Posts tagged health

Relief International’s Senior Program Officer, Virginia Zaunbrecher, Reports from the Field in Darfur, Sudan

November 18, 2012

Senior Program Officer, Virginia Zaunbrecher, writes from Darfur, Sudan, about how Relief International programs are keeping people alive and helping them move on with rebuilding their livelihoods.

Darfur is a place that is stuck in the middle.  There is still too much conflict for most people to return home, but there is too little conflict to garner public attention.  As aid workers, we find ourselves trying to triage the situation, and at the same time look for opportunities to help people move ahead.  Two of the people I have met so far exemplify this dynamic.

Relief International is a primary care provider for a population of approximately half a million people in North Darfur, including 164,000 displaced persons.  When visiting one of our malnutrition treatment centers in the Zam Zam camp for displaced persons last week, I met 18-month-old Fatima.  She was, bluntly stated, the most malnourished child I have ever seen.  She was tested for appetite and fed ready to use therapeutic food—popularly known as Plumpy-Nut.  She was also referred to the main state hospital 15 km away because she required substantial medical treatment, but that is an extremely long way for her mother to travel with her, especially given that there are other children at home that need attention. 

When I visited again this week, I was told that Fatima’s mother had not taken her to the hospital—a “defaulter” in nutrition program terms.  Relief International outreach workers are contacting Fatima’s mother and encouraging her to visit the RI clinic (closer than the main site hospital)—which is no small feat in this maze of 164,000 people.  Relief International has plans to open a stabilization center that can treat malnourished patients in the Zam Zam camp by 2013, so children like Fatima don’t have to travel for life-saving services.


Above, Staff weigh malnourished children at Relief International’s nutrition center in the Zam Zam Camp.

Just a short distance away at the Hassenfeld Community Center, I met someone who exemplified how the people of Darfur are trying to move forward.  Saida is a widowed mother of five, whose husband was killed in the conflict.  She fled to the Zam Zam three years ago with her children when they were forced from their village by fighting.  Saida’s leg is injured, so she is unable to work as a day laborer, which severely limits her options.  Undeterred, Saida hopes to provide a better life for her children.  While they are at school, Saida visits the library at the Community Center.  She studies books on work skills and English to improve her chances of getting a job.  When Relief International was stocking the library, we asked the community what kind of books would be most useful.  It is telling that their first request was items that could improve the capacity of people to find work.


Above, Saida (right, dressed in black) uses the library at the Community Center in the Zam Zam camp along with other women displaced by conflict.

Relief International staff find stories like this throughout North Darfur, and our programs here reflect that.  We provide basic life-saving health and nutrition services; at the same time we are developing a livelihoods program to help displaced people move forward, despite the challenging situation.  And every day we hope we encounter fewer Fatimas and have the privilege to meet more Saidas.


RI’s programming in Darfur is supported by the USAID Office of Foreign Disaster Assistance, the Common Humanitarian Fund, and individual donors.


Relief International Board Member, Ellen Frost, Reflects on her Visit to the Field in Ghana

October 9, 2012

Relief International’s board member, Ellen Frost, reflects on her visit to the field in Ghana this past September where board members held one of their quarterly meetings and got an exclusive look at RI’s ground-breaking programs in social enterprise and water, sanitation, and hygiene through field visits.

For members of Relief International’s board of directors, there is nothing like seeing projects firsthand to realize the contribution that Relief International is making to help people escape from poverty in places like Ghana. Imagine the scenes: Peter – a shy, soft-spoken Ghanaian – and his three assistants sitting under a tree at the edge of the Accra city dump, hammering scrap metal into charcoal-efficient cookstoves. At another location, a man is shaping ceramic stove filters using a foot-operated potter’s wheel, while another man punches out ventilation holes. At a third site, the filters are fired in brick ovens fueled by wood and corn cobs. These jobs provide livelihoods to a large number of people. All in all, there are 450 manufacturers and 500 vendors of these stoves, and the market continues to grow.

