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kmaherali
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Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

There is a related video at:

http://www.nytimes.com/2009/03/29/opini ... &th&emc=th

March 29, 2009
Op-Ed Columnist
A Boy Living in a Car
By NICHOLAS D. KRISTOF
CAP HAITIEN, Haiti

As America’s unemployment rate rises, those paying the severest price aren’t necessarily in Detroit or Miami. One of the newest street children here in this northern Haitian city is a 10-year-old boy whose father was working in Florida but lost his job and can no longer send money home. As a result, the family here was evicted, the mother and children went separate ways to improve their odds of finding shelter, and the boy found refuge in an abandoned wreck of a car.

The boy is one of 46 million people in the developing world — more than double the New York State population — who will be driven into poverty in 2009, according to a World Bank estimate.

In Haiti’s largest slum, Cité Soleil, in the capital, Port-au-Prince, I stumbled upon a one-room public school. The principal, Claude Lafaille, lamented that enrollment had dropped from 150 at the start of the year to 60 today.

“Haitians in America stopped sending money back, and so their family members can’t pay fees,” he said.

The school used to provide free breakfasts to ensure that students got at least one solid meal a day. But in January, the charity that provided the food had to stop because its donations were dropping, so now the remaining children are often too hungry to concentrate.

In the St. Catherine Labouré hospital in Port-au-Prince, the number of children admitted for malnutrition has approximately doubled since September, said a pediatrician, Dr. Armide Jeanty. She pointed to a 15-month-old child, Richardson, skeletal and covered with sores. He stared blankly, for when children are severely malnourished their bodies shut down and do not waste energy crying, laughing or smiling.

It’s natural in an economic crisis to look inward, to focus on America’s own needs, but it’s worth remembering that the consequence of a deep recession in a poor country isn’t just a lost job but also a lost child.

In Cité Soleil, a woman named Chantal Dorlus told me that her 5-year-old daughter, Nasson, starved to death last month, and neighbors confirmed the account. Ms. Dorlus said that her three other children would have starved as well if not for the generosity of her neighbors, who share their meager food supplies.

If slum-dwelling Haitians can share what little they have, I hope we can be equally generous during this downturn when needs are greatest.

On this trip, I met a couple of American women, Sasha Kramer and Sarah Brownell, both in their early 30s, who offer an example of outward commitment at a time when most of us are retrenching and focusing on ourselves. Sasha and Sarah run a hand-to-mouth aid group, called SOIL; they speak fluent Creole and get around on motorcycle taxis while waving back at legions of fans on every street. (You can watch a video of them at nytimes.com/ontheground.)

I was interested in their work because it addresses two of the developing world’s greatest but least glamorous challenges. One is sanitation, for human waste in poor countries routinely spreads disease and parasites. The second is agriculture, for poor countries must increase crop yields if they are to overcome poverty and hunger.

Sasha and Sarah create dry composting toilets that turn human waste into valuable fertilizer. They say that the yearlong composting process kills the pathogens in the waste, making it safe to use the fertilizer.

Frankly, I was taken aback when, 10 minutes after they had met me, they pulled out a Ziploc bag and proudly declared that it was compost made from their own toilet. They were so impressed with what they had accomplished that I felt obliged to take a whiff and hold it in my fingers; it simply felt and smelled like rich potting soil, and I would never have guessed its origins.

Haitian farmers use virtually no fertilizer — less than a pound per acre, compared with about 90 pounds in the United States — and soils are severely depleted. But Sasha calculates that if half of Haitians’ human waste could be used as fertilizer, that would amount to a 17-fold increase in fertilizer use, more than doubling the country’s agricultural production.

Sasha and Sarah have deployed 45 of their toilets, and now they are trying to introduce a municipal composting system in Cap Haitien.

I don’t know if this is feasible. But I love the idea that even when the needs of the United States are so immense, a couple of young Americans aren’t complaining or finger-pointing, but are hard at work to assist others whose distress is incomparably greater than our own.
kmaherali
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Post by kmaherali »

April 2, 2009
Op-Ed Columinst
At Stake Are More Than Banks
By NICHOLAS D. KRISTOF

As world leaders gather in London for the Group of 20 summit meeting, the most wrenching statistic is this: According to World Bank estimates, the global economic crisis will cause an additional 22 children to die per hour, throughout all of 2009.

And that’s the best-case scenario. The World Bank says it’s possible the toll will be twice that: an additional 400,000 child deaths, or an extra child dying every 79 seconds.

“In London, Washington and Paris, people talk of bonuses or no bonuses,” Robert Zoellick, the World Bank president, said this week. “In parts of Africa, South Asia and Latin America, the struggle is for food or no food.”

That’s what makes the G-20 summit — and Europe’s penchant for sniping at the United States instead of doing more to resolve the mess — so frustrating. Chancellor Angela Merkel of Germany is obstinately resisting a coordinated global stimulus package, President Nicolas Sarkozy of France threatened to walk out if he didn’t get his way and the Czech leader threw a tantrum.

For Americans like me who deeply believe in multilateralism, all this is enormously disappointing and makes us doubt Europe’s seriousness.

Granted, there are some exceptions here. The British prime minister, Gordon Brown, has a steady hand on his economy and has pioneered approaches to bank nationalization that we could learn from. But much of Europe seems paralyzed.

Japan’s prime minister, Taro Aso, drew on the lessons of Japan’s “lost decade” to scold Germany in an interview with The Financial Times for its dithering about a stimulus. When a Japanese prime minister scolds you for passivity, you know you’re practically a zombie.

As usual, the greatest price for incompetence at the summit will be borne by the poorest people in the world — who aren’t represented there and who never approved any bad loans.

I’m just back from Haiti and the Dominican Republic where I saw the impact of the crisis firsthand. In the Haitian slum of Cité Soleil, ravenous children tore at some corncobs that my guide had brought; it was their first food that day.

In a slum hospital, where admissions for malnutrition have doubled since September, I met a woman who used to sell shoes on the street. Shoe sales dropped with the sagging economy, so the woman was forced to use her sales revenue to buy food for her child instead of to replace inventory. Now she has no more merchandise to sell, no food to eat and the child she cradled was half dead with starvation.

Ann Veneman, the executive director of Unicef, says that reports coming in from the field suggest that malnutrition rates are rising.

“If you have prolonged malnutrition in kids, it will have a long-term impact on cognitive abilities,” she said. “It impacts your ability to learn in school and to earn as an adult.”

Impoverished parents in developing countries often try to keep their sons alive in famines by taking food from their daughters, so mortality is disproportionately female. The United Nations Development Program says that in some countries, the increase in child mortality during an economic downturn is five times higher for girls than for boys.

One of the most preposterous ideas floating about is that the world’s poor feel “entitled” to assistance. Entitled?

Wall Street plutocrats display a sense of entitlement when they demand billions for bailouts. But whether at home or abroad, the poor typically suffer invisibly and silently.

Oxfam has calculated that financial firms around the world have already received or been promised $8.4 trillion in bailouts. Just a week’s worth of interest on that sum while it’s waiting to be deployed would be enough to save most of the half-million women who die in childbirth each year in poor countries.

The 500 richest people in the world, according to a U.N. calculation a few years ago, earned more than the 416 million poorest people. It’s worth bearing in mind that the first group bears a measure of responsibility for the global economic mess but will get by just fine, while the latter group has no responsibility and will suffer the worst consequences.

If the G-20 leaders want to address these needs, there are many ways they can do so with negligible sums. Mr. Zoellick at the World Bank is pushing a trade support program to help developing countries sustain their trade. Muhammad Yunus, the microfinance pioneer who won the Nobel Peace Prize, urges the G-20 leaders to create a fund to invest in organizations that offer small loans or otherwise bolster commerce in poor countries.

So what will it be? More squabbling and recalcitrance, or something constructive for those whose lives are at stake in this downturn?
kmaherali
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Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

There is a related video linked at:

http://www.nytimes.com/2009/04/05/opini ... ?th&emc=th

April 5, 2009
Op-Ed Columnist
Pregnant (Again) and Poor
By NICHOLAS D. KRISTOF
PORT-AU-PRINCE, Haiti

For all the American and international efforts to fight global poverty, one thing is clear: Those efforts won’t get far as long as women like Nahomie Nercure continue to have 10 children.

Global family-planning efforts have stalled over the last couple of decades, and Nahomie is emblematic both of the lost momentum and of the poverty that results. She is an intelligent 30-year-old woman who wanted only two children, yet now she is eight months pregnant with her 10th.

As we walked through Cité Soleil, the Haitian slum where she lives, her elementary-school-age children ran stark naked around her. The $6-a-month rental shack that they live in — four sleep on the bed, six on the floor beside it — has no food of any kind in it. The family has difficulty paying the fees to keep the children in school.

There’s simply no way to elevate Nahomie’s family, and millions like it around the world, unless we help such women have fewer children. And yet family-planning programs have been shorn of resources and glamour for a generation now.

Nahomie is one of 200 million women worldwide who, according to United Nations estimates, have what demographers call an “unmet need” for safe and effective contraception. That is, they don’t want to get pregnant but don’t use a modern form of family planning.

This “unmet need” results in 70 million to 80 million unwanted pregnancies annually, the United Nations says, along with 19 million abortions and 150,000 maternal deaths.

The push for contraception was at the center of development efforts in the 1960s and 1970s, but then waned. In part, it was tarnished by its own zealotry, including coercion in China and India. Another reason was abortion politics, which led to a cutoff in American financing for the United Nations Population Fund — even though the upshot was more unwanted pregnancies and more abortions.

In addition, family planning turned out to be harder than many enthusiasts had expected, for it requires far more than condoms or the pill. Haiti has family-planning clinics, spending on contraception is fairly high, and women say they want fewer children — yet only one-quarter of Haitian women use contraceptives.

Nahomie’s story helps explain the enigma. She tried injectables, but she says they caused excess bleeding that frightened her. The clinic had little counseling to explain and reassure her, so she stopped after nine months.

A sexually transmitted infection at the time meant that she couldn’t use an IUD just then, and a doctor told her that the pill would be inappropriate because she has vascular problems. Reluctant to return to a clinic that seemed scornful of poor women, she drifted along with nothing.

A couple of babies later, her first husband left her, and her next husband wanted to have children with her, so she acquiesced. A few children later, she began to push back, but in Haiti’s social structure she felt she had to accede to her husband’s whims. “I asked to use condoms,” Nahomie said, “but he refused.” Last fall, shortly after she became pregnant with her 10th child, her husband ran off.

A book published a few years ago, “Reproducing Inequities,” notes that we are, painstakingly, learning what does work. The effective strategies go beyond the contraceptive devices themselves to include better counseling, more dignity for women in clinics, a greater choice of methods that are completely free — and a broad effort to raise the status of women.

The best way to elevate women, by far, is to educate girls and to give them opportunities to earn income through micro-loans, factory jobs or vocational training. It is sometimes said that the best contraceptive isn’t the pill or the IUD, but education for girls.

(A side note: Whenever I write about efforts to save children from malaria or diarrhea, I get cynical letters from neo-Malthusians who argue that saving children’s lives is pointless until birthrates drop. That’s incorrect. There’s abundant evidence that when parents are confident that their children will live, they will have fewer and invest more in each of them.)

In any case, the mounting academic evidence underscores what is intuitively obvious in Haiti: unless family planning is more successful in poor countries, they won’t be able to overcome poverty. “There’s no other way,” says Tania Patriota, the representative of the United Nations Population Fund in Haiti. “It’s indispensable.”

President Obama has already lifted the ban on aid for the Population Fund, and we now have an opportunity to lead a global effort to regain lost momentum for family planning. And while Nahomie’s story shows that this won’t be easy, it also underscores that there’s simply no alternative.
kmaherali
Posts: 25106
Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

Message from Bilaal Rajan

International Volunteer Week is taking place April 19 – 25, 2009, and to celebrate the occasion, I’ll be spearheading an initiative where I’ll live life without shoes for the entire week. As they say, “You never really know someone until you walk a mile in their shoes,” so I’m taking it a step further: I’m going barefoot!

I am asking fellow students, teachers and the general public to do the same, or as long as they can, to better understand the struggles faced by underprivileged children in the developing world – many of whom cannot afford shoes, let alone attend school or even know where their next meal is coming from.

Children in these countries walk miles in their bare feet every day to fetch water, work on their farm lands, go to school, or perform other chores. For many of them, the first priority is to take care of their families.

I am happy to say that people such as Nigel Fisher, president of UNICEF Canada, is on board. Also taking part is ORCA book publishers, award-winning novelist Eric Walters, World Partnership Walk deputy convenor Leigh McMaster-Virani, and most importantly, schools in Ottawa, Calgary and Montreal. The idea is also gaining momentum in countries as far away as Australia, Afghanistan, England, Thailand, Kenya, Malawi and Tanzania. The word on the initiative is travelling fast!

I am also featured in a documentary, Yes We Can!, produced by In Sync video, which is premiering on April 19, 2009 at the Sprockets Film Festival in Toronto, where the campaign is planned to officially kick off.

I’m urging everyone to spend just one hour bare feet any day during International Volunteer Week. Even better, you can spend a half or even a full day bare feet at work, at school or at home. What are you prepared to do to make the world a better place?

Visit http://www.makingchangenow.com/ for more details.

http://ismailimail.wordpress.com/2009/0 ... challenge/
kmaherali
Posts: 25106
Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

INTERNATIONAL VOLUNTEER WEEK

Going barefoot to raise awareness about poverty
Bilaal Rajan, 12, hopes to recruit others
KATE HAMMER

April 15, 2009

At least one pair of tired black dress shoes will get a rest next week, as 12-year-old Bilaal Rajan intends to go barefoot.

And he hopes to recruit others, not in a protest against his school's dress code, but instead to raise awareness about children and poverty during International Volunteer Week, which begins Sunday.

The initiative, dubbed the Walk a Mile Barefoot Challenge, stems from the adage about understanding another person's perspective by walking a mile in his or her shoes.

"It's simply to raise awareness to the fact that really there are so many children in other parts of the world that don't have something simple like shoes," Bilaal said in an interview yesterday from his home in Richmond Hill, Ont.

Print Edition - Section Front
Enlarge Image

"It's really about awareness, I realize that money is important and another way we'd be able to help, but how is anyone going to be able to help when they don't know what they're supporting, when they don't know the dire situation that other people are in?"

Bilaal's foray into fundraising began at the age of four with a box of clementines. Going door to door selling the small, sweet fruit, he raised $350 for earthquake victims in India.

He was eight years old when he was appointed as a child ambassador for UNICEF Canada and recently published a book, Making Change: Tips from an Underage Overachiever.

Throughout his young life, Bilaal has raised nearly $5-million for various children's causes, and last year he was named one of the country's Top 20 Under 20 by not-for-profit organization Youth in Motion.

Bilaal will kick off the barefoot challenge Sunday at the Sprockets film festival in Toronto, where he is the subject of a documentary set to premier at the event.

The idea for the barefoot challenge was hatched during a five-kilometre walk and fundraiser that Bilaal said was "pretty difficult, but I began to wonder how hard it would be to walk five kilometres without shoes."

The eighth grader has recruited nearly 500 participants through his Facebook page, and 150 students from his middle school at St. Andrew's College in Aurora, Ont., to abandon footwear for at least a day next week.

His parents, who own and operate a wholesale food distribution service, will be more reluctant participants: His mother, Shamim Rajan, has pledged to spend a day at home without shoes, but intends to have a box of bandages at the ready.

"I am concerned, he's going to play tennis in bare feet!" she said, referring to Bilaal's Wednesday practise with the school's tennis team.

Asked if he was hoping for good weather next week, Bilaal said he actually hoped for snow and ice.

"Then it'll be even better, because even more will we see how hard it is to live the life of others," he said.

http://www.theglobeandmail.com/servlet/ ... ilTPStory/

****
http://simerg.com/about/voices-bilaal-r ... refooters/

*****
Bilaal Rajan on CNN – UNICEF’s Youngest Ambassador
Posted: 06 Oct 2009 10:15 AM PDT

http://www.cnn.com/video/#/video/world/ ... tivist.cnn
/tag/bilaal-rajan/
Last edited by kmaherali on Wed Oct 07, 2009 8:25 am, edited 1 time in total.
kmaherali
Posts: 25106
Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

There is a related video linked at:

http://www.nytimes.com/2009/04/19/opini ... &th&emc=th

April 19, 2009
Op-Ed Columnist
Changing Lives, Mitt by Mitt
By NICHOLAS D. KRISTOF
AZUA, Dominican Republic

Whenever I write about global poverty, I’m deluged by readers with variants of a single question: What can I do?

It’s a vexing query, partly because thousands of excellent aid groups compete for your checkbook, and I don’t feel qualified to make endorsements — even if I were a philanthropic adviser, which I’m certainly not.

That said, let me tell you about my own visit recently to Yuneiris, a boy in the Dominican Republic (who turns 6 years old today — happy birthday, Yuneiris!). I’ve sponsored him since 2004 through Plan USA, a major aid group, and since I was in Haiti on a reporting trip I arranged a visit while I was in the neighborhood.

Look, I don’t know that sponsorship is the most cost-effective way of helping. Some people make small business loans on kiva.org, or support girls’ education, or buy anti-malaria bed nets, or pay for deworming children, or donate to organizations that battle modern slave traders, or underwrite trained rats that sniff out land mines. This is simply one more way in which almost anyone can lend a hand — and I do know that it felt pretty wonderful to meet a little boy whom I’d been supporting for five years.

I met Plan officials in Azua, in the particularly poor southwestern part of the Dominican Republic, and from there we drove together to the village and found Yuneiris and his family. He was beaming shyly at me — but especially at the baseball and glove I was carrying as a present for him.

