Farida holds up a photograph with the hope of finding her missing son, who worked at Rana Plaza.

Farida did not know if her son was alive or dead. Tears streaming down her face, Farida showed person after person his photograph, but no one had any information. Doctors, firefighters, policemen—no one had any evidence that he made it out alive.

Her son, a garment worker in the now-famous Rana Plaza, could be one of the more than 600 people killed when the nine-story building collapsed, enveloping more than 3,000 people in concrete and steel. I met her amidst the search-and-rescue mission the day after the factory collapsed as part of a small assessment team with the humanitarian organization, Concern Worldwide.

The scene was sheer chaos.

More than one thousand rescue workers, from members of the armed forces and firefighters to everyday people, tirelessly tore through the building’s remains in search of survivors. Emergency medical clinics were overflowing with people in need of immediate care, while relatives of garment workers, like Farida, frantically searched for their loved ones, their fear growing palpably greater by the minute that they would not be among the lucky ones pulled from the rubble.

More than a week has passed since Rana Plaza collapsed and with it, so has the hope that the remaining garment workers will be uncovered alive. The rescue mission still continues, and the injured need treatment. But that just scratches at the surface of what is needed for families—and Bangladesh as a country—to recover from this heart-wrenching tragedy.

Rescue workers search for survivors after the eight-story commercial building, Rana Plaza, collapsed outside Dhaka, Bangladesh on April 24, killing over 600 people.

For one, most of the workers who died or were injured were their families’ sole breadwinners. They will now have to figure out how to scrape by without those wages, and I firmly believe that it is the responsibility of the government, factory owners, and the owner of the building to ensure that the survivors and their families—most of whom are among the poorest in Bangladesh—are not driven deeper into poverty for a catastrophe that was not of their making.

The anguish of Rana Plaza began long before its walls buckled. Bangladesh’s garment-makers, most of whom are women, work around the clock just to earn $37 a month—the lowest wages paid by any garment-producing country in the world. Lowering costs inevitably leads to factories cutting corners of building regulations, and the health and safety issues of the workers. Workers are scolded or fired if they speak, and have no health care, sick leave, or benefits of any kind. They do not have the right to form a trade union. The fact that two women gave birth in the rubble of Rana Plaza is a testament to the working conditions these women endure every day to make the clothes that are sold on department store racks a world away.

Boycotting clothes made in Bangladesh is not the answer, but the end consumer needs to demand more from the stores they shop in. Clothing companies that rely on cheap labor to keep profit margins high also rely on the buyer to ignore the inhumane conditions their products are made in.

It’s time for that to stop.

Bangladesh’s garment-making industry employs more than four million people and generates more than $19 billion for the country each year.

While Prime Minister Sheikh Hasina on 2^nd May recognized that Bangladesh’s garment-making industry is wrought with problems and said her government was moving quickly to fix them, international buyers are also partly responsible and need to demand greater transparency on how their clothes are made. To start, retailers should sign onto the Bangladesh Fire and Building Safety Agreement, a plan that requires independent structural inspections of factories, the findings of which are made public. PVH, the parent company of Tommy Hilfiger and Calvin Klein, have embraced the agreement, but it will take more retailers to follow suit to change an industry that employs more than four million people and generates more than $19 billion for the country each year.

As a humanitarian organization working for more than 40 years in Bangladesh, Concern will work with our partners on initiatives to ensure that factories comply with the safety and security laws that are so often ignored—and as Rana Plaza showed us all, at immense human cost.

Hapines is Lovenes’ first daughter and at just three months old, she is already fighting malaria.

Lovenes Joas, 22, sits on the edge of a metal-frame hospital bed, cradling her three-month-old daughter, Hapines Joas, in her arms. As she he tries to comfort her squirming daughter, Lovenes crushes up a soft yellow pill and mixes it with water. She tilts her daughter’s head back to force the syrupy liquid down her throat. Hapines wails, tears streaming down her cheeks, and slowly settles back down to a whimper against her mother’s chest.

Hapines is Lovenes’ first daughter and at just three months old, she is already fighting malaria. Lovenes and Hapines share a bed with another mother and child, Stella Peter, 30, and Nizelesos Peter, 10 months, who is also being treated for malaria. “Malaria is a big problem in my family,” says Stella, raising her voice so that we can hear her above the cries of a dozen or so children. “I am a farmer. Right now I could be farming, but I am here losing time because of malaria. It hurts the health of my kids…Even now [while I am here], my three-year-old at home has malaria, but no one is available to take him to the hospital.”

Malaria is the number one health condition seen at Lukole Health Center in Ngara, in the green hills in far northwestern Tanzania. Its clinician in charge, Dr. Fred, has worked here for a year and estimates that each month he sees 300 cases of malaria among children and as many as 250 cases among adults. Of the roughly 40 patients in the in-patient ward, Hapiness and Nizelesos among them, some 30 percent are there because of malaria.