In the photo above, Peter and his assistants busy at work as Relief International videographer, Carlos, focuses in for the perfect shot.

Above, a ceramicist uses a foot-operated potter’s wheel to delicately craft a Gyapa liner.

Above, Gyapa liners equipped with ventilation holes, wait to dry before they are sent off to the kiln.

At a market stall that we visited, one vendor summarized what she tells customers when she recommends Relief International-sponsored stoves: “Same price as the others but saves lots of money.” The stoves cut charcoal consumption in half, thereby easing pressure on household budgets and reducing pollution – and they earn carbon credits as well.

In the photo above, some energetic children from a school that board members visited.

Another Relief International project of a different sort centers on clean water, sanitation, and hygiene (“WASH”). Here, the goals are both “hard” and “soft” – to purify or recycle water, build and install latrines, to teach people why they should use them and how they should adopt sanitary procedures such as washing their hands. Since children learn quickly and are natural crusaders, schools are a special target. Board members visited two schools, both of which were bursting with bright-eyed, giggly, energetic children. Also,we visited a group consisting of three long-robed tribal elders, the head of the local youth committee, and a woman who serves on the local water committee. The elders made it clear that the whole community was involved in addressing the community water, sanitation, and hygiene issues. 

In the photo above, two smiling boys who hope to become part of their school’s hygiene club that Relief International helped establish.

The board members were impressed by the high quality and dedication of Relief International’s field staff as well as by what we saw at each site. We came away feeling hopeful and encouraged. 


Relief International’s Development Director, Mark Dawson, Reflects on his Visit to the Field in Ghana

October 3, 2012


Development Director, Mark Dawson, reflects on his first visit to Relief International’s Ghana programs where he meet some unforgettable locals whose lives have been changed through Relief International’s innovative grassroots based approach to development.

I just returned from a trip to Ghana, where Relief International’s board of directors had their quarterly meeting and several opportunities for field visits.  The Relief International staff, all local with a very few exceptions, are impressive:  smart, devoted, hard-working, collegial, and proud to be a part of Relief International.  It was a privilege to meet them and to see the fruits of their good efforts.  As we traveled around, meeting many beneficiaries of our work, it was wonderful to witness the relationships that Relief International staff have with those whose lives we are working to improve.  Their mutual affection and respect towards each other was always evident.

Above, children excited about Relief International’s visit to their school.

One afternoon we met Peter, who, for nine years, has been assembling and selling the cook stoves that Relief International’s EnterpriseWorks division designed and has so successfully marketed.  His business has grown to one that now employs ten people, each of whom was clearly happy to have a livelihood.  Upon meeting Peter I was immediately a fan, due to his endearing personality and loving management of his team.  His plot of land, where the assembly of dozens of stoves takes place six days a week, is on the edge of a vast landfill.   Acres and acres of refuse and waste surround Peter and his “boys.” 

In the photo above, Peter Atta demonstrates to Development Director, Mark Dawson, and Advisory Board Member, Pamela Ogor, how he assembles the metal parts of a Gyapa cookstove.


Above, Peter and Pamela take a moment to smile for the camera.

Above, a ceramicist shows Relief International board member, Keith Allman, how to craft a ceramic liner for the Gyapa on the pottery wheel.

Along the perimeter of the dump we saw several merchants, each of whom had gathered his or her particular specialty:  rubber, tin, glass, all of which would be sold to a recycler.   As with Peter, I was amazed by how enterprising, industrious, and resourceful these people were, and by how they had transformed a landfill into a center of commerce.

In the photo above, a local Ghanaian school where Relief International hosts its hygiene and sanitation programs.

Above, children part of a hygiene club established by Relief International at their school. These children lead in the enforcement of healthy hygiene habits around their school and at home with their families.

