Plan staff blog on our work with children across the world.
Malaria mortality rates have decreased by nearly half since 2000 – but a lot still remains to be done, blogs Thidiane Ndoye, Plan USA Deputy Director of Health, ahead of World Malaria Day on 25 April.
23 April 2015: In the last 15 years, Malaria has gone from being a neglected disease to one that is a priority for the international health community and for governments. Plan International began implementing malaria programmes in the 1990s and began to form partnerships with governments, non-governmental organisations and communities.
We started innovating with bed net promotion and distribution before it was a generally accepted policy. As few manufacturers at the time were producing the nets, Plan trained local tailors to make nets and women’s groups to impregnate the nets with insecticide.
As a result, in 2013 Plan’s West Africa Regional Office received the Roll Back Malaria Award in recognition of the Plan staffs’ long-term commitment to malaria.
Millions of nets distributed
Plan is currently working with the Global Fund, the US government and other partners in 12 countries in West Africa and Latin America to provide communities with resources to take care of their health. Plan is promoting the use of insecticide-treated nets and has distributed (or participated in the distribution of) over 30 million of these over the past 7 years with the help of its partners.
Plan is also working with community health workers, who work with local governments, to partner on net delivery and are trained to provide home-based management of malaria, including screening, rapid diagnostic tests and medication.
In Burkina Faso, for example, a Plan-led project has supported 8,000 health workers and 905 community health delegates who have helped 3.4 million people with non-severe malaria in their homes.
Raising malaria awareness
A large focus of our malaria prevention work is also on behaviour change communication. Plan’s behaviour change strategy uses local media such as radio and TV, and cultural events to raise awareness, and pre-existing social networks for advocacy purposes.
A particularly successful example of this was in Togo where 2 net distribution campaign events happened in 2011 and 2014 and reached 2.8 million households and about 14 million people.
The efforts of Plan and other partners are transforming the lives of children in countries in which they operate. Huge investments by the Global Fund, the President’s Malaria Initiative, the UK Department for International Development and others have saved and transformed many lives.
The roll-out of 2 simple preventive measures, intermittent preventive treatment during pregnancy and insecticide-treated mosquito nets is significantly associated with an 18% decrease in the risk of death among newborns (2014 Roll Back Malaria Progress and Impact Report*).
Fall in mortality rates
A mother in a village 25km outside of Ouagadougou, Burkina Faso, told me:
“Before we started using the nets, my children were always sick, and we have lost many young lives in this village due to malaria. Now we, thank God, we barely have a child with fever during the year.”
The 2014 WHO World Malaria report shows that malaria mortality rates decreased by an impressive 47% between 2000 and 2013 globally, and by 54% in the Sub-Saharan Africa region.
Water and sanitation key
However, malaria is only one small part of a larger problem. While I was visiting a country in West Africa an elderly person approached and asked:
“We are drinking water with muds in it because we do not have a source of drinkable water. What is your organisation doing to get us out of this situation?”
This brings up an important question: how are we making sure, as an organisation, that we have a full package of interventions that address communities’ needs in a more systemic way and address the needs of children in particular? Our response to malaria works best when complemented by work in water and sanitation, an area where Plan has extensive expertise and experience.
I personally feel grateful to be part of this wonderful challenge. A lot of progress has been made and a lot still remains to be done.
World Malaria Day is commemorated every year on 25 April and recognises global efforts to control malaria.
Find out more about Plan’s global health work
*Plan is not responsible for the content on external websites
April 21, 2015 - During the World Water Forum (WWF) held in the Republic of Korea, I joined a delegation from Plan International, that teamed up with the Asian Development Bank (ADB) to demonstrate that youth could and have been part of the solution to the huge sanitation challenge in rural Asia.
Held every three years since 1997 by the World Water Council and the hosting country, the WWF is the largest international event in the field of water. Previously, the international forum focused on water and attracted participation mostly by water authorities, government and private sector, but the Forum has increasingly recognised the interlinkages of water, sanitation and hygiene and the role of the civil society.
Empowering youth together
The NGO and Civil Society Centre (NGOC) of the ADB requested that I - and other members from Plan - help to co-lead a Regional Session on Rural Sanitation for Asia and the Pacific, as part of its ongoing partnership in promoting youth engagement since mid-2014. Plan was entrusted by ADB to provide a Regional Small Scale Research and Development Technical Assistance on Women Led Sanitation as part of the initiative of driving change through ADB-CSO partnership
Against this backdrop, and with the support of Maja Cubarrubia, former Country Director for Plan Thailand, all the preparatory activities for the Session, including the selection of innovative sanitation solutions, were completed in time. Plan Korea provided extensive support that did not only ensure Plan’s visibility - prior and during the session - but also the logistical support for some of the key youth participants.
