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In South Sudan, Oxfam races the rains to save lives

By Tim Bierley

In the middle of war, even the simple solutions to staying healthy can feel impossible, but education and resources at the community level are saving lives every day.

Nyawal is a community heath volunteer, helping to educate her community about the importance of keeping their community clean, using clean water and practicing good sanitation to avoid diseases like cholera and diarrhea. Right now, Oxfam and volunteers like Nyawal are racing to educate and provide resources before the rainy season starts. Photo: Tim Bierley/Oxfam
 
You can do many simple things to keep control of cholera and diarrhoea, explains Yoal, an Oxfam health volunteer in Pading, South Sudan. But it gets more complicated when your town’s water pumps break down and people are forced to drink swamp water; when animals drink and defecate in the same water sources; when there are no toilets; when you only have one container for bathing, collecting water and washing clothes and dishes; when conflict cuts off your town from almost all trade and the price of soap is more than many people earn in a week; when sick people must walk 30 miles through blistering heat to reach the nearest hospital.

“It is hard for people to keep healthy here,” Yoal sighs. “In 2017, we had so many cases of cholera and diarrhoea. We lost 27 people.”

Yoal, an Oxfam community health volunteer, teaches the importance of keeping water containers clean in Lankien. Photo: Tim Bierley/Oxfam
 
Yoal’s home town of Pading is a small cluster of pointy-topped huts in Nyirol County in the northeast of South Sudan. It is extremely remote – surrounded by huge stretches of almost completely flat land, compressed into uniformity by the swamps which swell in the wet season between May and October. The swamps make delivering aid to places like Pading extremely difficult and they also increase the risk of cholera, as the expanding waters soak and mix up everything in their path.

Soon, those rains will thunder down on Pading again. With lives at stake, Oxfam is racing to make sure communities like this one are prepared with the means to fight off another outbreak during the wet season.

Oxfam and local leaders respond ahead of the rains

Last month, engineers from our mobile emergency response team repaired the town’s two water pumps, so Pading will have clean water this year. Now we’re working with volunteers like Yoal to teach people practical ways to keep disease at bay, as well as handing out supplies like water buckets, containers for bathing, soap and drinking cups.

The key to surviving in extremely risky situations like this, Yoal says, is being completely thorough.

“Sometimes, everyone within the family has to rely on the same containers for lots of different uses,” he says. “You have to be extremely careful about how you use your resources.”

He explains that as the war has dragged on, people have grown increasingly tired. They have seen friends and family die unnecessary deaths. It can be hard to persuade people that it’s possible to stop the slide, when it is clear the conflict is forcing people into ever worsening positions.

“You have to give really practical support like telling people that even if they cannot afford soap for washing, they can use ash. They should boil water if they are drinking it from the swamp. We explain exactly how each thing can affect them.”

Children are the common denominator

Convincing people that change is possible is not still not always easy, but Yoal says there is one thing that unites everyone: “It’s when people see the impact on their children’s health that they are really affected by what I say. Everyone just wants to keep their family safe.”

Nyawal, who volunteers for Oxfam in Lankien, a town nine hours walk from Pading, knows too well the impact cholera can have on a family. She lost two children to the disease last year. Like so many mothers in South Sudan, she felt that their lives were almost out of her control.

Nyawal, smiling with one of her children whose health has improved, is an Oxfam volunteer in Lankien helping with water and sanitation work. Photo: Tim Bierley/Oxfam

“I have always kept things clean and done everything I can to look after my family,” she says, but adds that people across the community do not realise the constant level of vigilance needed to prevent the spread of cholera.

Cholera can spread extremely quickly and through the most innocuous-seeming sources. Nyawal says she always knew that you should wave flies away from your food, for example. It’s instinctive. But she hadn’t seen it as a life and death matter. She doesn’t know what it was that caused her children to fall to cholera, but she wants to make sure her neighbours don’t suffer the same fate.