Another lasting impression was the children.  We had the chance to visit more than one school, where Relief International has water and sanitation programs.  The students were articulate, bold, confident, and welcoming, with an insatiable desire to learn.  They peppered with me questions:  about Relief International, life in the United States, English vocabulary, the distance from Accra to Los Angeles, and whether I could visit their school every day.  They introduced me to their “brilliant friend who is going to be president of Ghana one day;” another, who draws and paints beautiful pictures, and aspires to see his work in a museum; a soccer devotee, who quizzed me about my knowledge of famous athletes; and their math teacher, whom they adore.  Their gratitude for Relief International was abundant.  The spirited nature of these children animated my spirit, and even now a broad grin opens across my face as I think of them and remember their winning smiles. 

In the photo below, the ambitious children who peppered Mark with questions about Relief International and life in America.


Relief International Board Member and Filmmaker, Chip Duncan, Reports from the Field in Myanmar

June 5, 2012

Relief International Board Member and Filmmaker, Chip Duncan, reports from the field in Myanmar. This time Duncan gives a background on Burmese life and culture to create an understanding of modern Myanmar.

Understanding modern Myanmar (aka Burma) and Relief International’s efforts to facilitate long-term initiatives in health care, food sustainability and education requires basic knowledge of Burmese life and culture. 

More than 80 percent of the population in Myanmar practices Buddhism.  Most believe in an orthodox practice called Theravada Buddhism.  Theravada, considered the practice of the elders or ancient ones, is also common in the neighboring countries of Laos, Cambodia and Thailand.

Monastic life for young people in Myanmar is much like a spiritual rite of passage in other nations.  Most boys and girls, often as young as ten, enter monastic life for a period of time to learn and to meditate.  Young monks in particular, participate in daily begging rituals, but with an important twist:  the monks beg so others can give.  It’s not uncommon to see orange-robed monks or pink-robed nuns at meditation centers, monasteries, temples or simply walking in the communities throughout Myanmar.

The photo below shows young monks begging.

The most well-known spiritual sites in Myanmar include the Schwedagon Pagoda in Yangon and the fabled ancient Buddhist temples of Bagan.

The photo below shows the Bagan Temple ruins.

Located south of the capitol city of Yangon (aka Rangoon), is the delta region where most of Relief International’s programs are underway.  Most people in the delta region make their living on fishing and farming.  Rice is a major crop in the region and part of the Relief International team is working on sustainable agricultural initiatives including educating farmers about new hybrids of rice and best planting practices.

A Burmese fishermen pictured below.

The landscape of Myanmar varies from mountainous to the dry central plains to tropical areas in the south.  Most farming techniques are still small scale and hand-powered and currently Myanmar offers very little in terms of agricultural export.  Still, the country’s resources are vast and the open-air markets in Yangon offer a wide variety of fruits, vegetables, and fish.

The photo above shows a vendor at the Yangon market.

Chip Duncan

Relief International Board Member and Medical Director, Doctor Hernando Garzon, Reports from the Field in Myanmar

June 5, 2012

Relief International Board Member and Medical Director, Dr. Hernando Garzon, reflects on his visit to the field in Myanmar.

As a member of the board of directors and as a physician involved with Relief International health program operations in the field, I have wanted to make site visits to each of the ongoing Relief International health programs.  In conjunction with another board member, Chip Duncan, we’ve had the privilege of making such a visit to Myanmar. 

With the existing Relief International health program as the focus of our visit, our trip was designed to facilitate the development of additional and more comprehensive health programs, including the possibility of establishing a program to have U.S. health care volunteers spend time teaching local providers and providing care in under-served areas.  Our visit included trips to the rural delta outposts where substation clinics are manned only by a single midwife and suffer from lack of essential medical supplies, to meetings with the deputy minister of health, the director of foreign affairs, and the dean and faculty leaders of the premiere medical university in Yangon.  