Plan’s reputation and experiences as a proponent of community led approaches to sanitation improvement was highly appreciated by ADB and the WWF’s Organisers. The creativity of the ADB’s Youth Initiative team in launching youth friendly activities such as youth debates, youth water parliament, youth caravan and Plan’s strongly grounded experiences in sanitation improvement proved to be an effective combination of forces for the success of the Session.
Because youth can
For the first time in WWF history, the Session highlighted the youth’s enthusiasm and creativity in advocating for, as well as implementing, solutions to the sanitation challenges. Youth groups from countries with major challenges in rural sanitation including India, Indonesia and the Philippines showcased concrete experiences in implementing projects ranging from innovative solid waste management to sanitation in water scarce areas.
A debate was held between debate teams from Republic of Korea and India with the assistance of Maja’s experience in working with youth groups. Arguments from both sides showed in-depth understanding and a critical thinking ability of the young advocates.
Overall, the session emphasised the key message on the importance of meaningfully engaging youth, which ran in tandem with the Forum’s theme of ‘Water for Our Future’.
Youth engagement is an important component of the Sanitation and Hygiene Regional Strategic Plan of Plan International in Asia. 55% of the 2,002 communities supported by Plan have managed to attain open defecation free status with youth participation.
ADB mobilised 36 youth from 13 ADB member countries to participate in the WWF7 and 4th Asia Pacific Youth Parliament for Water where they served as youth rapporteurs, facilitators, and social media reporters.
I believe that it is important for Plan to continue promoting youth engagement in water and sanitation, particularly around community involvement as well as in policy dialogues and in efforts to hold governments accountable to meeting the water and sanitation challenges we deal with today.
20 April 2015: One of Plan’s key post-2015 recommendations is to ensure that children and young people have the space and capacity to participate in monitoring their country’s progress toward the sustainable development goals (SDGs). It is critical that they have a voice in the decisions that will affect their lives for the next 15 years, and that they can hold their leaders to their commitments.
To ensure the SDGs are truly transformative, Plan advocates for a continuum of accountability, so that important information is passed on from level to level, including the priorities and opinions of children and young people.
Plan is not alone in this call. On 12-13 March, I attended a global event on Participatory Monitoring and Accountability (PMA) in Lima, Peru, which brought together representatives of government, academia, civil society and the private sector. The meeting was the culmination of a year-long UN consultation process co-convened by the governments of Canada, Korea, and Peru to identify effective country-level practices that can inform implementation of the sustainable development agenda.
From Plan’s perspective, Peru was a serendipitous venue for that event. Last year Plan Peru celebrated its 20th anniversary of working in the country. While there, I learned that Plan has been working for years to build a continuum of accountability across the country and up to the global level.
Participation in local governance
I visited Plan’s programme unit in Piura, in the north of the country, and was struck by the level of extreme poverty in this relatively remote region of the country, despite Peru having attained upper-middle-income status. But far more striking were the results of Plan’s long-term commitment to the community, and the resilience of its residents, who are harnessing local resources to improve their lives and gain economic independence.
I met with a group of young people, parents, and community leaders who have all benefited from Plan’s support in a variety of areas: early childhood development, education, entrepreneurship, participation and governance.
A group of adolescent boys and girls explained that through Plan they had received training on child rights and protection issues, and that they felt empowered to advocate for themselves and others in their community.
When they become aware of protection concerns, for instance, the young people share the information with community leaders, who in turn support them in reporting incidents directly to municipal authorities.
In this way, local officials have become sensitised to consulting with children and youth, and the adolescent boys and girls see that their efforts have a real impact. Young people also participate as active members of the community’s advisory group.
Working at the regional level
Another adolescent girl described her participation in a regional initiative that brings together government and civil society actors across sectors to collaborate on reducing teen pregnancy and intergenerational violence.
Plan has been active in setting up CEFODIA, which translates roughly to “training centres for the integral development of adolescents”. The core objective of CEFODIA is to build a bridge between public policy and services in order to promote healthy lifestyles, reduce risks, and comprehensively address the needs and expectations of adolescent boys and girls.
Among CEFODIA’s achievements* is a reduction in the rate of teen pregnancies in 5 districts, from 236 in 2012 to 115 in late 2014.
Influencing national government
Back in Lima, I met with Country Director Ramin Shahzamani and his team to share an update on post-2015 processes happening in New York City and to explore synergies with Plan’s work in-country. I learned that Plan is very active in promoting the participation of children and youth at the national level, creating mutually reinforcing pathways that build on local and regional experiences.