“As someone who went through this experience I have to keep telling people to take care of themselves and their children – how to help stop these diseases. We’ve brought tools, including rakes and pangas to help people clean up the areas around their houses and we’re telling them how to ensure their food is safe.”

Clean water isn't always an option in a warzone

Just as it is impossible to keep every fly from infecting food, sometimes the conflict takes health completely out of people’s control. Just outside Lankien, William a village elder tells how fighting in the area forced him and his community to flee deep into the bush, fearing attacks on civilians. The priority was to hide, so it was not possible for people to use functioning boreholes in the area: most were close to the road and therefore considered to be too exposed.

Yoal and his family were forced to flee violence and were too afraid to seek out clean water or boil water where they were hiding. Photo: Tim Bierley/Oxfam

“During this time, we had to drink swamp water,” he says. “It was hot and dirty.”

He and his family could not even treat the water by boiling it, as demonstrated by Oxfam’s health volunteers, for fear that the smoke would give away their position, and almost inevitably disease spread.

“A lot of us got sick at this time,” says William. “People lost their lives.”

In a country at conflict, it is extremely hard for communities to eradicate the risk of disease completely. It makes a huge difference to have access to clean water and to the utensils needed to be thorough in hygiene practices, but simple bad luck is also an inevitable factor. The awful fortune of being surrounded by chattering guns is compounded by the resulting destruction of water sources, of trade, of whole ways of life. People continue to be forced from their homes, their routines, and their means of looking after themselves.

As long as this keeps going, thousands of people will continue to suffer from entirely preventable diseases. Oxfam will continue to help people access clean water, maintain their dignity and keep their communities alive. That is something we can at least control.

WASH in the camps

Women collecting drinking water supplied by Oxfam in Kalunga camp, Kalemie, Tanganyika, Democratic Republic of the Congo. Oxfam is providing water, sanitation services and training to keep families healthy. Photo: Diana Zeyneb Alhindawi/Oxfam

In Kalemie province in southeast Democratic Republic of the Congo (DRC), the extreme violence between the Bantu and the Twa ethnic groups and brutal clashes between armed group have very forced more than 654,000 people to flee their homes and thousands of families are facing an increasingly critical food shortage. Women, children and the elderly are among those most affected after having seen families killed, villages burned and fields destroyed. The situation remains volatile and threatens to flare up again at any moment, preventing the displaced from going back to their villages and rebuild their lives.

Oxfam has been working in Kalemie since February 2017 and has already reached 58,302 people forced from their homes and the communities who have welcomed them. Oxfam is helping to provide clean water and sanitation facilities and working with community volunteers to educate people about the importance of good hygiene for staying healthy.

Left: Therese*, a Public Health Promoter talks to a child in Kalunga IDP camp, Kalemie, Tanganyika, Democratic Republic of the Congo. Right: Therese cleans Oxfam sanitation facilities in her community. Photo: Diana Zeyneb Alhindawi/Oxfam.

Therese has been in the Kalunga camp since November 2016. When her village was attacked, she was separated from one of her children and her husband. Therese went looking for them after the attack but couldn't find them, and three months later she was told that their bodies had been found. Therese lives in the Kalunga camp with 9 of her children, ages 7-17 years old. She was trained by Oxfam to be a camp hygiene promoter, and she works daily to clean sanitation facilities in the camp, as well as distributing water purification tablets to families so they have safe water to drink.

Therese said: "We fled as we were. There was no time to pack anything. You only took your children and ran."

"We walked for two days before reaching here. I had so many thoughts in my mind. I had been left with nothing. Sometimes I wish it was me who had died instead of my husband, because this burden is too much for me to bear."

"I have 9 children remaining. One of them is paralyzed and so I had to carry her all the way."

"We reached here in November last year and were received well. We received food for the first two months as well as some money to help us buy other things from the shops. But how can you bring up 9 children in these conditions?"

"People have been talking of going back when the fighting ends. Others are even going there to check on their farms or what is left of their possessions."