Although I had also brought a load of books, pens, crayons and a soccer ball, it was clear where Yuneiris’s interest lay. He answered my questions about school politely, but his eyes were riveted on the baseball glove.

“There aren’t a lot of kids in the area who have a glove,” explained his mother, Cecilia. As soon as the conversation shifted, Yuneiris wriggled out of his seat and disappeared with the ball and glove to practice throwing with a chum.

I didn’t choose Plan over other sponsorship organizations through any elaborate research. As a backpacking student traveler in 1984 I had visited Aziza, a girl my parents were then sponsoring in Sudan through Plan, and my visit left me enormously impressed. So when I joined The Times later that year and began drawing a paycheck, I signed up myself and became one of the one million people worldwide sponsoring a child through Plan.

So I send in $24 a month, along with periodic letters, photos and birthday gifts. Every now and then, a letter arrives from my child’s family, with a drawing, a photo or a simple note from a family member, translated into English.

Through the letters, I learned that Yuneiris was living with Cecilia and other family members in a ramshackle wooden house. Cecilia worked as a domestic servant in the capital, Santo Domingo, returning to the village every other weekend.

Sponsorship is a bit of a marketing gimmick, since the donor’s money doesn’t go directly to the child’s family (which might spend it on beer). The funds underwrite community projects like new wells, toilets and clinics. Local people must volunteer their labor and some materials, and Plan supplies the money and the expertise.

Cecilia has taken courses, paid for by Plan, to learn how to use a computer and a cash register, so she hopes to find a better-paying job this year. In addition, Plan is starting up a microfinance group for women in the area, and the family would like to borrow to start a small baby-sitting and after-school tutoring business in the home.

Many people doubt the effectiveness of foreign aid, and a new best-selling book called “Dead Aid” by an African finance expert, Dambisa Moyo, even argues that government-to-government assistance is often harmful to recipient countries. It’s true that aid of all kinds is harder to get right than people usually assume, but the kind that has the best record is grass-roots investment — with strong local buy-in — in health, education, agriculture and microfinance. I’ve repeatedly seen these kinds of programs transform families and communities, from Africa to Afghanistan.

Frankly, this kind of aid is also pretty beneficial to the donor. For my part, I gain far more than $24 a month in psychic value from sponsoring Yuneiris, and my family’s tiny foreign assistance projects also remind my own kids that there is a world out there in which children have needs greater than the latest iPod.

Will my dollars and letters utterly transform Yuneiris’s life? Probably not. Will they make a significant difference? Probably yes. Is it worthwhile? For me, absolutely!

And if Yuneiris ends up pitching for the Yankees, I’m pretty sure he’ll get me season tickets.



I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.

****

April 19, 2009
Op-Ed Guest Columnist
It’s 2009. Do You Know Where Your Soul Is?
By BONO

I AM in Midtown Manhattan, where drivers still play their car horns as if they were musical instruments and shouting in restaurants is sport.

I am a long way from the warm breeze of voices I heard a week ago on Easter Sunday.

“Glorify your name,” the island women sang, as they swayed in a cut sandstone church. I was overwhelmed by a riot of color, an emotional swell that carried me to sea.

Christianity, it turns out, has a rhythm — and it crescendos this time of year. The rumba of Carnival gives way to the slow march of Lent, then to the staccato hymnals of the Easter parade. From revelry to reverie. After 40 days in the desert, sort of ...

Carnival — rock stars are good at that.

“Carne” is flesh; “Carne-val,” its goodbye party. I’ve been to many. Brazilians say they’ve done it longest; they certainly do it best. You can’t help but contract the fever. You’ve got no choice but to join the ravers as they swell up the streets bursting like the banks of a river in a flood of fun set to rhythm. This is a Joy that cannot be conjured. This is life force. This is the heart full and spilling over with gratitude. The choice is yours ...

It’s Lent I’ve always had issues with. I gave it up ... self-denial is where I come a cropper. My idea of discipline is simple — hard work — but of course that’s another indulgence.

Then comes the dying and the living that is Easter.

It’s a transcendent moment for me — a rebirth I always seem to need. Never more so than a few years ago, when my father died. I recall the embarrassment and relief of hot tears as I knelt in a chapel in a village in France and repented my prodigal nature — repented for fighting my father for so many years and wasting so many opportunities to know him better. I remember the feeling of “a peace that passes understanding” as a load lifted. Of all the Christian festivals, it is the Easter parade that demands the most faith — pushing you past reverence for creation, through bewilderment at the idea of a virgin birth, and into the far-fetched and far-reaching idea that death is not the end. The cross as crossroads. Whatever your religious or nonreligious views, the chance to begin again is a compelling idea.



Last Sunday, the choirmaster was jumping out of his skin ... stormy then still, playful then tender, on the most upright of pianos and melodies. He sang his invocations in a beautiful oaken tenor with a freckle-faced boy at his side playing conga and tambourine as if it was a full drum kit. The parish sang to the rafters songs of praise to a God that apparently surrendered His voice to ours.

I come to lowly church halls and lofty cathedrals for what purpose? I search the Scriptures to what end? To check my head? My heart? No, my soul. For me these meditations are like a plumb line dropped by a master builder — to see if the walls are straight or crooked. I check my emotional life with music, my intellectual life with writing, but religion is where I soul-search.

The preacher said, “What good does it profit a man if he gains the whole world and loses his soul?” Hearing this, every one of the pilgrims gathered in the room asked, “Is it me, Lord?” In America, in Europe, people are asking, “Is it us?”

Well, yes. It is us.

Carnival is over. Commerce has been overheating markets and climates ... the sooty skies of the industrial revolution have changed scale and location, but now melt ice caps and make the seas boil in the time of technological revolution. Capitalism is on trial; globalization is, once again, in the dock. We used to say that all we wanted for the rest of the world was what we had for ourselves. Then we found out that if every living soul on the planet had a fridge and a house and an S.U.V., we would choke on our own exhaust.

Lent is upon us whether we asked for it or not. And with it, we hope, comes a chance at redemption. But redemption is not just a spiritual term, it’s an economic concept. At the turn of the millennium, the debt cancellation campaign, inspired by the Jewish concept of Jubilee, aimed to give the poorest countries a fresh start. Thirty-four million more children in Africa are now in school in large part because their governments used money freed up by debt relief. This redemption was not an end to economic slavery, but it was a more hopeful beginning for many. And to the many, not the lucky few, is surely where any soul-searching must lead us.

A few weeks ago I was in Washington when news arrived of proposed cuts to the president’s aid budget. People said that it was going to be hard to fulfill promises to those who live in dire circumstances such a long way away when there is so much hardship in the United States. And there is.

But I read recently that Americans are taking up public service in greater numbers because they are short on money to give. And, following a successful bipartisan Senate vote, word is that Congress will restore the money that had been cut from the aid budget — a refusal to abandon those who would pay such a high price for a crisis not of their making. In the roughest of times, people show who they are.

Your soul.

So much of the discussion today is about value, not values. Aid well spent can be an example of both, values and value for money. Providing AIDS medication to just under four million people, putting in place modest measures to improve maternal health, eradicating killer pests like malaria and rotoviruses — all these provide a leg up on the climb to self-sufficiency, all these can help us make friends in a world quick to enmity. It’s not alms, it’s investment. It’s not charity, it’s justice.



Strangely, as we file out of the small stone church into the cruel sun, I think of Warren Buffett and Bill Gates, whose now combined fortune is dedicated to the fight against extreme poverty. Agnostics both, I believe. I think of Nelson Mandela, who has spent his life upholding the rights of others. A spiritual man — no doubt. Religious? I’m told he would not describe himself that way.

Not all soul music comes from the church.

Bono, the lead singer of the band U2 and a co-founder of the advocacy group ONE, is a contributing columnist for The Times.
kmaherali
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Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

There is a related video linked at:

http://www.nytimes.com/2009/05/10/opini ... ?th&emc=th

May 10, 2009
Op-Ed Columnist
The Killer No One Suspects
By NICHOLAS D. KRISTOF

On this Mother’s Day, let’s not only reach for flowers and dinners but also think of how we might make motherhood itself a bit happier.

One answer would be to confront the disease that kills more children than any other around the world. Quick, what do you think that might be? Hint: It’s not diarrheal disease (the No. 2 killer), malaria, measles or AIDS.

A further hint: It was threatening to kill an 18-month-old boy, Ousseynou Thiam, in a hospital in Dakar, Senegal. He lay on his back, his chest heaving, struggling frantically for breath, as his mother, Khady Thiam, hovered over him, her eyes ablaze with fear.

“He’s very seriously ill, for he’s not getting oxygen,” said the doctor, Boubacar Camara. “It’s too soon to tell what will happen. He may live. Or he may die.”

I’m taking a University of South Carolina sophomore, Paul Bowers, with me on my third “win-a-trip” journey through Africa, and watching a child at the edge of death marked a somber first leg of our trip. But traveling with a student gives me an excuse to step back and focus on immense challenges that we in journalism neglect because they’re not new enough to be “news.”

One of these is pneumonia, the ailment that was threatening to destroy not only Khady’s Mother’s Day but also her child’s chance of living even one more day. Pneumonia gets very little attention from donors or the public health community, yet it kills more than two million children a year, according to Unicef and the World Health Organization.

To put it another way, if you spend five minutes reading this column, at least 19 kids will die of pneumonia in that time. That’s more than will die of AIDS, malaria and measles combined.

Yet pneumonia goes ignored. It is the orphan of global health, attracting negligible investment.

To their great credit, advocates working against AIDS and malaria have goaded Western governments into spending significant sums on prevention and treatment. The result is that an AIDS diagnosis is no longer an immediate death sentence, and malaria infection rates are tumbling in some countries.

Meanwhile, pneumonia keeps on killing, while barely registering on the public consciousness. On Friday, the biggest pneumonia-related cause on Facebook (PS — Pneumonia Sucks) had 785 members — while the top five health-related causes had a combined 14.1 million.

But pneumonia is finally beginning to get traction. Last month, a group of health advocates including Save the Children announced that the first World Pneumonia Day will be Nov. 2, backed by an informative new Web site, worldpneumoniaday.org. At the same time, Hedge Funds vs. Malaria, an advocacy and fund-raising group, changed its name to Hedge Funds vs. Malaria and Pneumonia.

This incipient campaign against pneumonia could make a huge difference in Africa and Asia, because this is a cheap and simple way to save children’s lives.

On the second stop of our win-a-trip journey, Paul and I visited the impoverished former Portuguese colony of Guinea-Bissau, farther down the coast of West Africa. A 2-year-old boy named Paulino Biague arrived half-dead in the National Hospital suffering from convulsions; he turned out to have both malaria and pneumonia.

“If he hadn’t come in, he would have died,” said the doctor, Alfredo Manuel Biague. “And if he lived in a village in the countryside, he would have died.”

The hospital in Guinea-Bissau is dark and bleak, with women in labor crowded two to a bed, with electricity periodically failing and plunging the buildings into darkness. Yet doctors were able to put Paulino on anti-malarials and antibiotics immediately, and within a day he was out of danger.

A course of antibiotics used to treat pneumonia can cost only 27 cents.

Many Americans doubt whether foreign aid is effective, and it’s true that helping people is harder than it looks. Yet health programs have a particularly strong record (as do education and business-related initiatives like microfinance). One result of health campaigns is that the number of children dying by their fifth birthday has been cut in half since 1960, from 20 million annually to less than 10 million.

Children with AIDS and malaria already have advocates, so anyone looking for a cause should grab pneumonia and run with it. Think of it not as a grim and depressing initiative, but as potentially a happy turnaround opportunity, for these kids’ lives can be so breathtakingly easy to save.

In Dakar, doctors put an oxygen mask on little Ousseynou, to help him breathe, and gave him antibiotics. Already, doctors tell me via e-mail that he’s much improved and will almost certainly pull through — making this the most joyous Mother’s Day imaginable for Khady.
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Ending poverty a burger at a time

Staff photo by Daniel Ho
The End to Global Poverty Foundation organized a barbecue yesterday at the Loblaws on Mavis and Dundas in support of the relief effort for recent earthquake victims in Italy. Pasquale Montalbano volunteered as burger chef. EMAIL PRINT REPORT TYPO
By: John Bkila

May 10, 2009 03:20 PM - Almost 40 years ago, 17-year-old Rahim Mawani's mother was one of the 80,000 South Asians expelled from Uganda, and Italy was one of the few countries that took them in.

Affected by the earthquake that devastated Italy in April, Mawani and his nine-year-old brother Amyn felt the urge to host a charity barbecue in Mississauga yesterday to support the country that helped their relatives in the 1970s.

The earthquake killed more than 150 people and injured thousands more in the Italian city of L'Aquila, about 120 km northeast of Rome.

"We wanted to remember how the Italian people helped out our community," said Rahim, a Grade 12 student from Father Michael Goetz Secondary School.

Taking place at the Loblaws Superstore at Mavis Rd. and Dundas St. W., the charity event was sponsored by the grocery chain, which donated all the food and drinks for the day.

Organizers hoped to raise $10,000 from donations and food, T-shirt, wristband, and button sales.

All proceeds will go toward helping the earthquake victims through End To Global Poverty, a new organization founded by Rahim and Amyn.

The foundation's mission is to influence parliaments around the world to institute a World Fasting Day as a way to recognize those living in poverty and work toward ending the global issue, said senior administrator Nairisha Batada, 16, and a Grade 11 student at Rick Hansen Secondary.

The Mawani brothers got the idea for the foundation after years of taking part in The World Partnership Walk, Canada's largest annual event dedicated to increasing awareness and raising funds to fight global poverty.

"After raising $13,000 for that cause we decided to create our own organizaton," said Mawani. "That's what I want to do with my life, help others."

Amyn said he was happy to have co-founded such a great cause.

"I'd really like to see an end to global poverty," said the Grade 4 Ellengale Public School student.

The barbecue event had 30 to 40 youth volunteers from grades 4-12 from Ellengale Public School and Father Michael Goetz, Rick Hansen and St. Marcellinus Secondary Schools.

"I originally had gathered just 20 volunteers and then they told their friends, so it exploded from there," said Mawani.

Currently the End To Global Poverty foundation is made up of 10 people from Mississauga and the GTA.

jbkila@mississauga.net

http://mississauga.com/article/27117
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Joining the freedom ride in southern India

By Paula Arab, Calgary HeraldMay 14, 2009 3:03 AM

One of my favourite films this year was the Oscarwinning movie Slumdog Millionaire. It's the rags-to-riches story of an orphan boy who grew up in the slums of Mumbai, and wins the Indian version of Who Wants To Be A Millionaire. Jamal, the unlikely hero, is investigated for cheating. The story unfolds through a series of flashbacks, with Jamal explaining how an uneducated slumdog knows the answer to each question. Each answer is related to a traumatic experience from his unthinkable childhood.

The film, which quickly establishes a mood of fantasy, has its critics for making light of the sombre subject of human trafficking. But by dressing up the desperation of the slums with the cloak of romantic fantasy, the British and Indian directors brilliantly reached a mainstream audience. They served viewers the unpalatable images of real-life children, filmed running around in real Indian slums, by giving the audience a digestible out, through fairy tale and humour.

The issue of human trafficking is still so shameful, and such a taboo topic, even its brief treatment in Slumdog was considered radical. Protesters accused the film of stereotyping poverty in India and exploiting the child actors, who still find themselves living in Mumbai's slums, where nothing has changed. The father of one child actor has even been accused of trying to sell his daughter for profit.

In raising the sensitive subject of human trafficking, Slumdog spread awareness about this insidious crime beyond where any documentary could ever reach.

Now, through a series of bizarre coincidences, I find myself headed to India to spend my holidays connecting with real-life survivors; women and children who have been rescued from prostitution, child begging rings, exploitative marriages, sex slavery and bonded servitude. I'm one of 10 volunteers chosen from around the world (the only Canadian), who will escort 20 survivors of human trafficking on a 30-day bicycle trip, to 60 villages.

We will cycle 600 kilometres through southern India, discovering a different culture every 60 kilometres. We will stop at a Tibetan settlement of monks, and visit the Dalit caste, also known as the Untouchables. We will learn from each other, and expose ourselves to the various kinds of suffering in the world.

"We believe that womanhood and childhood are sacred," says Christina Lagdameo, the project coordinator for Odanadi Seva Trust, a British organization in Mysore that rescues and rehabilitates victims. "Human flesh is not a commodity. Every woman and child deserves a voice."

At each remote stop, these brave women will talk about their experiences as victims of human trafficking, so that others may avoid the traps set forth by those who prey on India's most vulnerable citizens. They will share their stories through song, dance and drama, warning of the devastating consequences the flesh trade has on individuals, families and the whole community.

Ultimately, they will expose their vulnerabilities and own suffering, learning to overcome their fears and to understand again that not all men are bad.

"There will be emotional, physical and psychological challenges," says Lagdameo, an American who quit her job at the White House in 2007 and has been with Odanadi ever since.

Odanadi, which means soulmate in the Kannada language, executes risky raids on brothels and runs a shelter, orphanage and school in Mysore. It also offers a number of counselling and rehab programs, and has introduced a novel education program for the children of the prostituted. The organization is well connected in India, with widespread support among the police, courts and politicians.

It even has support in Canada, with B. C. Senator Mobina Jaffer sponsoring the ride. She herself hoped to attend, but the 30-day campaign conflicts with her schedule in the Senate.

Through Odanadi, hundreds of victims have been rescued in the 20 years since it pioneered its program. Their work, however, represents a tiny fragment of the vast scale of human trafficking.