Dr. Fred: The number one health issue seen at Lukole Health Center in Ngara, Tanzania is malaria. The clinician in charge, Dr. Fred, estimates that 30% of the some 40 people in his in-patient ward are fighting malaria, many of whom are under five years old.

Lukole Health Center was originally established to meet the health care needs of Burundian refugees fleeing civil war, who streamed across the porous border just miles away. The Burundian refugees joined Rwandan refugees who were already living in Ngara following the genocide. The influx of refugees prompted the international community to respond, including Concern Worldwide, which provided water and sanitation and other support in the camps. It was in Great Lukole Camp that Concern discovered, almost by accident, the power that a very special plant could have in the fight against malaria.

When the international response wound down and the camps were no longer sprayed with insecticide, Concern’s program manager, Girmay Kahsay, and environmental health officers, Letician Missana and Donald Sokoni, started to look into how they could control malaria using indigenous plants. The Rwandan refugees living in Great Lukole Camp suggested a plant with bright yellow, pink, and red flowers, lantana camara (Lantana), as an effective, low-cost mosquito repellant.

The refugees are gone, but Concern, now the only international NGO operating in Ngara, decided to take the local knowledge further and conducted a study, together with the Tanzania-based Ifakara Health Institute, in which we planted Lantana around 231 homes and then measured the number of mosquitoes (or mbu, as the locals call them) inside the houses. What we found was remarkable—those houses that had Lantana had 56 percent fewer Anopheles gambiae and 83 percent fewer Anopheles funestas, both malaria-carrying mosquitoes, and 50 percent fewer mosquitoes of any kind.

In the first phase of research, Concern found that homes with Lantana planted around them had as much as 83 percent fewer malaria-carrying mosquitoes.

I spent the past five days in Ngara, speaking with households that have Lantana around their houses. Family after family said the same thing: there are fewer mosquitoes in their house because of Lantana and, most importantly, they now rarely get malaria. John Elfast, 60, first planted Lantana around his red-mud house, where he lives with his wife, 50, and four children, ages four to 17, in 2008.

“Since we planted Lantana, we no longer suffer from malaria,” he says. “None of [our] kids have been sick since we planted Lantana. It’s not only kids, but me and my wife too.”

His neighbor, Peruthi Eliasha, 52, has Lantana growing so high it nearly covers her windows. “I love it,” she says. “[Before we had Lantana], the kids had malaria at least two times a year and we would have to take the children to the hospital, which is a long walk. Since June of last year, no one in my family has had malaria.”

The contrast between families with and without Lantana is stark. We met a woman, Dora Joseph, 31, who had one bed net, but no lantana around the home she shares with her husband and four children. “Someone has malaria at least once a month,” she says. “We have seen several people die from malaria, including a four-year-old child. I worry that my kids will also die from malaria.”

Dora Joseph, 31, who had one bed net, but no lantana around the home she shares with her husband and four children.

It’s impossible not to think about the impact that a simple plant could have on the lives of Dora, Lovenes, Stella, and millions of mothers like them, not to mention their children. While Lantana will by no means be the end of malaria, it seems that it could be a powerful weapon against it, especially when used together with bed nets and residual spraying.

But while we know Lantana repels mosquitoes and we hear from family after family that they aren’t getting malaria as often as they used to, we need to prove it. The next step is a clinical trial that will measure not just the number of mosquitoes, but also the number of malaria cases across a wider number of households in Ngara and throughout Tanzania. It will cost approximately $1 million to do the clinical trial, but when you think about the millions of dollars that are spent on treating malaria every year, not to mention the number of lives that are needlessly lost in Tanzania and across the developing world, I cannot think of a more worthy investment.

Meanwhile, John, Peruthi, and the others share the same message: their lives are better because of Lantana and they wish more people were using it to keep the mbu away.

Voters queue to cast their ballots in Kajiado, Kenya during the 2007 general elections. Photo by Manaya Kinoti.

With less than 10 days before the first election under Kenya’s new constitution, fear and speculation are at an all-time high that what happened in 2008 could be repeated, even escalated. The results of the last general election in late 2007 were immediately disputed, and soon the nation exploded into weeks of political and ethnic violence, leaving with over 500,000 people displaced and more than 1,500 killed. I remember those grim days like they were yesterday.

The violence that erupted in 2008 caught the whole world off-guard, including the humanitarian community that then had to launch into an emergency response from scratch. Today, humanitarian organizations, including Concern Worldwide, are working with the UN’s Office for the Coordination of Humanitarian Affairs (OCHA) and Kenya’s National Disaster Operations Center to set up contingency plans if civil unrest sweeps across the country as it did in 2008.

The contingency plan is now finalized with eight humanitarian hubs set up strategically across the country. Concern Worldwide is leading the Nairobi humanitarian hub, and over the past weeks and months, we have gone through a simulation exercise to work out any kinks in the way we work with other humanitarian organizations to respond to needs as they unfold. We have mapped out potential hot spots and trained our staff so that we fully understand what our roles and responsibilities are, individually and as a team, if Kenya slides into chaos again.