"I have experienced war in my life but never have I been forced to leave my home and live in a (IDP) camp. I have never seen fighting like this."

"I never thought I would ever be here. My plan was to save money to build a house where my family could live comfortably and live an ordinary life. But now I can’t even think beyond today. How can I think of a good education for my children if I don’t know where their next meal will come from?"

Oxfam is suppling drinking water to the people in Kalunga camp. Oxfam also trained 61 women from the camp as hygiene promoters. Their daily work includes cleaning sanitation facilities (toilets and bath areas) in the camp, distributing water purification tablets to families.

Testing the Waters

How the local community and the government are joining forces to make a change in Jordan

A water community group meeting in Allan, Salt. Photo: Alixandra Buck / Oxfam

In Jordan, it is not common for government and citizens to talk face to face on issues of common concern. There is also skepticism on the role of civil society. (Chatham House).

Together with the Water Authority of Jordan, a group of people in Salt govornorate, Jordan are working to change that.

Abir Suleiman Mrooj, Buthaina Al-Zubi, and Majde Algharagher are three of the twelve men and women who comprise a water community group in the town of Allan, Salt. Now, people of Salt can collaborate freely with government officials, air their grievances, and work together to improve water access and governance in their community.

Rapid population growth, a mountainous landscape and neglect have frequently left people in Allan with insufficient access to water. Community members, including Mrooj and Al-Zubi, highlighted the issues to Algharagher, the Water Authority’s Director of Salt District. In turn he was able to convince the Water Authority to respond with extensive improvements to the local water network, valued at over 150,000 JOD (Approx. 210,000 USD). Now, leakages in Allan have gone down significantly - and further improvements are expected to reduce losses even more.

This is of particular importance in Jordan, one of the most water-scarce countries in the world. Water use far exceeds the replacement rate, and leaks, breakages and interrupted water supply are all too common - pointing to the need for systemic changes to water infrastructure, water governance and water use patterns.

Majde Algharagher was quick to recognize the issues: “There has been a huge increase in population in Jordan, so there is less water available per person,” he told Oxfam. “We are also seeing illegal pumping, which is making water even scarcer.”

Over 40% of water in Jordan’s network is lost through leakages and other losses [USAiD].

Majde Algharagher, the Director of Salt District for the Water Authority of Jordan, speaks with community members. Photo: Alixandra Buck/Oxfam

Abir Suleiman Mrooj, of Allan, told Oxfam, “The sight of wasted water all over the streets used to hurt us, as we were working so hard to save water in our homes... So at first, we were like a beehive around Mr Algharagher – always pushing until we got a solution to each issue.”

Collaborating with the community has made it easier for the Water Authority to find and stop water losses. According to Algharagher, “Now that I am in the water group, people can contact me directly by phone. Before they had to come to the office or call the ministry and it would be a long process to speak to me. We also have a Whatsapp group, so they can send me a picture of a broken pipe or any problem, and I can respond. I can immediately send maintenance staff, and they can fix it. The response is easier and faster than before.”

Mrooj told Oxfam, “We housewives were able to achieve something for our community. The Water Authority heard my voice, and through me, the voices of many people in Jordan. We feel so proud that we could impact our community and the government.” But things are still not perfect: “Now, my water is good. But honestly, other places still struggle.”

Abir Suleiman Mrooj, a water Ambassador from Salt, Jordan, is a leader in her community. Photo Alixandra Buck/Oxfam

With the support of Global Affairs Canada, Oxfam is working with community members, partners, and the Government of Jordan to improve water governance. We want to ensure that more people in the country can meet their basic water needs and participate in decision-making at the community and national level.