According to India's Ministry of Women and Child Development, there are three million prostitutes in the country, of whom 40 per cent are minors. Nearly 70 per cent are lured into the sex trade with the promise of a good job. Others are tricked into it by marriage proposals from husbands who then pimp their child brides.

The issue certainly reaches Canada. Our country has been identified as a source, destination and transit country for trafficking victims, according to Jaffer's website. "The RCMP conservatively estimates that between 800 to 1,200 people are victims of human trafficking each year."

It could be as high as 16,000, she says.

Much good work is being done around the world to eradicate human trafficking. However, Odanadi still sees far too many suicides. "The trauma they've endured, it's just very deep," says Lagdameo.

"The shame takes years for them to overcome. I can't say if they ever fully heal."

To follow my slumdogging in India, log on to my blog at calgaryherald.com.

parab@theherald.canwest.com

© Copyright (c) The Calgary Herald

http://www.calgaryherald.com/news/Joini ... story.html
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There is a related video linked at:

http://www.nytimes.com/2009/05/14/opini ... ?th&emc=th

May 14, 2009
Op-Ed Columnist
What a Little Vitamin A Could Do
By NICHOLAS D. KRISTOF
KOUNDARA, Guinea

I’m bouncing across West Africa in the back of a Land Cruiser with the winner of my “win-a-trip” contest, Paul Bowers, a student at the University of South Carolina, talking about wonky ways to tackle global poverty — such as vitamin A capsules.

Americans pretty much take vitamin A for granted, but many of the world’s poorest people lack it. And as a result, it is estimated that more than half-a-million children die or go blind each year. There’s a simple fix: vitamin A capsules that cost about 2 cents each.

I had planned this “win-a-trip” journey in part to introduce Paul to the problem of blindness as an element of global poverty. When I first visited West Africa myself as a backpacking law student, I was staggered and depressed by the blind beggars who circled me with outstretched palms.

So there we were, Paul and I, “enjoying” a 50-cent-per-person “breakfast” at a “restaurant” here in the town of Koundara in northern Guinea when we first came face to face with blindness on this trip.

A man named Amadou Bailo shuffled toward us, holding one end of a stick as his daughter held the other and walked ahead of him. In wealthy countries, the blind have seeing-eye dogs; in poor countries, the blind have seeing-eye children. The girl, Mariama, who thought she might be about 9 years old, has never been able to attend school because she spends her days guiding her father. Her older brother was the father’s guide before that, so he never went to school either.

“His blindness has kept two of his children from going to school,” noted Shawn Baker of Helen Keller International, an aid group that works on vision and nutrition issues. Mr. Baker met us, after we had crossed over from neighboring Guinea-Bissau, at such a sleepy border post that we had to wake up a border guard.

Mr. Bailo had lost his sight from an excruciating affliction called river blindness, which is caused by baby worms that infest the body and destroy the optic nerve. River blindness was once endemic in much of West Africa and seemed almost hopeless. Yet today, in one of the great triumphs of humanitarian workers, it is under control and perhaps close to being conquered.

Credit goes to former President Jimmy Carter for helping to lead the fight against the disease, to a number of aid groups and to Merck, which donated the medicines to kill the baby worms. Mr. Bailo will never recover his vision, but these days, virtually no one in West Africa is going blind from the disease.

Americans sometimes don’t want to help poor countries because of doubts about whether aid works. There are legitimate doubts about the effectiveness of many aid efforts, but there also are extraordinary triumphs that don’t get attention — such as the war on blindness.

Which leads us back to vitamin A.

In the major Sierra Leone city of Bo, which is about a three-day drive from Koundara, we visited the Paul School for the Blind, an audacious private institution that struggles to educate blind children in one of the world’s poorest countries. Some of its students were congenitally blind — and one girl had plastic melted into her eyes by rebel soldiers — but 80 percent of the students had lost their sight for reasons related to vitamin A deficiency.

According to the United Nations, half of the children in many African countries are deficient in vitamin A (which comes from liver, mangos, orange-fleshed sweet potatoes and dark, green leafy vegetables), and a disease like measles will quickly deplete their supply further and trigger blindness. The upshot is that vitamin A deficiency is the leading cause of child blindness in the world today.

Health wonks have found that vitamin A supplements reduce not only blindness, but also death from diarrhea and other diseases. A review by Unicef and Helen Keller International reports that in areas such as West Africa where many children lack the vitamin, child mortality drops by approximately 23 percent after vitamin A capsules are distributed to children.

“Addressing vitamin A deficiency may be the most cost-effective intervention you can implement,” said Mr. Baker of Helen Keller International.

Now there’s a big push already under way to distribute vitamin A capsules twice a year to all children at risk, by such organizations as Unicef, Helen Keller International and the Micronutrient Initiative of Canada. By one estimate, this could lead to 600,000 children’s lives saved each year in Africa — and, in the future, many fewer blind beggars being led by their children or grandchildren.

By now, Paul has bumped over so many potholed dirt roads with me that he probably wishes he had come in second in my contest. But it’s a special pleasure when our journey shows us not only the immense challenges that Africa faces, but also the immense progress that is being made.
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May 17, 2009
Op-Ed Columnist
This Mom Didn’t Have to Die
By NICHOLAS D. KRISTOF
BO, Sierra Leone

On this trip through West Africa with my “win-a-trip” contest winner, I was reminded of one of the grimmest risks to human life here. Despite threats from warlords and exotic disease, it’s something even deadlier: motherhood.

One of the most dangerous things an African woman can do is become pregnant. So, along with the winner of my contest for college students, Paul Bowers, I have been visiting the forlorn hospitals here in West Africa. According to the World Health Organization, Sierra Leone has the highest maternal mortality in the world, and in several African countries, 1 woman in 10 ends up dying in childbirth.

It’s pretty clear that if men were dying at these rates, the United Nations Security Council would be holding urgent consultations, and a country such as this would appoint a minister of paternal mortality. Yet half-a-million women die annually from complications related to pregnancy or childbirth without attracting much interest because the victims are typically among the most voiceless people in the world: impoverished, rural, uneducated and female.

Take Mariama, a 21-year-old pregnant woman with a 3-year-old child living in a village here in southern Sierra Leone. Mariama started bleeding one afternoon before we arrived, but her family had no money and was reluctant to seek medical care. When she was already half-dead, she was finally taken into the government hospital in Bo.

She was off-the-charts anemic, but there was no blood available for a transfusion. In that situation, the woman’s relatives are checked to see if they are of the same type and can give, but Mariama was accompanied only by her mother, who was too fragile to donate blood.

The only obstetrician, serving an area with two million people, was away, so nurses suggested that in the absence of a transfusion, Mariama receive a plasma expander for her blood. But that would have cost $4, and Mariama and her mother had no money at all.

So Mariama continued to hemorrhage right there in the maternity ward. At 1 a.m. the next morning, she died.

“We did our best to save her,” said Regina Horton, a nurse-midwife at the hospital. “But we had no blood.”

I’ve seen women dying like this in many countries — on the first win-a-trip journey in 2006, a student and I watched a mother of three dying in front of us in Cameroon — and it’s not only shattering but also infuriating. It’s no mystery how to save the lives of pregnant women; what’s lacking is the will and resources.

Indeed, Sierra Leone is now making progress with the help of the United Nations Population Fund, which is renovating hospital wards, providing free medicines and trying to ensure that poor women don’t die because they can’t pay $100 for a Caesarian section. The Bush administration cut off all American funds for the U.N. Population Fund, hobbling it, but this year President Obama has moved to restore the money. Other organizations that are focused on this issue include the White Ribbon Alliance for Safe Motherhood, CARE and Averting Maternal Death and Disability.

A bill introduced in Congress in March — the Newborn, Child, and Mother Survival Act — would establish American leadership in this area. But it has attracted pathetically little attention.

If the lives of women like Mariama were a priority, there would be many simple ways to keep them alive. For example, they could routinely be given anti-malarials and deworming medicine during pregnancy to flush out parasites. They should also receive daily iron tablets to overcome anemia, and a bed net. All this would cost just a few dollars and would leave pregnant women far less likely to die of hemorrhages.

Caesarian sections are necessary for perhaps 1 in 10 births worldwide, but village women put their trust in traditional birth attendants (partly because the attendants also perform genital cutting on girls, creating a bond). Doctors and nurses often are harsh and contemptuous toward uneducated women so that patients stay away until it is too late. If doctors and nurses had as good a bedside manner as the birth attendants, hospitals would be better used and lives saved.

Still, one sees the — limited — progress in Mabinti Kamara, who is 25 and went into labor in her village. When an arm came out, it was apparent that the fetus was sideways, so the birth attendant pushed hard on Mabinti’s abdomen to complete the process.

On Mabinti’s fourth day of labor, she was finally taken to a hospital in the city of Makeni, where a surgeon found that she had a ruptured uterus. The surgeon removed the dead fetus and repaired the uterus. Mabinti then lay on her bed in pain, disconsolate at losing her child. Still, the maternity ward was filled with women like her. Just a few years ago, they all would have died. They are reminders that women can be saved in childbirth — but only if their lives become a priority.

http://www.nytimes.com/2009/05/17/opini ... nted=print
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There is a related video linked at:
http://www.nytimes.com/2009/05/21/opini ... ?th&emc=th

May 21, 2009
Op-Ed Columnist
After Wars, Mass Rapes Persist
By NICHOLAS D. KRISTOF
MONROVIA, Liberia

Traditionally, an international issue was “serious” only if it was arcane and, preferably, incomprehensible. To be respected in foreign policy, it helped to smoke a pipe, spout theories about ballistic missiles, and frequently employ the word “hegemony.”

Now pipes are passé, three of the last four secretaries of state have been women, and a new foreign policy agenda is emerging around issues like poverty, genocide, climate change and a topic that until recently was hushed up — sexual violence.

In modern times, we’ve seen mass rape as an element of warfare in Congo, Darfur, Bosnia, Rwanda, Liberia — but the lesson here in Liberia in West Africa is that even when the fighting ends, the rape continues. And that brings us to Jackie, a lovely 7-year-old with tight braids and watchful eyes.

Jackie is too young to remember the 14-year civil war in Liberia, from 1989 to 2003, when as many as three-fourths of women were raped. Jackie’s world is one of a bustling, recovering Liberia with a free press and democratically elected leaders.

Yet somehow mass rape survived the end of the war; it has been easier to get men to relinquish their guns than their sense of sexual entitlement. So the security guard at Jackie’s school, a man in his 50s, took the little girl to the beach where, she said, he stripped her and raped her. Finally, he ran off as she lay bleeding and sobbing on the sand.

“I couldn’t walk well, so they took me to hospital,” Jackie told me. It was worse than that: She was hemorrhaging, and the hospital couldn’t stop it. So Jackie was rushed in critical condition to Monrovia’s largest hospital, where she spent weeks recovering.

Jackie is now in a shelter for survivors of sexual violence — and what staggered me is that so many of the girls are pre-teens. A 3-year-old survivor has just moved out, but Jackie jumps rope with girls aged 8 to 11.

Of course, children are raped everywhere, but what is happening in Liberia is different. The war seems to have shattered norms and trained some men to think that when they want sex, they need simply to overpower a girl. Or at school, girls sometimes find that to get good grades, they must have sex with their teachers.

“Rape is a scar that the war left behind,” said Dixon Jlateh, an officer in the national police unit dealing with sexual violence. “Sexual violence is a direct product of the war.”

The evidence is overwhelming that the best way to deal with rape — whether in Darfur or Liberia, or even in the United States — is to demystify it, dismantle the taboos, and address it directly. That is happening.

The United Nations Security Council held a formal session last year on sexual violence, and the International Criminal Court in The Hague issued its arrest warrant for Sudan’s president in part because of mass rapes. Senators Barbara Boxer and Russ Feingold chaired subcommittee hearings on rape just this month, focused on Congo and Sudan, where the brutality is particularly appalling. But the lesson of Liberia is equally sad: that even when wars end, mass rape continues by inertia.

In Liberia, sexual predation during the civil war was “normal.” One major survey found that 75 percent of women had been raped — mostly gang-raped, with many suffering internal injuries.

The incidence of rape has dropped since then but is still numbingly high. An International Rescue Committee survey in 2007 found that about 12 percent of girls aged 17 and under acknowledged having been sexually abused in some way in the previous 18 months.

Then there is the age of the victims. Of the 275 new sexual violence cases treated between January and April by Doctors Without Borders in Liberia, 28 percent involve children aged 4 or younger, and 33 percent involve children aged 5 through 12.

“The rape of little children is common,” said Oretha Brooks, a social worker at the excellent Duport Road Clinic in Monrovia. “It happens on a daily basis.” She introduced me to Wynnie, a 9-year-old girl in her waiting room who had been raped twice.

Yet there are signs of progress. Liberia’s president, Ellen Johnson Sirleaf, the first woman elected a president in Africa, has sent strong signals that rape is intolerable. Aid groups like the Carter Center are working to promote the rule of law and punish the rapists, recognizing that economic development will be elusive as long as women and girls are prey.

Maybe the greatest reassurance came from Jackie, the resilient 7-year-old. She appeared to have overcome the stigma of rape, for she explained that she wanted to grow up to build shelters for abused girls, adding, “I want to be president for Liberia.”
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There is a related video linked at:

http://www.nytimes.com/2009/05/24/opini ... ?th&emc=th

May 24, 2009
Op-Ed Columnist
The Hidden Hunger
By NICHOLAS D. KRISTOF
BISSAU, Guinea-Bissau

The most heartbreaking thing about starving children is their equanimity.

They don’t cry. They don’t smile. They don’t move. They don’t show a flicker of fear, pain or interest. Tiny, wizened zombies, they shut down all nonessential operations to employ every last calorie to stay alive.

We in the West misunderstand starvation — especially the increasing hunger caused by the global economic crisis — and so along with Paul Bowers, the student winner of my “win-a-trip” contest, I’ve been traveling across five countries in West Africa, meeting the malnourished.

At the extreme, they were like Maximiano Camara, a 15-month-old boy here in Bissau, who was so emaciated that he risked failure of major organs. His ribs protruded, his eyes were glassy, his skin was stretched taut over tiny bones.

(Doctors try to help but are overwhelmed: One was showing me Maximiano when a nurse rushed in from another room carrying a baby who had stopped breathing. The doctor paused, revived that child on the next bed, handed her back to the nurse, and then calmly resumed his discussion of Maximiano.)

Even if Maximiano survives, hunger may leave him physically stunted. Or poor nutrition may have already withered the development of his brain.

It’s impossible to know if Maximiano was starving because of the economic crisis or because of chronic malnutrition here, but the hardships in the developing world have been exacerbated by elevated food prices and declining remittances from workers abroad.

The World Bank has estimated that United Nations goals for overcoming global poverty have been set back seven years by the global crisis. It calculates that increased malnutrition last year may have caused an additional 44 million children to suffer permanent physical or mental impairment.

Yet one of the great Western misconceptions is that severe malnutrition is simply about not getting enough to eat. Often it’s about not getting the right micronutrients — iron, zinc, vitamin A, iodine — and one of the most cost-effective ways outsiders can combat poverty is to fight this “hidden hunger.”

Malnutrition is not a glamorous field, and so it’s routinely neglected by everybody — donor governments, poor countries and, yes, journalists. But malnutrition is implicated in one-third to one-half of all child deaths each year; the immediate cause may be diarrhea, but lurking behind it is a deficiency of zinc.

“That image of a starving child in a famine doesn’t represent the magnitude of the problem,” notes Shawn Baker of Helen Keller International, a New York-based aid group working in this area. “For every child who is like that, you have 10 who are somewhat malnourished and many more who are deficient in micronutrients.

“Lack of iron is the most widespread nutrition deficiency in the world, and yet you can’t really see it,” he added.

In my column last Sunday, I wrote about women dying in childbirth. One reason so many die of hemorrhages is that 42 percent of pregnant women worldwide have anemia, according to the World Health Organization. And here in Guinea-Bissau, 83 percent of youngsters under age 5 suffer from iron deficiency.

An American or European typically has a hemoglobin, or Hb, level of 13, while anemic women and children in Africa are sometimes at 5 or below.

“In Europe, we get worried when Hb drops to 9, and then we consider a transfusion,” said Dr. Annette Kröber, a German working at a Doctors Without Borders clinic for malnourished children in Sierra Leone. “Here, when we get Hb up to 6, we’re very happy.”

The general rise in food prices (in part because of American use of corn for ethanol) is leading to more micronutrient deficiencies. One study found that a 50 percent rise in food prices in poor countries leads to a 30 percent drop in iron intake.

One solution is to distribute supplements to vulnerable people, or to fortify foods with micronutrients. A panel of prominent economists produced the “Copenhagen Consensus” on which forms of aid are most cost-effective, and it ranked micronutrient supplements as No. 1 (malaria prevention was No. 12, sanitation No. 20, and microfinance No. 22).

Americans typically get micronutrients from fortified foods, and the same strategy is possible in Africa. Helen Keller International is helping Guinea’s leading flour mill fortify its products with iron, folic acid and vitamin B (zinc is coming soon). We visited the mill, and managers said that the fortification costs virtually nothing — a tiny fraction of a penny per loaf of bread — yet it will reduce anemia, maternal mortality and cognitive impairments around the country.

None of this is glamorous, but it’s hugely needed — and truly a bargain.

*****
There is a related multimedia linked at:

http://www.nytimes.com/2009/05/24/healt ... ?th&emc=th

May 24, 2009
Death in Birth
Where Life’s Start Is a Deadly Risk
By DENISE GRADY
BEREGA, Tanzania — The young woman had already been in labor for two days by the time she reached the hospital here. Now two lives were at risk, and there was no choice but to operate and take the baby right away.