The hub has 60 members drawn from international humanitarian organizations, faith-based organizations, UN agencies, the Kenya Red Cross Society (KRCS), and Government agencies. All hub members have prepositioned resources so that we can quickly facilitate assistance such as first aid, health, food, shelter, and water and sanitation.

As the lead agency in urban nutrition, Concern will address malnutrition and support livelihoods in slum communities in Nairobi and Kisumu, Kenya’s third largest city, some 200 miles to the west, if violence breaks out. It is anticipated that an emergency would cause malnutrition among children and breastfeeding mothers living in slum communities to skyrocket because food will be less available to them.

Electoral results were immediately disputed, which resulted in political and ethnic violence that left 500,000 people displaced and over 1,500 killed. Photo by Manaya Kinoti.

Concern is working to make sure these women and children have a safety net by prepositioning food and supplies to treat and manage malnutrition at various health facilities throughout the slums, and have trained health workers and outreach staff to identify, treat, and manage malnutrition. If the situation calls for it, we will provide these services through the 102 health facilities (80 in Nairobi and 22 in Kisumu) that we currently support, reaching approximately 12,000 children under five and 2,800 pregnant and breastfeeding mothers.

But it’s not just about treating malnutrition. We also need to prevent it. Concern is ready to help 3,000 families (about 15,000 people) meet their household food needs for a period of two to three months. This can be done through cash transfers via cell phone, something that Concern has implemented previously during the food crisis that rocked the country in 2011. If cash transfers do not work for one reason or another, we are working with key supermarket suppliers so that we can provide people with food directly.

No matter how much we prepare, I can’t help but worry, as a humanitarian and a Kenyan. The memory of 2008 is still very much on the surface for all of us. I just hope that it stays as a memory and does not spill over into reality. Until Kenya heads out to the polls on March 4th, we will continue to prepare and hold our breath until.

The presidential candidates in their first debate have pledged to accept defeat and use the courts in the case of any disputes, but it is my hope that they will also manage their supporters in an event of an electoral loss.  As a humanitarian community we stand prepared, but we welcome an outcome that would require us to put none of our plans into action.

Concern staff prepare kits for distribution

When academics or the media criticize aid organizations for inefficiencies or promises unfulfilled, I can’t help but think about the vast and endlessly tangled complexities of this work.  Crisis follows crisis, harsh realities are compounded by harsh realities, and every day there are situations where we are forced to take decisions when no option offers the perfect solution.

That’s often the case here in the Democratic Republic of Congo (DRC), the epicenter of what was called ‘Africa’s World War’ (1998-2003), the deadliest conflict since World War II, and especially in the eastern reaches of the country where violence and terror have continued since the supposed end of that war.  Conflict and preventable disease continue to take the lives of tens of thousands each month—five years ago a fellow international organization here put the toll at over five million.  The situation has little changed since then.

In November, the M23 rebel group invaded Goma, a city in the country’s war-torn east. The Congolese army put up little resistance, leaving it largely for their taking. When they first took over, upwards of 100,000 people fled their homes, often leaving everything behind to seek refuge in official camps, churches, and schools—anywhere that provided some semblance of safety.

Harsh reality #1: 100,000 people are displaced and in urgent need, in a province where approximately 400,000 more people were already displaced by conflict.  

Concern and other NGOs unload NFIs to the distribution site

People needed everything with which to eke out a basic existence away from home, from food to medicine, blankets, clothes, and kitchen utensils. When the M23 took over, we at Concern Worldwide immediately started preparations together with other organizations to provide kits containing basic households goods (or as we call them, non-food items, NFI) such as blankets, jerry cans, plastic sheeting, kitchen sets, sleeping mats, clothes, and women’s hygiene kits. These items would help families to keep warm and dry, to prepare food, to wash themselves and their clothes, and to store water.

Unfortunately, our plans were stalled by reports of lootings and rapes in and around the sites.  A constant struggle in reaching people in need is the fact that order is hard to come by in DRC where multiple armed groups operate.  It would have been impossible to hide that we were planning a large-scale distribution and to carry on in such circumstances would have simply added fuel to the flames and placed those we were supposed to be helping, as well as our own staff, at unacceptable risk.  Frustrating as it was, we were left with little choice but to hold out until the camps could be secured by the police and UN peacekeepers.

Harsh Reality #2: Aid often has to be targeted to the poorest and most in need, amidst a population who are often barely better off.

To make sure our aid reached those most in need, approximately 100 people, Concern staff among them, set off while it was still dark one Tuesday morning to different camps around Goma to try and count people while they were still fast asleep and before anyone else could arrive and pretend they too were living there. With an understanding of how many people were in each camp, it was decided that Concern was responsible for distributing to 6,000 families in Mugunga 1, a camp on the western outskirts of Goma.