Plan-supported youth councils operate at all levels, and many have been recognised formally by authorities. Plan also supports a youth-led coalition of about 25 organisations, which convenes children and youth around the country to work on their own priorities, including advocating for the institutionalisation of participation in governmental processes.
Finally, Plan has contributed significantly to the non-governmental organisation (NGO) report to the Committee on the Rights of the Child in Geneva, which will review the child rights situation in Peru this coming May.
The NGO report includes a chapter from Plan on participation, as well as a chapter written entirely by children and young people themselves. Thus, the experiences and needs of children and youth within Peru are carried upward to inform accountability mechanisms as high as the global level.
My brief time in Peru provided a firsthand glimpse of a continuum of accountability in action, including meaningful participation of children, adolescent boys and girls, and youth.
From the local to the regional, national, and international levels, Plan Peru is working with a broad range of stakeholders to strengthen the kind of inclusive, accessible, and responsive accountability mechanisms and processes that are needed to make the SDGs truly transformative.
Read about Plan’s work in Peru
*Plan is not responsible for the content on external websites
Attacks by Boko Haram fighters are forcing thousands of children and their families to seek refuge in the Far North region of Cameroon where they are struggling to survive, blogs Berenger Berehoudougou, Plan's West Africa disaster risk management manager.
Plan International is working to provide vital support to affected families – including water and sanitation, education and child protection.
10 April 2105: The lives of thousands of children and their families are at risk in the Far North region of Cameroon. This is the story of Almara, who fled her village and now lives in a settlement camp.
"They came at night, on motorbikes, and started shooting and killing people, taking our livestock and belongings. They burnt everything. We ran away in the night to save our lives. The only things I took from my house were a map and one single cooking pot. I left behind all my jewellery, and you know how important these are for a Fulani women like me," she whispered.
I met Almara in one of the settlements for internally displaced people (IDPs) in the Far North region of Cameroon earlier this month. Her pastoralist village situated alongside the Nigerian border had been attacked 3 months back by Boko Haram insurgents.
During the attack, Almara and her 7 children witnessed very violent scenes. Her husband's uncle was killed in front of them, and she saw a pregnant woman being thrown into the fire and many other people killed, including men, children and women.
Almara confessed she couldn't sleep and had constant nightmares - her children still have nightmares and frequently shout and cry at nights.
"My children are able to play with other children in the settlement but when they see a foreigner, they cry and run away. Even now, there is a woman in our settlement who runs and hides in the neighbouring bush whenever she hears the sound of a motorcycle,'' she added.
Almara escaped with few people from her village. "We walked 20 days in the bush from Mozoko circle to this place. It was a painful journey, full of fear, hunger and thirst," she said.
"We sold some of our livestock to local communities to buy food. Having drinking water was a bigger challenge. At times, we would stay the whole day long without any drop of water and most of our livestock would collapse on the way," said Allasane, Almara's father-in-law.
When Almara and her family arrived in Golmavi circle, they were welcomed by the local communities who shared with them the little resources they had, endangering their own limited coping capacities.
"We seem to be forgotten"
So far, the IDPs say they have received very limited support from non-governmental organisations (NGOs).
"They [NGOs] came to provide some food and tarpaulin 2 months ago. We seem to be forgotten. We struggle to find drinking water for not only ourselves but also for the little livestock we have. The animals drink once a day by turn to allow the wells to recharge. Animals are all that we have to survive. They provide us with milk to feed our children,' said Amadou, the leader of Almara's settlement, which hosts 9 families of about 79 people.
In this Sahelian part of Cameroon, resource scarcity is part of daily life: water points are rare and crowded, access to pasture lands is crucial, food stock and prices are volatile. There is a risk that conflicts arise if nothing is done urgently to help the IDPs and host communities cope with this unusual burden on a fragile environment.
Hunger and thirst
The forthcoming rainy season will make the situation worse as flash floods are common in this area. Road access will be much more complicated and cases of malaria and waterborne diseases are predictable. Despite the security situation, if the few humanitarian actors present in the Far North region of Cameroon are not given the means to act quickly, lives of thousands of children and their families are at risk.
Like Almara and her family, there are about 96,042 internally displaced people* affected by the Boko Haram insurrection, who are dispersed in a region as big as Belgium and Luxembourg together. They live in small temporary settlements in the suburb of isolated villages. All of them are witnesses or survivors of violence and are in desperate need of support. Humanitarian assistance hardly reaches them. Small settlements difficult to locate and lack of funding hamper the international NGOs to adequately address their needs.
Poor road conditions and the lack of funding, makes IDPs one of the priority groups to address for Plan International, as it is estimated that around 60% of them are school going age children.
In Almara's community alone, 40 children do not attend school, the nearest school being too far. Children suffer hunger and thirst and miss the basics under their temporary straw shelters with roof built with fine tarpaulin.