It was just before dawn, and the operating room, powered by a rumbling generator, was the only spot of light in this village of mud huts and maize fields. A mask with a frayed cord was fastened over the woman’s face. Moments later the cloying smell of ether filled the room, and then Emmanuel Makanza picked up his instruments and made the first cut for a Caesarean section.

Mr. Makanza is not a doctor, a fact that illustrates both the desperation and the creativity of Tanzanians fighting to reduce the number of deaths and injuries among pregnant women and infants.

Pregnancy and childbirth kill more than 536,000 women a year, more than half of them in Africa, according to the World Health Organization.

Most of the deaths are preventable, with basic obstetrical care. Tanzania, with roughly 13,000 deaths annually, has neither the best nor the worst record in Africa. Although it is politically stable, it is also one of the world’s poorest countries, suffering from almost every problem that contributes to high maternal death rates — shortages of doctors, nurses, drugs, equipment, roads and transportation.

There is no single solution for a problem with so many facets, and hospital officials in Berega are trying many things at once. The 120-bed hospital here — a typical rural hospital in a largely rural nation — is a case study in the efforts being made around Africa to reduce deaths in childbirth.

More at the above mentioned link.
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June 2, 2009
The Deadly Toll of Abortion by Amateurs
By DENISE GRADY

BEREGA, Tanzania — A handwritten ledger at the hospital tells a grim story. For the month of January, 17 of the 31 minor surgical procedures here were done to repair the results of “incomplete abortions.” A few may have been miscarriages, but most were botched operations by untrained, clumsy hands.

Abortion is illegal in Tanzania (except to save the mother’s life or health), so women and girls turn to amateurs, who may dose them with herbs or other concoctions, pummel their bellies or insert objects vaginally. Infections, bleeding and punctures of the uterus or bowel can result, and can be fatal. Doctors treating women after these bungled attempts sometimes have no choice but to remove the uterus.

Pregnancy and childbirth are among the greatest dangers that women face in Africa, which has the world’s highest rates of maternal mortality — at least 100 times those in developed countries. Abortion accounts for a significant part of the death toll.

Maternal mortality is high in Tanzania: for every 100,000 births, 950 women die. In the United States, the figure is 11, and it is even lower in other developed countries. But Tanzania’s record is neither the best nor the worst in Africa. Many other countries have similar statistics; quite a few do better and a handful do markedly worse.

Eighty percent of Tanzanians live in rural areas, and the hospital in Berega — miles from paved roads and electric poles — is a typical rural hospital, struggling to deal with the same problems faced by hospitals and clinics in much of the country. Abortion is a constant worry.

Worldwide, there are 19 million unsafe abortions a year, and they kill 70,000 women (accounting for 13 percent of maternal deaths), mostly in poor countries like Tanzania where abortion is illegal, according to the World Health Organization. More than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America and the Caribbean.

Reliable figures on abortion in Tanzania are hard to come by, but the World Health Organization reports that its region, Eastern Africa, has the world’s second-highest rate of unsafe abortions (only South America is higher). And Africa as a whole has the highest proportion of teenagers — 25 percent — among women having unsafe abortions.

The 120-bed hospital in Berega depends on solar panels and a generator, which is run for only a few hours a day. Short on staff members, supplies and even water, the hospital puts a lot of its scarce resources into cleaning up after failed abortions.

The medical director, Dr. Paschal Mdoe, 30, said many patients who had had the unsafe abortions were 16 to 20 years old, and four months pregnant. He said there was a steady stream of cases, much as he had seen in hospitals in other parts of the country.

“It’s the same everywhere,” he said.

On a Friday in January, 6 of 20 patients in the women’s ward were recovering from attempted abortions. One, a 25-year-old schoolteacher, lay in bed moaning and writhing. She had been treated at the hospital a week earlier for an incomplete abortion and now was back, bleeding and in severe pain. She was taken to the operating room once again and anesthetized, and Emmanuel Makanza, who had treated her the first time, discovered that he had failed to remove all the membranes formed during the pregnancy. Once again, he scraped the inside of her womb with a curet, a metal instrument. It was a vigorous, bloody procedure. This time, he said, it was complete.

Mr. Makanza is an assistant medical officer, not a fully trained physician. Assistant medical officers have education similar to that of physician assistants in the United States, but with additional training in surgery. They are Tanzania’s solution to a severe shortage of doctors, and they perform many basic operations, like Caesareans and appendectomies. The hospital in Berega has two.

Abortions in Berega come in seasonal waves — March and April, August and September — in sync with planting and harvests, when a lot of socializing goes on, Dr. Mdoe said. He said rumor had it that many abortions were done by a man in Gairo, a town west of Berega. In some cases, he said, the abortionist only started the procedure, knowing that doctors would have to finish the job.

Dr. Mdoe said he suspected that some of the other illegal abortionists were hospital workers with delusions of surgical skill.

“They just poke, poke, poke,” he said. “And then the woman has to come here.” Sometimes the doctors find fragments of sticks left inside the uterus, an invitation to sepsis.

In the past some hospitals threatened to withhold care until a woman identified the abortionist (performing abortions can bring a 14-year prison term), but that practice was abandoned in favor of simply providing postabortal treatment. Still, women do not want to discuss what happened or even admit that they had anything other than a miscarriage, because in theory they can be prosecuted for having abortions. The law calls for seven years in prison for the woman. So doctors generally do not ask questions.

“They are supposed to be arrested,” Dr. Mdoe said. “Our work as physicians is just to help and make sure they get healed.”

He went on, “We as medical personnel think abortion should be legal so a qualified person can do it and you can have safe abortion.” There are no plans in Tanzania to change the law.

The steady stream of cases reflects widespread ignorance about contraception. Young people in the region do not seem to know much or care much about birth control or safe sex, Dr. Mdoe said.

In most countries the rates of abortion, whether legal or illegal — and abortion-related deaths — tend to decrease when the use of birth control increases. But only about a quarter of Tanzanians use contraception. In South Africa, the rate of contraception use is 60 percent, and in Kenya 39 percent. Both have lower rates of maternal mortality than does Tanzania. South Africa also allows abortion on request.

But in other African nations like Sierra Leone and Nigeria, abortion is not available on request, and the figures on contraceptive use are even lower than Tanzania’s and maternal mortality is higher. Nonprofit groups are working with the Tanzanian government to provide family planning, but the country is vast, and the widely distributed rural populations makes many people extremely hard to reach.

Geography is not the only obstacle. An assistant medical officer, Telesphory Kaneno, said: “Talking about sexuality and the sex organs is still a taboo in our community. For a woman, if it is known that she is taking contraceptives, there is a fear of being called promiscuous.”

In interviews, some young women from the area who had given birth as teenagers said they had not used birth control because they did not know about it or thought it was unsafe: they had heard that condoms were unsanitary and that birth control pills and other hormonal contraceptives could cause cancer.

Mr. Kaneno said the doctors were trying to dispel those taboos and convince women that it was a good thing to be able to choose whether and when to get pregnant.

“It is still a long way to go,” he said.
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July 9, 2009
Op-Ed Columnist
Would You Let This Girl Drown?
By NICHOLAS D. KRISTOF

It’s the Group of 8 summit in Italy, and world leaders are strolling along when they spot a girl floundering in a pond, crying out and then dipping beneath the surface.

There are no cameras around. The leaders could safely rescue the girl, but they would get drenched and risk damaging their $600 shoes. A rescue would also delay the group’s discussion of Very Important Issues.

In that situation, I’m convinced, the presidents and prime ministers would leap into the water to save the girl. So would you or I.

(The difference is that the G-8 leaders would then hold a televised press conference to spotlight their compassion, perhaps canceling their session on humanitarian aid to do so.)

This raises an interesting question: If the G-8 leaders are so willing to save one child, why are they collectively so far behind in meeting humanitarian aid pledges to save other children?

A few countries, including Canada and the United States, will meet the aid targets for 2010 that they set in 2005. But France is falling short, and Italy — the host of the G-8 summit this year — is disastrously far behind.

In a thoughtful book published this year, “The Life You Can Save,” Professor Peter Singer of Princeton University offers the pond example and explores why we’re so willing to try to assist a stranger before us, while so unwilling to donate to try to save strangers from malaria half a world away.

One of the reasons, I believe, is that humanitarians are abjectly ineffective at selling their causes. Any brand of toothpaste is peddled with far more sophistication than the life-saving work of aid groups. Do-gooders also have a penchant for exaggeration, so that the public often has more trust in the effectiveness of toothpaste than of humanitarian aid.

There’s growing evidence that jumping up and down about millions of lives at stake can even be counterproductive. A number of studies have found that we are much more willing to donate to one needy person than to several. In one experiment, researchers solicited donations for a $300,000 fund that in one version would save the life of one child, and in another the lives of eight children. People contributed more when the fund would save only one life.

“The more who die, the less we care.” That’s the apt title of a forthcoming essay by Paul Slovic, a psychology professor at the University of Oregon who has pioneered this field of research.

Yet it’s not just, as the saying goes, that one death is a tragedy, a million a statistic. More depressing, appeals to our rationality actually seem to impede empathy.

For example, in one study, people donate generously to Rokia, a 7-year-old malnourished African girl. But when Rokia’s plight was explained as part of a larger context of hunger in Africa, people were much less willing to help.

Perhaps this is because, as some research suggests, people give in large part to feel good inside. That works best when you write a check and the problem is solved. If instead you’re reminded of larger problems that you can never solve, the feel-good rewards diminish.

Another factor is personal responsibility: How many people share it? Professor Singer notes that in one experiment, students filled out a market research study while a young woman went behind a curtain and then appeared to climb on a chair to get something — and fell down. She then moaned and cried out that her ankle was injured.

When the person filling out the form was alone, he or she helped 70 percent of the time. But when another person was in the room, also filling out the survey and not responding, then only 7 percent tried to help.

In the case of fighting poverty, there are billions of other bystanders to erode a personal sense of responsibility. Moreover, humanitarian appeals emphasize the scale of the challenges — 25,000 children will die today! — in ways that are as likely to numb us as to galvanize us.

I also wonder if our unremitting focus on suffering and unmet needs stirs up a cloud of negative feelings that incline people to avert their eyes and hurry by. Maybe we should emphasize the many humanitarian successes, such as the falling child mortality rates since 1990 — which mean that 400 children’s lives are saved every hour, around the clock.

There are no easy answers here, but if a toothpaste company had these miserable results in its messaging, it would go back to the drawing board. That’s what bleeding hearts need to do as well.

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July 12, 2009
Op-Ed Columnist
Clean, Sexy Water
By NICHOLAS D. KRISTOF
People always ask: What can I do to make a difference?

So many people in poor countries desperately need assistance. So many people in rich countries would like to help but fear their donations would line the pocket of a corrupt official or be lost in an aid bureaucracy. The result is a short circuit, leaving both sides unfulfilled.

That’s where Scott Harrison comes in.

Five years ago, Mr. Harrison was a nightclub promoter in Manhattan who spent his nights surrounded by friends in a blur of alcohol, cocaine and marijuana. He lived in a luxurious apartment and drove a BMW — but then on a vacation in South America he underwent a spiritual crisis.

“I realized I was the most selfish, sycophantic and miserable human being,” he recalled. “I was the worst person I knew.”

Mr. Harrison, now 33, found an aid organization that would accept him as a volunteer photographer — if he paid $500 a month to cover expenses. And so he did. The organization was Mercy Ships, a Christian aid group that performs surgeries in poor countries with volunteer doctors.

“The first person I photographed was a 14-year-old boy named Alfred, choking on a four-pound benign tumor in his mouth, filling up his whole mouth,” Mr. Harrison recalled. “He was suffocating on his own face. I just went into the corner and sobbed.”

A few weeks later, Mr. Harrison took Alfred — with the tumor now removed — back to his village in the West African country of Benin. “I saw everybody celebrating, because a few doctors had given up their vacation time,” he said.

Mercy Ships transformed Mr. Harrison as much as it did Alfred. Mr. Harrison returned to New York two years later with a plan: he would form a charity to provide clean water to save lives in poor countries. But by then, he was broke and sleeping on a friend’s couch.

Armed with nothing but a natural gift for promotion, and for wheedling donations from people, Mr. Harrison started his group, called charity: water — and it has been stunningly successful. In three years, he says, his group has raised $10 million (most of that last year alone) from 50,000 individual donors, providing clean water to nearly one million people in Africa and Asia.

The organization now has 11 full-time employees, almost twice as many unpaid interns, and more than half a million followers on Twitter (the United Nations has 3,000). New York City buses were plastered with free banners promoting his message, and Saks Fifth Avenue gave up its store windows to spread Mr. Harrison’s gospel about the need for clean water in Africa. American schools are signing up to raise money to build wells for schools in poor countries.

“Scott is an important marketing machine, lifting one of the most critical issues of our time in a way that is sexy and incredibly compelling — that’s his gift,” said Jacqueline Novogratz, head of the Acumen Fund, which invests in poor countries to overcome poverty.

Mr. Harrison doesn’t actually do the tough aid work in the field. He partners with humanitarian organizations and pays them to dig wells. In effect, he’s a fund-raiser and marketer — but that’s often the most difficult piece of the aid puzzle.

So what’s his secret? Mr. Harrison’s success seems to depend on three precepts:

First, ensure that every penny from new donors will go to projects in the field. He accomplishes this by cajoling his 500 most committed donors to cover all administrative costs.

Second, show donors the specific impact of their contributions. Mr. Harrison grants naming rights to wells. He posts photos and G.P.S. coordinates so donors can look up their wells on Google Earth. And in September, Mr. Harrison is going to roll out a new Web site that will match even the smallest donation to a particular project that can be tracked online.

Third, leap into new media and social networks. This spring, charity: water raised $250,000 through a “Twestival” — a series of meetings among followers on Twitter. Last year, it raised $965,000 by asking people with September birthdays to forgo presents and instead solicit cash to build wells in Ethiopia. The campaign went viral on the Web, partly because Mr. Harrison invests in clever, often sassy videos.

One popular video shows well-heeled Manhattanites stepping out of their luxury buildings and lining up to fill jerrycans with dirty water from a lake in Central Park. We watch a mother offer the murky water to her small children — and the upbeat message is: you can help ensure that other people don’t have do that, either.

Mr. Harrison’s underlying idea is that giving should be joyous, an infectious pleasure at the capacity to bring about change.

“Guilt has never been part of it,” he said. “It’s excitement instead, presenting people with an opportunity — ‘you have an amazing chance to build a well!’ ”

I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.

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Youth clean up graffiti
Jennifer Moreau, Burnaby Now
Published: Wednesday, July 15, 2009

A band of Ismaili Muslim youth put paint brushes to walls along a graffiti ridden neighbourhood in Burnaby recently.

It was part of a larger initiative called CIVIC, which stands for Challenging Ismaili Volunteers In Communities.

Here in Burnaby, the city's anti-graffiti coordinator got a helping hand from 40 local volunteers from the Ismaili Muslim community.

View Larger Image(photo)
Clean sweep: Noorshan Nanji, member of the Ismaili youth group, cleaning up graffiti near the SkyTrain line in Burnaby.
Jason Lang/BURNABY NOW


They helped paint over graffiti in an effort to reclaim the community and discourage taggers.

"A lot of the youth get a bad name," says Kathy Wipf, the city's anti-graffiti coordinator. "And now we've got a group that wants to make it better."

This year's CIVIC day was July 5. Roughly 180 youth around the Lower Mainland volunteered with several projects, including planting trees, cleaning up parks and working in soup kitchens.

jmoreau@burnabynow.com

© Burnaby Now 2009

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July 19, 2009
Op-Ed ColumnistHis Maternal Instinct
By NICHOLAS D. KRISTOF
KARACHI, Pakistan

She is an illiterate woman from the tribal areas of Pakistan who almost died in childbirth a year after marrying at the age of 12. She suffered a horrific injury during labor called a fistula that left her incontinent and smelly, and for the next 13 years she was confined to her house — never stepping outside for shame at the way she was leaking wastes.

He is a famous Pakistani ob-gyn who was educated in Ireland. After spending eight years there, he returned with plans to set up a fertility clinic for rich patients and zip around in a Mercedes-Benz. But he was so shattered by the sight of women dying unnecessarily in childbirth that he decided to devote his career instead to helping impoverished women like her.

So they met in one of the hospitals established by the doctor, Shershah Syed, and he has been helping the young woman, Ashrafi Akbar. She is scheduled to undergo a final repair of her fistula in that hospital today.

People in the West are properly outraged by Taliban oppression of women in parts of Pakistan. But some of the greatest suffering of women here isn’t political or religious. It comes simply from the inattention to maternal health care.

Here in Pakistan, a woman dies every 35 minutes because of problems from pregnancy or childbirth, according to United Nations figures.

The underlying reason is that maternal health has never been a priority globally, either to poor countries or to foreign aid donors like the United States. The only exceptions are Britain and Norway, and I hope the Obama administration will back them up.

In this part of Pakistan, Sindh Province, there is a saying that goes: If your cow dies, that is a tragedy; if your wife dies, you can always get another.

“This is simpler than an atomic bomb,” Dr. Shershah said, speaking of improving maternal health in Pakistan. “We have an atomic bomb, but we haven’t done this because the government isn’t interested. The day the government decides it doesn’t want maternal deaths, we will have no more mothers dying.”

Ashrafi’s case was typical: She tried to deliver at home with the help of an untrained birth attendant. But her pelvis wasn’t big enough to accommodate the baby’s head, so four exhausting days of labor produced nothing.

Finally, the family took Ashrafi to a clinic, and the baby was delivered dead. Then she found that she was dribbling urine and stool through her vagina. She smelled, and the salts in her urine left sores on her thighs.