Concern registers beneficiaries at distribution site

Meanwhile, back at base, Concern’s office suddenly resembled a mixture between a builder’s yard and Santa’s workshop. Trucks loaded with goods came and went. Our logistics team worked frantically and tirelessly to prepare thousands of kits—each of which contained 20 items—and every square inch was covered with tarpaulin-wrapped piles of blankets, plastic sheeting, second-hand clothing, soap, jerry cans, and sleeping mats.

After all this preparation and planning, the first day of the distribution finally arrived.

My alarm went off at 4:30 am. By dawn we were already setting up the distribution site, creating separate areas for people to line up, be marked off the distribution list, and receive their items. As the team got to work, the mood lifted suddenly when a generator was set up and loud Congolese and Nigerian pop music blasted through speakers. A group of 30 kids gathered around, dancing in time to the beat. With such a festive mood, my tiredness suddenly evaporated. Within a couple of hours, the real work began and by the end of the first day, some 1,500 households received assistance. By the second day, we reached 1,713 more. This left some 2,800 households to be served on the last day—an ambitious, but not impossible, target.

Harsh Reality #3: External forces, especially insecurity, often delay assistance or prevent us from reaching those most in need.

The last day of any distribution is always the most difficult and highlights some of the challenges in providing humanitarian assistance. There is an awareness that the end is nearing.  As more and more bystanders gathered near the site, tensions ran high and by lunchtime, they were palpable. Our job now was to get the distribution done as quickly and calmly as possible.

Recipients carry relief items at Concern's distribution in Goma

Despite the presence of the national police and a UN peace-keeping force, the situation was deteriorating and we decided to suspend the distribution until security could be guaranteed.  To try to finish it would only have put everyone there, ourselves and most of all the people we were there to help, in possible harm’s way.  With around 700 households still to be served, it was difficult to leave the job unfinished, but we were left with little choice.

It was impossible not to feel deflated after being so close to reaching all 6,000 households, even though the situation was out of our control. I tried instead to focus on the 5,300 households that we did reach, and knew that planning would start immediately to make a second attempt to reach them. Indeed, a second registration process is underway and these households will soon be receiving assistance.

Harsh Reality #4: As long as the constant crisis that is the DRC goes unnoticed by the rest of the world, Concern and our partners will continue to struggle to provide life-saving relief, let alone work hand-in-hand with communities to achieve lasting change.

Since our distribution, a relative calm has settled in over Goma, but the situation remains volatile.  While the M23 are no longer in control of Goma, they are stationed just four kilometers away and armed groups elsewhere in the Kivus continue to aggravate any hope for peace. All eyes are on the negotiations that are underway in Kinshasa between M23 and the government but what the outcome will be is anyone’s guess. What is clear is that the situation could deteriorate again at any moment, provoking further suffering and reinforcing the cycle of conflict and violence that communities, women and children here have suffered for decades.

Juna Dely, one of the first participants in Concern's Path to a Better Life program, with her one-year-old son.

Juna Dely lives on the island of La Gonave, Haiti, with her partner Jean Wodline, his mother, and five of her six children. Between 2007 and 2009, Juna participated in Concern Worldwide‘s Chemen Lavi Miyo program, which translates to “Path to a Better Life.” The program sought to do exactly that—give Haiti’s poorest people a path to a better life through income-generating activities as well as access to health, education, and credit services based on their needs.

I met Juna because I am currently researching to see how effective the program was in breaking the cycle of poverty over the long-term. She is one of 500 female-headed households that have participated in Path to a Better Life across four of Haiti’s districts. As to be expected, I am finding that the program had many successes, but it was not without challenges.

Juna was part of one of the first participants in Path to a Better Life. It used what we called the “graduation model,” which recognizes that poverty is multi-layered and cannot be overcome through one loan alone. The rationale behind the model is simple: some households are too poor to access credit, so Concern helps to jump-start their finances by providing them with income opportunities and encouraging them to save.

After they graduate from Path to a Better Life, the participants are encouraged to get a small loan (usually $25) from our local partner, Fonkonze, a Haitian micro-finance institution, which they can use to expand the business they established while in the program. If they successfully repay the loan, they can access another one at a higher amount and continue to grow their business and family income.

Juna Dely describes how her life changed after graduating from Path to a Better Life. While there were successes, the program encountered challenges as well.

Juna said that when she first graduated from Path to a Better Life, her income increased, but as the years went on and the country was rocked by natural disasters and food price increases, she now struggles to send all of her children to school. However, she told me reading level continues to improve and she showed off her hand-writing (which, I admit, is far better than mine). She and her family represent some of the limits to Path to a Better Life—sometimes the gains made are not enough to overcome external obstacles that our outside of Juna and her family’s control.

In the town of Saut d’Eau in Central Haiti, another participant, Sencia Tranquille, is still growing her business that was established through Path to a Better Life. She took the livestock that she received through Path to a Better Life and expanded on it, selling chickens in a market stall and buying a young calf, a status symbol in Haiti.

