Tag Archives: aid work

Hand in Hand in Afghanistan

The news broke that President Obama had accepted General McChrystal’s offer of resignation an hour before I was scheduled to do a live interview on CNN about Mountain2Mountain and our work to create education and opportunity for the women and children of Afghanistan .  We watched the news all morning, waiting to hear if the interview would be bumped and engaged in a discussion about how NGOs relate to the US military presence in Afghanistan.  We wondered about how the change in leadership will affect us and talked about the important relationship between the military and aid organizations.

While we do not work with the military directly, President Obama’s decisions about military leadership and strategies in Afghanistan do have a direct impact on us.  We follow the news closely, knowing that our relationship with the military is a symbiotic one; the success of one mission is tied to progress toward the other. Our work with women and children in Afghanistan would be almost impossible without the presence of international security forces.

And we believe that our work, and the work of other NGOs in Afghanistan is a direct deterrent to the insurgency.  If a family starts to thrive, the village begins to thrive, and that ripples through an entire tribal area and province.  Healthy communities are more likely to stand up to threats from the Taliban than those that are teetering on the edge of survival.  Today, many are easily manipulated, bullied and coerced into supporting the insurgency.  But if we work to provide healthcare, plant crops, repair roads, educate children, and create jobs, local communities will have something valuable to protect from the Taliban.

As a non-profit aid organization, we work independently of the military and the government.  Our goal is to implement programs and projects that are focused on education, training, and job creation in Afghanistan.  We believe that women and girls are world’s most underutilized resource and can be significant agents of change in conflict regions across the globe. But our task is not easy in a country entering its fourth decade of conflict with one of the worst records on the planet for women’s rights and gender equity.

It is incredibly difficult to operate safely inside Afghanistan.  If the array of countries providing security, training Afghan soldiers and fighting the Taliban insurgency weren’t there, our ability to educate women and girls, train rural midwives, build schools or even travel the country would be severely impaired.  Many aid organizations rely on the military to travel safely through Taliban-controlled areas by helicopter or convoy.

But the safety of aid workers isn’t the only issue.  In many cases, the international forces work directly with the locals to develop leadership from within communities and provide mentorship.  One example is at a prison in Maimana in the northern Jawzjan province.  Here the Norwegian military has a presence and their local Provincial Reconstruction Team (PRT) helped with the women’s prison we are working with today.

In many prisons we’ve visited, women are jailed with their young. The treatment cannot be described as humane.  There are not enough clothes or food, and all too often the female prisoners are raped by the prison guards paid to watch over them.  Remarkably, the Norwegian PRT came in and worked with the prison commander to address these and other concerns.  They built a separate prison building for the women with a small courtyard and separate, clean sleeping facilities.  They flew the prison commander and his staff to Norway to visit the open-air prisons and to the United States to learn how other prisons are run and how prisoners could be treated humanely despite being jailed.

This work paved the way for our visit.  We were received warmly by the Afghan commander and given full access to talk with the women, take photos.  Eventually, we were able to set up a kindergarten for the children and a vocational training program for the women.   Contrast that with prisons that haven’t had that sort of mentorship the PRT provided. Access is denied, commanders are cagey, and we are often not allowed to speak privately with the women.

The relationship is reciprocated as aid organizations help rebuild and create sustainable, functioning communities on the heels of the military.  In an article written for Joint Force Quarterly, a military publication, Admiral Mike Mullen said that US efforts in Afghanistan to send a positive message about US military action and development efforts hurt US credibility when they do not coincide with what the populace sees on the ground.  He went on to say that the gap between promised and actual improvements harms the credibility of the US message.

Aid organizations work to ensure that communities in Afghanistan can see the value of the internationals forces.  They help change perceptions based on decades of conflict.  Instead of occupier it is possible to become a collaborator, community builder and vital service provider.  We can go from enemy to ally.  If communities in the areas worst hit by the ravages of war and poverty are given support through health care, education, agricultural development, and reconstruction of roads, bridges and buildings, the Afghan people see a partner with a willingness to help them claw their way back and build healthy, thriving communities.

Large development agencies can repair roads, build clinics, and make sweeping structural changes.  Small, grassroots organizations like Mountain2Mountain are limited by funding, but tend to operate in a more person-to-person, village-to-village approach.  We focus on bringing training to local women to deliver babies, building girls schools, training teachers and creating women’s co-ops that allow widowed women an opportunity at survival in a male-dominated culture.

A change in military leadership always presents a few unknowns, but with General Petraeus at the helm it is bound to be a relatively smooth transition.  He has overseen the Afghanistan blueprint and is intimately familiar with the region.  In Iraq, Gen. Petraeus implemented rules of engagement that reduced civilian casualties, which increased local support. At the same time, these new rules of engagement gave more latitude to local commanders than the current rules in Afghanistan.  This allows for faster decision-making on the ground.  It is widely viewed that the General’s experience in Iraq will be invaluable in addressing the current strategy in Afghanistan.

As an article in the Vancouver Sun stated last weekend, women will be the first casualties of any surrender in Afghanistan.  I agree.  Our work depends on the international forces not surrendering, not turning their backs on the women and children of Afghanistan.  This has happened once already.  We must persevere from all sides and work together to make the sustainable, lasting, generational changes that ensure a stable future for both Afghanistan and our own country.

Published on HuffingtonPost June 25, 2010

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Small Footprint Approaches to Solve Large Problems

Afghanistan ranks 191 – currently dead last –  on the Quality of Life Index. To compare: DR Congo and Cambodia are tied at 160.

Maternal deaths are the 2nd highest in the world., where one women dies every 30 minutes.

Newborn deaths are the highest in the world with 1 in 4 children dying before their 5th birthday.