One woman leading the way for healthy mothers in Bangladesh's refugee camps

By AJM Zobaidur Rahman, Campaigns and Communications Officer, Oxfam in Bangladesh

Rajiah, sitting here in her home in Cox's Bazar, Bangladesh, is a community health volunteer who helps share health information with pregnant refugee women. Photo Credit: OXFAM

Rajiah, 46, fled violence near her home in Myanmar 6 months ago, with her younger daughter, who is 15 years old. She is now living in a refugee camp in Bangladesh with thousand other Rohingya. Rajiah is one of close to a million Rohingya people have fled violence in Myanmar to seek refuge across the border in Bangladesh. This unprecedented number of refugees, of whom more than half are children, has caused a large-scale humanitarian crisis.

Left: Rajiah sharing health information with a pregnant woman in her home in Cox's Bazar, Bangladesh. Right: Rajiah walking through the refugee camp to visit her pregnant neighbor in Cox's Bazar, Bangladesh. Photo Credit: OXFAM

WOMEN HELPING WOMEN SURVIVE AND THRIVE

Rajiah has been surrounded by women throughout her life as the eldest of 10 sisters. She herself has 5 daughters, two of which are also in camps living as refugees in Bangladesh with their husbands, while the other two remain in Myanmar. Tragically, Rajiah’s husband disappeared when the violence broke out in Myanmar and Rajiah has no way of knowing where he is. Like so many women in the camp, Rajiah must head up her household alone.

Oxfam has come to know Rajiah as a leader when she was unanimously selected to represent her community during an Oxfam assessment of what their most pressing needs were. Rajiah is well educated and has been working with and for her community throughout her life. She told us that she delivered some 10,000 babies as a midwife in Myanmar.

Now, as a refugee in Bangladesh, she is making sure she puts her experience to good use and supports and provides information to the pregnant women in her community. Her name means “Hope” - a true reflection of her personality and life’s work.

Left: Rajiah and her younger daughter inside her house in the refugee camp. Right: Rajiah taking notes about International Women's Day. Photo Credit: OXFAM

RAJIAH BRINGS LEADERSHIP TO COX'S BAZAR

Rajiah was born in a relatively affluent family in Myanmar. Education was an important part of her childhood, and her family made sure all the girls had 8 years of schooling. Rajiah speaks particularly highly of her father, who she says was the greatest influence in her life.

Rajiah honed her leadership skills from a young age, starting at school as a class leader. Later, organizations who were working in her community, including the UN, selected Rajiah as one of their volunteers. She continued working as a health worker and played a major role in the vaccination process in her area, helping to prevent children dying needlessly from preventable illnesses.

Rajiah is outspoken and confident, a full believer in women’s role outside the household. That way, she says, women can get knowledge and they can advance – and then other women can also come forward simply by seeing these role models. She is very keen on working and further helping her community, especially the women in her community.

OXFAM IS THERE

Oxfam is planning to organize women’s groups in the camps and Rajiah is the ideal person to lead this process in her community. With her leadership skills, kind and warm personality, she will undoubtedly make great progress with the women in the community. Oxfam is also currently focusing on providing water and sanitation and adapting to better deal with the crowded conditions and sheer numbers of people. We are drilling wells and installing water points, toilets and showers. We’re also helping people stay healthy and hygienic by distributing soap and other essentials and working with community-based volunteers to emphasize the importance of clean water and good hygiene, especially as monsoon season approaches. So far, we have reached at least 185,000 people, and hope to reach more than 250,000 in the coming months.

Donate now to help those in refugees camps in Bangladesh

Yemenis struggle to find bare essentials three years on from first Saudi airstrikes, warns Oxfam

Food price shock adds to war’s misery

People in Yemen are struggling to survive on dirty water and meagre portions of bread three years after a Saudi-led coalition carried out its first airstrike on the country in its war with the Houthis, Oxfam said today.

Families in remote areas of Amran governorate in the north west of the country told Oxfam they could only afford half a bag of wheat a month and had to walk three kilometres two or three times a day to fetch untreated water from a well. Several women told Oxfam they were struggling to make ends meet and had no money for clothes or other supplies after their husbands had been killed in the conflict.

