about the health of the children in his village. It is of great inspiration knowing that he, and others like him, are willing to do whatever they can to help others who are in need.

p.s. My apologies to those who had submitted comments to be posted and for the delay of this entry, there were some technical problems with the website that have now been resolved.
posted by Adam Johnston at 12:49 AM

2 Comments:
Anonymous said...
Hi Adam,Your job seems very demanding, do you get down time to explore the beauties of the countries that you've been to? Which were most memorable and why? Does part of your job include making presentations of your project when you return to Canada? It would be interesting to see...Warm regards from cold Toronto,Ann Nguyen
March 20, 2007 6:02:00 AM PDT
Adam Johnston said...
Hi Ann, Yes the work we are involved in can be very demanding at times and requires a willingness to sacrifice to some degree some of the 'balance' that a more 'normal' 9-5 job might allow. However, I feel myself fortunate to do a job that I am passionante about and that I find fullfilling... and we are very fortunate to work and travel to some amazing places where we are surrounded by both natural beauty and the inner beauty of the people we meet...It's hard to say which places have been most memorable; I'd find them all memorable in their own way, and hope that I will remember them all. Each place is unique just as each person you meet is unique. Certainly the places I feel most fortunate to have visited through my work are the areas I wouldn't have otherwise had access to such as the villages of Sierra Leone, the remote regions of Papua, and the refugee camps in Kenya.I will in fact be doing a month of public engagement and advocacy when I return home in April... If you are interested or if you have a group that might be interested in a presentation email me at adamkjohnston@hotmail.comThanks for your comment.Adam
March 20, 2007 9:18:00 AM PDT

A Note from Nairobi...

Monday, February 12, 2007

Sitting on the deck of my apartment in Nairobi earlier today, watching the glow of the late afternoon sun seep through the surrounding trees, I nearly forgot I was in the middle of one of the largest urban centers in Africa. Nairobi is an interesting city - it is like most other modern urban cities in the developing world, but unlike others whose landscape is dominated by urban sprawl, Nairobi’s is partly camouflaged by a blanket of greenery. Although, when caught under a thick cloud of smog, bumper to bumper in the city’s notoriously bad traffic jams, there is no questioning it is a true urban center.

This incongruous dichotomy is epitomized by one of the city’s strangest sites; the large pelicans that fill the trees that line Mombasa Road; Nairobi’s busiest and most congested artery. Despite the noise of the traffic, the pelicans stand somberly in the trees with their heads down as though they were in mourning. It’s a site I observe often as I shuffle along in traffic on my commute across town to the Kenyan Red Cross office.

I have been working alongside the Kenyan Red Cross, where my focus continues to be on malaria prevention, only now within a broader context of health and disaster relief programs. I just returned from a trip to Bora, in eastern Kenya, where flooding occurred in December displacing thousands of people and leading to outbreaks of Rift Valley Hemorrhagic fever and malaria. The Kenyan Red Cross has been working to provide relief to the Internally Displaced People (IDPs) whose villages were washed away and who now find themselves living in camps. Several Red Cross Emergency Response Units (ERUs) - specially designed rapid response medical and water/sanitation units - were deployed from other Red Cross National Societies to provide support. I went there as part of an assessment mission to gauge the impact of the response and to participate in an ERU coordination meeting.

In north-eastern Kenya’s dead flat landscape, the vegetation is limited to dry scrub brush, thorn bushes and low stunted trees. With temperatures normally in the 40’s, it has an extremely hot, dusty, and seemingly inhospitable climate. The people who live there are mostly nomadic goat herders of Somali decent. Their tall slender frames are draped in colorful cloth that reveals only glimpses of their sleek features and light brown skin. The area has historically been prone to drought which has been especially devastating in the past few years. Now, only a few short months after recovering from the most recent drought, severe flooding has washed away many villages, forcing many people to live in camps.

Walking through these camps, I was truly struck by what it means to be vulnerable; it was easy to see why and how camps such as these are the most precarious places to survive. With only the most basic materials for shelter, those affected found refuge on the high points near roads where they were safe from the flooding but where no clean water or food could be found. These people were almost entirely reliant on the aid provided through the emergency relief of the Kenyan Government, the UN, non-governmental organizations and the Red Cross.

Even still there were signs of people’s resilience and strength; something you don’t see in television images of refugee camps. Guided by a local Red Cross water and sanitation volunteer, the men in a camp I visited were digging latrines and the women were gathering and burning garbage. The initiative shown was a clear indication of the desire for self-reliance. With the flooding now over, some people have been able to return to their villages, but others have nowhere to return to and now face the difficult task of resettlement.

In a region of such scarcity, the resettlement of displaced peoples can overwhelm the limited resources available. As such, tensions can mount quickly between newly arrived displaced people and those already living in the area. For example, what little exists in the way of health care facilities can quickly become overburdened with the outbreak of disease that often occurs in camps such as these. While the medical services provided by the Red Cross ERUs help mitigate the demands on local health facilities, they offer only a short term solution. For this reason, close collaboration with the Kenyan Ministry of Health and the Kenyan Red Cross is important to strengthen the local capacity to meet the demand for services.

The links between disasters, migration, disease, and conflict are palpable in regions such as this, perpetuating the cyle of vulnerability. Those who are poor and marginalized are at greater risk of being displaced by disasters such as floods; once displaced they are at greater risk of succumbing to diseases such as malaria – which itself is exacerbated by flooding. Outbreaks of disease in turn put pressure on limited health facilities and add to the competition for limited resources that can, in turn, lead to tension and even conflict. The already vulnerable people are further marginalized and impoverished.

The rise in disasters in recent years in Kenya, and around the world, is evidence of a further link in the cycle of vulnerability; one to climate change. Changes in rainfall amounts and severe weather events are being attributed, at least in part, to global warming. Desertification, drought, even the latitudinal and altitudinal spread of malaria is proving to be caused by increases in the earth’s temperature. Given there is now a general consensus that we all contribute to global warming through the emission of greenhouse gases, there is a link between our consumption habits and the vulnerability of others. This global interconnection highlights how our actions can negatively affect the lives of others, but it should also serve to remind us that we can choose actions with different outcomes.

In this regard, I continue to be inspired by not only those who work here on the ground to alleviate and prevent human suffering, but also by those back home who understand the capacity they have to do the same in their everyday actions. I recently had the opportunity to connect with a group of such people when I was linked in by phone to a conference held in Vancouver by the Red Cross Youth Training in Action Program (Youth TAP).The aim of Youth TAP is to tap into the energy, creativity and compassion of youth and to provide them with the skills and support to take effective action as global citizens. Youth are often referred to as the leaders of tomorrow, but they are also the leaders of today. The local actions of youth in their schools and communities have been have been at the leading edge of global changes such as the ban on anti-personnel landmines, the international protocol to end the use of child soldiers and the rising attention to the HIV/Aids pandemic.

During the call, the youth participants had the opportunity to ask me questions about life as a Red Cross delegate and about how I became involved. Many did, however, most of the questions were about the bigger issues of malaria andchallenges facing a post-conflict country like Sierra Leone. These young people understand the power of knowledge and are eager to know more about the world they live in so that they can decide how best to act in the interest of humanity. I came to be involved with the Red Cross for the same reason, and while I am now undertaking a career in humanitarian aid, I think of my career choice as only one extension of my commitment to personal action as a global citizen.