She told me that she, not her husband, is the one who makes the decisions at home, from what to put on the table to what assets to sell and buy. The new income also allowed her to put a concrete floor in her home, put healthy meals on the table, and buy a table and chairs for her family to eat their meals on. Sencia is the goal and while the model is not a silver bullet to eradicating poverty or Haiti’s deep-rooted problems, I am encouraged that it can change a life.

An estimated 1.6 million people are living with HIV in Kenya. While we know that the majority of them are from Nyanza Province, the region in the country’s southwest around Lake Victoria, there is much that we still do not know about HIV and AIDS in Kenya. For example, there are no clear records of the prevalence rate in urban slums, especially when many people likely do not know they are HIV-positive.

A community conversation groups meets in Migori District, Kenya. Photo: Concern Worldwide

Concern Worldwide uses what we call “community conversations” in Nyanza Province as well as Mukuru, a slum east of Nairobi, to break down many of the barriers that keep people from getting tested, and if they are diagnosed, taking antiretroviral (ARV) medications. We first piloted the approach in 2010 as a way for people to talk about their challenges and find solutions. There are now 24 community conversation groups across Nyanza Province and in Nairobi’s urban slums—all of which tackle HIV and AIDS head-on.

I spoke with my colleagues Belinda, Jane, and Julia, who are all community conversation facilitators in different areas of Mukuru. They said that community members see HIV and AIDS as one of their biggest challenges, with orphans and single parenting on the rise due to HIV and AIDS. Many are living in denial of their status, refusing to take ARVs. This is exactly where community conversations come in. 

Jane said that it was very difficult to get community members to understand that HIV and AIDS is a virus, not a curse. “We managed to take approximately 150 people to different centers to start taking ARV medication through community conversations,” she said. “It is unfortunate that people are still living in denial—very few people are going for counseling and testing, while others have refused to take ARV medication because of the stigma around HIV and AIDS.”

Community conversations also pushed 80 people from other parts of Mukuru slum to start taking ARVs. “We have established a support group for people who are HIV-positive,” said Belinda. “We support them in what they do so that they can feel part of the society and I am happy to tell you that we don’t have anyone who is bed-ridden because of HIV and AIDS in my community.”

A community conversation group in Nairobi's Mukuru slum.

Nyanza Province is no different, with stigma and discrimination keeping many from getting tested and on a treatment plan. An estimated nine percent of people living in Nyanza Province are HIV-positive. Crippling poverty and deeply embedded cultural practices, like wife inheritance, drive the spread of HIV. Through community conversations, Concern is educating the community on HIV and how the virus is spread. We encourage mothers to get tested at ante-natal clinics (which are more discrete than a testing facility) and we worked with a local chief to discourage promiscuity and promote condom use.

Community conversations are where that dialogue begins—and silence will never put an end to HIV and AIDS. We need to keep talking.

Concern Worldwide is supporting village clinics throughout Malawi, making health care more accessible for women and children.

In many of the countries where Concern Worldwide works, health care services can be extremely hard to come by. Malawi is no different. Mothers often have to walk for hours to get to the nearest health center—a major barrier that keeps them, and their children, from getting care when they need it.

Concern is working to make health care more accessible to communities in two areas in central Malawi, Nkhotakota and Dowa. The point of the program is to prevent and treat the major killers of children under five years old—malaria, respiratory infection, diarrhea, and malnutrition—by working with the Ministry of Health to make sure there are trained health workers based in villages, not just in centralized health centers.

I recently visited a village called Kalebe in Nkhotakota. When Concern offered to support the services of a trained health worker in their village, families in the community were so thrilled that they offered to build the local clinic themselves. They provided all of the timber, straw, water, and sand used to build the clinic. Whatever materials were still needed, they saved their money to help purchase. Together, they built the clinic from the ground up.

Health worker Halidi Bwanali with Margaret Lajabu and her daughter Yankho, who needed treatment, Kalebe village clinic, Nkhotakota district, Malawi

We saw this pattern repeated village after village—if Concern could provide a trained health worker and a start-up kit of all the drugs supplies, then communities would build the clinics for them to work in. I found this determination to bring health care services closer to home to be nothing short of remarkable. They did not just want a handout. They wanted to be a part of improving their communities—and were proud of the clinics that they built.

Because these clinics were designed specifically to fight common illnesses that affect children, particularly those under five, they provide a critical first-line of defense from diseases, like malaria, that claim the lives of millions of children every year. The Kalebe village clinic alone serves 913 people—155 of whom are children. Their health worker, Halidi Bwanali, was trained by the Ministry of Health to treat common childhood illnesses, and he staffs the clinic, which opens Tuesdays and Thursdays each week. When he is not in the clinic, Halidi also takes patients in his home.