The health care status of Myanmar looks much like that of a developing country with under-served medical needs.  Myanmar spends an average of $14 per person a year on health care. Compare this to the $44 per person a year the World Health Organization says is the minimum required to provide basic health services (The U.S. spends $7,960 per person a year). With $14 per person, Myanmar simply cannot provide basic medical services for its population! In addition, Myanmar is behind schedule in achieving the health related U.N. Millennium Development Goals (MDG’s) by 2015 (MDG #3: Reducing under age five child mortality; MDG #4: Improving maternal health; MDG #6: Combating HIV/AIDS, Malaria, and other diseases). 

Myanmar has only 4.6 doctors and eight nurses/midwives for every 10,000 people. Compare this with the U.S. which has 24.2 doctors and 98.2 nurses per every 10,000 people. I could go on and on, but this alone should be enough to see that the challenges Myanmar faces in providing adequate basic health care for its population are huge.

Dr. Hernando Garzon, third from left, pictured below.


Getting to “experience” these statistics in action and seeing the reality of health care delivery in this limited resource setting was a very moving experience. The substation clinic medication cupboards are bare, medical equipment is antiquated or broken and non-functional, and huge gaps exist in supplies, staffing, and training.  Although I have seen poor patient outcomes from such limited resources before, perhaps the most difficult part of my trip came during a routine tour of a township hospital.  During our tour, a third trimester pregnant mother of seven arrived to the hospital hemorrhaging, and we witnessed the initial stages of her evaluation and treatment.  With no blood bank system as we know it in the United States, they immediately called several volunteers from their pool of “live blood bank donors.”  They responded quickly to what is certainly an innovative and somewhat risky solution to provide an emergency and potentially life-saving blood transfusion.  In the end, neither mother nor baby survived – and I continue to struggle with the idea that “if only” adequate resources were available, both would have made it.           

Relief International is coordinating very well with the ministry of health and the national plan for improving maternal and child health and basic comprehensive medical care in Myanmar.  In addition to health programs, Relief International is also involved with livelihoods and agriculture programs.  The work being done by the Relief International Myanmar staff is exceptional and I am very hopeful that Relief International will continue to make a difference in the health and economic development for the people of Myanmar.

Dr. Hernando Garzon

Relief International Board Member and Filmmaker, Chip Duncan, Reports from the Field in Myanmar

June 5, 2012

Relief International Board Member and Filmmaker, Chip Duncan, reports from the field in Myanmar. 

Myanmar (aka Burma), achieved independence from the British in 1948.  Since that time, the nation has experienced significant challenges both economically and politically. Until very recently, Myanmar was largely isolated and was considered a difficult place for foreigners to visit. Today, Myanmar is undergoing a domestic reform movement resulting in democratic elections and new efforts promoting international trade and commerce. Recent diplomatic visitors to Myanmar include India’s Prime Minister and the US Secretary of State.

I made my first visit in 1995 while filming the television series “Mystic Lands.”  The episode on Burma, entitled “Triumph of the Spirit,” featured the devout Buddhist spiritual life of the Burmese people. The episode included stories about the Schwedagon Pagoda, the ancient city of Bagan, Mount Popa and the monastic retreats in and around Mandalay and the Sagaing Hills.

The picture below shows tropical housing on a delta in Myanmar.

This past May, I returned to Myanmar with Dr. Hernando Garzon with the goal of assessing and documenting the maternal health and food sustainability programs of Relief International. Relief International was among the humanitarian aid groups responding to the devastating Cyclone Nargis during May 2008.  The cyclone is considered among the worst natural disasters in modern Burmese history.  Nearly 120 mph winds and a huge tidal surge had a devastating impact on coastal and delta areas south and west of the capitol city of Yangon (aka Rangoon).  Families in the region relied largely on fishing and rice production for their livelihoods, much of which was destroyed by the cyclone. Damages exceeded $2.4 billion. Estimates are hard to quantify but it’s believed that more than 80,000 people were killed with as many as 300,000 missing. Women and children were most impacted by the cyclone.

Smiling Burmese children in the picture below.