Find out more about Plan’s work in Cameroon
*Plan is not responsible for the content on external websites
7 April 2015, World Health Day: Over the past few weeks there has been a moderate increase of new cases of Ebola in Guinea, Liberia and Sierra Leone. Far from the dramatic figures of late 2014, but certainly not close to the “zero cases” target that the 3 countries hoped to achieve a few weeks ago.
It is difficult to pinpoint the reasons: I just returned from Conakry, where about 57 new cases were confirmed this week (49 the past week, an increase of over 10%) and a number of other cases were under observation, and I noticed there that to some extent the preventive measures were starting to be less strict than before.
Hand washing is always compulsory in all public places, offices, schools, but it was somehow perceived as an unnecessary measure since Ebola cases were dropping. Probably households lowered their guard as well. Plan and other international agencies have been intensely disseminating preventive messages and still work on public awareness - I wonder how much prevention is really becoming a permanent habit for everyone.
New urban surge
This new moderate surge of new cases has different features: it seems to be more “urban” than before – the new cases detected in Guinea were in most part located in the surroundings of Conakry, a new case in Liberia was detected in Montserrado, not too far from Monrovia.
The modalities of infection are still the same, with unsafe burials being still one of the major causes, but there’s also an increased number of Ebola cases diagnosed post-mortem. This might possibly be due to decreased attention to the symptoms, and it has significant consequences meaning the undiagnosed bodies are buried with traditional ceremony, where possibilities of infections are extremely high.
In addition, there is evidence of at least one case of infection through sexual contacts with a survivor of Ebola. Medical evidence shows that the virus survives in body fluids for some weeks after the illness is declared healed.
Burial traditions still strong
In Guinea, unsafe burials are still being practiced. While certainly less cases have been observed and reported, it is clear that local traditions are still relatively strong, both in urban and rural settings.
The number of cases in Guinea is growing again, at a time when local authorities, international donors and agencies are looking at the recovery phase. But is the emergency really over?
On 28 March the President of Guinea Alhpa Conde declared 45 days of special increased prevention measures, including screening, road-posts to check cars - especially taxi drivers, often transporting patients and increased hygiene measure in schools and hospitals. Just a few days ago, I was travelling through Conakry, and I noticed several police cars checking drivers on the main road to the airport.
I visited Liberia about 2 weeks ago. The high hopes to reach 42 days with no new cases were dashed when a new case was identified not far from Monrovia on the 25th day. Again, urban setting, physical contacts, lower attention to prevention, and back to square one.
This is really the time where social mobilisation and preparedness for possible new cases are absolutely critical.
Rainy season fear
The rainy season is approaching: in some areas of Liberia and Guinea rains have started already, and by May heavy rains will be recorded, especially in Liberia. Roads will be flooded, it will be difficult to reach hospital and clinics, electricity will not be available for long periods, and water infrastructure - including sewage, will be disrupted. In Liberia, some of the counties where Plan is working will not be reachable by car anymore. The already weakened health systems in the affected countries will be put to further stress which they have little capacity to withstand.
This is the time for a renewed effort to prevent a new disaster: increased hygiene measures, increased screening, and increased social mobilisation are the key factors in putting forward a robust response to this new surge.
The best way to honour the lives that Ebola wiped out is by ensuring that it doesn’t repeat itself, writes Unni Krishnan, Plan International’s Head of Disaster Preparedness and Response.
March 2015: After a marathon Ebola outbreak that has lasted a year and devastated thousands of families in Guinea, Liberia and Sierra Leone, projections are that all 3 countries are well on their way to ‘point zero’. However, the threat of a future outbreak is not over.
Thus the anniversary of the outbreak provides an opportunity to reflect on the lessons from the past as well as to prepare for the future, in Africa and beyond. To drive to the future, good drivers always use their rear view mirrors.
Every disaster provides learning opportunities. Mizuta Masahide, 17th century Japanese poet and samurai said: “Since my house was burned down, I now own a better view of the rising moon.”
The best way to honour the lives that Ebola wiped out is by ensuring that it doesn’t repeat itself. Rather than speculate, it is necessary to take a can-do approach. How can we make the response different next time?
A few urgent measures are vital in order to write a different story next time. Here is my take.
Speed is an important factor for any successful emergency response: Next time, to outsmart the virus, we need to act fast through quick deployment of equipment, specialists and field hospitals. Speed will play a critical role in writing a different story for the first hundred days – in Africa or elsewhere.