One question I was asked was; ‘do I see a difference?’ At the time I think I misunderstood the question and answered only in terms of the impact of the malaria prevention program. Leaving the camps of Bora a few days after the conference call, I thought again about this question and realized that it was perhaps much broader. I got to thinking, is the work being done by organizations like the Red Cross making a difference? While there is always more that could be done, the work being undertaken by humanitarian organizations is making a difference in the lives of those who are vulnerable; people like those displaced in Bora. Are we collectively, in the broadest sense, making a difference? While there is plenty of evidence where more needs to be done, there is hope to be found in the cases where our collective voices have influenced international laws or policy.

As I thought about the question and the youth participants of the conference, I was reminded of a quote by Margaret Mead – “Never doubt that a small group of thoughtful committed citizens can change the world. Indeed it is the only thing that ever has.” The choices and actions we all make are important and the youth involved in the Youth TAP conference should take pride in the role they play in addressing the root causes of vulnerability.
posted by Adam Johnston at 10:11 AM

5 Comments:
Patrick said...
The occurrence of “natural” disasters amid complex political crises is increasingly widespread: over 140 natural disasters have occurred alongside complex political crises in the past five years alone (UN 2006). “The dramatic increase in major disasters witnessed in the last 50 years [also] provides worrying evidence of this trend, [and] if climate change produces more flooding, heat waves, droughts and storms, this pace may accelerate” (UN 2004). In fact, average worldwide losses from natural disasters have been increasingly exponentially since 1960 (Munich Re 2005). To make matters worse, where conflicts already exist, “the threat of climate change is likely to exacerbate, rather than ameliorate matters because of uncertainty about the amount of future resources that it engenders” (IPCC 2001, Working Group II). At the same time, political crises and armed conflicts indirectly exacerbate the impact of natural disasters by exhausting coping mechanisms and response capacities. Indeed, human-driven “environmental degradation has enhanced the destructive potential of natural disasters and in some cases hastened their occurrence” (UN 2004). In this rush of feedback loops, the catastrophic risks are magnified by the fact that some of the risks are positively correlated, which implies that “regional climate change, as with other causes of environmental degradation, could make armed conflict more likely” (Purvis and Busby 2004).Clearly then, studying the linkages between human insecurity and conflict and between humanitarian crises and conflict is vital, yet these linkages have not been as widely studied as the political and military factors that lie behind them. More effective cross-disciplinary research is desperately needed to bridge the archipelago of disaster studies. To be sure, partitioning the general study of disasters from other fields, and partitioning specialties within disaster studies from other specialties, creates a patchwork of isolated approaches rather than what we need: a coherent, comprehensive, and connected view.These isolated approaches explain why the disaster management and conflict prevention communities hardly collaborate. Indeed, they opine that disaster and conflict early warning systems “are logically different” (Schmeidl and Jenkins 1999) even though both types of disasters have commonly led to massive internal and external displacements of people, and many disasters, whether man-made or natural, are interlinked, and disaster-prone regions, countries or group are vulnerable to any kind of disasters. In other words, despite the different origins of disasters, they share many common elements. Moreover, there are obvious functional parallels in risk assessments, monitoring and warning, dissemination and communication, response capability and impact evaluation. These analogous functions have real operational consequences for implementing organizations and stakeholders. Still, the two communities are not engaged in either joint dialogue or scientific research. This is ironic given repeated concerns that disaster early warning systems are too narrowly focused on meteorological and agricultural information at the expense of socio-political indicators (UN 2006), while conflict early warning systems are being urged to integrate environmental change indicators into their analyses. These converging trends clearly demonstrate that disaster and conflict early warning share the same functional logic: early detection and early response. The salience of this logic for prevention, mitigation and adaptation to climate change needs to be operationalized.http://fletcher.tufts.edu/phd/students/Meier.html
February 14, 2007 5:40:00 AM PST

Kent said...
Hi Adam, My name is Kent and I've been following your travels with great interest from my home in Ottawa. I was wondering what advice you had for recent university grads who are applying to the CIDA-funded internships? Did any particular technique or strategy work for you when in a similar position before joining the CRC as a youth intern?I was living in Dar two years ago as a student and would love to return to that area of the world as an intern. Thus any advice you have would be appreciated. Also, I noticed your interests in pursuing a career in humanitarian assistance. Have you heard of the joint-masters program on humanitarian action (NOHA)? It's offered by seven universities across Europe and is designed to train fellows for professional careers in relief and humanitarian management. Check it out at http://www.noha.deusto.es/introduction.aspThanks again for your advice! Best, -Kent-
February 19, 2007 2:00:00 PM PST

Anonymous said...
Hi Adam!I am really happy to see that you are still out there doing an amazing job! I just find out about this blog. Just to let you know, most of the btc group from last year did the ERU last week. So maybe will be seeing you on the field!Take careClaudia
February 23, 2007 6:55:00 PM PST

Anonymous said...
Hi Adam,You have travelled and seen so much misery and even though it must be overwhelming for you at times, I always notice how you are able to see the beauty around you, in the country and it's people. I think it is important for us to remember and understand, that even the harshest and devastated place has beauty. That the diseased, impoverished and devastated people of these poor countries, have a beauty and strength that most of us will never know.I am sure your work will have a positive affect on the people you are trying to help, as well as on us here at home.Take care and stay safe.Love Gaile, Al & Family
March 1, 2007 12:33:00 AM PST

Adam Johnston said...
My apologies for the delayed response to those who have left comments or asked questions. Due to technical problems it has not be possible to post your comments or reply to them until now.For those who have specific questions or want to get in touch with me directly, I can be reached by email at adam.johnston@redcross.ca I'd be happy to provide any responses or suggestions to those interested in humanitarian work, or the work of the Red Cross.Thanks for the interest and support you have shown through your questions and comments.Adam

Kenya

Sunday, January 21, 2007

Having barely touched down in Nairobi after traveling from the easternmost part of Indonesia, I found myself in the air again. This time I was off to Kisumu - a town in Western Kenya perched on the shore of Lake Victoria. We were headed there to help facilitate a visit from a group of Canadian Members of Parliament who had come to Kenya to see first hand some of the major health issues facing not only this country, but all of Africa.

The focus of their visit was on HIV/AIDS, tuberculosis, and malaria; three diseases that have a crimpling effect on Africa, accounting for over 12 million deaths and immesurable human suffering. Statistics like these tend to wash over us without imparting much meaning or having much impact. Often they only have the effect of leading to a defeatist attitude that the problem is too big. A visit such as this gives a human face to these complex health issues and provides an opportunity to better understand the efforts currently underway that are having a positive impact.

Flying in across the great Rift Valley, I could see the vibrant green hillsides drop sharply down to the valley bottom and spread into an ironed flat sea of green grassland that drained out to Lake Victoria where the orange glow of the evening’s sunset mirrored itself in the distance. The shores of Lake Victoria border on three countries that are home to some of the most vulnerable people in Africa. For the Red Cross, this is a priority region and there are a number of programs operating here including an integrated health initiative for people living with HIV/AIDS.

The region has some of the highest levels of HIV infection and those infected and suffering from decreased immune systems are more susceptible to malaria and water born diseases that are also highly prevalent. By integrating malaria, water and sanitation, and HIV/AIDS home based care program, a single village based volunteer is able to address these interlinking health issues during each individual house visit. This approach ensures that those living with HIV have received LLINs (nets), Household Safe Water Treatment Systems and that they are being used properly and that information regarding treatment and prevention is understood.

We visited a village about an hour and a half’s drive from Kisumu called Siaya, where we were greeted at the local Red Cross office by a jubilant group of volunteers who broke in to raucous song as we arrived. Their exuberance was inspiring and was like a contagion of positive energy. Their chairman expressed his gratitude, saying that a visit to their small village by government officials from as far away as Canada gave them hope and encouragement. He explained the many challenges his village faced with high rates of HIV infection, tuberculosis and malaria but also of how his village had benefited greatly from the mobilization of volunteers.