Like so many Relief International efforts, the success of Relief International’s immediate crisis relief and humanitarian assistance evolved into long-term, sustainable programs in maternal health care and food sustainability.  The needs continue and Relief International has stated a commitment to serving the people of Myanmar for many years to come.

Below is a nurse midwife at Kyon Dah Station Hospital.

Dr. Garzon and I visited several locations in the delta region featuring the health care work of the Relief International team including the Kyon Dah Station Hospital on the island of Kyon Dah, the Dedaye Township hospital and the Pya Pon District hospital. The 40 person Relief International staff is comprised almost entirely of Burmese personnel with only one expat on the administrative team.  Please visit Dr. Garzon’s blog post for specific details on the health care programs and assessment. 

Chip Duncan

Relief International’s Technical Director, Jon Naugle, Reports from the Field in Uganda

May 23, 2012


Relief International’s Technical Director, Jon Naugle, reports from the field in Uganda, where he met a woman by the name of Mama Manjeri, whose life was greatly influenced by Relief International’s domestic rainwater harvesting bag, Bob™.

Before purchasing her rainwater bag, Bob, a Ugandan woman named Mama Manjeri used to walk two and a half miles over a ridge and down the other side of a hill to fetch water and then walk back the same distance carrying a container of water. She is a very spry woman who still works in her garden even though she is in her late seventies. Mama Manjeri had heard about Bob — Relief International’s innovative low-cost rainwater bag — from her husband who had seen a demonstration in a nearby town. She told her neighbors that the next time the sales agent from her district came by she wanted to see him to purchase one. 

The next time Adam Juko, the Relief International Bob sales agent, came by he stopped to see Mama Manjeri and she told him that she wanted a Bob. Unfortunately, he did not have one with him that day, but he promised to come back the next day. Mama Manjeri purchased her Bob the next day with 125,000 Ugandan Shillings (approximately $50 USD) for Bob with 1,000 and 2,000 shilling notes that were all neatly folded — money that she had earned from her garden.

The photo below shows Mama Manjeri standing proudly next to her Bob™.

As Relief International’s Technical Director, I got to visit Mama Manjeri. Mama Manjeri had constructed a base for her Bob and had started building a mud and wattle shelter to protect it. I could see that she clearly values her Bob and appreciates having water for washing, bathing, cooking and drinking right at her door step. Mama Manjeri was so happy with Bob that she insisted on giving me a 1,000 shillings, neatly folded, as all the bills she used to pay for Bob. This is something that I will treasure, knowing that the efforts of this project are changing people’s lives for the better.

Relief International Senior Program Development Officer Virginia Zaunbrecher reports from the field

Relief International Senior Program Development Officer Virginia Zaunbrecher reports from the field and talks about her experiences working in Myanmar this January. Virginia is a part of Relief International’s relief and development efforts in the region. She is currently working with the Program Development team to design sustainable ventures and economic programs to empower local people to lift themselves and their families out of poverty. 

Visit: January 18-21, 2012


I travelled from the Delta region, where Relief International currently provides health services to an area of Myanmar called the Dry Zone.  This is one of the poorest regions in an already poor country (the average annual income in Myanmar is just $1,500 USD).  In January, I travelled with some of our program staff to investigate what could be done to help people in the area increase their incomes and improve food security.

As the name suggests, this part of the country is very dry, making year-round agriculture impossible without irrigation.  To make things even more challenging, nearly half the population does not own any land at all, which can keep families from earning an income in this agrarian society.  People without land must try to find work as casual laborers, but wages are low, and work can be hard to find. In many countries, employers also reported a gender wage gap between men and women.  Every employer we spoke during our trip said they paid women half as much as they paid men for the same type of work.

Our working assessment is just the first step in trying to increase incomes for low-income people in this area.  Now that we collected information about what the economy is like in the local area, we will start to design sustainable activities and programs that we think will increase local incomes.


Best wishes,



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