Build a strong public health system: Earthquake specialists have taught us a simple lesson: earthquakes don’t kill people or children attending classes in a school. But bad construction and unsafe school buildings do. A strong public health system can withstand the shock of an epidemic or pandemic threat next time, not just of an Ebola outbreak, but also other disease outbreaks such cholera, meningitis, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and avian flu.
Monitor and be vigilant: There are concerns in West Africa about the coming rains. Health and transport systems are exceptionally weak in this part of the world, and we need to close that gap before the rainy season starts. Last year as Ebola spread through communities, unkind weather and the rainy season hampered the response and made roads so waterlogged that nothing could get through. In the absence of strong health machinery and social safety nets, rains and floods amplify the impact of an outbreak.
Prepare and don’t panic: Enhance readiness by preparing and training communities, especially health workers. It often takes weeks and months for external actual aid to arrive. During the initial days of the Ebola outbreak, except for very limited support from agencies such as Médecins Sans Frontières, Red Cross and Plan International, ordinary people were battling this deadly virus on their own. If a community is prepared adequately to respond to Ebola or any single disaster, they can very well beat most of the other disasters.
Start disaster preparedness, first aid and public health lessons straight from schooldays to build a culture of readiness and minimise deaths and devastation. I was at the world conference on disaster risk reduction in Sendai, Japan, last week. A deadly cocktail of multiple disasters – an undersea earthquake, a massive tsunami and a broken nuclear reactor – killed 15,891 people in Sendai and neighbouring areas in 2011. However, Japan has demonstrated that disaster risk reduction and preparedness save lives. It is far better and more cost effective to invest in preparedness than do firefighting after disasters strike.
Don’t ignore the invisible needs: While the priority action should be to stop the spread of the virus and safe burials, it is necessary to take care of the invisible impacts. For every public health crisis, there is an invisible humanitarian crisis, such as shut schools and high food prices. Further, it left many a scars on young minds.
A research report by Plan International concludes that Ebola has challenged the needs of children for loving relationships, for hope and for self-belief just as severely as it threatened their physical needs. Emotional wellbeing and psychosocial care and support should find a central place in relief and recovery efforts.
Orphans that Ebola has created are the true and living face of the outbreak. Many a local family has started taking them under their wings.
The world needs to supplement this true demonstration of African generosity with material support, so that such children don’t end up as an additional burden on families who are already struggling to find sufficient food and school fees for their own children.
Information key in a crisis
Information is a lifesaver in a public health crisis and media and social media can play a critical role. Rumours and ignorance have resulted in attacks on health and humanitarian workers, costing some of them their lives. In a crisis like Ebola, when lives and truth become first casualties, the media needs to go beyond the usual role of reporting. It has a lifesaving role to play to inform, educate and empower people.
After all, you can’t beat an invisible and deadly virus only with doctors.
A vigilant media can also help to make authorities accept the reality rapidly and thus start a quick response. As Albert Camus said, the best way to deal with plague is by being honest about it. Creative collaboration between technology, media, social media, health and humanitarian workers can help to write a different story during the next outbreak.
One year on since the Ebola outbreak, Damien Queally, Deputy Regional Director – Programmes for West Africa, reflects on how Plan International has responded to the crisis and what it is doing to aid recovery at this delicate stage.
March 2015: When the outbreak of Ebola was declared 12 months ago, no one really knew what a change this would bring about to the lives of people not only in Guinea, Liberia and Sierra Leone, but globally as people struggled to understand the disease, its transmission, the risks, the devastation, the emotion.
From the day the outbreak was declared in Guinea, Plan International started supporting community awareness raising on the disease and offering practical hygiene advice on how to reduce risk of transmission.
There was a lot then we didn’t know about Ebola, but we did know that good hygiene practices, such as not touching sick or dead people, were critically important.
Over the course of the response knowledge grew, rumours spread, fear came and went and came again, families were wiped out, communities quarantined, farms not tended to, health centres locked down, basic services stopped and social cohesion and norms challenged like never before.
During this time, Plan International remained in the worst affected countries and took this journey into the unknown with the people of Guinea, Liberia and Sierra Leone.
Caring for children
We worked with health and communication experts to develop appropriate messaging to help families and communities to stop themselves getting infected with Ebola. We set up temporary care centres for children who had been orphaned, abandoned or stigmatised because of Ebola and provided them with food, care and a safe space. We worked and continue to work with these children to reunite them with family or foster parents who can provide them with a safe and caring home.
Seeing that awareness raising alone was only part of the solution. Plan International also set up localised community care centres, close to communities with high incidences of the disease. The purpose – to isolate people with symptoms quickly so as to reduce the risk of infecting others from staying at home. Also to offer them food and water to maintain their strength to fight the virus.
People in these centres were tested and transferred to appropriate centres based on test results. Ensuring food, water, education, replacement of essential household items infected with the Ebola virus were also key elements of Plan International’s response.