Ashrafi had heard that doctors in Karachi might be able to cure her, and she asked if someone could take her. Instead, Ashrafi’s husband divorced her. Embarrassed and humiliated, Ashrafi fell into a deep depression. She locked herself up in her parents’ home and refused to see anyone.

Thirteen years passed. Ashrafi says she didn’t leave the house once. I asked her, and a cousin of hers whom I reached by telephone, how she spent her days. The answer: sewing, caring for her sick mother — and crying.

Finally, she prevailed upon her brothers to take her to Karachi, where she was examined by Dr. Shershah. At 56, he is one of his country’s best-known doctors and is president of the Society of Obstetricians and Gynecologists of Pakistan. But three times he has been pushed out of his job, he said, for saying that resources would be better spent on education and health than on atomic weapons or F-16s.

With government support nine years ago, Dr. Shershah started a top-level maternity wing in a public hospital in Orangi, an impoverished Karachi neighborhood that by some reckonings is the largest slum in the world. The hospital now handles 6,500 deliveries a year — yes, 6,500 — and accepts women from hundreds of miles away. Several years ago, a half-dead woman came from Baluchistan Province — by camel.

In addition, Dr. Shershah is hitting up friends to try to build a new maternity hospital on the grounds of a former madrassa on the edge of Karachi. So far, he has built a wing to repair fistulas free of charge and to train midwives. He says that in five years or so, as the money trickles in, the hospital will be complete. (Friends in America have set up a tax-deductible charity, National Health Forum. For more information, please go to my blog, www.nytimes.com/ontheground.)

In addition to his regular work, Dr. Shershah repairs fistulas there every Sunday, and that is how he encountered Ashrafi. Her case turned out to require a series of operations because of the long wait. But after six months of surgeries, she should be repaired and ready to go home by the end of this month.

Already, the nurses say, she is different from the shy, morose young woman who arrived. Now she smiles and sometimes laughs, and she spends her days outside in the hospital courtyard, bathing in the sunlight that she missed for 13 years.

I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.

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July 26, 2009
Stanford
Documenting Brutalities to Change the World
By FATIMA HASSAN

In 1991, civil war devastated my parents’ homeland, Somalia, spawning a vast diaspora of refugees. My seven siblings and I grew up in Katy, Tex. I remember sitting with my parents in the comfort of our living room in America, listening to international journalists and humanitarian workers on CNN. I am still haunted by the weak bodies of Somali children and the panic etched into the faces of their emaciated mothers as their beloved family fell victim to hunger. These images are imprinted in my consciousness and galvanized me to shift from being a spectator to an activist.

Therefore my major and minor, honors thesis, research and academic work have helped me understand the plight of women. History and current events across cultures remind us of the prevailing view of women as objects. Being in college has deepened my understanding of this history. But books and classes don’t compare with learning directly. I want to share one field experience I had when I went to Uganda, Rwanda and Eritrea to blog about women’s lives on behalf of Americans for the United Nations Population Fund.

When you hear the word "survivor," you usually think of that reality TV show pitting contestants against one another on some remote island. In Rwanda, “survivor” refers to those who survived the genocide. I had the privilege of visiting a survivor’s village an hour outside of Kigali to hear from women who have survived extreme sexual violence.

As I walked into their community center, I noticed a woman standing apart from the crowd of children, wrapped in her white scarf painted with purple and yellow flowers. I recognized her as a fellow Muslim. That afternoon, I listened to the testimony of 10 women like her who, in their own words, were “defiled” and left pregnant by their rapists. I had grappled with the ethics of asking women to share these brutal moments. Then a woman spoke up, saying that she was grateful that my group had come all the way from America to listen to them speak because fellow villagers do not want to hear of their pain. As I left the center, I noticed puddles on the floor. Half of the women developed traumatic fistulas from the assault, causing them to still leak bloody urine 14 years after the genocide.

I rarely look at the pages of notes from that day. I never need to because these women’s struggles are written into my soul, fueling my desire to change world. The power of listening is that it can change you. When you are fully engaged in a moment, you awaken the world to unseen ugly realties.

Violence against women is an inconvenient truth in many societies — one of three women worldwide has experienced rape or sexual assault. I would like to use research, advocacy and public policy to combat gender violence that is systemic in conflict zones. The failure of governments and societies to address crimes against women — including rape, female genital cutting, lack of treatment for obstetric and traumatic fistula, forced and early marriages and the trafficking of women — is alarming.

Nearly two million women today live with obstetric and traumatic fistula, leaking urine and/or feces. As a research assistant with the Stanford Eritrean Maternal Health project, I was able to travel and listen to patients who were ostracized by families and forced off public buses because of the fistulas related to assault and giving birth. In Uganda, I saw sex workers, some as young as 10, willing to sell their bodies for chapatti and mango juice to stave off hunger. I witnessed three women sharing a hospital bed in a maternity clinic, sidestepping blood on the floor of women in labor.

I am honored to be a part of this graduating class, and eager for us to create a better world together. When we truly listen to the communities we wish to serve, we absorb their pain and invigorate our search for justice and solutions. We cannot trick ourselves into thinking “someone else will do it” because we are the ones privileged to have attended college. It is now our responsibility to rethink and implement sustainable change, whether local or global.

Fatima Hassan, Stanford, class of 2009, human biology major

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July 30, 2009
Op-Ed Columnist
Crisis in the Operating Room
By NICHOLAS D. KRISTOF
KARACHI, Pakistan

Afterward, they comforted each other with the blasphemy: “It was God’s will.”

It was the first pregnancy for Shazia Allahdita, 19. I was in the operating room at a public hospital here in Karachi as surgeons performed a Caesarean section on her to try to save her life.

As she lay unconscious under the anesthesia, doctors plucked a baby boy from her uterus and then labored to revive the child. “He has a heartbeat, but he’s not crying,” Dr. Aijaz Ahmed explained tersely as he gave the boy oxygen. “He’s not responding. I think he’s getting weaker.”

These dramas play out constantly in poor countries. One woman dies a minute from complications of pregnancy or childbirth somewhere in the world, and 20 times as many suffer childbirth injuries.

There’s no mystery about how to save these lives. Some impoverished countries, such as Sri Lanka, have succeeded stunningly well at saving mothers simply because they have tried. But foreign aid donors like the United States have never shown much interest in maternal mortality, and impoverished women are typically the most voiceless, neglected people in their own countries — so they die at astonishing rates. Here in Pakistan, 1 woman in 74 will die at some point in her life from complications during pregnancy.

Shazia’s suffering is typically unnecessary. It all would have worked out fine if she had gone to a hospital to deliver her baby. She wanted to. Her husband and relatives all agreed, when I interviewed them later, that she had had her heart set on delivering at the public hospital here. It’s also free, so long as supplies haven’t run out (other times, family members have to rush out to buy supplies).

But Shazia’s female in-laws thought that a hospital birth was a silly extravagance, and a young Pakistani woman is at the mercy of her mother-in-law and sisters-in-law. (In Pakistan, men are little involved in such decisions about childbirth.) It didn’t help that the in-laws resented Shazia because she and her husband, Allahdita, had breached tradition by marrying out of love rather than by family arrangement.

When Shazia went into labor, the family summoned a traditional birth attendant to help with the delivery. Hours passed. Nothing happened. Shazia asked to go to the hospital, but it was far away and would require what for them would be an expensive taxi fare of 300 Pakistani rupees, equivalent to about $3.75.

“If she went to the hospital, then every time the family visited it would be a long way to go and very inconvenient,” explained an aunt, Qamarunnisa. “It was so much easier to go to the local health post. It seemed easier.”

So the family eventually took her to a local clinic, where Shazia struggled to deliver for another 24 hours of labor. The family discussed taking her to the hospital, but the obstacle was the 300 rupee taxi fare. “If it hadn’t been for the money, she would have come here,” said Qamarunnisa.

But nobody wanted to pay. Shazia’s in-laws truly are poor, but it’s hard to imagine that they would have balked if it had been a man in the family who was in danger — or if they had known that Shazia was carrying a baby boy.

“If they had known it was a son, they would have come up with 500 rupees,” said Dr. Sarah Feroze, as her colleagues struggled to save Shazia and her baby.

Finally, some 30 hours after Shazia’s water had broken, an aunt paid for the taxi to the hospital. The doctors immediately saw that Shazia’s baby could not fit through her pelvis and rushed her into the operating theater for the C-section.

Shazia lived. The baby died.

I visited Shazia the next day. She was in a crowded, stifling ward. The power had gone out. Her bedding was soiled. She was crying.

Outside, her husband, Allahdita, was grieving but philosophical. “It is God’s will,” he said, shrugging. “There is nothing we can do.”

That’s incorrect. If men had uteruses, “paternity wards” would get resources, ambulances would transport pregnant men to hospitals free of charge, deliveries would be free, and the Group of 8 industrialized nations would make paternal mortality a top priority. One of the most lethal forms of sex discrimination is this systematic inattention to reproductive health care, from family planning to childbirth — so long as those who die are impoverished, voiceless women.

Thankfully, there is the dawn of a global movement against maternal mortality. Prime Minister Gordon Brown of Britain and the United Nations secretary general, Ban Ki-moon, are trying to work with the United States and other countries to hold a landmark global health session at the U.N. focusing, in part, on maternal health. If that comes to pass, on Sept. 23, it will be a milestone. My dream is that Barack and Michelle Obama will leap forward and adopt this cause — and transform the prospects for so many young women like Shazia.



I invite you to visit my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.

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Mosharraf Zaidi: The Miseducation of Thomas Friedman


This past weekend, two of the New York Times’ finest columnists wrote about the excellent work of philanthropists and social entrepreneurs in helping Pakistan respond to the challenges of building a better society. Dr. Shershah Syed’s work in maternal and womens’ healthcare (which Nicholas Kristof wrote glowingly about) and “Three Cups of Tea” author Greg Mortenson’s building of rural schools (which was highlighted in Thomas Friedman’s column), are both excellent examples of the kinds of innovation and enterprise being deployed by ordinary people of extraordinary compassion and commitment.

Let’s be clear and unambiguous. The philanthropy, social enterprise, intellect and integrity of folks that do their bit for humanity, is something that should inspire and instruct all our lives. So when Greg Mortenson drinks his third cup of tea and becomes a part of the communities he learned to love, and establishes fifty or one hundred schools, or several hundred more, in Pakistan— Pakistanis should salute him. Of course, Pakistani arms would get tired, very rightly, for having to salute several hundred standout philanthropists and social entrepreneurs for their work in education. There is a long list of accomplished individual and collective efforts to educate Pakistan. Those efforts come in all shapes, sizes and colours — secular, non-profit, faith-based, or for-profit.

Parsi schools have churned out the finest (in all senses of the word) young ladies of Karachi for decades. Catholic schools have produced some of Pakistan’s most talented citizens (with a well-deserved shout out reserved for the holy trinity of Pakistani Catholic schools — St. Joseph’s and St. Patrick’s in Karachi, and the incomparable St. Mary’s of Rawalpindi).

As with everything else in Pakistan, the landscape is incomplete without the mention of Muslim philanthropy, and the shining beacon of the Lord’s nur in that regards has been the Ismaili community’s contributions to education, starting from the very top, by His Highness the Prince Aga Khan and his family. There is perhaps no better example of Pakistani excellence than what Pakistanis produce every minute of every day at the Aga Khan University Hospital in Karachi.

Of course, one need not necessarily be inspired by their faith, to act in deeply humane and divine ways. Indeed some of the most humane work is done by people that don’t feel the need to invoke faith to do good. Pakistan’s philanthropy landscape is populated by hundreds of those kinds of groups too. The Citizens Foundation is an avowedly non-religious organization. They’ve established over six hundred schools (that’s at least four times the number Mr. Mortenson’s Central Asia Institute has built). They cater to over 80,000 students. They too are worthy of deep praise. So are the folks at Read Foundation. They’re catering to over 65,000 students through more than 330 schools. Smaller, more strategic, and more research oriented philanthropy in education is provided by individuals like Shahid Kardar, who was instrumental in breathing life into the Punjab Education Fund for the last several years, and organizations like SAHE, where Hamid Kizilbash (and later Fareeha Zafar) have constructed a most impressive array of policy lessons for the education sector.

Of course, if the emphasis in Thomas Friedman’s piece on education was not on education -- which given Friedman’s track record on Pakistan, it was almost unquestionably not -- then it was on the secularity of such education. In addition to non-religious organizations and their efforts in the philanthropic arena, it is useful to remember the contribution made to Pakistan by private schools, despite the class structures which they have exacerbated (and in some ways attenuated). The Beaconhouse and City School enterprises, despite being often demonized for being “too business-minded” have replicated success everywhere, under every government, in every major city in Pakistan. Perhaps their success is not just about the money, but about a quality product that produces globally competitive young Pakistanis, every year, like clockwork. As big as those two are, small can be beautiful too -- as demonstrated by Sami Mustafa’s legendary work at the Centre for Advanced Studies in Karachi and Firoza Zaidi’s work at EMS High School in Islamabad (disclaimer: Mrs. Zaidi was my first and best teacher, and happens to be my mom).

All of these for-profit efforts certainly help deepen the class divide between the have and have-nots in Pakistan—but they also help bridge the have-some, and have-overwhelmingly-most-of-it crowds. It would not be incorrect in fact to suggest that the emergence of Pakistan’s urban middle class has been timed, almost to perfection, with the coming of age of the first wave of private school products this country has known.

What is the purpose of walking the reader through this long list of bright spots in a country that has an overwhelmingly dismal record of darkness in terms of educating its young people?

More than anything else, it is that the efforts of philanthropists and social entrepreneurs deserve our unreserved admiration, and our unflinching moral support. However, what they do not deserve and must never get, is the status of somehow representing a solution to Pakistan’s most egregious problems -- one of which, most definitely, is educating its young.

In 1981, out of a total of 84 million Pakistanis, 38.6% were of school-going age. That put the number of school-aged children in 1981 at 32.5 million. By the 1998 census, Pakistan’s population had ballooned to almost 130 million. Of that population, 39% were between the ages of 5 and 19 -- the school-going age. That meant that between 1981 and 1998, Pakistan experienced a systemic growth in the demand for education, from 32.5 million clients, to 50.3 million clients -- a total increase of about 18 million kids that needed a school to go to.

This year, conservative estimates suggest that Pakistan’s population is expected to top-off at around 180 million. If the percentage of school-going children drops off, say down to 38%, it means that the total number of kids that need to be at school in Pakistan this year is about 68.4 million. Let me write that down differently.

68,400,000

That represents another increase of 18 million. However, the time it took to increase by 18 million in 1998 was 17 years (1981 to 1998). In 2009 it has taken just 11 years to increase the demand on the Pakistani education system by 18 million new students.

There is no NGO, no philanthropist, no social entrepreneur, no genius, no saint, no sage, no mom, no Ataturk, no Ayatollah, no Mullah, no madam, no mercenary of any kind, anywhere that can deliver the kind of miracle Pakistan needs.

To educate almost seventy million children, the only “cup of tea” that will do, is the one that is served by the state. The state is not only ultimately responsible -- legally, morally, and politically -- for educating Pakistan’s children. It is responsible , and internally wired, to ensure Pakistan’s survival. Educating these kids is a matter of survival -- not because we should be scared of madrassahs (though some are honest to God, really scary) -- but because it is immoral to not be concerned about this problem.

And there are no two ways about this simple fact: the next addition of 18 million new students with no school to go to in Pakistan, will come faster than it ever has before. There is no end in sight to the growth in this market.

Pakistan needs many things to enable its young parents to educate their kids in a manner that can help empower those children to live up to their natural potential. While we are at it, it is vital to help children that do not have potential, for natural reasons such as disabled kids, or that are denied potential, for man-made reasons, such as girls.

One of the things it needs is a serious conversation about education that contextualizes philanthropy as a useful demonstration of the realm of possible, rather than as a replacement for the state. Philanthropy can contribute to the conversation by helping Pakistanis acknowledge that an overwhelming majority of Pakistani teachers are unqualified to teach, and cannot be fired. That democratic MNAs, MPAs, senators, and ministers have helped teachers get their jobs. That the Supreme Court will invariably help them keep those jobs. That the World Bank building new schools for incapable and disincentivized teachers -- much like putting stale wine in fancy new bottles -- will simply not do the trick. That the Ministry of Education with no reason to exist other than to keep its officers and office boys (and drivers and clerks) employed, has no capacity to think. That the provincial departments of education, with the best civil service officers busy getting Masters and PhD degrees, are bereft of talent, even when the political and administrative will to perform does exist.

This is a massive agenda, even in terms of a policy conversation. It does not represent even the tip of the Titanic, but it does represent a set of serious issues. Pakistanis should get serious about education. 3 cups of tea just won’t do for 70 million school-age kids. Thomas Friedman can afford to not be serious. He speaks of Pakistan from a helicopter in Helmand. Pakistanis have no such luxuries.

Mosharraf Zaidi is a public policy adviser and columnist who writes for the Egyptian newspaper Al-Shorouk, and the International News in Pakistan. He can be reached through his website www.mosharrafzaidi.com
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Gates Foundation Helps Poor Save Money, Open Accounts (Update1)

Interview by Farah Nayeri

Aug. 11 (Bloomberg) -- Bill Gates, the world’s richest man, wants to provide the poor with a safe place to put their money.

The Seattle-based Bill & Melinda Gates Foundation has committed $350 million toward projects that let the planet’s poor who have no access to banking keep cash deposits via their local post office, lottery outpost, or cellphone account.

The foundation, which had an endowment of $29.7 billion on Dec. 31, spends two-thirds of its resources on health. Since 2006, when billionaire Warren Buffett promised to give it 10 million shares in his company Berkshire Hathaway Inc. -- a pledge the foundation said was worth $31 billion when made -- the Gateses have branched out into new areas, including banking services for the poor.