Many of the volunteers are HIV positive but were empowered by the realization that they can play a role in improve the health and wellbeing of themselves and their communities. Through their work, the community itself has been strengthened by the same realization - that there are ways they can improve their own lives and livelihoods whether by making use of a bed net, a water storage system, or by seeking treatment.

The positive impact of these programs was evident in the homes we visited and in the people we spoke with. Beyond the immediate benefit of having received an LLIN, a water treatment system, or ARV drug therapy, the critical benefits of community invovlement were also evident.

By mobilizing community based volunteers in an integrated and interactive, the Kenyan Red Cross has developed culturally appropriate messages and approaches that utilize a variety of communication channels. The effect of this effort has not only been a positive change in behavior amongst the targeted group – those living with HIV, but also amongst the wider community. This was evidence in the open manner in which people in Siaya discussed their HIV status; a sharp departure from the stigma normally associated with the disease.

The homes we visited were mud-grass huts, sparsely filled with a few household items, mostly used for cooking and perhaps a mat or two for sleeping. In between the homes, chickens darted between small gardens where smatterings of corn and root vegetables grew. Children to young to attend school looked at us nervously as they sat between yellow-orange mosaics of grain spread out on the ground to dry in the sun.

This glimpse into rural African life was for some of the MPs their first, and many of them were struck by how basic their living conditions were. Some were at times visibly overwhelmed by the vulnerability of the people of Siaya, especially those living with AIDS. However, they also recognized their strength, resilience and how, with the adoption of a few tools and methods, their overall health and livelihoods could be dramatically improved.

Often it is not a question of not having solutions but of lacking the resources to implement them. The resolve of the volunteers and community members of Siaya can be found throughout Africa, but without the most basic of tools – nets, sanitation kits, and drugs - many villages are unable to carry out successful programs such as this.

The MPs who came to Kenya came by invitation but, they came by choice, and they should be commended for taking interest in issues that often do not receive the attention they deserve. Their attention, as elected MPs, is of course significant because of the role they have in determining how Canada can help improve the health and wellbeing of our global society. However, we all have a role in this; we are all represented by a Member of Parliament. As such, all of our attention to these issues is important as it will determine how Canada will act. Something as simple as taking a few minutes to write a letter to your MP or donating a few dollars to an aid organization can signal your support, and help ensure health issues like TB, HIV/AIDS and malaria are a priority. Collectively our actions shape and influence the world in ways we often don’t even realize.
posted by Adam Johnston at 3:38 PM

3 Comments:
Anonymous said...
Hi Adam,I am glad to hear that some of our officials are taking an interest and seeing first hand, the problems that our country needs to help with. We can only hope their visit will have a positive effect, on how Canada proceeds in helping the Red Cross, help these people.It must be rewarding for you to see how even basic aid can help make a difference.Keep up the good work and be sure to look after yourself.Love Gaile, Al & Family
February 28, 2007 11:58:00 PM PST

Sue Gunter said...
Hello AdamCongratulations Adam and the Red Cross on your work in Kenya! Kudos for offering the Canadian officials a window into what life looks like for hundreds of millions of vulnerable people in Africa. Thank you for encouraging readers to write to their MP's; a smart and very effective way to let our government know how we feel and what we would like done. We, a group of 10 ladies from Montreal, Canada visited Itegero, a village not far from Kisumu, last year for 3 weeks, and are still actively working to empower the people of Itegero and also attempting to meet some of their needs. We would really value speaking to you regarding our project, and resectfully request a reply to this comment. Many thanks, Sue

March 14, 2007 7:36:00 AM PDT
Adam Johnston said...
Hi Sue,Thanks so much for your comments. Great to hear of other Canadians taking action for humanitarian causes. I would be happy to hear more about your project... I can be reached by email at adamkjohnston@hotmail.comRegards,Adam

Papua New Guinea

Monday, January 15, 2007

Getting up at 3:30am is never a pleasant experience… Those that know me know that 3:30am for me is more likely to be a late night than an early morning. Fortunately our early start was for a flight to Irian Jaya - a trip I had been looking forward to for some time.

One of the two objectives for our mission to Indonesia has been to develop a proposal for Canadian Red Cross and the Canadian International Development Agency for a bed-net campaign in eastern Indonesia where malaria morbidity and mortality rates are extremely high and where there is currently no prevention strategy in place. We’ve come to Irian Jaya to assess the malaria situation and get a better understanding of field conditions in this remote part of Indonesia.

Irian Jaya is a recently created province on the island of Papua New Guinea, at the far eastern edge of the vast Indonesian archipelago. This island is one of the most remote regions on earth where isolated and marginalized communities suffer the highest rates of malaria morbidity and mortality, maternal mortality, and malnutrition in Indonesia.

We were joined on our early morning flight by our UNICEF – Malaria Program counterpart, Dr. Endang, who acted both as our guide and our translator. Joining us once we arrived was the local Ministry of Health - National Malaria Control Program representative. Together we made our way out of the main town site to the more remote rural villages to conduct house to house visits in order to speak with community members.As we drove, glimpses of crashing waves caught between the passing palms made it impossible not to be awestruck by the island’s sheer beauty. Home to one of the oldest and most biologically diverse rainforests on earth, an alluring sense of mystery seemed to emanate from the dense jungle hillsides that rose abruptly from the island’s coast.
We arrived in a small rural village made up of a scattering of 40 or so homes; basic wood structures raised on stilts that peeked out from the dense forest.

Our arrival drew attention from many of the village’s children who came to check us out while their mothers peered shyly from windows and door frames. We were welcomed graciously into their modest homes where we sat crowded round on the floor listening as Dr. Endang asked them about their family’s living conditions and overall health.

They explained that they and their children were often sick with fever and many families reported having lost children who had died following fevers. This confirmed the high prevalence of malaria in the region though it was clear there was little understanding of the disease. Many attributed fevers and other illness to ‘spirits’ and when asked if they sought treatment when they or their children were sick replied that they relied on traditional spiritual healers.

When asked if they would ever seek treatment at medical centres, some said they would but only if illness persisted for longer than three days; much too late given how critical the first 24 hours from the onset of malarial fever are for treatment. Others said they were not able to reach medical centres as there were none close by and the cost of travel to the nearest facility was too expensive. When treatment was sought, and when it was available, often it was not effective as most places were only able to treat with chloroquine, an older treatment method whose effectiveness has been compromised by drug resistance.

These testimonials underlined the need not only for better access to malaria treatment but also for grassroots education around malaria; its cause, its symptoms, and its treatment and prevention. The lack of knowledge of the link between malaria and mosquitoes was one factor why most people we spoke with were not familiar with bed-nets, the most effective and affordable form of prevention. As such, any bed-net distribution would surely have to involve a great deal of education and socialization on net use.

Information gathered from these types of visits seemed invaluable for formulating a regionally and culturally appropriate malaria prevention strategy. For example, sitting on the slatted wood floor of a stilt-raised home, I noticed how easily mosquitoes could pass up through the floor between the slats. Given that most villagers slept on very small mats or directly on the floor, consideration would have to be given to the design of the bed-net to ensure their effectiveness.

The responsibility to ensure aid and health programs are regionally and culturally appropriate cannot be overstated. While societies such as the ones here in Irian Jaya are able to adapt (and do), cultural changes should occur on their terms. Mostly isolated until the turn of the last century, the remote villages of Irian Jaya now reflect some of the cultural shifts seen round the world.