81% of women deliver at home without assistance.   Women and their babies die in childbirth or in the first two days due to lack of medical care and support.

80% of these deaths could be managed by a skilled birth attendant (SBA).

19% of newborn deaths come from asphyxia, and 50% from simple infections.  Both are preventable with simple tools.

That’s the cold hard facts.  Women are not valued the same as men or boys in Afghanistan.  In populated areas, often families are simply unwilling to pay for available health care for women when they are sick.  Their lives are simply not worth a $25 doctor’s visit.  In rural areas, the family may not HAVE $25 for a doctor’s visit.

Mountain 2 Mountain is approaching this problem with a fully unique approach that mirrors their cyclical model for education, training, job creation, and small business start ups.  Smaller footprint, less infrastructure, more education and training, microfinance, and sustainable development to reduce dependence.

The traditional model employed by larger NGO’s build and staff midwifery training clinics in large communities so that they can bring graduates to a centralized location.  Afghanistan is a decentralized country even at the government level, and when coupled with the gender and cultural issues that often prevent young women to travel outside of their communities alone for schooling, it is often ineffective.  Conversely, it is difficult to encourage graduates of these schools to travel to rural areas to live and work as health care workers.  Freedom of movement and relocation for Afghan women is not the same as it is in other regions of the world.  This model is cumbersome and doesn’t address the immediate issue at hand. High rates of women and babies will continue to die in rural communities.

Our approach not only takes these important points into account by bringing the education to the rural communities and training local girls, often only a 4th grade level.  These candidates can learn enough during an intensive four week training in their community to effectively manage and potentially prevent nearly 70% of maternal and newborn deaths.

Each year another 4 week training will take place to continue their education and allow it time to be put into practice.  The full program would take 5 years to complete.  This may seem like a long process, but the effect is immediate after the initial 4 week training.

Skilled birth attendants can make an impact by decreasing birthing deaths, teaching basic sanitation and prenatal care to their community, and creation of jobs for women in rural communities that often have no opportunities for female employment.

The long term effect is a thriving, healthy community, and a shift in the role of women within the male dominated society.  They prove their worth and earn respect organically by provided a needed service to their community.

That’s not to say that certified midwives and OB/GYN’s are not needed.  They most definitely are, but larger NGO’s can do that work best with bigger budgets and deeper resources.

When strong candidates, with talent, education, and family support, emerge for continued education we would sponsor those candidates for further nursing or midwife training programs and ensure that we can set them up with clinics and support back in their village upon completion of their training.

This model can be replicated throughout rural communities across the country, with Western doctors and nurses that have a knack for teaching and want to donate their time for the 4 week trainings.   Spending the majority of the funding on education, training, equipment, and resources, versus construction and staffing of large scale training clinics.

We plan to move forward with this village to village approach to health care and midwifery with our first communities this year, so that our first round of skilled birth attendants can make an impact in their respective villages.  We look forward to sharing with you their progress in the months and years to come.

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Thunderstorm Mission

“I guess the real question is, do we want to be a trickle or a thunderstorm?”  That was the question our Board Member, Wessel Booynsen, asked when I returned from Afghanistan last October.

Music to my ears.

My main goal with my return from Afghanistan was to look at the overarching vision – what change do we want to effect?    Do we limit ourselves to education?  To women and girls?  To Afghanistan?  Limitations kill my motivation.  Its like dousing a fire with a bucket of sand, not even a spark remains.

Thinking big is scary, but sometimes you have to put the cart before the horse, and look ahead at what you want to achieve in order to work backwards from there.   Sure, we could be a trickle.  Neatly ticking off one project at a time in an orderly fashion.  But I’m more excited by the thunderstorm, allow ourselves to think outside the box, expressing the magnitude of what we want to accomplish and then finding a way to get the lightening cracks started.

Moving beyond the staid, straightforward models that typically are associated with war zones dealing with the serious issues of gender inequity, abuse of women and girls, slavery, human trafficking, extreme poverty, and daily violence.   We would become a new generation of non profit.

1.  Work WITH Afghans, listen to them, learn from them, and look at ways we can act as catalysts for change.   Letting go of assumptions and

2. Create a cyclical model whenever possible.  Work to make deep, sustainable change by following through projects to the end goal. Education is our entry point towards empowerment, not the end result.  We need to focus on creating jobs, markets, and opportunities.  If we identify a region that is lacking midwives, we will work not only to train women from the area, but also work to set up small clinics for them to work out of.   We will also look at ways we can help home births in regions until midwives or health care practitioners are trained in the region, preventing unnecessary maternal and newborn deaths in a region that has the highest death rate in the world.

3.  We will be agile and nimble – working to solve problems, not create a replicable project.  More difficult?  Yup.  More beneficial?  Definitely.

4. We are focused on Afghanistan, but will also embrace opportunities that present themselves in other remote regions and conflict areas where women and children’s rights and lives are ignored.  If we can affect change, we must not let borders be an excuse not to.

5.  We will partner wherever possible.  Instead of trying to do a little of everything, we will focus on what we do best and partner with others that do what THEY do best.  Especially when we can utilize the support of local community organizations that deeply vested in change.   Eliminating the need to stamp our name on every project we do, we instead work behind the scenes help to empower locals.

6.  We will embrace our original and founding ethos of connecting communities and cultures – it is not just a toss away thought.  It is actually as important as the projects themselves.  Using photography, bikes, storytelling, and school project exchanges, we will work to connect our cultures, our schools, and our communities to further the potential for long term understanding and support.

As I look to my next return to Afghanistan this month, I am excited by the freedom the Board has entrusted me with to create the thunderstorm.  Look out for rainy days ahead!

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