Of course we did not do this alone, but with the support of local and international partners, community groups, young people who are at the heart of our response, donors, governments and the general public who contributed so much to our response.
The risk remains
Now we are seeing Ebola cases go down, fear lifting, discussions on recovery taking place, people beginning to move around, schools reopening and a slow, but cautious return to normal life. Having been part of Plan International’s response from the outset, this is great to see. But, it is also worrying. I am worried that many now think the crisis is over. As long as we still have cases of Ebola, this crisis is very much alive and the risk of increasing victims a reality.
Over 10,000 people have now died from Ebola and almost 25,000 people have been infected by the disease. However, weekly incidences have fallen to just over 100, with Liberia having no new cases for the past two weeks. Of course a country needs to have no new cases for 42 days to be declared Ebola-free. Given that Liberia borders Guinea and Sierra Leone, even if it passes the 42 day milestone, it could always ‘import’ a case or two.
Keeping all of the above in mind, Plan International’s response is evolving just as the crisis evolves. We will continue to invest in good health systems, knowledge and skills so the gains made to date fighting Ebola will not be lost, but are embedded in each country for this and any future crisis.
We are investing in water, sanitation and hygiene interventions in schools so the risk of falling ill is minimised in the learning environment. Health monitoring is being supported also in schools so symptomatic children can be removed and receive proper testing and treatment.
Teacher training on psychosocial care for children is being provided so teachers can help the thousands of children who have witnessed loss, death and pain. Orphaned children will continue to be supported, with the goal to get those without parents into a stable and caring family structure.
Families need support before the rains come
Support to families to regain their livelihoods will be a critical part of the next phase of Plan International’s response. Families have survived on very little since the outbreak. Many markets have been closed, farms have not been tended to, businesses shut down, loans taken with no means of repayment, savings used and livestock consumed or sold.
For these families to get back on their feet, we cannot focus on business as usual. We need timely and effective injections of cash and in-kind goods into families so they can bounce back from the crisis, and rebuild their livelihoods and lives. With the rainy season approaching, the timing for this is now.
Ebola has taught us many things. We have learned that something that starts off in one small village can become a global threat. We have learned that fear will not beat Ebola, but bravery and action will. We have learned that decades of traditions, even when faced with death, are not easy to stop. We have learned that human emotion can never be more greatly tested than when you know that by helping a loved one you can get sick, die, infect others and possibly cause them to die. How could a parent not comfort a child in pain?
From all this emotion and risk, heroes have emerged. People who gave first and considered themselves second. Plan International staff amongst them.
17 March 2015: At the 59th Commission on the Status of Women (CSW) here at the UN in New York, we are surrounded by familiar themes and discussions. Delegates rush between meetings, working groups and consultations, discussing issues as diverse as child marriage, safeguarding girls in conflict zones, school related gender-based violence or education financing.
However, despite this multiplicity of focal areas, there is still a common theme to our work this year and a common message being spread from podiums and meeting tables alike; the ingrained and harmful social norms which have held women and girls back from achieving their full potential must be eradicated.
Nowhere was this message more strongly heard than in the US premiere of India’s Daughter last Monday night.
With the Plan-supported film marking the start of the CSW with a star-studded event attracting hundreds of guests, line-ups spread around the block with people wanting to celebrate the life and mourn the death of one remarkable woman. However, this film was about much more than just young Jyoti Singh. Director and Plan ambassador Leslee Udwin created a story that reflected the social norms that directly contribute to such tragedies.
"A girl is far more responsible for rape than a boy," Mukesh Singh, one of the 6 rapists convicted in the 2012 attack, says in the documentary, because "a decent girl won't roam around at 9 o'clock at night."
The film reveals several of these shocking but ingrained cultural norms that continue to persist among our societies, and it paints with vivid detail the thought processes of the perpetrators who commit these crimes. Only by exposing the attitudes and beliefs that result in violence against women can we address and prevent that violence from occurring.
The important dialogue that this film kicked off and the high-level attention and endorsement that it has received, has truly set the tone for these 2 critical weeks as decision-makers from around the world join together to shape and influence the post-2015 gender agenda.
Advocating for lasting change
The Plan delegation at CSW59, made up of dozens of committed gender, child and education experts from across our global family, has been committed to advocating for lasting change, which means ensuring that incorporating men and boys, engaging with youth and education access are all critical priority areas.
In doing so, we can ensure that not only the symptoms, but also the root causes of violence, harmful practices and discrimination are addressed.
While India’s Daughter was undoubtedly a harrowing film that left most viewers in tears, it also is a film that gives us strength. We are empowered by the resilience shown by Jyoti’s parents and the young people that flooded the streets of Delhi in the aftermath of her brutal murder.