The juxtaposition between the spears and bows leaning in the corner of one home we visited and the television set beside them provided evidence that even the traditional hunting and subsistence societies found here are part of our increasingly interconnected world. The tattered poster of Avril Lavigne that hung as the sole decoration in another home served as an equally good, if not somewhat more perplexing, example.

While it is probably fair to question the value of either a television set or a poster of a Canadian pop star, for me they are positive signs for what is possible; the exchange of tools and ideas. There are valid concerns with the pace and manner in which cultures shift, but when it comes to preventing children from dying there is little room for argument when proven and effective prevention and treatment strategies exist.

In one house we visited a young child pulled herself awkwardly across the floor, her emaciated legs unable to carry the weight of her ballooned, worm filled stomach. A de-worming tablet costing less than three cents could very well save her life, but without it she would likely die within a week.

Images such as this stand out as a reflection of the reality here, but so to do images of local community members who have the willingness and capacity to help. There is a danger in allowing the former to overshadow the latter, as for every example of tragedy there are equally as many of hope.
posted by Adam Johnston at 10:30 PM

1 Comments:
Anonymous said...
Hi Adam,I keep reading your blogs as you add new information and each time I am struck by the realism you bring home to us. I think we are all aware of the problems you are describing, but we are so removed from them that it is easy to forget how fortunate we really are.Please stay safe and healthy.Love Gaile, Al & Family
February 28, 2007 11:36:00 PM PST

From Africa to Asia...

Wednesday, January 10, 2007

The heady smell of clove cigarettes and durian fruit lingers in the air, a constant reminder that I now find myself transplanted in Indonesia nearly 16,000 kilometers from where I began my mission in Sierra Leone.

I have come to work alongside Marcy Erskine, the Canadian Red Cross malaria program advisor, to assist her in supporting the Indonesian Red Cross, the Indonesian Ministry of Health and UNICEF with malaria prevention.

In Indonesia, approximately 100 million people (nearly half the entire population) are at risk of malaria infection, with an estimated 42,000 dying of malaria annually. Health care is often not affordable in a country where an estimated 18 per cent of the population lives below the poverty line and 49 per cent of the population live on less than US$2 per day. In some regions, basic health services are not even available.

Following the tragic Indian Ocean tsunami that took the lives of 150,000 Indonesians, fears of a malaria outbreak amongst survivors and the availability of money led some UN agencies and Non Governmental Organizations to conduct malaria control efforts in tsunami-affected areas. This has stimulated government Ministry of Health efforts to also improve malaria control outside of the tsunami-affected regions, to areas where the malaria burden is as high as the most malaria-endemic regions of Africa.

In the isolated and marginalized communities of Indonesia’s outer islands, approximately 43 per cent of two – nine year olds were infected with malaria, while infection rates for all age groups were found to be in excess of 60 per cent. High malaria incidence contributes to the high rates of anemia and malnutrition, and in Indonesia 40 per cent of pregnant women, and 48 per cent of children under five are anemic. Anemia, malnutrition and malaria function to contribute to the overall precarious health status of populations in Indonesia, furthering the cycle between disease and poverty.

While statistics such as these highlight the scale of the malaria problem, they often do little to convey the human suffering caused by this brutal disease. In its early stages malaria causes fever, chills, headache, body pains, and anemia that weaken and incapacitate you, preventing you from working, farming or going to school. In its advanced state, painful convulsions lead to an excruciating death and leave families marred by the loss of loved ones, especially young children.

There is an urgent need for rapid scale-up of malaria prevention in Indonesia, especially in eastern Indonesia. Improved diagnosis and treatment, improved community outreach, and some tentative exploration of the utility of environmental management to reduce transmission are under way. However, high coverage of long-lasting insecticide treated mosquito nets is needed to rapidly bring down transmission to ensure that other strategies have maximal impact.

An integrated vitamin A supplementation and net distribution campaign is currently planned for six provinces in Sumatra. Our role in this campaign has largely been to offer best practices and lessons learned from past campaigns in other countries. This type of support has helped ensure success from country to country and is a large part of why Canadian Red Cross is now recognized as an organization that can provide appropriate, timely and successful program support to countries embarking on mass net distributions.

Having arrived in Jakarta late on the 24th of December, Marcy and I enjoyed a low key Christmas day; the only evidence of the holidays, the reindeer antlers we donned to help mark the occasion. Soon we were back at work, meeting with the Indonesian Red Cross Society to help them plan and prepare for the training and mobilization of volunteers for the upcoming campaign in Sumatra. As with past campaigns in other countries, the Red Cross’ focus is on social mobilization, utilizing its vast network of local volunteers to conduct grassroots community and household education regarding the campaign, including the importance of vaccination and the correct utilization of nets.

One of the Indonesian Red Cross’ main strengths is its ability to mobilize a large number of well-trained and equipped volunteers to respond to frequent natural disasters, which affect Indonesia. They also assist the government in preventive health activities and with response to various health emergencies and epidemics. It was clear from meeting with them that involvement in malaria prevention is an area in which they have the capacity to be involved, as well as an area from which to expand further into community based health services.

Following our meetings in Jakarta, we headed to Bandar-Lampung in south Sumatra for the campaign micro-planning meetings. Over two days, regional representatives from the Ministry of Health, UNICEF and the Red Cross planned out the details of the campaign. Marcy was often looked to for technical advice and through a translator was able to help facilitate the planning process. While the meetings were conducted entirely in Bahasa Indonesian, it was interesting for me to see how the planning for a campaign of this scale comes together.

It was also interesting to see the cultural differences in how meetings are conducted. Both Marcy and I noted how acceptable it seemed to be that most of the room was talking while presentations were being conducted. Music was even playing from a lap top near the back of the room. That it was the song ‘Barbie Girl’ added to the oddity of the situation as I find the universal and long lasting appeal of that song a particularly strange phenomenon.

My own aversion to that song aside, that two young women wearing hijab, the Muslim head covering worn by many women, were listening to western pop is, in a way, a fitting example of the cultural complexity of Indonesia. In a country where the influences of both western and Islamic culture have been adopted and integrated in uniquely ‘Indonesian’ ways, there is a diversity here that often goes unnoticed when filtered through the headlines we read back home in Canada. From the modern sprawling cityscape of Jakarta to the remote rural villages of Papua, Indonesia is as varied in its cultural make up as it is in its famed biodiversity.

Indonesia’s diversity is one of many sources of incredible strength and capacity, but Indonesia has also experienced a great deal of tragedy in recent years. Faced with everything from conflict to tsunami, to earthquakes, to flooding, Indonesia has been marred by disasters, and often it is the most vulnerable who are affected. Malaria is one of the contributing factors to this vulnerability, one that can be greatly reduced by malaria prevention strategies such as the one we are here to support.
posted by Adam Johnston at 2:03 PM

3 Comments:
Calvin said...
We want to hear more about YOU Adam! How you are feeling, what you are doing etc.!
January 16, 2007 9:02:00 PM PST

Anonymous said...
Wow. I can't tell you how much we wait for your new articles. They are so well written, with so much detail that it sure helps us to understand what you are doing, why it is so important to you and the people you are striving to help.Your experiences are giving us a new understanding of the Red Cross and how important their campaigns are. Knowing what you are doing, makes it easier for us, having you so far away.You are always on our minds and in our hearts. Please be safe.Love Gaile, Al & FamilyP.S.Hope we can celebrate Christmas with you this summer.