“We looked around at what were the financial needs or requirements of poor families,” says Bob Christen, 53, who heads the foundation’s 20-person financial-services division. “There’s a tremendous demand for deposit services, for a safe place to keep your money.”

“Poor people have to save in ways that really aren’t very convenient,” says the affable, silver-haired Christen at a meeting in a London hotel lobby. He wears a striped white shirt with beige trousers; reading glasses dangle from his neck.

To the lay observer, microfinance is often confused with microcredit, or loans to the poor, pioneered by Nobel Peace Prize laureate Muhammad Yunus and his Bangladesh-based Grameen Bank. Today, more than $2 billion a year goes to microcredit, says Christen; rather than add more money to that heap, the Gateses were looking to “make a difference.”

Vulnerability

How can savings accounts help? Often, the poor are poor because of their inability to face sudden costs linked to illness, crop failure or unexpected calamity. “When you look at what takes people into poverty, it’s medical emergencies, loss of a job, lack of a safety net,” he explains. “Having deposit services can change people’s vulnerability to circumstances.”

Yet in large parts of sub-Saharan Africa or South Asia, many lack bank accounts. For the almost 2.5 billion people who live on less than $2 a day, a trip to the bank to put away cash might involve a costly bus or taxi ride and hours of waiting in line. “You’ve got to be out of pocket $3 to save a couple of dollars,” says Christen.

So the poor save with cash, jewelry, extra building materials and spare animals. “Stuff gets stolen, animals die, and things happen to those savings that erode their value,” says Christen, who notes that informal savings shed a fifth of their value, on average, each year. “That’s the equivalent of going to the ATM and getting only $80 for the $100 you put in.”

Safety Nets

Banking can be a way out. “It sounds less direct than a loan,” says Christen. “Except that as you go up, things happen, and you get pushed right back down again, because you don’t have safety nets.”

Acting through a long list of partner institutions such as Opportunity International Inc. and the Aga Khan Foundation U.S.A., the Gates foundation funds so-called “agent banking.” The aim is to make banks hook up with retailers in villages or neighborhoods where cashiers can take people’s deposits and funnel them into their accounts.

Another method is to let people buy airtime for a prepaid cellphone account that they can then send to another cellphone account. That way, people can “load up a little bit of money and send it to their mom by the phone,” says Christen.

Banking Networks

The longer-term aim is to persuade successful savings banks in one country to expand into neighboring countries or markets. Another plan is to link credit unions in Africa so an accountholder in one place can bank in another. “These are things we take for granted here,” he says.

Christen has a lifetime’s experience in development finance. After the Peace Corps sent him to Chile and he married a Chilean woman, he worked with credit unions and agricultural cooperatives in the late 1970s and early 1980s in Latin America, where he has spent most of the past 30 years.

He also worked for six years at the World Bank as a senior adviser to the Consultative Group to Assist the Poorest (CGAP), helping draw up standards for the industry. Christen still heads the Boulder Institute of Microfinance, which brings together the top experts in microfinance once a year.

The Gates foundation is a change from all of that.

“I’ve never actually worked for an organization that donated money: It was never my job,” says Christen, who now lives in Seattle and sails in his spare time. “What’s nice is to be able to be strategic in a place where I can execute.”

What role do Bill, who tops Forbes’s list of the world’s billionaires, and Melinda play in his work? “I don’t see them every day, but they’re a pretty engaged couple,” he says. Do they leave him alone? He laughs. “I have a fair amount of autonomy,” he says. “I’m doing exactly what I set out to do, so I’m pretty happy.”

Christen says the Gateses’ profile helps the cause. “We’re already starting to see savings moving up people’s agenda just because we’ve declared our interest in it,” he says. “It’s a powerful voice: That’s a lot of what’s fun about it.”

To contact the writer on the story: Farah Nayeri in London at Farahn@bloomberg.net.

http://www.bloomberg.com/apps/news?pid= ... AtkOmYJyjg
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August 23, 2009
The Women’s Crusade
By NICHOLAS D. KRISTOF and SHERYL WuDUNN

There is a related slide show at:
http://www.nytimes.com/interactive/2009 ... index.html

IN THE 19TH CENTURY, the paramount moral challenge was slavery. In the 20th century, it was totalitarianism. In this century, it is the brutality inflicted on so many women and girls around the globe: sex trafficking, acid attacks, bride burnings and mass rape.

Yet if the injustices that women in poor countries suffer are of paramount importance, in an economic and geopolitical sense the opportunity they represent is even greater. “Women hold up half the sky,” in the words of a Chinese saying, yet that’s mostly an aspiration: in a large slice of the world, girls are uneducated and women marginalized, and it’s not an accident that those same countries are disproportionately mired in poverty and riven by fundamentalism and chaos. There’s a growing recognition among everyone from the World Bank to the U.S. military’s Joint Chiefs of Staff to aid organizations like CARE that focusing on women and girls is the most effective way to fight global poverty and extremism. That’s why foreign aid is increasingly directed to women. The world is awakening to a powerful truth: Women and girls aren’t the problem; they’re the solution.

One place to observe this alchemy of gender is in the muddy back alleys of Pakistan. In a slum outside the grand old city of Lahore, a woman named Saima Muhammad used to dissolve into tears every evening. A round-faced woman with thick black hair tucked into a head scarf, Saima had barely a rupee, and her deadbeat husband was unemployed and not particularly employable. He was frustrated and angry, and he coped by beating Saima each afternoon. Their house was falling apart, and Saima had to send her young daughter to live with an aunt, because there wasn’t enough food to go around.

“My sister-in-law made fun of me, saying, ‘You can’t even feed your children,’ ” recalled Saima when Nick met her two years ago on a trip to Pakistan. “My husband beat me up. My brother-in-law beat me up. I had an awful life.” Saima’s husband accumulated a debt of more than $3,000, and it seemed that these loans would hang over the family for generations. Then when Saima’s second child was born and turned out to be a girl as well, her mother-in-law, a harsh, blunt woman named Sharifa Bibi, raised the stakes.

“She’s not going to have a son,” Sharifa told Saima’s husband, in front of her. “So you should marry again. Take a second wife.” Saima was shattered and ran off sobbing. Another wife would leave even less money to feed and educate the children. And Saima herself would be marginalized in the household, cast off like an old sock. For days Saima walked around in a daze, her eyes red; the slightest incident would send her collapsing into hysterical tears.

It was at that point that Saima signed up with the Kashf Foundation, a Pakistani microfinance organization that lends tiny amounts of money to poor women to start businesses. Kashf is typical of microfinance institutions, in that it lends almost exclusively to women, in groups of 25. The women guarantee one another’s debts and meet every two weeks to make payments and discuss a social issue, like family planning or schooling for girls. A Pakistani woman is often forbidden to leave the house without her husband’s permission, but husbands tolerate these meetings because the women return with cash and investment ideas.

Saima took out a $65 loan and used the money to buy beads and cloth, which she transformed into beautiful embroidery that she then sold to merchants in the markets of Lahore. She used the profit to buy more beads and cloth, and soon she had an embroidery business and was earning a solid income — the only one in her household to do so. Saima took her elder daughter back from the aunt and began paying off her husband’s debt.

When merchants requested more embroidery than Saima could produce, she paid neighbors to assist her. Eventually 30 families were working for her, and she put her husband to work as well — “under my direction,” she explained with a twinkle in her eye. Saima became the tycoon of the neighborhood, and she was able to pay off her husband’s entire debt, keep her daughters in school, renovate the house, connect running water and buy a television.

“Now everyone comes to me to borrow money, the same ones who used to criticize me,” Saima said, beaming in satisfaction. “And the children of those who used to criticize me now come to my house to watch TV.”

Today, Saima is a bit plump and displays a gold nose ring as well as several other rings and bracelets on each wrist. She exudes self-confidence as she offers a grand tour of her home and work area, ostentatiously showing off the television and the new plumbing. She doesn’t even pretend to be subordinate to her husband. He spends his days mostly loafing around, occasionally helping with the work but always having to accept orders from his wife. He has become more impressed with females in general: Saima had a third child, also a girl, but now that’s not a problem. “Girls are just as good as boys,” he explained.

Saima’s new prosperity has transformed the family’s educational prospects. She is planning to send all three of her daughters through high school and maybe to college as well. She brings in tutors to improve their schoolwork, and her oldest child, Javaria, is ranked first in her class. We asked Javaria what she wanted to be when she grew up, thinking she might aspire to be a doctor or lawyer. Javaria cocked her head. “I’d like to do embroidery,” she said.

As for her husband, Saima said, “We have a good relationship now.” She explained, “We don’t fight, and he treats me well.” And what about finding another wife who might bear him a son? Saima chuckled at the question: “Now nobody says anything about that.” Sharifa Bibi, the mother-in-law, looked shocked when we asked whether she wanted her son to take a second wife to bear a son. “No, no,” she said. “Saima is bringing so much to this house. . . . She puts a roof over our heads and food on the table.”

Sharifa even allows that Saima is now largely exempt from beatings by her husband. “A woman should know her limits, and if not, then it’s her husband’s right to beat her,” Sharifa said. “But if a woman earns more than her husband, it’s difficult for him to discipline her.”

WHAT SHOULD we make of stories like Saima’s? Traditionally, the status of women was seen as a “soft” issue — worthy but marginal. We initially reflected that view ourselves in our work as journalists. We preferred to focus instead on the “serious” international issues, like trade disputes or arms proliferation. Our awakening came in China.

After we married in 1988, we moved to Beijing to be correspondents for The New York Times. Seven months later we found ourselves standing on the edge of Tiananmen Square watching troops fire their automatic weapons at prodemocracy protesters. The massacre claimed between 400 and 800 lives and transfixed the world; wrenching images of the killings appeared constantly on the front page and on television screens.

Yet the following year we came across an obscure but meticulous demographic study that outlined a human rights violation that had claimed tens of thousands more lives. This study found that 39,000 baby girls died annually in China because parents didn’t give them the same medical care and attention that boys received — and that was just in the first year of life. A result is that as many infant girls died unnecessarily every week in China as protesters died at Tiananmen Square. Those Chinese girls never received a column inch of news coverage, and we began to wonder if our journalistic priorities were skewed.

A similar pattern emerged in other countries. In India, a “bride burning” takes place approximately once every two hours, to punish a woman for an inadequate dowry or to eliminate her so a man can remarry — but these rarely constitute news. When a prominent dissident was arrested in China, we would write a front-page article; when 100,000 girls were kidnapped and trafficked into brothels, we didn’t even consider it news.

Amartya Sen, the ebullient Nobel Prize-winning economist, developed a gauge of gender inequality that is a striking reminder of the stakes involved. “More than 100 million women are missing,” Sen wrote in a classic essay in 1990 in The New York Review of Books, spurring a new field of research. Sen noted that in normal circumstances, women live longer than men, and so there are more females than males in much of the world. Yet in places where girls have a deeply unequal status, they vanish. China has 107 males for every 100 females in its overall population (and an even greater disproportion among newborns), and India has 108. The implication of the sex ratios, Sen later found, is that about 107 million females are missing from the globe today. Follow-up studies have calculated the number slightly differently, deriving alternative figures for “missing women” of between 60 million and 107 million.

Girls vanish partly because they don’t get the same health care and food as boys. In India, for example, girls are less likely to be vaccinated than boys and are taken to the hospital only when they are sicker. A result is that girls in India from 1 to 5 years of age are 50 percent more likely to die than boys their age. In addition, ultrasound machines have allowed a pregnant woman to find out the sex of her fetus — and then get an abortion if it is female.

The global statistics on the abuse of girls are numbing. It appears that more girls and women are now missing from the planet, precisely because they are female, than men were killed on the battlefield in all the wars of the 20th century. The number of victims of this routine “gendercide” far exceeds the number of people who were slaughtered in all the genocides of the 20th century.

For those women who live, mistreatment is sometimes shockingly brutal. If you’re reading this article, the phrase “gender discrimination” might conjure thoughts of unequal pay, underfinanced sports teams or unwanted touching from a boss. In the developing world, meanwhile, millions of women and girls are actually enslaved. While a precise number is hard to pin down, the International Labor Organization, a U.N. agency, estimates that at any one time there are 12.3 million people engaged in forced labor of all kinds, including sexual servitude. In Asia alone about one million children working in the sex trade are held in conditions indistinguishable from slavery, according to a U.N. report. Girls and women are locked in brothels and beaten if they resist, fed just enough to be kept alive and often sedated with drugs — to pacify them and often to cultivate addiction. India probably has more modern slaves than any other country.

Another huge burden for women in poor countries is maternal mortality, with one woman dying in childbirth around the world every minute. In the West African country Niger, a woman stands a one-in-seven chance of dying in childbirth at some point in her life. (These statistics are all somewhat dubious, because maternal mortality isn’t considered significant enough to require good data collection.) For all of India’s shiny new high-rises, a woman there still has a 1-in-70 lifetime chance of dying in childbirth. In contrast, the lifetime risk in the United States is 1 in 4,800; in Ireland, it is 1 in 47,600. The reason for the gap is not that we don’t know how to save lives of women in poor countries. It’s simply that poor, uneducated women in Africa and Asia have never been a priority either in their own countries or to donor nations.

ABBAS BE, A BEAUTIFUL teenage girl in the Indian city of Hyderabad, has chocolate skin, black hair and gleaming white teeth — and a lovely smile, which made her all the more marketable.

Money was tight in her family, so when she was about 14 she arranged to take a job as a maid in the capital, New Delhi. Instead, she was locked up in a brothel, beaten with a cricket bat, gang-raped and told that she would have to cater to customers. Three days after she arrived, Abbas and all 70 girls in the brothel were made to gather round and watch as the pimps made an example of one teenage girl who had fought customers. The troublesome girl was stripped naked, hogtied, humiliated and mocked, beaten savagely and then stabbed in the stomach until she bled to death in front of Abbas and the others.

Abbas was never paid for her work. Any sign of dissatisfaction led to a beating or worse; two more times, she watched girls murdered by the brothel managers for resisting. Eventually Abbas was freed by police and taken back to Hyderabad. She found a home in a shelter run by Prajwala, an organization that takes in girls rescued from brothels and teaches them new skills. Abbas is acquiring an education and has learned to be a bookbinder; she also counsels other girls about how to avoid being trafficked. As a skilled bookbinder, Abbas is able to earn a decent living, and she is now helping to put her younger sisters through school as well. With an education, they will be far less vulnerable to being trafficked. Abbas has moved from being a slave to being a producer, contributing to India’s economic development and helping raise her family.

Perhaps the lesson presented by both Abbas and Saima is the same: In many poor countries, the greatest unexploited resource isn’t oil fields or veins of gold; it is the women and girls who aren’t educated and never become a major presence in the formal economy. With education and with help starting businesses, impoverished women can earn money and support their countries as well as their families. They represent perhaps the best hope for fighting global poverty.

In East Asia, as we saw in our years of reporting there, women have already benefited from deep social changes. In countries like South Korea and Malaysia, China and Thailand, rural girls who previously contributed negligibly to the economy have gone to school and received educations, giving them the autonomy to move to the city to hold factory jobs. This hugely increased the formal labor force; when the women then delayed childbearing, there was a demographic dividend to the country as well. In the 1990s, by our estimations, some 80 percent of the employees on the assembly lines in coastal China were female, and the proportion across the manufacturing belt of East Asia was at least 70 percent.

The hours were long and the conditions wretched, just as in the sweatshops of the Industrial Revolution in the West. But peasant women were making money, sending it back home and sometimes becoming the breadwinners in their families. They gained new skills that elevated their status. Westerners encounter sweatshops and see exploitation, and indeed, many of these plants are just as bad as critics say. But it’s sometimes said in poor countries that the only thing worse than being exploited in a sweatshop is not being exploited in a sweatshop. Low-wage manufacturing jobs disproportionately benefited women in countries like China because these were jobs for which brute physical force was not necessary and women’s nimbleness gave them an advantage over men — which was not the case with agricultural labor or construction or other jobs typically available in poor countries. Strange as it may seem, sweatshops in Asia had the effect of empowering women. One hundred years ago, many women in China were still having their feet bound. Today, while discrimination and inequality and harassment persist, the culture has been transformed. In the major cities, we’ve found that Chinese men often do more domestic chores than American men typically do. And urban parents are often not only happy with an only daughter; they may even prefer one, under the belief that daughters are better than sons at looking after aging parents.

WHY DO MICROFINANCE organizations usually focus their assistance on women? And why does everyone benefit when women enter the work force and bring home regular pay checks? One reason involves the dirty little secret of global poverty: some of the most wretched suffering is caused not just by low incomes but also by unwise spending by the poor — especially by men. Surprisingly frequently, we’ve come across a mother mourning a child who has just died of malaria for want of a $5 mosquito bed net; the mother says that the family couldn’t afford a bed net and she means it, but then we find the father at a nearby bar. He goes three evenings a week to the bar, spending $5 each week.

Our interviews and perusal of the data available suggest that the poorest families in the world spend approximately 10 times as much (20 percent of their incomes on average) on a combination of alcohol, prostitution, candy, sugary drinks and lavish feasts as they do on educating their children (2 percent). If poor families spent only as much on educating their children as they do on beer and prostitutes, there would be a breakthrough in the prospects of poor countries. Girls, since they are the ones kept home from school now, would be the biggest beneficiaries. Moreover, one way to reallocate family expenditures in this way is to put more money in the hands of women. A series of studies has found that when women hold assets or gain incomes, family money is more likely to be spent on nutrition, medicine and housing, and consequently children are healthier.