Jyoti lived her life regardless of the social norms that were all around her. Asking her father to put the money he had saved for her marriage into her education instead, she showed strength and courage that we here at CSW59 have seen repeated over and over again in the young people around us.
Jyoti’s spirit was seen last week when 16-year-old Plan delegate Patricia spoke to government leaders about overcoming the stigma and abuse experienced as a child with visual impairment. It was seen when teens Nohelia and Gema from Plan communities in rural Ecuador took to the stage in front of their country ambassador to share their aspirations to be a surgeon and a congresswomen.
CSW59 may have started with sorrow as we came together to share Jyoti’s story, but it will conclude with a renewed commitment to embrace the resilience and strength of India’s Daughter.
At Plan, we commit to renewing our efforts to address the damaging social norms and structures that enabled such a tragedy and will continue to support young people like Nohelia, Gema and Patricia to ensure that they reach the full potential that was denied to Jyoti.
Read more about Plan and the youth delegates at CSW59
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- Jacob Lew, US States Secretary of the Treasury
17 March 2015: 25 years after its creation, the Convention on the Rights of the Child (CRC) - the world’s most ratified human rights treaty - still lives on pocket money. This occurred to me when listening to states highlight their efforts to invest in children’s issues, after I had addressed them as member of a panel discussing "investment in children's rights" in this year’s Annual Day on Children’s Rights at the UN Human Rights Council in Geneva.
Don’t get me wrong. Hearing about the many efforts made by various states to put money to issues important for children and their well-being is encouraging. The examples raised by the distinguished audience showed that the idea that realising human rights costs money is widely accepted, which was (and is) not always the case.
The problem is that thinking about investments in childhood has not evolved beyond allocating money to certain budget lines considered important for children. Children’s rights don’t need pocket money, they need an investment plan.Theoretically, there is enough money in the world to adequately provide for its 2.2 billion children. But we haven’t quite figured out yet how to use it best to ensure that every child can grow up healthy, go to school, enjoy protection and participate in society.
Not just the poorest countries
In the poorest countries of Africa or Asia, where states’ tax incomes are not enough to cover the needs of their population, development assistance will continue to play a crucial role in realising children’s rights and to direct global wealth towards vulnerable regions.
But this lack of adequate financial planning doesn’t only affect children in these countries. The consequences are increasingly visible in middle-income countries, where statistically most of the world’s poor live today.
In Latin America, more than half of the population under 18 lives in poverty or severe poverty; in Europe, every 5th child is at risk.
Involving children to ensure fair budgets
We need measures to more equitably distribute wealth. We need to better understand how fiscal measures to address economic crisis will impact on the most vulnerable population. We need more effective tax systems, including measures to prevent tax evasion.
The real issue is, however, that hardly any state has a master plan for making the rights of children (nor for other vulnerable groups) reality. Many of the policies that are issued to protect children’s best interest have no corresponding budget and thus remain empty promises.
Such a master plan will need to be built on a better understanding of which rights are compromised and of whom. That requires good statistics, but also must involve ongoing discussions with children and adults – and particularly those who are at the margin of society - to understand where most pressing needs are and how they can be met.
The message emphasised strongly in my intervention on the panel was that involving children and adult citizens in monitoring the use of state money is critical to make this happen and alert government about waste and misuse of funds. Without money we cannot implement the CRC.
No more empty promises
This debate is only the beginning. In the coming weeks and months, a number of policy documents will be adopted on this important issue. These will give states concrete recommendations on how to move from giving pocket money to children’s rights and hold them accountable to create a comprehensive plan on how to invest in children.
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Emotional care should find a central place in disaster settings, blogs Plan International's Head of Disaster Preparedness and Response, Unni Krishnan.
15 March 2015: If you want to respond to and recover from a disaster and its impact on the mind, be prepared, play hard and plan for the future. Some might say it’s a mind game.
Immediately after a disaster, life-saving aid floods into a country. Yet, while humanitarian workers are adept at dealing with the physical needs, they can miss the invisible needs of disaster survivors – such as mental health and psychosocial support, especially for children.
Tropical Cyclone Pam, which hit Vanuatu at the weekend, resulted in catastrophic damage. The storm, one of the worst ever to hit the Pacific, reminds us of the real world we live in and how quickly it can tear lives apart and leave thousands homeless. The storm also affected Solomon Islands, Tuvalu and Kiribati. The frequency and intensity of storms are increasing with each year, and it is imperative we are prepared to deal with them, both physically and mentally.
In short, the mind matters and healing is as much of a ‘mental’ process as it is a physical one.