January 17, 2007 11:45:00 PM PST
Anonymous said...
Hi Adam,I amazes me at how much we take for granted in this country, most of us know of the horrible diseases in other countries, but don't spend much time thinking about it. I find reading your posts (which I find very professionally written) that I am gaining a new understanding and respect of the Red Cross and their efforts to help alleviate some of the problems, that can be easily helped without much cost - just a lot of organization and volunteer workers.A pat on the back to all of you, for doing something to help.Keep the posts coming when you can, so we can keep our eye on you and learn more at the same time.We miss you and can't wait to see you.Please take care and be safe.LoveGaile, Alan and Family

Closing a Chapter

Saturday, December 16, 2006
Sprawling impossibly up steep coastal mountains, Freetown normally provides for spectacular ocean views, which have of late been obscured by a thick haze. With the dry season, Harmattan, has arrived - the wind that blows in from the Sahara across West Africa to as far as South America. The cool dry wind brings relief from the oppressive heat and humidity of the recent rainy season, but also dust and sand picked up from the desert, creating what’s known as Harmattan Haze.

That particles of desert sand can find themselves transplanted to the lush green hillsides of tropical Sierra Leone reminded me how truly interconnected the world is despite vast distances. I sometimes feel like one of those particles of sand, a foreign object transplanted far from home.

The decision to live and work overseas was never an easy one for me, despite my belief that we have a responsibility to each other that is not limited by regional or national boundaries. I’ve often wondered if working and living in a cultural context that is not my own was the most responsible or effective way for me to work. Recently I have taken solace that like the sand brought by the Harmattan wind, while foreign, I’m also part of a natural force of interconnectedness that has existed since the earliest of human migrations.

Here in Sierra Leone, a migration of sorts is under way for the Canadian Red Cross delegation. With the distribution campaign portion of the Sierra Leone Malaria Program finished, the supporting team members here have begun heading home. As such, the past two weeks have been busy with wrap up, including everything from consolidating finances to writing final reports to conducting debriefing meetings.

For me, the day to day work during the past two weeks has been mostly spent at the office, in meetings or running around town trying to find replacement parts for the Landcruisers. You wouldn’t believe how difficult it can be to find ‘Genuine Toyota Parts’ in Freetown (as opposed to knock off imitation parts that would nullify our insurance).
Shopping here is definitely more of an art than a science. There is no phone book, and if there were, there are usually no phones. The shops are often not well identified and usually stock such a bizarre mish-mash of things that it would take a blind guess for someone who doesn’t know any better (like me) to find something as specific as ‘Genuine Toyota Parts’.

Luckily for me I had the help of one of our drivers, Francis. Like most drivers, Francis is a source of support and assistance and someone we rely on heavily for everything from translating to negotiating. To call them drivers seems, at times, to do a disservice to all the other ways they contribute.

This past weekend we were fortunate enough to enjoy a very rare day off, which we spent at the beach. There are beautiful beaches here, clean white sand stretches out under towering palms into crystal clear water. We spend almost all day everyday in the office and normally continue to work once we arrive home in the evenings to our delegate house, so this trip to the beach was a welcomed break. My impression is that it can be tough sometimes for delegates to strike a balance between work and time for themselves and the results are often cumulative stress and burn out. As such, the few times we can go out to eat or for a walk around town are to be relished for the peace of mind they bring.

For those headed home, it was one last bit of sun before stepping off the plane in Ottawa to what I can only imagine is cold and snow. For those of us staying, it was a chance to say goodbye. I will now stay on and assist Marcy, the Malaria Program Advisor with other malaria prevention campaigns in other countries.

Like the particle of Saharan desert sand, I will gladly go where the wind takes me.

Post Campaign

Tuesday, December 12, 2006

I have spent the past few days traveling up country with Hlin, our finance delegate, to Makeni and Bo for regional meetings with the field officers from all of Sierra Leone’s 12 districts. We went primarily to gather data, consolidate finances and conduct debriefings, but also to listen to and gather any feedback on the campaign.

The core responsibility of the Sierra Leone Red Cross before, during and after the campaign was social mobilization. This required organizing 4,000 volunteers to sensitize their respective communities to the issue of malaria, to bed-net use, and to ensure they came out during the campaign to receive vaccinations and nets for their children under five.

The Hang-Up portion of the project finished last week with volunteers circulating house-to-house across the country to ensure nets were received by all under fives and that they are properly hung and being used.

It was great to hear the enthusiasm of the field officers as they explained how successful the program has been so far. Most felt that because of the program, there is now better recognition of the Red Cross in their communities and more interest from volunteers to continue to work on community based health initiatives.

These are encouraging signs for a country rebuilding from conflict and struggling with a myriad of health issues. Local communities now have a base of volunteers willing and able to continue with not just malaria prevention but other community-based health care initiatives, and community members are now more aware than ever that the Red Cross can provide such care.

Returning to Freetown, it reminded me again of the stark contrast between it and the small rural villages up country. There you find no more than two dozen mud brick homes with thatched palm roofs between which women pound grain, lay out laundry or cook on open fires. Children, when not balancing bundles of wood or buckets of water a top there heads, are either playing barefoot or are part of a seemingly endless procession of those dressed in crisp bright school uniforms on their way to or from school.

By contrast, Freetown is a jumble of decaying concrete buildings and corrugated tin shacks. There is garbage littered everywhere, sometimes in huge piles on the side of the road. The streets of Freetown are crowded with taxis and mini buses and people carrying oil, coal, wood, tires, everything you can imagine.

Christmas decorations and small artificial Christmas trees have even appeared amongst the street vendors over the past few weeks. You can find almost anything here, but without knowing where, you might think that all that can be bought are used clothes and mobile phones. What an amazing phenomenon that in a place with little or no electrical, water, or sanitation systems, almost everyone here has a cell phone.

As a good friend recently reminded me, it can be easy to be lured into romanticizing rural village life, especially in contrast to the chaos of urban centres, but there is nothing idyllic about the poverty in which people live. In both Freetown and the rural villages, life is hard, even putting aside the atrocities faced by most during the war; daily life is a brutal grind. There are few opportunities for employment and most people struggle to make more than a dollar a day.

In spite of the difficulties they face, people are extremely resilient. One of the dangers in trying to describe (or to understand for that matter) a place like Sierra Leone is the tendency to describe (or see) only what is different from home. The most important things often go unnoticed like the playfulness of children, the love of their parents, and the camaraderie of friends.

Here, as everywhere, there is life in all its tragedy, joy and complexity.

posted by Adam Johnston at 10:51 AM

3 Comments:
Anonymous said...
Adam,I continue to be enamoured with your adventures and detail. You describe the evidence of joy, even when there has been so much tragedy in Sierra Leone. I believe everyone can learn from that! A great movie with the same topic is "scared sacred."Thank you for your reports Adam!Best Wishes,Shannon Moore
January 19, 2007 1:43:00 PM PST
Anonymous said...
Adam, You continue to surprise me with your beautiful ability to appreciate the complexity of life. Keep well. Love M.
January 20, 2007 3:04:00 AM PST
Anonymous said...
Adam,Putting out fires in the 'skag' is miniscule to the work you are doing in Africa. I came across your blog while 'googling' names of the old crew. Who would have known you had the ability to write from the heart like you do; I think that 33% pfb has been replaced with something more substantial. Take care and if you are ever in Dawson City, Yukon, you have a place to stay.mouse
March 14, 2007 9:36:00 AM PDT

The Campaign

Wednesday, November 29, 2006
Ushered in by a parade of school marching bands, traditional drumming groups and hundreds of volunteers, the National Measles and Malaria Campaign was officially launched last week. For the Canadian Red Cross Malaria Prevention Project Team and their Sierra Leone Red Cross counterparts, the campaign was the culmination of months of work procuring and delivering nearly 900, 000 nets and training and mobilizing over 4,000 volunteers. The result of their hard work; in addition to being vaccinated against measles, receiving a vitamin A supplement and de-worming treatment, all children under five in Sierra Leone were provided with a bed-net that will offer them protection from malaria-bearing mosquitoes, significantly improving their chances of survival in this, the country with the highest infant mortality rate in the world.