In Ivory Coast, one research project examined the different crops that men and women grow for their private kitties: men grow coffee, cocoa and pineapple, and women grow plantains, bananas, coconuts and vegetables. Some years the “men’s crops” have good harvests and the men are flush with cash, and other years it is the women who prosper. Money is to some extent shared. But even so, the economist Esther Duflo of M.I.T. found that when the men’s crops flourish, the household spends more money on alcohol and tobacco. When the women have a good crop, the households spend more money on food. “When women command greater power, child health and nutrition improves,” Duflo says.

Such research has concrete implications: for example, donor countries should nudge poor countries to adjust their laws so that when a man dies, his property is passed on to his widow rather than to his brothers. Governments should make it easy for women to hold property and bank accounts — 1 percent of the world’s landowners are women — and they should make it much easier for microfinance institutions to start banks so that women can save money.

OF COURSE, IT’S FAIR to ask: empowering women is well and good, but can one do this effectively? Does foreign aid really work? William Easterly, an economist at New York University, has argued powerfully that shoveling money at poor countries accomplishes little. Some Africans, including Dambisa Moyo, author of “Dead Aid,” have said the same thing. The critics note that there has been no correlation between amounts of aid going to countries and their economic growth rates.

Our take is that, frankly, there is something to these criticisms. Helping people is far harder than it looks. Aid experiments often go awry, or small successes turn out to be difficult to replicate or scale up. Yet we’ve also seen, anecdotally and in the statistics, evidence that some kinds of aid have been enormously effective. The delivery of vaccinations and other kinds of health care has reduced the number of children who die every year before they reach the age of 5 to less than 10 million today from 20 million in 1960.

In general, aid appears to work best when it is focused on health, education and microfinance (although microfinance has been somewhat less successful in Africa than in Asia). And in each case, crucially, aid has often been most effective when aimed at women and girls; when policy wonks do the math, they often find that these investments have a net economic return. Only a small proportion of aid specifically targets women or girls, but increasingly donors are recognizing that that is where they often get the most bang for the buck.

In the early 1990s, the United Nations and the World Bank began to proclaim the potential resource that women and girls represent. “Investment in girls’ education may well be the highest-return investment available in the developing world,” Larry Summers wrote when he was chief economist of the World Bank. Private aid groups and foundations shifted gears as well. “Women are the key to ending hunger in Africa,” declared the Hunger Project. The Center for Global Development issued a major report explaining “why and how to put girls at the center of development.” CARE took women and girls as the centerpiece of its anti-poverty efforts. “Gender inequality hurts economic growth,” Goldman Sachs concluded in a 2008 research report that emphasized how much developing countries could improve their economic performance by educating girls.

Bill Gates recalls once being invited to speak in Saudi Arabia and finding himself facing a segregated audience. Four-fifths of the listeners were men, on the left. The remaining one-fifth were women, all covered in black cloaks and veils, on the right. A partition separated the two groups. Toward the end, in the question-and-answer session, a member of the audience noted that Saudi Arabia aimed to be one of the Top 10 countries in the world in technology by 2010 and asked if that was realistic. “Well, if you’re not fully utilizing half the talent in the country,” Gates said, “you’re not going to get too close to the Top 10.” The small group on the right erupted in wild cheering.

Policy makers have gotten the message as well. President Obama has appointed a new White House Council on Women and Girls. Perhaps he was indoctrinated by his mother, who was one of the early adopters of microloans to women when she worked to fight poverty in Indonesia. Secretary of State Hillary Rodham Clinton is a member of the White House Council, and she has also selected a talented activist, Melanne Verveer, to direct a new State Department Office of Global Women’s Issues. On Capitol Hill, the Senate Foreign Relations Committee has put Senator Barbara Boxer in charge of a new subcommittee that deals with women’s issues.

Yet another reason to educate and empower women is that greater female involvement in society and the economy appears to undermine extremism and terrorism. It has long been known that a risk factor for turbulence and violence is the share of a country’s population made up of young people. Now it is emerging that male domination of society is also a risk factor; the reasons aren’t fully understood, but it may be that when women are marginalized the nation takes on the testosterone-laden culture of a military camp or a high-school boys’ locker room. That’s in part why the Joint Chiefs of Staff and international security specialists are puzzling over how to increase girls’ education in countries like Afghanistan — and why generals have gotten briefings from Greg Mortenson, who wrote about building girls’ schools in his best seller, “Three Cups of Tea.” Indeed, some scholars say they believe the reason Muslim countries have been disproportionately afflicted by terrorism is not Islamic teachings about infidels or violence but rather the low levels of female education and participation in the labor force.

SO WHAT WOULD an agenda for fighting poverty through helping women look like? You might begin with the education of girls — which doesn’t just mean building schools. There are other innovative means at our disposal. A study in Kenya by Michael Kremer, a Harvard economist, examined six different approaches to improving educational performance, from providing free textbooks to child-sponsorship programs. The approach that raised student test scores the most was to offer girls who had scored in the top 15 percent of their class on sixth-grade tests a $19 scholarship for seventh and eighth grade (and the glory of recognition at an assembly). Boys also performed better, apparently because they were pushed by the girls or didn’t want to endure the embarrassment of being left behind.

Another Kenyan study found that giving girls a new $6 school uniform every 18 months significantly reduced dropout rates and pregnancy rates. Likewise, there’s growing evidence that a cheap way to help keep high-school girls in school is to help them manage menstruation. For fear of embarrassing leaks and stains, girls sometimes stay home during their periods, and the absenteeism puts them behind and eventually leads them to drop out. Aid workers are experimenting with giving African teenage girls sanitary pads, along with access to a toilet where they can change them. The Campaign for Female Education, an organization devoted to getting more girls into school in Africa, helps girls with their periods, and a new group, Sustainable Health Enterprises, is trying to do the same.

And so, if President Obama wanted to adopt a foreign-aid policy that built on insights into the role of women in development, he would do well to start with education. We would suggest a $10 billion effort over five years to educate girls around the world. This initiative would focus on Africa but would also support — and prod — Asian countries like Afghanistan and Pakistan to do better. This plan would also double as population policy, for it would significantly reduce birthrates — and thus help poor countries overcome the demographic obstacles to economic growth.

But President Obama might consider two different proposals as well. We would recommend that the United States sponsor a global drive to eliminate iodine deficiency around the globe, by helping countries iodize salt. About a third of households in the developing world do not get enough iodine, and a result is often an impairment in brain formation in the fetal stages. For reasons that are unclear, this particularly affects female fetuses and typically costs children 10 to 15 I.Q. points. Research by Erica Field of Harvard found that daughters of women given iodine performed markedly better in school. Other research suggests that salt iodization would yield benefits worth nine times the cost.

We would also recommend that the United States announce a 12-year, $1.6 billion program to eradicate obstetric fistula, a childbirth injury that is one of the worst scourges of women in the developing world. An obstetric fistula, which is a hole created inside the body by a difficult childbirth, leaves a woman incontinent, smelly, often crippled and shunned by her village — yet it can be repaired for a few hundred dollars. Dr. Lewis Wall, president of the Worldwide Fistula Fund, and Michael Horowitz, a conservative agitator on humanitarian issues, have drafted the 12-year plan — and it’s eminently practical and built on proven methods. Evidence that fistulas can be prevented or repaired comes from impoverished Somaliland, a northern enclave of Somalia, where an extraordinary nurse-midwife named Edna Adan has built her own maternity hospital to save the lives of the women around her. A former first lady of Somalia and World Health Organization official, Adan used her savings to build the hospital, which is supported by a group of admirers in the U.S. who call themselves Friends of Edna Maternity Hospital.

For all the legitimate concerns about how well humanitarian aid is spent, investments in education, iodizing salt and maternal health all have a proven record of success. And the sums are modest: all three components of our plan together amount to about what the U.S. has provided Pakistan since 9/11 — a sum that accomplished virtually nothing worthwhile either for Pakistanis or for Americans.

ONE OF THE MANY aid groups that for pragmatic reasons has increasingly focused on women is Heifer International, a charitable organization based in Arkansas that has been around for decades. The organization gives cows, goats and chickens to farmers in poor countries. On assuming the presidency of Heifer in 1992, the activist Jo Luck traveled to Africa, where one day she found herself sitting on the ground with a group of young women in a Zimbabwean village. One of them was Tererai Trent.

Tererai is a long-faced woman with high cheekbones and a medium brown complexion; she has a high forehead and tight cornrows. Like many women around the world, she doesn’t know when she was born and has no documentation of her birth. As a child, Tererai didn’t get much formal education, partly because she was a girl and was expected to do household chores. She herded cattle and looked after her younger siblings. Her father would say, Let’s send our sons to school, because they will be the breadwinners. Tererai’s brother, Tinashe, was forced to go to school, where he was an indifferent student. Tererai pleaded to be allowed to attend but wasn’t permitted to do so. Tinashe brought his books home each afternoon, and Tererai pored over them and taught herself to read and write. Soon she was doing her brother’s homework every evening.

The teacher grew puzzled, for Tinashe was a poor student in class but always handed in exemplary homework. Finally, the teacher noticed that the handwriting was different for homework and for class assignments and whipped Tinashe until he confessed the truth. Then the teacher went to the father, told him that Tererai was a prodigy and begged that she be allowed to attend school. After much argument, the father allowed Tererai to attend school for a couple of terms, but then married her off at about age 11.

Tererai’s husband barred her from attending school, resented her literacy and beat her whenever she tried to practice her reading by looking at a scrap of old newspaper. Indeed, he beat her for plenty more as well. She hated her marriage but had no way out. “If you’re a woman and you are not educated, what else?” she asks.

Yet when Jo Luck came and talked to Tererai and other young women in her village, Luck kept insisting that things did not have to be this way. She kept saying that they could achieve their goals, repeatedly using the word “achievable.” The women caught the repetition and asked the interpreter to explain in detail what “achievable” meant. That gave Luck a chance to push forward. “What are your hopes?” she asked the women, through the interpreter. Tererai and the others were puzzled by the question, because they didn’t really have any hopes. But Luck pushed them to think about their dreams, and reluctantly, they began to think about what they wanted.

Tererai timidly voiced hope of getting an education. Luck pounced and told her that she could do it, that she should write down her goals and methodically pursue them. After Luck and her entourage disappeared, Tererai began to study on her own, in hiding from her husband, while raising her five children. Painstakingly, with the help of friends, she wrote down her goals on a piece of paper: “One day I will go to the United States of America,” she began, for Goal 1. She added that she would earn a college degree, a master’s degree and a Ph.D. — all exquisitely absurd dreams for a married cattle herder in Zimbabwe who had less than one year’s formal education. But Tererai took the piece of paper and folded it inside three layers of plastic to protect it, and then placed it in an old can. She buried the can under a rock where she herded cattle.

Then Tererai took correspondence classes and began saving money. Her self-confidence grew as she did brilliantly in her studies, and she became a community organizer for Heifer. She stunned everyone with superb schoolwork, and the Heifer aid workers encouraged her to think that she could study in America. One day in 1998, she received notice that she had been admitted to Oklahoma State University.

Some of the neighbors thought that a woman should focus on educating her children, not herself. “I can’t talk about my children’s education when I’m not educated myself,” Tererai responded. “If I educate myself, then I can educate my children.” So she climbed into an airplane and flew to America.

At Oklahoma State, Tererai took every credit she could and worked nights to make money. She earned her undergraduate degree, brought her five children to America and started her master’s, then returned to her village. She dug up the tin can under the rock and took out the paper on which she had scribbled her goals. She put check marks beside the goals she had fulfilled and buried the tin can again.

In Arkansas, she took a job working for Heifer — while simultaneously earning a master’s degree part time. When she had her M.A., Tererai again returned to her village. After embracing her mother and sister, she dug up her tin can and checked off her next goal. Now she is working on her Ph.D. at Western Michigan University.

Tererai has completed her course work and is completing a dissertation about AIDS programs among the poor in Africa. She will become a productive economic asset for Africa and a significant figure in the battle against AIDS. And when she has her doctorate, Tererai will go back to her village and, after hugging her loved ones, go out to the field and dig up her can again.

There are many metaphors for the role of foreign assistance. For our part, we like to think of aid as a kind of lubricant, a few drops of oil in the crankcase of the developing world, so that gears move freely again on their own. That is what the assistance to Tererai amounted to: a bit of help where and when it counts most, which often means focusing on women like her. And now Tererai is gliding along freely on her own — truly able to hold up half the sky.

Nicholas D. Kristof is a New York Times Op-Ed columnist and Sheryl WuDunn is a former Times correspondent who works in finance and philanthropy. This essay is adapted from their book “Half the Sky: Turning Oppression Into Opportunity for Women Worldwide,” which will be published next month by Alfred A. Knopf. You can learn more about “Half the Sky” at nytimes.com/ontheground

http://www.nytimes.com/2009/08/23/magaz ... nted=print[/b]
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Development Challenges in Pakistan
Middle East Institute, Washington DC
19 August 2009

The Middle East Institute’s Center for Pakistan Studies hosted Shamsh Kassin-Lakha for an address focused on the progress of locally-managed social development in Pakistan. Dr. Lakha is a veteran government and education policymaker and former President of the Aga Khan University. He based his statements on the growth of two elements in Pakistan—local philanthropy and civil society—as the foundation of local social development.

Dr. Lakha cited acute poverty, lack of good governance and the poor mobilization of adequate resources as the contributors to uncertainty and radicalization in Pakistani society. These have been detrimental to development. Advancement in infrastructure and standards of life in Pakistan have only reached a few, particularly the elite. Such a lack of equity, he contended, causes widespread discontent with such pervasive social injustice, and potentially breeds radicalization. Moreover, the
international community is experiencing donor fatigue due to the misappropriation of funding in development projects.

As the development challenge has grown in Pakistan, Dr. Lakha said civil society groups have taken on the tasks of implementing development programs in a variety of areas, including women’s empowerment, economic growth, judicial reform and environmental protection. Civil society groups have prospered from a healthy partnership with the state, which has in recent years opened itself to counsel and cooperation with citizen bodies and non-state partners. Grassroots development
projects are effective in addressing basic community needs. Supported by philanthropy, such initiatives can become credible conduits of change, he said.

Yet the big question for Pakistan is how philanthropic and religious giving can be translated into sustainable social development. “Organized philanthropy” provides effective means by which to optimize donations from local Pakistanis and the diaspora community, Dr. Lakha mentioned. The largest such initiative is the Pakistan Centre of Philanthropy (PCP), which facilitates the translation of donor gifts into social development, providing a link between grassroots initiatives, the government
and the donor community. The PCP offers certification of NGOs, insuring the credibility of projects and thus fostering trust in the delivery of funds to programs.

With a rise in charitable giving in Pakistan since 2000, as well as external donations, private-public partnerships of “organized philanthropy” are an effective model for project delivery in Pakistan. Such a model facilitates grassroots—rather than externally implemented—development projects. Dr. Lakha cited the large potential for the expansion of such programs and private-public partnerships in Pakistan.

Religious philanthropy emanates from efforts to promote equity and social justice, he said, supporting locally-run and volunteer-based development initiatives can deliver such ends.

http://pomed.org/wordpress/wp-content/u ... -19-09.pdf
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FMFB and Harvard University to Research Social Performance

Karachi, Pakistan, 11 September 2009 - The First MicroFinanceBank Ltd. (FMFB) recently signed an agreement with Harvard University to develop social performance indicators through a participatory approach whereby the poor articulate their needs and influence the Bank’s creation of microfinance products and services.

The ultimate aim of this project is to integrate the social performance indicators into the Bank’s organisational performance management system so they can be used to assess the impact of the Bank’s services on poor populations in Pakistan.

Guy Stuart, a lecturer in public policy at the Harvard’s Kennedy School of Government, is working with FMFB to conduct research on a participatory approach for the development of the indicators. This project will survey 10,000 households throughout Pakistan to understand how communities rate poverty and what they consider as poverty indicators. The survey will differentiate the rural, urban and mountain rural areas of Pakistan. The Social Performance Research (SPR) project has been undertaken in partnership with Harvard University and with financial assistance from the Swiss Development Corporation.

As part of the SPR project, FMFB and Harvard conducted a series of participatory need assessment surveys across Pakistan in addition to Participatory Wealth Ranking (PWR) exercises. Through these exercises, a cross section of poor households in rural and urban areas was engaged to identify and prioritise their needs so that the Bank could address them through targeted financial services. These indicators will be integrated into FMFB’s management information system so that the Bank can conduct impact assessment surveys to track the changes in the livelihood of the poor in relation to its services. The methodology for this project was piloted in 500 households, in nine areas throughout Pakistan. Now that the pilot is complete, 10,000 households will be surveyed.

FMFB, as a member of the Global Social Performance Task Force, has also been engaged to translate its social development mission into practice through the implementation of social performance management into its core operations.

Over the last 70 years, the Harvard Kennedy School has been leading research into public policy and is one of the world’s most prominent social science research institutions, with 15 centres of research and more than 30 degree programmes. Each year, faculty at the school write more than 35 books and publish more than 300 academic papers on subjects ranging from the nature of leadership to urban poverty. In partnership with FMFB, the Harvard Kennedy School is responsible for the research and the development of the scorecards and evaluating the results of the PWR exercises.

FMFB is a non-commercial, private sector microfinance bank licensed by the State Bank of Pakistan. FMFB has been ranked as seventh among top 100 microfinance institutions by World Bank affiliate, the Consultative Group to Assist the Poor. The Bank strives to alleviate poverty through sustainable economic development by offering credit, savings and life insurance services along with an efficient and low cost fund transfer service to its target populations. FMFB has over 157 business locations comprising 89 automated branches and 68 Pakistan Post Sub Offices throughout Pakistan. From December 2008 to June 2009, FMFB has disbursed over 219,820 loans, valued at PKR 3.054 million (US $0.04 million).