Since the war started the cost of food has rocketed. Rice is up 131 per cent, beans 92 per cent, vegetable oil 86 per cent and flour for making bread up 54 per cent. Over the same period the number of people going hungry increased by 68 per cent to reach almost 18 million people.

Over 3 million people have been forced to flee their homes, more than 5,500 civilians have been killed and 2,000 more have died of cholera in a country where half of the health facilities are no longer functioning because of the conflict.

With 22 million people in need of aid across the country, Yemen is already the world's worst humanitarian crisis and the site of the largest cholera outbreak since records began, with over a million suspected cases.

Jim Clarken, Oxfam Ireland's Chief Executive, said: “Oxfam has been working in Yemen since 1983 and we have never seen a humanitarian crisis of this scale. Three years on from the eruption of this devastating conflict, the country is teetering on the brink of famine. Families are facing a daily struggle just to get hold of the bare essentials like food and water.

“We are stepping up our work in Yemen to tackle this humanitarian crisis. Since July 2015 we have reached more than 2.8 million people in nine governorates of Yemen.

“We are providing water and sanitation services, cash assistance and food vouchers, including 430,000 people as part of our cholera response to prevent and contain the disease. We are trucking water and providing cash for people to buy food.

“Malnutrition can lower the body's immune system, and the lack of clean and safe drinking water and sanitation and a weakened health system allow diseases such as cholera to spread more easily. But the closure of sea and air ports has hampered efforts to get food, water, fuel and medicines to all those who need them.”

The appointment last month of Martin Griffiths as the new UN envoy to Yemen, and recent UN Security Council calls for moves towards a ceasefire and to ensure essential goods are given free passage, present an opportunity for the international community to reinvigorate efforts to achieve peace.

Mr Clarken added: “Three years of war is more than enough. Too many bombs have been dropped and shells fired, too many people have gone hungry, too many lives have been lost. All sides need to call time on this war. The appointment of a new UN envoy to Yemen is a chance to push for a ceasefire and put the country on the road to a lasting peace.

“Without an inclusive political settlement, the conflict will only continue to make life unbearable for the vast majority of the population.”

The public can support Oxfam Ireland's humanitarian response in Yemen online, by donating online via www.oxfamireland.org/hunger, by calling 1850 30 40 55 (Republic of Ireland) or 0800 0 30 40 55 (Northern Ireland) or calling into your local Oxfam shop

ENDS

For interviews or more information, contact: Phillip Graham on 00 44 (0) 7841 102535 / phillip.graham@oxfamireland.org

NOTES TO EDITORS

Footage, photos and feature stories are available.

For updates, please follow @OxfamIreland.

Oxfam’s response in Yemen

Since July 2015 Oxfam has reached more than 2.8 million people in nine governorates of Yemen with water and sanitation services, cash assistance and food vouchers, including 430,000 people as part of its cholera response.

Oxfam’s water and sanitation equipment includes water storage tanks, buckets, tap stands, hand washing water dispensers, water testing and purifications kits, oral rehydration sachets, insecticide sprayers, pipes and fittings.

Oxfam is repairing water supplies and carrying out disinfection of water storage and sources with chlorine, providing households with water purification equipment and distributing hygiene materials, constructing latrines and providing solid waste management facilities, training community volunteers to spread hygiene messages for cholera prevention and treatment, conducting public health campaigns, supplying oral rehydration sachets to ensure that people can quickly rehydrate when suffering from signs and symptoms of cholera.

Left: Three of Jameela's children sitting inside the house in the afternoon. Photo: Ameen Al-Ghaberi/Gabreez Right: Mohammed* is a first-grade student. *Name has been changed. Photo: Ameen Al-Ghaberi/Gabreez.

Left & Right: Ahmed and his siblings in Al-Okasha IDP camp, Abs district, Hajjah governorate - Credit: Ahmed Al-Fadeel / Oxfam Yemen.

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