It has only been two days since the end of the campaign, but already the relative calm of the Sierra Leone Red Cross office is a sharp contrast to the flurry of the past week’s activity. Following the boisterous day of the launch, nearly a thousand distribution and vaccination sites were set up in hospitals, clinics, Red Cross offices, churches, mosques, community centers, markets and street side stalls in communities and neighborhoods throughout the country.

Hundreds of thousands of mothers brought their children to distribution and vaccination sites throughout the week. Some of them, having walked for hours down dusty rural roads with their children on their backs, waited patiently in line for hours at a time to vaccinate their child and receive a net before making the journey home.

Every effort was made to ensure every child was vaccinated and received a net: Volunteers circulated door to door to inform residents, radio stations played campaign jingles, local theatre groups performed sensitization skits in the streets, notices and posters were put up, and newspaper ran articles. T-shirts worn by volunteers and staff during the week of the campaign that read ‘Use Maskita Net For Fet Malaria’ and featured an image of a child sleeping under a bed-net were seen at every turn throughout the week.

For the Red Cross Malaria Project Team, the week was filled with site visitations from representatives from the Canadian Red Cross, CIDA and the media. Visitors to the campaign included the President of the Canadian Red Cross, Jane McGowan, and its Special Ambassador, David Pratt. They had the opportunity to see first hand the distribution of the nets and to meet with the Red Cross staff and volunteers. Returning to Canada with a broad understanding of the scope and scale of the Canadian Red Cross Malaria Prevention Program, these special guests and representatives’ will be able to give Canadians a first-hand account of the work being done in Africa.

A full team effort and good coordination was required to ensure a balance was struck between the visitor agenda and the broader responsibilities of the team in supporting the Sierra Leone Red Cross with the distribution. Months of planning and coordination paid off when the distribution went off with great success. The real stars of the campaign were the Sierra Leone Red Cross volunteers who tirelessly set up sites every morning and spent each day managing sites, distributing nets, and explaining how to properly use and care for the nets. Together with their Ministry of Health counterparts they worked patiently in the heat and humidity over the cries of children to deliver a critical intervention that offers hope for a better future to thousands of children in a country desperately in need.

I spent the first part of the week checking on the urban distribution sites around Freetown. The calm, patient, and relatively small crowds lined up at hundreds of distribution sites around town were one of the greatest success stories of the campaign. Good planning and good messaging prevented overcrowding by ensuring there were enough sites and that it was clear the campaign would run for a full week.

Later in the week I made a trip inland to Bo, a major town in central Sierra Leone with a noticeably quieter feel than Freetown. Together with Doug Mole - our team Logistics Delegate, Emanuel Tommy - Deputy Secretary General of the Sierra Leone Red Cross, and Ken Porter - Program Analyst with CIDA, we checked on number of distribution sites, both urban and rural. Each site we visited had a slightly different set up but each demonstrated effective vaccination administration and net distribution. At every site we were greeted by grateful mothers, curious children and proud volunteers.

The face of Sierra Leone was apparent throughout the campaign. Its courage - visible in the children who fought back tears after receiving a vaccination, its strength - visible in its mothers who waited patiently in the heat to ensure the health of their children, and its determination - visible in the volunteers who worked tirelessly to deliver hundreds of vaccinations and nets for days on end, all gave reason to believe the future of Sierra Leone will be brighter than its recent past.

As I watched wide eyed child after child leave the distribution points clutching in one hand their mothers, in the other their newly acquired nets, I felt a cautioned sense of hope for Sierra Leone. Even as Mr. Tommy described the chaos and destruction of a conflict that ended only five years ago, it was hard not to be impressed with even the small signs of recovery.

Mr. Tommy himself offers such a sign. He speaks of the future of Sierra Leone with measured optimism – discussing how the Sierra Leone Red Cross can build off this current campaign’s partnership with the Ministry of Health and strengthen its broader health care programming. Acknowledging that malaria is only one problem faced by Sierra Leone, he has confidence that the Sierra Leone Red Cross, like the country itself, has the ability to build a better future but he understands also that it needs the support of organizations like the Canadian Red Cross and countries like Canada.

If, as I believe, all of our actions (and inactions) are unquestionably linked to the fate of humanity, than my hope is that Canadian support of this successful campaign is only one example of a broader commitment to humanitarian issues.
posted by Adam Johnston at 1:12 PM

6 Comments:
WINDSORAIRCADET said...
Hi Adam your adventure there seams to be a great experience. What I would like to know is what is the food and water the red cross is providing for you like and where does it come from. Have you gotten sick at all while over there and if so how was this handled.And lastly how long is your deployement for. I myself am thinking of joining the red cross in disater management and am curious as to how the overseas deployements are for red cross volunteers. Good luck in the coming weeks and i will be looking for your response thanks

November 30, 2006 5:22:00 AM PST
Adam Johnston said...
Thanks for your post. In response to your questions, conditions will vary from mission to mission. Here in Sierra Leone there are a number of very real health risks but we as delegates are fortunate enough to be able to take precautions. Aside from the vaccinations that we have access to back home in Canada, we are able to boil and filter our drinking water. Water born diseases are prevelant here and we would be at high risk, not to mention unable to do much good should we fall sick. That being said, it certainly happens that delegates fall ill. Two of the three Canadian Red Cross delegates who have been here for six months have been sick with malaria and stomach ailments are common for all of us. Illness and disease are a part of everyday life for most people in Sierra Leone and have much more serious consequences than they do for us as delegates who can afford and have access to medical care. This renews my apreciation for how fortunate I am to be in good health and it further encouages to do what I can to help others who are less fortunate. In response to your second question, I myself am on a five month deployment but this too will very from mission to mission. I hope this provides a bit of insight. Be sure to read about delegate work under 'International Oportunities' and related links on the Canadian Red Cross website and if you get the chance, visit your local Red Cross branch. Also be sure to check back here. Good luck.

November 30, 2006 3:54:00 PM PST
Anonymous said...
Hey AdamGlad I finally found your blog, I must say it seems like you are up to a world of good over there. I definetly plan on keeping up on you and your work in Sierra Leone. Things in TO are well and hopefully we will have a chance to catch up on your way back home. Anyway bud my thoughts are with you.. Keep up the good work..Much loveRubadub

December 3, 2006 5:45:00 PM PST
Ali Paul said...
My friend, you're doing great work! Keep it up, and keep the stories coming. Cheers, Ali :)

December 9, 2006 10:27:00 AM PST
Anonymous said...
Hi Adam, this blog is very informative and gives us back home some insight into what you are up to, we are so proud of what you are doing - you are helping to make a difference in so may lives. The Red Cross needs to be commended on all of their wonderful efforts to help make these peoples lives better and safer.Please be careful and stay safe.LoveGaile, Al & Family

December 12, 2006 4:51:00 PM PST
Aaron from SPIIN said...
Hey Adam!What your doing is sooo inspiring to us back here at home. My parents and I saw "Blood Diamond" last night and that has spurned some more interest in volunteering from them. I hope your blog will make them feel better about my hope to volunteer in Africa in the next few years. Maybe your blog could convince them to volunteer with me!anyhoo. keep up the amazing work. Everyone here is so amazed with your work and many of us aspire to do the same.Cheers!Aaron RobinsonDr. Charles Best Secondary School

January 2, 2007 12:27:00 PM PST

Trip to Bonthe

Friday, November 17, 2006

Well, to bring you up to speed a bit, I have spent the past week primarily supporting the logistics side, supporting Doug Mole. He and I have been busy overseeing the final loading of delivery trucks taking the last of the 800 000 nets out of the central warehouse and out to the Regional centres.