The day I visited Kalebe clinic was a busy one. Thirty-seven children were there for care. While I was there, I met a mother, Margaret Lajabu. She arrived very early with her daughter, Yankho, who had diarrhea. She explained that the clinic was a short walk from her home and that before the clinic opened, whenever they needed to see a doctor or nurse, they would have to travel to the main health center—a six-mile journey by foot.

I watched quietly as Halidi examined Yankho. He confirmed that she was still hydrated, but prescribed oral rehydration salts (ORS) and zinc so that she stayed that way. He showed Margaret how to mix the ORS in water—and explained the importance of that water being clean—and then gave the solution to Yankho to start the treatment right away.

Women wait for the health worker to see their young children, Kalebe village clinic, Nkhotakota district, Malawi

I thought about how different Yankho’s condition might have been if Halidi was not close by and they had to walk six miles just to get care. I also thought of my own two boys, who are three and five years old, and how since their birth they have never gone without seeing a doctor when they are ill. Our doctor is just a five-minute walk from our house.

It’s hard to imagine walking two hours with your sick child just so that he or she can see a doctor, but if I did, I like to think that I would be like the mothers in Kalebe and other villages across Central Malawi, who did not wait for a clinic to come to them, but who came together, fueled by passion and determination, and built it themselves.

A flood defense system in Rustaq

Takhar Province in the far northeast corner of Afghanistan is a remote and unforgiving place. High in the mountains, it has more major earthquakes, landslides, and flash floods than any other part of the country. The landscape is stark and barren and poverty is crippling.

As winter settles in, children scour the hillsides for animal dung and withered thistles to use as fuel to keep warm. In the dead of winter, temperatures can plummet to a mere five degrees Fahrenheit. Heavy snowfall makes it completely impossible to travel in or out of. Last year, which was the worst winter in decades, snow drifts were as high as 50 feet—the height of a six-story building.

When the snow melted in April, it triggered violent flash floods that washed away homes, bridges, and other critical infrastructure. One village, Rustaq, saw nearly 100 feet of river bank engulfed by water, taking with it 60 homes. In Chall District, the floods washed out a bridge that was the only connection to the nearest village for 770 villagers and 150 students who crossed the bridge every day to go to school. Some villages, like Khailan, were told they had to relocate altogether. As part of Concern Worldwide’s emergency response team, I was deployed to Afghanistan as Emergency Program Manager in Takhar to oversee a program to repair the damage that was done because of last year’s floods and brace communities for the upcoming winter and future disasters.

A dry river bed in Takhar Province, which experiences flash floods every spring when the snow melts

Without heat and proper clothing, hypothermia is a major risk to people living in Takhar, so we are distributing “winterization kits” that have supplies to get people through the winter. Each kit is custom-built to the needs of each family with items for all women of child-bearing age and culturally appropriate clothes and footwear for each individual family member.

In addition to families, we are also giving winterization kits to 38 women and 20 children and babies held in a detention center in Taloqan for “moral crimes.” The women in the detention center may or may not have refused to marry, committed adultery, or divorced their spouse and are being held indefinitely, without access to social protection services, with little to no clean water, sanitation, or even cots for their children to sleep on. Many of the children were born in the facility and have no access to education. The youngest child in the detention center is just three months old. The oldest woman is 80. I hope the winterization kits remind these women and their children that they are not forgotten.

But preparation is much more than winterization kits.

Abdullah, 70, is receiving a wage from Concern Worldwide to build a flood defense mechanism around his village

For 441 people who were forced to relocate from Khailan due to the floods, Concern is providing materials (cement, brick molds, windows, roofing poles, door, and polythene sheeting) and technical advice to help them build a new home in Chab-ab that will be less vulnerable to natural disasters. We are also repairing the bridge that was washed away in Chall, paying women to weave nets that will work as a flood defense system for Rustaq, and efforts that will allow some 35,000 people to access water from canals and protect the homes of 540 people from flood waters. For the people of Khailan who were forced to relocate due to the floods, we are providing safe water near their new homes in Chah-ab. We are building water and sanitation facilities in the women’s detention center in Taloqan and providing hygiene kits and health and hygiene education in Chab-ab, Chall, and Taloqan.

Abdullah, 70, lives with his wife and three daughters in Hehata abi village in Rustaq. “I live in my own house, which is located near the river bank,” he said. “We are concerned about our future because every year the flood destroys some of the land and is coming closer to our house.”

Concern is now paying Abdullah to help build the flood defense near his home. “I am very happy that Concern started these emergency activities in our villages,” he said. “I am satisfied with my income from the work and we know that now we are protected from flash floods for many years.”

But infrastructure and supplies can only do so much. Communities need to understand the areas that are most at risk to flooding, landslides, and avalanches so that they do not build their homes and plant their crops in harm’s way. To do this, we work with the local people to do hazard mapping on their villages and surrounding areas and create early warning systems that signal that a disaster could be on the horizon.