For further details, please contact:

Salimah Shiraj
Head of Communications & Brand Management
Tel: +92-21-35822432, 35370095
Fax: +92-21-35822434
Cell: +92 300-8200350
Email: salimah.shiraj@mfb.com.pk

Notes:

About the Aga Khan Agency for Microfinance

Since its establishment in 2005, AKAM has brought together over 25 years of microfinance activities, programmes and banks that were administered by sister agencies within the Aga Khan Development Network. The underlying objectives of AKAM are to reduce poverty, diminish the vulnerability of poor populations and alleviate economic and social exclusion. AKAM is a not-for-profit, non-denominational, international development agency created under Swiss law. Its headquarters are in Geneva, Switzerland. It is governed by an independent Board of Directors. The Chairman of the Board is His Highness the Aga Khan.
http://www.akdn.org/Content/843

*****

Kenya charity agencies given tax relief
By KENNETH OGOSIAPosted Wednesday, September 16 2009 at 22:15

Money donated to charity organisations will be exempted from tax as the Kenya Treasury seeks innovative ways to reduce hunger and human suffering in the wake of prolonged drought.

Humanitarian organisations meeting under the East African Association of Grant-makers have asked well-wishers to take advantage of the waiver to help communities facing starvation.

The association’s chief executive, Mrs Lucy Githaiga, on Wednesday said the food deficit and drought highlighted in the press called for concerted efforts to support the government’s emergency programme.

Organisations that are members of the association include the Aga Khan Foundation, the Rattansi Educational Trust, the Kabaka Foundation and Kilimo Trust.

All of them are worried about the high rate of children dropping out of school due to hunger — an issue the Daily Nation raised on Tuesday.

Under the Income Tax Act for Charitable Organisations (2007), the Finance minister can approve any project that helps in reducing poverty or suffering or that helps develop education in the country for the tax waiver.

“We are allowed to claim deduction of capital expenses, administrative expenses, repayment of loans, payment of taxes and donations to other trusts from the total income,” Mrs Githaiga said.

On Tuesday, the Nation published a report revealing how more than 500,000 children have been forced out of school by hunger, and thousands more risk joining them if nothing is done.

It said that in the Rift Valley, for example, rain failure has forced families to scavenge for food in the most unlikely places, including quarries, and most consider themselves lucky if they have a single meal in a day.

In Eastern and North Eastern provinces, and in pastoral communities in particular, children have abandoned school in droves and left their homes in search of water and pasture for their families’ livestock.

The school feeding programme under the World Food Programme came just a week after the start of the Third Term, at the end of which Standard Eight pupils sit their national exams.

However, the plan is likely to be strained by the millions of households across the country that will rely on food donations until harvests are made from the coming rains.

The report estimates that 3.8 million Kenyans will need food aid in the next six months — a sharp increase from the 2.6 million currently receiving food rations from the WFP.

http://www.nation.co.ke/News/-/1056/659 ... index.html
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[Feature]The women who would restore a symbol of Hunza’s history

September 21, 2009

DSC07937

by Noor & Asghar Khan

As the nine hundred years old Altit Fort gets completely restored in the year 2010, not only would facade of the ancient fort have changed in the middle of Hunza valley, a deeper social change would also have taken roots in terms of perceptions regarding gender roles in the society.

Traditionally labour of the the female folk of Hunza was limited to bringing up children, grazing animal, watering crop fields, collecting wood for fuel, grass for the cattle, or doing other indoor choirs, as allowed by the society. However, with the passage of time the women of Hunza adopted other roles entering other mainstream professions, like teaching, medicine, politics, social development and, recently, the armed forces. This was made possible by the education system introduced by His Highness the Aga Khan, through AKDN.

Now, the women of Hunza have taken yet another step towards social emancipation.

Seventy percent of the total people working on restoration of the fort are trained female skilled workers. Female electricians, carpenters, masons and plumbers restoring the Altit fort are making history by venturing into new areas of opportunity and expression, hitherto considered forbidden for the “fair” sex.

This is a welcome change as far as economic, psychological and social independence of the women of Hunza is concerned.

The restoration project is undertaken by the Aga Khan Trust for Culture. The trust has trained and employed a large number of women of Hunza, creating new opportunities of earning livelihood for half of the population, while also breaking taboos that limited choices for the women to a selected number of gender roles, as determined by a patriarchical society.

It is, now, also important to further work for objective sensitization of the society at large regarding the changed gender roles and their implications. One major negative implication can be lesser work available for the men who used to perform such tasks in the past. This might frustrate a segment of the society, no matter how small.

What is required is a holistic, inclusive, strategic planfor balanced social development where the emancipation of one segment of the society does not shrink choices for the other, neutralizing the impact of change. This is vital for maintaining social harmony and family life, in a changed and charged social environment.

Men of Hunza have, logically, been supportive of the processes that have led to creation of the society that we have today. What they need to further understand is that when the social roles are changed, rules of the game of social life also change, by default. They will have to learn to live and compete in a beautifully different and a meritocratic society.

http://pamirtimes.net/2009/09/21/featur ... s-history/
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October 26, 2009
Bill to Increase Access to Contraception Is Dividing Filipinos
By CARLOS H. CONDE

MANILA — Gina Judilla already had three children the first time she tried to terminate a pregnancy. “I jumped down the stairs, hoping that would cause a miscarriage,” she said. The fetus survived and is now an 8-year-old boy.

Three years later, pregnant again, she drank an herbal concoction that was supposed to induce abortion. That, too, failed.

Three years ago, in another unsuccessful attempt to end a pregnancy, she took Cytotec, a drug to treat gastric ulcers that is widely known in the Philippines as an “abortion pill.”

What drove Ms. Judilla, a 37-year-old manicurist, to such extreme measures is a story of personal tribulation familiar to many Filipino women. She and her unemployed husband are very poor — barely able to buy vitamins for their youngest child, let alone send more than two of their older children to school.

“When I had my third child, I swore to myself that I will never get pregnant again because I know we could not afford to have another one,” Ms. Judilla said in a recent interview at her home in Pasig City, on the eastern outskirts of Manila.

Abortion is illegal in the Philippines. Birth control and related health services have long been available to those who can afford to pay for them through the private medical system, but 70 percent of the population is too poor and depends on heavily subsidized care. In 1991, prime responsibility for delivering public health services shifted from the central government to the local authorities, who have broad discretion over which services are dispensed.

Many communities responded by making birth control unavailable.

More recently, however, family planning advocates have been making headway in their campaign to change that. Legislation before the Philippine Congress, called the Reproductive Health and Population Development Act, would require governments down to the local level to provide free or low-cost reproductive health services, including condoms, birth control pills, tubal ligations and vasectomies. It would also mandate sex education in all schools, public and private, from fifth grade through high school.

Supporters of the bill cite urgent public health needs. A 2006 government survey, which interviewed 46,000 women, found that between 2000 and 2006, only half of Filipino women of reproductive age used birth control of any kind. According to the Guttmacher Institute, a nonprofit organization based in the United States that researches reproductive health policy, 54 percent of the 3.4 million pregnancies in the Philippines in 2008 were unintended.

Most of those unintended pregnancies — 92 percent — resulted from not using birth control, the institute said, and the rest from birth control that failed. Those unintended pregnancies, the institute says, contributed to an estimated half-million abortions that year, despite a ban on the procedure. Most of the abortions are done clandestinely and in unsanitary conditions. Many women resort to crude methods like those Ms. Judilla tried.

The bill’s main proponent in Congress, Representative Edcel C. Lagman, also says there is a need for a check on population growth in the interest of national welfare. The Philippine population is estimated at 98 million and is growing at more than 2 percent annually, one of the highest rates in Asia. “Unbridled population growth stunts socioeconomic development and aggravates poverty,” Mr. Lagman wrote in an op-ed column in The Philippine Daily Inquirer recently.

But attempts to make reproductive services more broadly available have met resistance, leading to the defeat of several bills in Congress over the past decade.

The main opposition in this overwhelmingly Roman Catholic country has come from the church and affiliated lay organizations, which say the proposed law would legalize abortion. In churches across the country, signs have been posted that read: “Yes to Life! No to RH Bill!”

One organization, the Catholic Alumni United for Life, said in a position paper that the legislation would promote abortion by financing abortion-inducing drugs, and therefore “violates explicit Catholic teaching.”

The Rev. Melvin Castro of the Episcopal Commission on Family and Life, an arm of the Catholic Bishops Conference of the Philippines, said the Catholic Church and the laity would fight the bill, if passed into law, up to the Supreme Court.

“The Constitution is very clear that the state should protect life from conception up to its natural end,” Father Castro said.“Regardless of their religion, Filipinos are God-fearing and family-loving. This bill will change that culture.”

Still, proponents of the bill are optimistic, noting that this is the first time such legislation has won the support of the House committee on health. Previous proposals never even made it into committee. They also cite public opinion surveys that show support for the bill and hope it can be passed before the current Congress adjourns in June.

It seems certain that debate over the legislation will heat up with the approach of national elections in May.

Already, the church has issued statements calling on Senator Benigno Aquino III, expected to be the opposition’s presidential candidate, to oppose the bill. Mr. Aquino, the son of Corazon Aquino, the late president, who was extremely close to the church, has said he will not do this.

President Gloria Macapagal Arroyo, who is barred from running for another term, has been sending mixed signals about her position. In previous statements, however, she has said she will let her Catholic faith guide her.

“My faith has a very, very strong influence on me,” she said last year.

Other politicians, particularly those on the local level, have chosen to side with the church. In 2000, Jose Lito Atienza, who was mayor of Manila at the time, issued an executive order ending government-financed birth control in the capital. Condoms and other contraceptives were removed from government clinics and hospitals. Patients who asked for them were turned away.

Mr. Atienza, who is now the environment secretary, defends his order as “the right thing to do.”

“Contrary to what many are saying, that policy was meant to protect women, to protect their wombs from those who want to take away life,” he said.

Passage of the reproductive health bill would automatically nullify Mr. Atienza’s order, said Clara Rita A. Padilla, executive director of EnGendeRights, a nonprofit group that supports the bill. “The poor women of this country need this law to protect them,” she said.

http://www.nytimes.com/2009/10/26/world ... ?th&emc=th
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November 1, 2009
Op-Ed Columnist
New Life for the Pariahs
By NICHOLAS D. KRISTOF

Perhaps the most wretched people on this planet are those suffering obstetric fistulas.

This is a childbirth injury, often suffered by a teenager in Africa or Asia whose pelvis is not fully grown. She suffers obstructed labor, has no access to a C-section, and endures internal injuries that leave her incontinent — steadily trickling urine and sometimes feces through her vagina.

She stinks. She becomes a pariah. She is typically abandoned by her husband and forced to live by herself on the edge of her village. She is scorned, bewildered, humiliated and desolate, often feeling cursed by God.

I’ve met many of these women — or, often, girls of 13, 14, 15 — in half a dozen countries, for there are three million or four million of them around the world. They are the lepers of the 21st century.

Just about the happiest thing that can happen to such a woman is an encounter with Dr. Lewis Wall, an ob-gyn at Washington University in St. Louis. A quiet, self-effacing but relentless man of 59, Dr. Wall has devoted his life to helping these most voiceless of the voiceless, promoting the $300 surgeries that repair fistulas and typically return the patients to full health.

“There’s no more rewarding experience for a surgeon than a successful fistula repair,” Dr. Wall reflected. “There are a lot of operations you do that solve a problem — I can take out a uterus that has a tumor in it. But this is life-transforming for everybody who gets it done. It’s astonishing. You take a human being who has been in the abyss of despair and — boom! — you have a transformed woman. She has her life back.”

“In Liberia, I saw a woman who had developed a fistula 35 years earlier. It turned out to be a tiny injury; it took 20 minutes to repair it. For want of a 20-minute operation, this woman had lived in a pool of urine for 35 years.”

Dr. Wall started out as an anthropologist working in West Africa, and he speaks Hausa, an African language. But he concluded that the world needed doctors more than it needed anthropologists, so at age 27 he went to medical school.

He has had a dazzling career as an academic, writing several books and scores of journal articles, but his passion has been ending the scourge of fistulas. In 1995, he founded the Worldwide Fistula Fund, and he has been campaigning tirelessly year after year to build a fistula hospital in West Africa. That has been his life, his dream.

Now it is a reality.

The West African country of Niger recently approved Dr. Wall’s plan for a fistula hospital, affiliated with an existing leprosy hospital run by SIM, a Christian missionary organization. Eventually, when $850,000 in fund-raising is complete, a new 40-bed fistula hospital, modeled on the extremely successful Addis Ababa Fistula Hospital of Ethiopia, will rise on vacant ground next to the leprosy hospital. (For information on how to help, please visit my blog, nytimes.com/ontheground.)

For the time being, an existing operating theater in the leprosy hospital has been renovated for fistula repairs. Dr. Wall has already shipped a container of medical supplies to Niger, and he expects to go with a team to conduct the first fistula repairs there in December.

The day the final approval came through, Dr. Wall sent me an elated e-mail message with the news. “There are tears in my eyes,” he wrote.

Aside from repairing fistulas, the hospital will also organize outreach efforts to promote maternal health and reduce deaths in childbirth. It will also undertake education and microfinance efforts to empower women more broadly.

It could be just the beginning. The new hospital is part of a grand vision to eradicate fistulas worldwide by building 40 such hospitals in the world’s poorest countries. The plan, drawn up by Dr. Wall, would cost $1.5 billion over 12 years and operate as an American foreign aid program.

I can’t imagine a better use of foreign assistance dollars — or better symbolism than having the most powerful nation on earth reach out to help the most stigmatized, suffering people on the planet. The proposal for the global plan is circulating in Congress, the State Department and the White House, as well as among religious and aid organizations that are lining up to back it. President Obama hasn’t signaled a position yet, but I hope he will seize upon it.

The new fistula hospital in Niger is a tribute to the heroic doggedness of Dr. Wall, and with luck it will be replicated in many other countries. Anybody who has seen a fistula patient after surgery — a teenager’s shy, radiant smile at something so simple as being able to control her wastes — can’t conceive of a better investment.

I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.

http://www.nytimes.com/2009/11/01/opini ... nted=print
kmaherali
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Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

Welcome to the Rupani Foundation

Founded in 2006 by Mr. Nasruddin Rupani, a U.S. citizen of Pakistani origin and a renowned industrialist in the global Gems and Jewelry industry, the Rupani Foundation aims to reduce poverty and promote social entrepreneurship within Mountain communities. Motivated by the Islamic ethics of philanthropy and the ethos of corporate social responsibility, the Rupani family has resolved to invest their time, knowledge and resources toward this end.

The Foundation's objective is to create economic opportunities, knowledgeable leadership, and 'aristocracies of merit' for the marginalized communities, particularly women and youth. The first significant area of endeavor is to assist the Mountain communities in the Northern Areas of Pakistan, Afghanistan, Tajikistan, and the surrounding regions.

http://www.rupanifoundation.org/
kmaherali
Posts: 25106
Joined: Thu Mar 27, 2003 3:01 pm

Post by kmaherali »

Charity drive looks to spread 'Joi' around
By Tamara Gignac, Calgary Herald
November 27, 2009

Hafiz Mitha (left) and co-workers (from left) Mathew Chow, Sheryse Legaspi, Thomas Politeski, Paul Oslund, Phead Meas and Steven Mah are hoping to distribute 1000 boxes to needy people in Calgary this Christmas season.Photograph by: Grant Black, Calgary Herald

The recession has been kind to Hafiz Mitha. Business is booming at his upstart web design firm, Joi Media, but the 25-year-old entrepreneur is troubled by the fact that many in the city are struggling to afford basic necessities.

With Christmas fast approaching, the company has launched a citywide campaign to supply useful items and gifts to children and adults in need.

Dubbed "Joi to the World," Mitha and business partner Brock Murray hope to fill 1,000 shoeboxes and distribute them to various agencies in the city.

Joi filled 350 boxes in 2008 and hopes to more than triple that number this year.

They are getting a little help from corporate donors like Scotiabank but are reaching out to the public to assist in their goal.

"Our company has actually thrived through the recession. We've grown to three times the size and would like to fill three times the boxes," said Mitha.

"We've been so blessed and we want to give back to our community."

Some may hold an unfortunate misconception that 20-somethings are apathetic when it comes to philanthropy, but the Joi campaign proves otherwise, said the former banker and University of Calgary graduate.

The initiative was spearheaded entirely by Joi staff --a team of people under the age of 27.

Not only that, 90 per cent of last year's donations came from the 18-to-35 demographic.

The Joi campaign is looking to fill shoeboxes with a variety items for children, such as diapers, wipes and bottles as well as school supplies, colouring books and crayons.

For adults, toiletry products that include toothpaste, deodorant and soap are ideal as well as useful items such as warm hats and gloves, transit tickets, books and grocery store vouchers. Gifts such as zoo passes, movie tickets or department store gift certificates are also welcome.

These are just ideas, said Mitha. It's up to the individual donor what he or she would like to give; however, used items and most food products will not be accepted.

Items collected will be distributed to various Calgary agencies, including the Calgary Women's Emergency Shelter, Inn From the Cold, Sheriff King Home and Awo Taan Healing Lodge.

Individual boxes can be picked up at Joi Media's office. The company will deliver and pick up larger quantities from interested donors. For more information, call 403-457-8008 or visit www.joimedia.comand click on the Joi to the World icon.

tgignac@theherald. canwest.com

© Copyright (c) The Calgary Herald

http://www.calgaryherald.com/business/C ... story.html
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