We recently returned from a trip to Bonthe where we went to meet with the Sierra Leone Red Cross Field Officer to check on the distribution of nets from the Regional centre to the outlying communities. Bonthe is located on an island on the southern coast requiring a six hour drive and a four hour boat ride and so provided a good opportunity to see a bit of the country outside of Freetown.

To say the roads in Sierra Leone are bad is to do it somewhat of an injustice. The broken pavement that paves most of Freetown virtually ends outside of the immediate surrounding area. The roads in most of the country are narrow dirt lanes filled with at best - potholes, at worst - vast craters that turn to impassable ponds and mud bogs with the rains.

Shacking and bouncing along in one of the trademark white Landcrusiers with red cross emblems I was amazed out how thick the jungle walls were on either side of the road. I immediately gained an appreciation for why it is referred to as the bush… It is so thick it like one giant, seemingly impenetrable plant. The only noticeable breaks were the cotton trees that rose stories above the rest of the jungle like huge otherworldly giants.

Along the way we passed through small rural villages that typified how different rural Sierra Leone is from urban Freetown. In Freetown the maze of streets are jammed with taxis and overflow with crowds of people carrying or selling modern wares. The streets are lined by decayed colonial buildings, the gaps between them filled by shanty dwellings.

By contrast, most villages number at most only a few hundred. They live in mud-brick homes with palm thatched roofs or occasionally made of correlated tin. Visitors and vehicles aren’t a common sight and through each village we were greeted by the smiles and waves of young children – some dressed neatly in formal school uniforms, others barely dressed at all.

The following day we arrived at the dock to board the boat that would take us to Bonthe Island. A long, low, narrow wood boat was being loaded up with the large bails of nets along with other cargo. Standing there in the relentless heat and humidity I couldn’t help but marvel at how they managed to fit it all on board… My confidence in the seaworthiness of the vessel only came it to question once they started to squeeze most of the crowd of people who stood patiently by into all crooks and corners of the craft.

Having stood out in the heat for so long I had started to feel a bit faint and Doug commented that I looked white. That got a good laugh from the locals… To them it was stating the obvious :)

Puttering along the Jong River as it fed out to the Atlantic, I looked out at the remote villages that bordered the river - seemingly cut off by not just roads but time. Further out, mangrove trees lined the banks of islands made entirely from the sand that had settled out of the river.

Surrounded by the laughter and chatter of the women on board, I played with a young girl with beautifully big eyes who had taken an interest in my finger. Her mother’s smile, like so many I have seen since I arrived, spoke volumes of the people of Sierra Leone. The signs of poverty and disease in this country are perhaps only outnumbered by the signs of the strength and spirit of its people. ‘Welcome to Sierra Leone’, the Mayor of Bonthe says to me with a warm smile and hand shake, reaching across a crowd of people on the boat. Welcome indeed.


posted by Adam Johnston at 12:44 PM

3 Comments:
Chiran said...
Very happy to hear things are going well and the project is getting underway. Keep us posted on more details!- Chiran
November 26, 2006 6:05:00 PM PST
Anonymous said...
you should start giving people more eggs. Not condoms
November 30, 2006 8:05:00 AM PST
Adam Johnston said...
In response to your comment anonymous, LLITN's are in fact Long Lasting Insecticide Treated Nets, and not condoms. These bed nets have proven to be effective in significantly reducing infant morbidity and mortaliy caused by malaria; the leading cause of death for children under five throughout Africa. While local food stuffs, including eggs, are widely available and affordable to most people in Sierra Leone, LLITN's are not. The Canadian Red Cross Malaria Prevention Program's net distribution is only one of many humanitarian assistance intiatives that work in concert to address complex humanitarian issues. Thank you for you comment, hope this provides some clarification.
November 30, 2006 2:15:00 PM PST

Arrival in Freetown

Thursday, November 9, 2006
Peering out the open porthole window of the rugged Sikorsky helicopter the night of my arrival I tried to catch a glimpse of the city below only to be thwarted by the near total darkness. The Atlantic Ocean, black as the storm filled night sky, blended seamlessly against the steep mountains of the dense jungle. Between them lay Freetown, evidenced only by a few specs of light but otherwise obscured by the absence of wide-scale electricity. Noting my anticipation, I conceded to the fact that despite any previous knowledge or preparation, a degree of the unknown awaited.

In this way my arrival serves as a fitting metaphor for this, my first overseas mission with the Red Cross. I have come as a Junior Delegate, and join the Canadian Red Cross delegate team in supporting the Sierra Leone Red Cross’ part in the Measles and Malaria Campaign, an integrated child survival initiative.

Still recovering and rebuilding from a brutal decade long conflict, Sierra Leone, long one of the poorest countries in Africa – the poorest continent on earth, was just recently ranked at the bottom, 176 out of 177, again this year on the UN Human Development Index.

In a country where the average life expectancy is 40, health issues have a major social and economic impact. This is why issues such as malaria have been identified by the UN in the Millennium Development Goals as critical.

In Sierra Leone there are many health issues; virtually every imaginable major disease is present here. To address them the Government of Sierra Leone is working together with non-governmental aid organization, both domestic and international. The Measles and Malaria Campaign being undertaken is an example of how many diverse partners can come together to address complex health and social issues.

The Sierra Leone Ministry of Health, WHO, and UNICEF have worked together with the Sierra Leone Red Cross who, with the support of the Canadian Red Cross, has undertaken the incorporation of Long Lasting Insecticide Treated Bed Net distribution into the existing measles vaccination campaign. With its large volunteer base the Sierra Leone Red Cross is contributing to the social mobilization of communities for vaccination and Bed Net use while the Canadian Red Cross supplies technical support and, with funding from the Canadian International Development Agency (CIDA), the nets.

Long Lasting Insecticide Treated Bed Nets have proven to be an effective and affordable way of greatly reducing morbidity and mortality resulting from malaria when integrated with other critical interventions. When nets are distributed to the most vulnerable, children and pregnant women, all round infant mortality is significantly decreased.

Malaria is the number one killer of children under five in Africa, killing one child every 30 seconds, and Sierra Leone is one of the most affected countries. There is no vaccine for malaria and thus no ‘magic bullet’ solution. Instead a multi-pronged approach including prevention, early detection and accessible and affordable treatment is required. Interventions such as this are critical for countries such as Sierra Leone whose children deserve a better future.

So that’s a bit of background on the program… (well a bit more than a bit :) As for my role, I’m here to work with Dr. Marcy Erksine, the Africa Malaria Advisor and the rest of the Canadian Red Cross Delegate team; Colin MacKay – Project Manager, Doug Mole – Logistics, Hlin Baldvinsdottir – Finance, and Jackie Thereot – Communications Officer. All are from Canada except Hlin who is from Iceland but who is an honorary Canadian if I ever met one. When I arrived I received a warm welcome from the team, most of who have been here for six months. There is a great deal of experience amongst the group and I have already begun to learn a great deal from each of them… And on top of it, they are a fun group and always good for a laugh.

As the Canadian Red Cross’ Junior Delegate, an internship funded by CIDA, I have been fortunate to have been provided with such a unique opportunity to gain valuable first hand experience in the field of humanitarian aid. I look forward to learning as much as I can while contributing to such an important initiative but I hope also to use this opportunity to be a link to Canadians interested in international aid programs and the work of the Red Cross – especially Canadian youth. Having volunteered with the Humanitarian and Youth Programs of the Canadian Red Cross, I understand the importance of the role they play and hope to support their work in any way I can. So please, ask questions and write comments. These are simply my own thoughts and views and as such, they reflect only one of countless perspectives, so you are welcome to add your own.