A gabion basket is sealed

But in Afghanistan’s rugged high country, disasters will continue to be a reality. The investments we are making now will leave the people of Takhar safer and less likely to lose their homes and livelihoods next time an avalanche comes crashing down the mountainside or the snowmelt bursts the riverbanks.

It’s hard for us—even impossible—to imagine living as the people of Takhar do every day without running water, a toilet, a health clinic, a warm shelter, and access to education. Despite their hardships, I have not heard a single complaint since I arrived about the conditions they face every day. What I have heard again and again is ‘thank you’—a testament that warmth, hospitality, and gratitude can still persevere even in the most unfriendly and hostile terrain.

People gather to listen to the first address by the M23 rebels spokesperson Vianney Kazarama at a stadium in Goma. Photo: REUTERS/James Akena

Information in eastern Democratic Republic of Congo (DRC) is often like a game of telephone. It’s hard, if not impossible, to pinpoint where a rumor begins, let alone how much it changed from the original source and if it had any credibility to begin with.

As the Area Manager for the international humanitarian organization Concern Worldwide in the war-torn province of North Kivu in eastern Democratic Republic of Congo, distinguishing fact from fiction is a big part of my job. And in a country where security can change in an instant, acting on lies and failing to act on truth can have very real—even fatal—consequences.

Reports of a potential advance towards the provincial capital, Goma, by the M23 rebel movement started to circulate on Wednesday, November 14^th.  I got a call from one of our national staff who had heard that they were planning to ‘enter Goma soon,’ but was initially quite skeptical as no other source could confirm this.  When I woke up that next morning, I learned that the M23 were fighting the Congolese national army, FARDC, in Kibumba, just 19 miles north of Goma. By Saturday, M23 had taken control of Kibumba. Suddenly, what seemed unlikely had become a tangible threat.

As the M23 moved from Kibumba to Kibati, the final village on the way to Goma, we started to receive reports that FARDC troops were abandoning their posts and retreating. As the M23 advanced, one of the main internally displaced persons (IDP) camps north of Goma emptied, sending some 60,000 fleeing their homes and belongings to neighborhoods and areas, mostly to the west of Goma, thought to be safer.

As the rumors flew, one thing was clear: panic had set in.

No one was sure what the arrival of the M23 would bring.  While some families fled their homes as the M23 arrived in their neighborhoods, others barricaded themselves in, too scared to come out.   A few lined the streets to watch them enter and welcome them in.  While I had been lucky enough to move across the border to Rwanda and the relative safety of Gisenyi, the well-being and location of our staff who were still in Goma was a constant worry.   Knowing that they were crouched under beds and tables, as we spoke on the phone and hearing shelling and gunfire in the background was incredibly difficult.

A woman carries her child in Minova, west of Goma. Photo: REUTERS/Goran Tomasevic

However, by Tuesday, November 20^th, the M23 had full control of Goma and with it, they brought relative calm. They met little resistance when they arrived. Most FARDC fled and left it for the taking, while the UN peacekeeping forces, known as MONUSCO, did not resist. Soon after they arrived, they took over government offices and border posts and broadcast a message on the radio, requesting that life return quickly to normal.

Initially it was difficult to get a good sense of the number of people who were displaced as the fighting moved around Goma. Those from Kanyaruchinya IDP camp, to the north of Goma, initially moved west and into schools, churches, and homes in the city center, but as the fighting moved west, families often fled again.  Fighting in Sake, a town 12 miles west of Goma, also pushed thousands to flee in the direction of Goma. The United Nations now estimates that 140,000 people were displaced because of the fighting in the M23 advance and takeover of Goma.

When I was first able to re-enter Goma on November 26^th, I was surprised the city was surprisingly relatively calm, at least on the surface. People were out and about. Government offices were open—though now with M23 members inside them. However, reports of general, as well as targeted, looting and violence tell a different story.  Banks also remain closed as do most schools. Even those schools that are open may not have many children in them—many parents are still too scared to let their children go to school for fear that violence will flare up again, and many others are housing hundreds or thousands of displaced people.

Government army FARDC soldiers stand in a military base in Goma. Photo: REUTERS/Goran Tomasevic

While the M23 withdrew from Goma on Saturday, December 1, ending their 10-day occupation of the city, the humanitarian needs do not vanish with their departure. Because families are forced from their homes with few, if any, supplies, they are often unable to meet even the most basic human needs, like food, clean water, and shelter. People often do not have access basic services like health care and education for their children is disrupted.

Cholera is also a threat. Before the M23 takeover, there was a cholera outbreak in Kanyaruchinya camp—the camp that emptied as the M23 entered Goma. Its 60,000 residents are now scattered across the city, many of them living in spontaneous camps without clean water and sanitation facilities, making cholera very difficult to contain.

Concern is now preparing to distribute basic household supplies to 4,500 households throughout IDP settlements across Goma. These supplies, what we aid workers call “non-food items,” will allow people to cook and collect water and stay warm, dry, and clean.