Why? Well, there’s only so much a person can take, literally. Liken the mind to a balloon. If you keep pumping air into it and don’t let off the pressure, something has to give.
Disasters result in bitter memories. Psychological suffering manifests instantly and often remains for a long time. These involve normal, natural reactions to an abnormal situation. When you live through a disaster, there is a limit to what your mind can take – much like a balloon.
Safe spaces to heal
Around this time last year, while responding to the armed conflict and humanitarian crisis in South Sudan, I came across a group of 100 children in Awerial in the Lake District in South Sudan – some singing, playing and some crying.
Yet, in that crowd, there were 2 girls that stood out – Madiha*, 9, and Lina, 4*. The pair had sought refuge in a Plan International child-friendly space and it was there I discovered their story.
Madiha told me how her hometown of Bor, Jonglei state, had turned into a battleground. She saw armed men killing everyone in sight. The violence spiralled out of control, thousands died and a mass exodus began.
On 28 December 2013, armed men seized Madiha’s mother and father. Later that day, they were shot dead at close range. The young girl witnessed it all.
The girls needed support to heal their wounds - physically and emotionally – and staff were on hand at Plan’s child-friendly space to help them make sense of what had happened.
This real life event is not a case in isolation. Such situations reiterate that mind should find a central place not just in relief settings, but in disaster preparedness and risk reduction work.
The Third UN World Conference on Disaster Risk Reduction is currently taking place in Sendai, Japan. It provides a good opportunity to stress the importance of a holistic, community-centred approach and to make such work child-friendly.
The prime minister of Japan announced at the conference that his country will contribute over US$4 billion for disaster risk reduction and preparedness in developing countries over the next few years. Material and mind matters are inseparable in disaster preparedness.
The mind matters in a crisis
With disasters frequently occurring across the world, it is imperative adults and children are equipped to deal with them.
Different disasters impact the mind in unique ways. For example, in Japan, the nuclear evacuees face a more difficult future than the survivors of the tsunami, according to researchers from Fukushima Medical University**. While tsunami-area people are improving, nuclear evacuees are becoming more depressed day by day.
As for the current Ebola outbreak in West Africa, psychosocial support is important.
Plan International recently conducted research amongst children in Sierra Leone and Liberia. It found that Ebola has challenged the needs of children for loving relationships, hope and self-belief, just as severely as it threatened their physical needs, as many have lost family and friends.
Psychiatrists alone can’t stop trauma
So how do 2 countries in the throes of a huge health crisis cope, when each country employs one practicing psychiatrist each?**
Even if physical health care needs are taken care of, people’s minds require attention. Mind is a complex matter and psychosocial support is not all about expert psychiatrists. You can’t stop trauma only with psychiatrists.
The algorithm of mind healing in disaster settings involves recognising people’s needs, fears and aspirations, social capital. It also requires an early start, long term vision, community support and sensitive psychological and social interventions.
If access to treatment for mental health issues is tough to come by - and that goes for aid workers and disaster victims - a community-based approach must be put in place.
Nowadays the idea of community-based psychosocial care is gaining momentum. It’s cost effective, demonstrates ownership and is contextual. Inter Agency Standing Committee’s guidelines on mental health** and psychosocial support in emergency settings and Sphere Humanitarian Standards** gives guidance, while Psychological First Aid** was a tool translated to Japanese to fast forward community-based care following the multiple disasters of 2011.
Prepare, play, plan
During my initial days in the Tōhoku region working with Plan International Japan and CARE Miyagi, I learnt the importance of prepare, play, plan when it comes to disasters and I stand by that motto.
At a global level, donors, the UN must include mental health more actively in needs assessments, programme design – not just after disasters strike, but during and before too.
Planning for the future in a responsible and creative way is essential. Schools serve not only as rescue shelters and places where children can return to normalcy, but as places to educate children about the risk of disasters.
Remember to play hard. Dealing with the mind is complex. But is it too serious to be left to specialists?
No, let people connect with it. Demystify matters of the mind, make it part of popular science – something that is fun to deal with. To make this happen, creative collaboration is key. Plan works with Clowns Without Borders**, an organisation that deploys clowns to offer laughter to relieve those suffering in humanitarian settings.
But, if we really want to make a community based-approach a reality, academics and experts must move beyond the walls of their labs, consulting rooms and lecture halls. Japan’s automobile industry demonstrates that through better engineering and design, you can make automobiles simpler and easier to drive.
Perhaps the mental health sector should take lessons from it. It needs to be open to new ideas and to recognise that innovative plans can come from collaboration and community.
Unni Krishnan is attending the UN World Conference on Disaster Risk Reduction in Sendai, Japan, which runs from 14-18 March.
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*Names have been changed
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