P.S. Access to a computer has been a bit difficult with infrequent electricity and the amount of things going on right now but I promise to be back soon.
posted by Adam Johnston at 11:26 AM

1 Comments:
Anonymous said...
I am interested in internation aid programs that i can participate in. Can you advise me how you have done this, I am a 28 year old mother and military wife. I would love the opportunity to help, my skills range from Office Administration, Customer Service, Canadian Army Reserves. Is there something that needs to be done aside from becoming a doctor that could be of use. I have a love and compassion for children and people and really want to help.
November 30, 2006 3:04:00 PM PST

Community Efforts by Community Members

Friday, March 23, 2007

Even for someone from the west coast of Canada the recent rhythm of the rain has seemed an almost foreign sound after months of straight sunshine. It signals the beginning of the rainy season, and with it, an increase in mosquitoes harboring the malaria parasite. In preparation, the Kenya Red Cross has mobilized its volunteers for an intensive ‘Hang Up’ campaign to encourage the use of mosquito nets.

When properly hung over sleeping spaces, insecticide treated nets prevent malaria by providing an effective barrier to mosquitoes. In July and September 2006, the Kenya Red Cross - in partnership with the Kenya Ministry of Health, distributed approximately 3.5 million long-lasting insecticide treated nets free of charge, but now they must promote proper usage by those most at risk – children and pregnant women. Over the longer term, a ‘Keep Up’ program will be conducted through periodic house to house visits by volunteers to continue to promote net use as well as communicate other health messages such as prompt treatment of fever and completion of immunizations.

The Kenya Red Cross, like other national societies, is a volunteer based organization rooted at the community level. This enables Red Cross to be effective in social mobilization - a process to reach, influence, and involve all relevant segments of society to affect positive behavior and social change. However, organizational capacity does not guarantee program success and it is therefore critical to gauge and evaluate programs in order to adapt approaches and strategies and become more effective. The Kenya Red Cross and the International Federation of Red Cross and Red Crescent Societies, with technical support from the American Red Cross, will be conducting an evaluation of the “Keep Up” program to assess its effectiveness, and I have been working to support Dr. Patricia David - Senior Health Advisor with the American Red Cross prepare the initial survey.

]In order to prevent inaccurate results, a great deal of thought and attention must be put into the careful wording of every question asked in a survey of this nature. It is critical to rely not only on the advice of professionals who specialize in the field of data collection and analysis, but also on people with local knowledge who understand the cultural context. Questions must be easily understood, even by those with little or no education, but must not be overly leading, or they risk encouraging false responses.

This baseline survey will provide information about current net ownership and use as well as gauge the level of general malaria knowledge. When compared against the final survey, the results will reveal the impact and effectiveness of the program and will provide information that can be used to develop guidelines and training materials for future Red Cross programs and for other civil society organizations wishing to implement similar initiatives.

Outside of work, and through a strange twist of fate, I have had the opportunity to link up with a grassroots women’s group from Kibera – one of Nairobi’s slums, and one of the largest in the world. There are nearly a million people living in Kibera, approximately one quarter of the population of Nairobi. Though they pay rent, they have no legal entitlement to the land on which they live. They are forced to seek protection from forced displacement through political or tribal patronage, or they risk having their homes dismantled or burnt down. With each wave of migration towards the urban center and away from the problems of rural underdevelopment faced throughout the country and the region, Kibera has become home to residents from all the major tribal and ethnic groups. This multi-ethnic make up combined with the system of political and tribal patronage has been the source of many violent and volatile conflicts over the years.

The group I met was formed spontaneously by women representing all of Kibera’s tribes and major religions who came together despite that their differences were often the source of conflict, with a common desire to provide protection and support to women being targeted for rape and abuse during the tribal warring of 2000. Since then, they have grown to nearly 200 members and evolved into a branch of a broader movement called the Vision Sisters. Today, the Kibera Branch meet regularly and are involved in everything from support and care to people living with HIV/Aids to pooling funds to acquire legal entitlement to land.

As the lack of land ownership is one of the main reasons for the marginalization of those living in Kibera, the primary goal of the Vision Sisters is to raise funds to purchase legal land and shelter outside of the slum for all of its members. However, in recognition that this will take time, they have also turned their attention to meeting the immediate needs of the most vulnerable among them, and within the broader community. To support their initiatives, they run a catering service for local weddings and celebrations that provides a source of revenue they use to rent a meeting room and fund their activities and land purchases.

Until now, the group has been entirely self-funded and independent, but through meetings with local contacts and introductions to other contacts, the group is beginning to tap into some of the resources and support structures that they can access through partnerships and collaborations. As a result of their networking, several members were invited to participate in last summer’s World Urban Forum held in Vancouver. When Mama Hamza, the group’s Chairlady, shared with me her thoughts on the conference, I could see the pride and confidence the experience had instilled in her. At the World Urban Forum, they were able to meet with other grassroot groups as well as major organizations from all over the world to share ideas and learn from each other. These women, most of whom are of a generation that didn’t have the opportunity to attend school beyond primary level, now speak the language of development; talking about organizational capacity, income generation activities, and good governance. With the support of a local contact with the United Nations Development Programme, occasional access to a public computer for email and typing, and a small budget for printing, they are now preparing to write a proposal for funding to build a women’s shelter and have interest from a major international donor.

Knowing the language and systems of organizations may seem insignificant, but that knowledge is the key to accessing outside support. With this support, a local group like the Vision Sisters can develop programs that are based on their understanding of the needs and capacities of their community that those on the outside would likely never be able to. While I was not there in an official Red Cross capacity, I helped to brainstorm ways that they could tap into the services and training provided by the Red Cross, such as First Aid training and the HIV/Aids home based care program. In its essence, this is how the Red Cross can best serve the most vulnerable - by tapping into the potential within vulnerable communities and empowering community members to actively improve their circumstances.

Walking through Kibera, the vibrancy of life is evident throughout; its narrow dirt pathways - arteries of activity - wind between the jumble of tin shelters. A butcher hacks at hind quarters along side a barber who cuts hair, and nearby a rough piece of blackboard advertised in chalk a ‘movie theatre’ - a cramped dark room playing pirated dvd’s on a small television. Evident also is the tragic realities of utter poverty; garbage and feces line the paths - evidence of the ‘flying toilet’ - a practice of disposing of human waste by simply tossing away the bag used as there is nowhere to properly dispose of it - and flows into streams used for drinking, contributing to the spread of disease. Substance abuse is rampant, as is physical abuse. Children are especially vulnerable as many have been orphaned by mother’s succumbing to HIV/Aids, a growing problem with one fifth those infected with HIV in Kenya, living in its slums.

It was humbling to see the strength and resilience of those who live there; to see that people find ways to support their families, ways to have their children go to school, ways to feel joy and happiness even when surrounded by hardship. However, it is also discouraging knowing the immense challenges they face, and I can’t help but feel that the slum phenomenon will be one of the biggest challenges the world will face in the next hundred years if globalization continues to further marginalize people through gross disparities of wealth.

…As I looked out over the ever expanding horizon of tin roof tops, feeling overwhelmed and somewhat dejected, Mama Hamza tapped me on the arm knowingly as a close relative would and spoke in almost reassuring tones about the future of Kiberia. She remains optimistic that things can improve, and she has taught me that if women like her, who have seen and experienced so much hardship, can find reason for optimism then all of us should