Whatever the outcome of the current crisis, and even if the M23 rebellion abates, long-term peace in North and South Kivu remains an unlikely prospect. Other armed groups will continue to tear apart eastern DRC and subject the Congolese people to displacement and horrific human rights violations, destroying any possibility for peace and security.  Unfortunately, it’s only when one rebel group takes a large provincial city here that DRC makes it onto the evening news or into the newspaper.

The sad fact is that violence in DRC is constant. As Congolese activist Vava Tampa recently reported in an article on CNN, the conflicts in DRC “have claimed nearly the same number of lives as having a 9/11 attack every single day for 360 days, the genocide that struck Rwanda in 1994, the ethnic cleansing that overwhelmed Bosnia in the mid-1990s, the genocide that took place in Darfur, the number of people killed in the great tsunami that struck Asia in 2004, and the number of people who died in Hiroshima and Nagasaki—all combined and then doubled.”

What will happen next in DRC? Anything is possible—and we need the world to keep listening. As many as 5.4 million people died in the last Congo war. That is fact, not fiction. And we cannot afford for it to happen again.

This blog was originally posted on the Huffington Post .

An M23 rebel fighter walks past a resident as they withdraw from the town of Sake. REUTERS/Goran Tomasevic

Almost two weeks have passed since I returned from Masisi in the North Kivu province in the Democratic Republic of the Congo (DRC). There I witnessed civilian suffering on a shocking scale. We looked on helplessly as innocent families were deliberately targeted and burned out of their homes. They carried their belongings wrapped up in blankets as they scattered across the countryside just to escape the ravages of a conflict not of their making. The same scenes played out in village after village across many valleys in North Kivu.

Fighting has escalated rapidly. The country is on the brink of a devastating crisis, yet it still fails to make the headlines. This is hugely difficult to reconcile with the horror and absolute dismay we felt as we watched homes and livelihoods go up in smoke. Some 10,000 people were forced to seek refuge in Masisi center following these events. And this was just a sideshow to the main event. Opportunistic armed groups taking advantage of weakened security in the area while government (FARDC) troops were re-deployed elsewhere to deal with the growing threat posed by the M23 rebel group.

Congolese Revolution Army (CRA) rebels sit in a truck as they patrol a street in Goma in the eastern Democratic Republic of Congo (DRC). REUTERS

Displacement on a massive scale has taken place again as a result of M23’s advance on Goma—at least 60,000 already displaced people were forced to flee again from a camp in Kanyaruchinya. It is estimated that some 450,000 Congolese have sought refuge in neighboring countries, while a further 1.4 million remain internally displaced in the eastern region of the DRC. These are all people who been cut off from their means of income and are relying now on host families and humanitarian agencies for food, water, shelter—their most basic needs. But agencies have experienced serious setbacks in delivering the required aid as many, including Concern Worldwide, have been forced to evacuate staff from affected areas.

Securing safe access to assistance is the just one step on the road to building some semblance of a normal life for the people of eastern DRC. In this regard, the UN stabilization forces, known as MONUSCO, must fulfill their mandate to protect civilians. They were present in Masisi when we witnessed local militia groups wreak havoc on innocent people’s lives but they did not intervene. Nor were they able to halt the progress of M23 as they took Goma and continued onwards to Sake and Bukavu. Following negotiations this week, some reports suggest that M23 have agreed to retreat from Goma without conditions. However, the situation remains incredibly unpredictable and civilians are still being subjected to unimaginable levels of human rights abuses.

Displaced people cross the border from the Democratic Republic of Congo (DRC) into Rwanda. REUTERS/James Akena

There are deeply disturbing reports of civilians suffering abuse at the hands of armed troops on all sides, including financial exploitation, abduction, rape, and murder. Horrifyingly, these are not unfamiliar experiences for the people of this region. Conflicts have raged in eastern DRC since the mid-1990s. More than 500,000 women have been raped and six million people have been killed in this time. It is a vicious cycle which must be broken. Until it is, the Congolese people need all the protection they can get and the capacity of MONUSCO to deliver on its mandate must be strengthened.

At the heart of all the fighting is the vast mineral wealth contained within the Kivu provinces. An abundance of metals like coltan, cassiterite, and gold has proved a curse to local populations rather than a blessing. These are all used in the production of mobile phone and other electronic technology and the high demand has fuelled conflict for years as different groups struggle to control supply. This places a huge obligation on manufacturers to ensure the traceability of the materials they are using.

It is simply not acceptable for consumer demand to drive such misery.

Long-term stability, however, will not be brought to the region until decisive political action is taken. The Congolese government needs to recognize this fact and work to foster regional cooperation. Economic initiatives which encourage cross border trade would strengthen capacity for long-term peace-building efforts and could finally enable civilians to benefit from the resource-rich land.

After almost two decades of displacement, exploitation, and violent abuse, civilians must now come first.